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Piriformis Syndrome | Pain, Confused with Sciatica or Lower Back Pain.

Mon 19 Oct 2015

Piriformis syndrome, causes pain in the buttock which may radiate down the leg. It is due to the sciatic nerve being impinged by a tight piriformis muscle deep in the buttocks.

Causes of Piriformis Syndrome.

The causes of piriformis syndrome, are unknown. some causes include:

  • Muscle spasm in the piriformis muscle, either because of irritation in the piriformis muscle itself, or irritation of a nearby structure such as the sacroiliac joint or hip
  • A tight muscle, can be a response to injury or spasm
  • Inflammation of the piriformis muscle, a response to  injury or spasm
  • Bleeding around of the piriformis muscle.

Piriformis syndrome is a condition in which the piriformis muscle, its in both buttocks and causes spasms and buttock pain. The piriformis muscle can also irritate the Sciatic nerve, causing pain, numbness and tingling down the back of the legs and some times into the feet .

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  • Pain in the buttock muscles.
  • The pain can radiate down the back of the legs into the hamstring muscles and  even into the calf muscles.
  • It is common for pain to initially be confused with a hamstring strain or hamstring tendinopathy. However there will be no pain when touching  around the hamstring area.
  • Reduced range of motion of the hip joint, especially into internal hip rotation is often seen.


The piriformis muscle is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the sacrum bone at the bottom of the spine and attaches to the thigh bone or femur roughly near the outside crease of the buttocks. The sciatic nerve runs very close to this muscle and in around 12 per cent of the  population it passes straight through the muscles fibers. If the piriformis muscle becomes tight it can compress the sciatic nerve and cause pain which can radiate down the leg, commonly known as sciatic pain.

It has been suggested that this condition would be better referred to as piriformis impingement due to the impingement of the sciatic nerve. A common cause of piriformis syndrome is tight adductor muscles on the inside of the thigh. This means the abductors on the outside cannot work properly and so put more strain on the piriformis muscle.

Piriformis Syndrome Treatment

Treatment consists of two phases. First reducing pain by relaxing the muscle through low level laser therapy, Shockwave therapy, Chiropractic treatment, including Physiotherapy when pain allows strengthening exercises to help prevent the injury recurring whilst gradually returning to full training levels.

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