Piriformis Syndrome: Causes, Symptoms & Relief

Piriformis Syndrome

Piriformis syndrome is a muscular skeletal disease that can make your mobility limited and painful. Do you have pain, numbness, or tingling in your buttocks and legs that won’t go away? It could be piriformis syndrome. This piece will cover what causes it, its symptoms, and how to find relief. You’ll learn about dealing with piriformis syndrome and pain and finding natural remedies and home remedies for piriformis syndrome.

We’ll explore both traditional medical treatments and acupuncture for piriformis syndrome with natural remedies. By the end, you’ll have a good grasp on how to manage this issue. This knowledge will help you get the right care and find what works best.

Key Takeaways

  • Piriformis syndrome causes pain, numbness, and tingling in the buttocks and legs from pressure on the sciatic nerve by the piriformis muscle.
  • It’s often due to muscle overuse, injury, or body differences that squeeze the sciatic nerve.
  • You might feel pain in your buttock, like sciatica, or numbness and tingling in your leg, foot, or toes.
  • Doctors diagnose it with an exam or, sometimes, tests to check for other problems.
  • There are many treatment choices, from therapy and medicine to surgery, but natural options like stretching, heat or cold, and acupuncture.

What is Piriformis Syndrome?

Piriformis syndrome is when you feel pain, numbness, or tingling in your buttocks and legs. It happens because the piriformis muscle presses against the sciatic nerve. This muscle is small and flat, deep within your buttocks. It goes from the lower spine to the top of the thigh bone. The piriformis muscle helps you move your hips and legs.

Definition and Overview

When the piriformis muscle gets tight, spammed, or inflamed, it can push against the sciatic nerve. This causes the symptoms of piriformis syndrome, like pain and tingling. You might feel it in your buttocks, hips, and legs. These feelings can be very uncomfortable.

Anatomy of the Piriformis Muscle

The piriformis muscle is a key player in hip and leg movement. It’s located deep inside the buttocks. This muscle starts from the lower spine and joins at the top of your thigh bone. Its job is to rotate your hip and leg outward. Plus, it helps move your thigh away from your body. Knowing how this muscle works helps doctors diagnose and treat piriformis pain.

Causes of Piriformis Syndrome

The causes of piriformis syndrome often stem from two main factors: excessive use of the piriformis muscle and its shape and proximity to the sciatic nerve.

Muscle Overuse or Injury

Overusing the piriformis muscle or hurting it can cause problems. This can happen when you keep doing certain activities. For example, running, cycling, or sitting too long can wear out the muscle. This can squeeze the nearby sciatic nerve. Also, getting a direct hit to the buttocks can hurt the muscles, leading to piriformis pain.

Anatomical Variations

Some people are born with a different setup. The sciatic nerve goes through or under the piriformis muscle in their bodies. This unusual path can increase the chances of nerve compression and piriformis pain.

Cause Description
Piriformis Muscle Overuse Doing actions that overuse the piriformis muscle, like running or sitting for long periods, can make the muscle tight and inflamed. This can press on the sciatic nerve.
Piriformis Muscle Injury Getting hurt in the buttocks area, like from a fall, can harm the piriformis muscle. This is another way piriformis syndrome can start.
Anatomical Variations For some individuals, the sciatic nerve might take a different route. It might go through or under the piriformis muscle. This increases the risk of nerve compression and piriformis syndrome.

Symptoms of Piriformis Syndrome

Piriformis syndrome shows pain, numbness, or tingling in the buttocks and nearby areas. You might feel a dull, achy pain in your buttocks, which can spread down to your leg. This almost feels like sciatica. Some people also feel a burning or tightness in their buttocks.


Buttock Pain

A key sign of piriformis syndrome is an achy feeling in your buttocks. The pain can stay in your buttocks or travel down your leg. This is similar to what happens with sciatica.

Sciatica-like Symptoms

When the piriformis muscle presses on the sciatic nerve, you might feel like you have sciatica. This means pain, numbness, and tingling in your leg. These feelings could be in your buttocks, thigh, calf, or foot.

Numbness or Tingling

Alongside pain, some people feel numbness or tingling. This happens in the leg, foot, or toes. The sciatic nerve is getting pressed on or irritated, which can cause these odd sensations down your leg.

The symptoms vary from person to person and depend on how much the nerve is being squeezed. It’s important to see a healthcare provider for the right diagnosis and treatment.

