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Piriformis Syndrome and Sciatica

Piriformis Syndrome and Sciatica

Piriformis syndrome occurs when the piriformis muscle, located in the buttocks, spasms and causes pain in the buttocks and surrounding area. Since the piriformis muscle is located very near the sciatic nerve, symptoms can also include the classic radiating pain of sciatica. Patients may have pain that runs from the buttock down the back of the thigh. It can also continue down as low as the knee and foot.


Other symptoms of piriformis syndrome include:

  • Pain when climbing stairs
  • Pain that is worse after sitting a long time
  • Dull, constant ache in the buttock area
  • The hip joint may have reduced range of motion

When the piriformis muscle causes sciatica through the irritation of the sciatic nerve, the pain can be intense. Diagnosis is accomplished through a physical exam, patient history, diagnostic tests, evaluation of symptoms and through the elimination of other possible causes. Chiropractors often perform various orthopedic exams to determine the root cause of the pain.


This condition can have a number of possible causes. Muscle spasms may be caused by irritation of the piriformis muscle by adjacent structures, such as the sacroiliac joint. It can be caused by bleeding from the piriformis. Swelling and tightening of the muscle are two other possibilities.


Piriformis syndrome is generally a self-limiting condition. It tends to disappear, in time, whether it’s treated or not, but usually returns if left untreated and can turn into a chronic condition. Because the pain involved is often severe, patients typically do seek chiropractic treatment to ease their pain. Some common treatments include:

  • Stretching exercises
  • Chiropractic manipulation
  • Trigger point therapy
  • Manual therapy
  • Physical therapy

Special Stretching for Piriformis Syndrome

Gently stretching your piriformis muscle will help to keep it out of spasm and keep you out of pain. Here is one to try:

Lie on your back, feet flat on the floor, knees bent. Pull your right knee up to your chest, grab it with your left hand and pull it towards your left shoulder. Hold for 5 seconds at first. Work up slowly to a 30-second hold. Repeat for the other side. Try to do three sessions a day.

Chiropractic Care

The pain of piriformis syndrome can be extreme. Chiropractic adjustments and trigger point therapy may release the pain-causing muscle tightness. Your chiropractor will evaluate your symptoms. A chiropractor also performs a thorough exam to determine the root cause of the pain.  He or she will look for signs of sciatic irritation, too. You may be evaluated to be sure your legs are the same length to rule out any pelvic misalignment. Don’t be afraid to consult with a chiropractor. Take advantage of every possible method of relief that you can find. Remember, the best treatment is the one that works for you.

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