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Piriformis Syndrome

Written by: Scott Bentson, DC, MS

What is Piriformis Syndrome?

A small muscle located deep in the buttock, the piriformis is prone to spasm with overuse or injury. The sciatic nerve runs closely to the piriformis and in some cases, actually pierces the muscle. When the muscle is overused or injured it may cause compression or irritation of the sciatic nerve resulting in pain or tingling that radiates down the leg. This is often referred to as sciatica. Not every person with piriformis syndrome experiences sciatica; sometimes the only symptom is pain in the buttock. There are a few different causes of piriformis syndrome. Muscle imbalance, falling on the buttocks, sitting for long periods (especially with a wallet in the back pocket), and activities that result in overuse of the muscle such as running are all established causes of the syndrome. Piriformis syndrome is commonly treated by the chiropractors at Lehigh Valley Chiropractic.

How is Piriformis Syndrome diagnosed?

Piriformis Syndrome is generally diagnosed by history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. An exam will be performed that will consist of orthopedic and neurologic tests to determine the cause of the pain. If your pain is related to activity, your chiropractor may also provide a biomechanical assessment (watching you in action) to establish if there are any abnormalities of gait and movement. In some cases, further testing such as an x-ray or MRI will be ordered. Although piriformis syndrome cannot be seen on an x-ray or MRI, these types of tests may be helpful in ruling out other conditions.

What Are the Options for Treating Piriformis Syndrome?

Piriformis syndrome is commonly treated at Lehigh Valley Chiropractic. You may experience relief with the conservative treatments rendered by our chiropractors. For this condition, treatments such as myofascial release, therapeutic ultrasound, strengthening exercise, muscle energy techniques, stretching and application of heat are safe and effective. Other options including pain medication and botox/steroid injections may be beneficial in certain patients who don’t respond to conservative treatment. That being said, prior to injecting your buttocks with botulism, schedule your appointment at Lehigh Valley Chiropractic.

• Piriformis syndrome, diagnosis and treatment. Kirschner JS, Foye PM, Cole JL. Muscle Nerve. 2009 Jul;40(1):10-8. Review.
• Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. J Orthop Sports Phys Ther. 2010 Feb;40(2):1.
• Diagnosis and management of posttraumatic piriformis syndrome: a case study. Mayrand N, Fortin J, Descarreaux M, Normand MC.

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This article is not a substitute for medical advice. The information provided is not intended to diagnose or treat any condition.