Diagnosing Piriformis Syndrome

Diagnosing piriformis syndrome involves a complete checkup. This includes a full physical check and, sometimes, imaging tests. Doctors can determine what’s wrong and plan the best treatment by examining the patient from different angles.

Physical Examination

Doctors will feel around the piriformis muscle during the checkup. They’re looking for any pain, tightness, or unusual spots. They might also do a FAIR test, which checks how well the muscle moves. This gives clues about the causes of the pain.

Imaging Tests

Sometimes, imaging tests are needed to check further. This helps rule out other issues, like a herniated disc or pressure on the sciatic nerve. Tests such as X-rays and MRI are common. They help see the piriformis muscle and any problems clearly. An Electromyography (EMG) might also be done to look at the nerves more closely.

After all the tests, the doctor pieces everything together. This complete view helps them confirm if it’s piriformis syndrome. Then, they can decide on the right treatment. This approach aims to tackle the root problem and ease the patient’s symptoms.

How to Diffirintiate Sciatica and Piriformis?

The similarity in symptoms between sciatica and piriformis syndrome makes diagnosis challenging. The following are some signs of both conditions:

  • Ache running down the back of the leg and in the buttocks
  • A pins-and-needles sensation in the legs is known as paresthesia.
  • A soreness that gets worse after extended sitting or from repetitive action

Since these symptoms are present in both disorders, it is necessary to differentiate between them by closely observing the painful areas. For instance, piriformis patients are less likely than sciatica patients to experience lower back discomfort. However, sciatica sufferers may have a heavy feeling in the affected leg.
Patients’ movements and the places where they experience pain vary depending on their condition. For example, piriformis patients experience increased pain during hip flexion and prolonged sitting. When lying down, sciatica patients typically experience discomfort when elevating the leg that is affected.
However, patients benefit most from a professional consultation to diagnose their illness because the pain patterns associated with both conditions are irregular and tend to radiate in the lower body.

Sciatica vs. Piriformis Syndrome

Buttock discomfort varies in intensity. For instance, sciatica, or pain from nerve irritation, is frequently diagnosed as the reason for buttock discomfort radiating down the leg. On the other hand, the symptoms of piriformis syndrome are comparable yet arise from an entirely different source. Thus, how can I determine if I have piriformis or sciatica?
Our skilled physical therapists at the Philadelphia Acupuncture Clinic in Philadelphia, PA, collaborate with you to pinpoint the source of your pain and choose the most effective treatment plan. A professional diagnosis is crucial for managing similar illnesses. Otherwise, receiving the wrong care could make your symptoms worse.

Piriformis Syndrome Treatment Options

There are many ways to treat piriformis syndrome. The goal is to ease pain, restore function, and prevent the problem from returning. Typically, doctors start with nonsurgical treatments.

Conservative Treatments

Treatments without surgery for this syndrome include rest, ice, heat, and medications you can buy without a prescription. Taking it easy can lower swelling and pain. Ice or heat packs can make things feel better and speed up healing. Medicines like ibuprofen or naproxen also work well because they lessen swelling and pain.

Physical Therapy

Physical therapy is key for tackling piriformis syndrome. A therapist can whip up a plan just for you. It might include stretches, strengthening exercises, and hands-on methods to relax the tight piriformis muscle. This can boost your flexibility, stop spasms, and take the pressure off your sciatic nerve.


Sometimes, medicine is needed for the symptoms. You could get muscle relaxers to stop spasms and pain. If things are really bad, you might also take neuropathic pain medications to deal with the nerve pain.


The next step might be injections if the easy treatments don’t work. These can be corticosteroids to lower swelling and pain or Botox to loosen up the tight muscles and ease the pressure on the nerve.

Piriformis Syndrome Surgery

Usually, surgery for piriformis syndrome is the last option. It’s for when other treatments have not worked well over time. The choice to go for surgery depends on how bad the symptoms are and if other efforts without surgery helped at all. It also looks at the physical reasons behind the condition.

When is Surgery Recommended?

If all non-surgical treatments have been tried, but the symptoms don’t get better, surgery might be needed. Signs that surgery could help include severe buttock pain, nerve pain down the leg, and nerve problems that affect life and daily activities.

Surgical Procedures

A common surgery for piriformis syndrome is piriformis muscle release. Here, the muscle is cut to stop it squeezing the sciatic nerve. Sometimes, part of the piriformis muscle is taken out, too, or any physical issues causing the squeeze are fixed.

