The piriformis muscle is a muscle located deep in the buttocks and pelvis and allows you to rotate your hip outward. Within the piriformis muscle the sciatic nerve can be found. Piriformis syndrome refers to the irritation of the sciatic nerve as it passes through the piriformis muscle. Irritation and inflammation of the sciatic nerve can occur if the piriformis becomes tight or goes into muscle spasm.
There will be pain deep in the buttock region – it may feel like a burning sensation. The pain can also sometimes travel down the thigh as well. Often pain is increased when the hip is rotated out (e.g. when you cross your legs). As it is a nerve that is irritated there may be also symptoms such as tingling, numbness and weakness in the buttcks/thigh region.
Diagnosis and treatment
Diagnosis involves eliminating the back area as the source of pain. This is because the sciatic nerve originates in the back before it passes through the buttocks region and can therefore become irritated in the case of a disc bulge in the low back. In most cases your physiotherapist will be able to diagnose this condition.
The treatment of piriformis syndrome will initially involve reducing inflammation and pain. This may involve the use of electrotherapeutic modalities, ice, gentle soft tissue techniques and gentle stretching. Rest from aggravating activities is also recommended. Once the initial pain and inflammation has settled soft tissue techniques and stretching will become more vigorous. Your therapist will also look at any other predisposing factors (e.g. poor running technique, muscle weakness).