Piriformis Syndrome Treatment

What is piriformis syndrome?

The piriformis is a flat, narrow muscle that runs from your lower spine through your buttocks to the top of your thighs. It is an important muscle that helps you move your lower body.

Piriformis syndrome is a disorder of this narrow muscle which causes buttock pain. It can also irritate the nearby sciatic nerve and become inflamed. The piriformis runs above the sciatic nerve which then travels from your spinal cord, through your buttocks, down the back of each leg, to your feet. It’s the longest, largest nerve in your body.

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What causes piriformis syndrome?

There are several causes of piriformis syndrome, and sometimes it is confused with sciatica.

Causes are most often due to:

  • Inflammation or swelling in the muscle or the tissues around it
  • Muscle spasms
  • Scarring in the muscle
  • Abnormal anatomy of the placement of the piriformis muscle (primary piriformis syndrome)
A woman sits on a beige sofa, holding her lower back with a pained expression, suggesting back pain. She is wearing a gray long-sleeve shirt and jeans. The room is decorated with neutral colors and plants.

What are the symptoms of piriformis syndrome?

Piriformis syndrome causes pain deep in the buttock, and is not a very common cause of back pain. The pain can also be felt in the hip or upper leg. The pain often is worse after participating in physical activities like running or walking, but may also occur after sitting or repetitive hip or thigh motion. Most pain episodes go away in a few days or weeks with rest and simple treatments. The pain may be:
  • Aching
  • Burning
  • Throbbing
  • Shooting

How to Diagnose Piriformis Syndrome

As you visit with Midwest Orthopedic and Musculoskeletal Alliance about your symptoms, you may need a physical exam or other tests to confirm a diagnosis of piriformis syndrome. If you suspect you have piriformis syndrome, you can:
  • Explain your symptoms and activity habits
  • Discuss your medical history
  • Review any injuries or previous pain episodes
  • Have Midwest Orthopedic and Musculoskeletal Alliance stretch, rotate, press and move your hip, buttock, and leg
  • Order additional imaging or tests
A female doctor in a white coat talks to a male patient holding his lower back, suggesting back pain, in a bright medical office with a model of the spine on the desk.

What can I do to help with piriformis syndrome?

If you have piriformis syndrome, the overall goal is to reduce inflammation.

Piriformis syndrome surgery is usually not recommended unless all other therapies fail. Surgery for this condition may involve removing scar tissue or other sources of pressure on the nerve.

Most treatment involves helping improve mobility and promote the body’s natural healing process. Lifestyle adjustments may need to be made such as proper warm-up, improved posture, proper exercise, proper lifting techniques, or avoiding activities that may cause pain.

Treatments commonly include:

  • Rest
  • Over-the-counter pain medications
  • Stretching exercises or physical therapy
  • Massage
  • Anti-inflammatory drugs
  • Steroid injections
  • Ice or heat on the muscle
  • Botulinum toxin injections (Botox®)
  • Surgery

Schedule Your Piriformis Syndrome Appointment Today

If you are experiencing deep buttock pain or suspect piriformis syndrome, contact Midwest Orthopedic and Musculoskeletal Alliance today at 414-384-6700. Our orthopedic specialists in Southeastern Wisconsin will evaluate your condition and recommend the most appropriate treatment plan.

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