The surgery is done through a small cut in the buttocks. How long it takes to get well again varies. But, most people will need therapy to regain their strength and move like they used to.

Surgery can help some people with piriformis syndrome, but it’s not right for everyone. It’s important to understand that surgery has risks and not just benefits. Doctors will help patients choose the best path based on their situation and what they want from treatment.

Home Remedies for Piriformis Syndrome

In addition to medical treatment, try some home remedies for piriformis syndrome. These include stretching, heat and cold therapy, and even acupuncture.

Stretching and Exercise

Stretching and exercise can really help ease piriformis syndrome. Cross one leg over the other and gently twist your hip to stretch the piriformis muscle. This helps with muscle tightness and spasms.

Also, do exercises like glute bridges, squats, and clamshells. They strengthen your core and hip muscles, stabilize the pelvis, and take pressure off the piriformis muscle and sciatic nerve.

Stretching exercises

Heat and Cold Therapy

Heat and cold therapy can both be beneficial for piriformis syndrome. Heating pads or warm baths can relax the muscles and boost blood flow, while cold therapy, like ice packs, reduces inflammation and pain.

Proper Posture and Body Mechanics

It’s key to maintain proper posture and use the right movements daily. Focus on how you sit, stand, and walk. Make sure your shoulders are back, and your core is strong. Use a supportive chair to keep your lower back in a natural shape when sitting. This stops the piriformis muscle from getting too tight.

Strength and Flexibility Training

Adding specific exercises to your routine is important. These strengthen the muscles near the piriformis and make them more flexible. Squats, lunges, and bridges are great exercises. Don’t forget about piriformis stretches. They help the muscles stay loose and stop tightness and cramps.

Acupuncture for Piriformis Syndrome

Acupuncture is a great option, too. It’s a traditional Chinese medicine that can lower muscle tension, boost blood flow, and reduce pain. It works by stimulating certain points in your body.

Finding a licensed acupuncturist who knows about musculoskeletal issues can really help. Combining these remedies with a doctor’s advice can make managing piriformis syndrome easier.

Preventing Piriformis Syndrome

There’s no one sure way to fully prevent piriformis syndrome. However, keeping good posture and using the right body movements can lower the risk. Adding certain strength and flexibility exercises will also help.


What is piriformis syndrome?

Piriformis syndrome causes pain and numbness in the buttocks and legs. The piriformis muscle irritates or squeezes the sciatic nerve, which causes it to happen.

What causes piriformis syndrome?

Muscle overuse or injury can cause piriformis pain. Anatomical differences, such as how the sciatic nerve moves under or through the piriformis muscle, may also play a role.

What are the symptoms of piriformis syndrome?

The key symptoms are sharp pain in the buttocks, like sciatica (leg pain, numbness, or tingling), and tight buttock muscles.

How is piriformis syndrome diagnosed?

Doctors diagnose piriformis syndrome with a physical exam and sometimes imaging tests. These tests help rule out other causes of the symptoms.

What are the treatment options for piriformis syndrome?

To treat piriformis pain syndrome, you might try physical therapy, anti-inflammatory medication, or injections. Surgery is an option for severe cases.

What home remedies can help with piriformis syndrome?

Stretching, using heat and cold, and acupuncture can bring relief at home and help with healing.

How can I prevent piriformis pain?

To prevent this syndrome, keep a good posture and move correctly. Regular exercise to improve strength and flexibility is also important.

Acupuncture for piriformis syndrome in Philadelphia

At the Philadelphia Acupuncture Clinic, licensed practitioners provide acupuncture for piriformis pain syndrome treatment using the most modern and practical approaches, including classical acupuncture, auricular therapy (Ear Acupuncture), electrical acupuncture, moxibustion, meridian massage, injections of homeopathic Traumeel, and more. We are located in the NorthEast region of Philadelphia, near public transportation and shopping places.

The Master of Oriental Medicine, Da Wei Hu, LAc, provides acupuncture services at the clinic.

David Wu, Master of Oriental Medicine, provides treatment for Piriformis syndrome

He has extensive experience treating various medical conditions that cause pain and discomfort. To schedule your initial evaluation and treatment appointment with Dr. David Wu (short for Da Wei Hu), contact Philadelphia Acupuncture Clinic at (267) 403-3085 or use the widget below.