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If you suffer from piriformis syndrome, you literally have a pain in the buttock. It can feel similar to sciatica, but it is located in the piriformis muscle. This small muscle runs diagonally deep within the buttock located behind the gluteus maximus.

The piriformis muscle is necessary for rotation of the hip and turning the leg and foot outward. It starts at the base of the spine and connects to the thighbones. The sciatic nerve runs vertically just beneath or through the piriformis. Because of the location of the sciatic nerve, caution must be taken not to put pressure on the nerve when working to relieve pain in the muscle.

Treatment for discomfort caused by piriformis syndrome depends on the severity of the pain and other symptoms. A combination of non-invasive approaches to pain relief may be used to treat the condition.

Symptoms of Piriformis Syndrome

As a syndrome, there are several things to look for with piriformis syndrome. You may feel acute tenderness in one buttock. Pain similar to that of sciatica may shoot from the back of your thigh down to your calf and foot. Other symptoms may include:

  • Dull aching in buttock
  • Increased pain when walking up inclines and stairs
  • Increased pain after sitting for long periods
  • Reduced range of motion in the hip joint

Women are more likely to experience piriformis pain than men. It also occurs most often in people in their 40s and 50s. Because of the nature of the condition, it is frequently confused with other issues such as sciatica.

Diagnosing Piriformis Syndrome

Accurate diagnosis of piriformis syndrome begins with a physical examination. Your doctor will move your leg in various positions to determine the pain level. Occasionally specific tests are required for correct diagnosis. These may include computerized tomography or CT scan and magnetic resonance imaging (MRI), which are sometimes used to rule out other conditions that can irritate the sciatic nerve.

While the pain from piriformis syndrome and sciatica are very similar, the difference has to do with the origin of the pain. Hip and buttock pain is associated with piriformis syndrome. Leg pain is more pronounced in sciatica and often can radiate into the toes. Both conditions can present with lower back pain, a burning sensation in the buttock and back of the leg, tightness in the lower back and buttock and increased discomfort when sitting.

While the two conditions are a bit different, some individuals have both at the same time. It is important to identify the source of your pain in order to develop an effective treatment plan. Successful treatment addresses the underlying cause of the nerve irritation.

Treatment of piriformis syndrome will not necessarily be the same as that for sciatica. A degenerated disc or herniated disc can cause sciatic pain, and the stretching exercises used in the treatment of piriformis syndrome could exacerbate the pain.


After diagnosing piriformis syndrome, your doctor will create a treatment plan to help alleviate the pain. Treatment often involves a comprehensive approach using various techniques:

  • Ice packs are good for relieving the pain of inflammation and any swelling that may be present. Ice is also good to use immediately after any activities that have increased pain.
  • Heat therapy can be used as well for up to 20 minutes. Some find it helpful to alternate between heat and ice.
  • Electrical stimulation or TENS, or interferential current stimulator (IFC), is used to ease muscle spasms and block the pain of piriformis syndrome.
  • Stretching exercises, when done correctly to target the piriformis muscle, can be very effective in easing discomfort.
  • Acupuncture is another treatment that can ease the muscle spasms which may be putting pressure on the sciatic nerve.

You can expect your doctor to recommend a combination of treatments to help relieve your pain and discomfort. Only in the severest of cases is surgery recommended to remedy the problem.

When you have lower back pain and or pain in your buttock region, contact Dr. Rolland Miro at Manhattan Sports Therapy. Excellent care with non-invasive treatments await. Schedule your appointment for an exam and consultation.

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