Piriformis syndrome is a cause of buttock pain, and sometimes leg pain, that arises from the piriformis — a small but important muscle deep in the buttock. Because the sciatic nerve runs very close to this muscle, piriformis problems can produce symptoms that mimic sciatica, which is why a careful assessment matters. The good news is that it usually responds well to hands-on care and the right exercises. At Back in Action in Penwortham, we care for people across Preston and Lancashire with piriformis-related pain.
Understanding piriformis syndrome
The piriformis is a flat, band-like muscle that runs deep within the buttock, from the base of the spine to the top of the thigh bone. Its job is to help rotate and stabilise the hip, and it works hard during walking, running and changing direction. When the piriformis becomes tight, overworked or goes into spasm, it can cause pain in the buttock itself and, because the sciatic nerve passes directly beneath or sometimes through it, it can irritate that nerve and send symptoms down the leg.
This close relationship between muscle and nerve is the key to understanding piriformis syndrome. It is a mechanical, soft-tissue problem rather than a sign of anything serious, but because its symptoms can look so much like nerve-related low back pain or a disc problem, part of a good assessment is telling these apart so that care is directed in the right place.
It is also worth knowing that piriformis syndrome can be something of a contested diagnosis — buttock and leg pain can have several overlapping causes, and the picture is not always clear-cut. In practice, what matters less than the precise label is identifying the muscles, joints and movements that are contributing to your symptoms, and addressing those. That is the approach we take.
What piriformis syndrome can feel like
Symptoms vary from person to person, but commonly include:
- A deep ache or pain in the buttock, often on one side
- Tenderness deep in the buttock that can be uncomfortable to sit on
- Pain that worsens with prolonged sitting, climbing stairs or running
- Symptoms that may spread down the back of the thigh, mimicking sciatica
- A feeling of tightness or cramping deep in the buttock
- Symptoms that ease when you get up and move after a spell of sitting
Unlike a disc-related problem, piriformis syndrome tends to centre on the buttock rather than the lower back, and the symptoms are often clearly linked to sitting and to activity that works the hip.
Common causes and risk factors
Piriformis syndrome usually develops from a combination of factors rather than a single event. Common contributors include:
- Prolonged sitting, particularly on hard surfaces or a wallet in a back pocket
- Overuse from running, walking or sport, especially with a sudden increase in activity
- Weakness or imbalance in the muscles of the hip and buttock
- Stiffness or altered movement in the lower back, pelvis or hip
- A direct knock or fall onto the buttock
Part of our assessment is judging how likely the piriformis is to be the source of your symptoms, and what is keeping it irritated, so that care can be directed sensibly.
When to seek help
Piriformis-related pain is not dangerous, but it can be persistent and limiting, and it has a habit of lingering when left to its own devices, so seeing someone can help you understand it and settle it more quickly. As with any low back or leg pain, please seek urgent medical attention if you develop difficulty controlling your bladder or bowels, numbness around the back passage or inner thighs, or numbness or rapidly worsening weakness affecting the legs. These signs are rare but important and need ruling out.
How chiropractic care can help
Chiropractors care for many people with buttock and hip-related pain of this kind. The aim of our care is to ease the pain, release what is tight, restore comfortable movement, and address the factors that allowed the problem to build, so that it is less likely to return. Following a thorough assessment, our hands-on, drug-free care may include soft-tissue work to release the tight piriformis and surrounding muscles, mobilisation of the lower back, pelvis and hip where movement is restricted, and rehabilitation exercises to stretch and strengthen the area and address any underlying imbalance. Because we are a multi-practitioner clinic, we can also draw on physiotherapy and massage. We will always be honest about what care can realistically offer, and refer you on where appropriate.
What to expect at Back in Action
Your first visit is mostly about understanding your symptoms. We will take a careful history and carry out a physical examination, which for suspected piriformis syndrome includes assessing the hip, pelvis and lower back and using specific tests to help distinguish it from other causes of buttock and leg pain. We will explain what we have found in plain language and discuss whether chiropractic care is appropriate. Because buttock and leg pain can have more than one cause, this assessment is genuinely useful in its own right, helping make sense of symptoms that can otherwise be confusing. You can read more on our new patients page, with current charges on the fees page, and we will review your progress as we go.
Helping yourself: self-care and prevention
Much of the lasting improvement in piriformis problems comes from what you do between appointments — the stretching and strengthening, and the changes to habits that were loading the muscle. There is plenty you can do, much of it centred on reducing what irritates the muscle and improving the strength and flexibility around it:
- Break up long periods of sitting, and avoid sitting on hard surfaces or on a wallet
- Keep gently active and introduce regular, gentle stretching of the buttock and hip
- Build strength in the hip and buttock muscles over time
- Increase running or training loads gradually rather than in sudden jumps
- Pay attention to one-sided habits that may load the area unevenly
If you would like guidance tailored to you, we can build self-care and exercise advice into your care plan so that progress in the clinic is supported by what you do at home. Stretching and strengthening generally need to be kept up consistently over a few weeks to make a lasting difference, rather than done intensively for a day or two, and we will help you find a routine that fits realistically into your life.
Related conditions and treatments
Piriformis syndrome is closely linked to sciatica, low back pain, sacroiliac joint syndrome and hip, groin and pelvis pain, and where the nerve is irritated it overlaps with nerve pain. The care we provide draws on approaches such as chiropractic manipulation and exercise and rehabilitation, and may form part of a wider plan alongside our chiropractic, physiotherapy and massage services.
Take the first step
If buttock or hip pain is getting in the way of your life, you do not have to simply put up with it. We are happy to talk it through and help you understand your options. You can get in touch to book an appointment, or to ask any questions before your first visit.