Piriformis Syndrome

Are you having butt pain when you are sitting for too long? Does the pain radiate down the leg? There are many causes of pain in the hip. One of which could be caused by tight muscles in the buttock in a condition called piriformis syndrome. Let’s take a look at what is piriformis syndrome and what treatments are involved to fix it.

Women suffering from piriformis syndrome is rubbing her buttock.

What is it?

The piriformis is a muscle that is located in the buttock. Excessive tension in the piriformis can cause pain in the buttock and even compress the nearby sciatic nerve. Compression of the sciatic nerve can lead to pain, numbness, and tingling in the thigh, calf, and feet. Tension in the piriformis can be caused by a general lack of activity and prolong periods of sitting. However, over training and a lack of stretching and recovery work can also cause tension in the piriformis.


What are the signs and symptoms?

-symptoms can vary and include: pain, numbness, tingling, swelling, and burning.

-symptoms can be in the buttock, back of the thigh, calf, and feet. These symptoms can be in all or just one of those areas.

-discomfort with prolong sitting.

-pain with walking on even ground, inclines, or stairs.


How is it treated?

Although this issue is referred to as piriformis syndrome the cause of this injury often involves many of the surround muscles in this area. There are many muscles around the piriformis that is also tight so they will all need to be treated by your physiotherapist. Tension in the piriformis and the surrounding muscles can be release through stretching, massage, active release, and dry needling. Massage and active release are both soft tissue treatments your physiotherapist can apply. With active release treatments, your physiotherapist will apply a massage like pressure to your hip while stretching the piriformis.

Dry needling is a form of acupuncture. Dry needling is particularly effective at releasing tight muscular knots in muscles. Although you may feel some mild discomfort during this procedure the pain relief is significant and long lasting. To perform dry needling your physiotherapist will feel for tight muscular knots in your piriformis with their hands. Your physiotherapist will insert a needle into the piriformis. Often when the acupuncture needle is inserted into the tight knot, you will see and feel a muscle twitch response indicating the knot has been released.


Common Home Exercises

Piriformis stretch/ foam rolling

Perform the piriformis stretch in sitting. Cross your foot over the opposite knee. Hinge forward at your hip and you will feel a nice stretch along your buttock. Hold this stretch for 20-30 seconds and repeat for 3 sets. Foam rolling your buttock will also be a good option since it will massage your piriformis and nearby buttock muscles.

Sciatic nerve floss

If you are feeling buttock pain and pain/numbness/tingling down your leg this may be a sign of your sciatic nerve being compressed by your piriformis. To loosen the sciatic nerve you can floss the sciatic nerve free from the piriformis. This is similar to when you floss to clean your teeth. Perform this exercise in sitting with your feet on the floor and head looking down. Straighten your knee as you look up toward the ceiling. Repeat for 10 repetition and 3 sets.

Physiotherapist Eric Lau is demonstrating a sciatic nerve floss exercise.

Clam shell

Lye on your side with your hip bent to about 45-60 degrees. Separate your knees while keeping your feet together. For increased resistance you may place a band at your knees. Perform 10-20 repetitions for 3 sets.

Physiotherapist Eric Lau is demonstrating a clam shell exercise.

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