What is Piriformis syndrome ?

The piriformis muscle runs diagonally from your sacrum (triangular bone at the bottom of your spine) to the greater trochanter (large bump top of femur bone). The sciatic nerve runs under it or in 15-20% of people through it. During some movements of the leg / hip external rotation, abduction, some extension, the muscle shortens during its contraction and compresses the sciatic nerve. The muscle is often found shortened or in spasm.


You may experience some or all the following:

  • Pain, tingling, numbness in buttock
  • Pain can extend down gluteal area, posterior thigh and leg, lateral foot 
  • Worse after sitting for a long time, running, cycling, stairs, or vigorous activity 
  • Usually unilateral


Anatomic: sciatic nerve passing through it

Primary: 15% of patients 

Secondary:  due to precipitating causes like trauma, local ischemia, trauma to buttock (injection), inflammation, muscle spasm.  

  • After lumbar or sacroiliac joint injury or overuse 
  • Shortened muscle due to lower limb mechanics, altered low back/pelvis torsions, malalignments.
  • Long distance walk/run
  • Direct compression from sitting on hard surface for long time 
  • Ischial bursitis   

Other possible causes must be ruled out for sciatic nerve compression from spine injuries.

Many spinal consultants do not believe in this injury as a standalone and state there are always some spinal components around the L5-S1 segment involvement or an underlying disc injury.


Diagnosis is based on full medical history, physical examination to test muscles strength and reflexes. Images test, will allow the therapist or professional to determining the cause and severity of Piriformis syndrome.

The most common imagery test are:

  • Confirmed by X-ray
  • TC scans
  • MRIs


Home treatment

  • Avoid pain triggering activities 
  • Rest, ice pack
  • Stretch 
  • Neural flossing 

The aim is to reduce the sciatic nerve compression and a health professional needs to test and establish where the compression starts, if it’s only in the gluteal area or if there is a spinal component and what other structures are involved in causing or maintaining the injury.

Hands on treatment

Osteopathic manipulative technique has been proven to relieve pain, increase range of movement in restricted areas and rebalance the pelvis.


  • Anti inflammatories 
  • Pain killers

We can help you!

Lymphatic Drainage


Osteopathy Clinic


Perea Clinic


Treatments that can help

Here are some treatments that can help with Piriformis syndrome Pain:

  • Massage (Soft Tissue)
    Help decompress the nerve impingement due to tight muscles
  • Osteopathy
    Helps restore normal movement due to misalignment and decompress nerve impingement
  • Physiotherapy/Sports Therapy
    Helps stabilise weak areas and restore normal movement
  • Acupunture
    Helps to loosen up the tissue decompress the nerve impingement in tight muscles

Book a Consultation with

Here are some therapist that can help with Piriformis syndrome Pain:

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