What is piriformis syndrome?
Your piriformis muscle runs from your lower spine to the top of your thigh bone. Piriformis syndrome occurs when this muscle presses on your sciatic nerve (the nerve that goes from your spinal cord to your buttocks and down the back of each leg). This can cause pain and numbness in your lower body.
Symptoms of piriformis syndrome
The most common symptom of piriformis syndrome is sciatica. This term describes pain, tingling, or numbness that starts in your buttocks and runs down the back of your leg. Sciatica may start as an intense, burning pain deep in the buttocks. The pain gets worse during activities that cause the piriformis muscle to press against the sciatic nerve, such as sitting, climbing stairs, or running.
When should I call my doctor?
Talk to your doctor if any of the following are true:
- Your pain lasts longer than a few weeks
- You have sudden, severe pain in your lower back or your leg, or you have muscle weakness or numbness in your leg
- Your pain started after you have been injured in a traumatic event
- You have problems controlling your bowels or bladder
What causes piriformis syndrome?
You can develop piriformis syndrome from everyday activities, such as long periods of inactivity or sitting for long periods of time, climbing stairs, walking, or running. You can also develop it after a traumatic event, such as a car accident or a fall. Abnormal anatomy at birth can also be the cause.
How is piriformis syndrome diagnosed?
Your doctor will perform a physical exam. They will move the affected leg into several different positions to check your pain level.
If your doctor thinks something other than piriformis syndrome is causing your sciatica, they may order additional tests. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans can’t diagnose piriformis syndrome. However, they may show your doctor if something else is pressing on your sciatic nerve.
Can piriformis syndrome be prevented or avoided?
Once your symptoms improve, you may need to change your activities to avoid developing piriformis syndrome again. The following are some tips to help prevent piriformis syndrome:
- Exercise regularly, but always stretch first.
- Maintain good posture when you’re sitting, driving, or standing.
- Don’t bend over to lift. Lift an object by bending your knees and squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting.
- Avoid sitting or lying down for long periods of time in a position that puts too much pressure on your buttocks.
Piriformis syndrome treatment
Most people who have piriformis syndrome get better with treatment and lifestyle changes. Failure to treat this condition can lead to permanent nerve damage, so be sure to follow your doctor’s instructions.
Self-care tips for piriformis syndrome include the following:
- Temporarily stop doing activities that cause pain, such as running or bicycling.
- Take regular breaks to walk around and stretch if you have to sit for a long period of time.
- Use cold packs and warm packs. Start by using a cold pack on the affected area several times a day for about 15 minutes at a time. After using a cold pack for a couple of days, switch to a warm pack or heating pad. If you continue to have pain, alternate between a cold pack and a warm pack.
- Take a nonsteroidal anti-inflammatory drug (also called an NSAID), such as ibuprofen (two brand names: Advil, Motrin), aspirin, or naproxen (one brand name: Aleve) to help relieve your pain. You can also take acetaminophen (one brand name: Tylenol) for pain relief.
- Do exercises to stretch the piriformis muscle. Your doctor can give you information about what stretches will help.
- Massage the affected area. If your pain doesn’t get better with self-treatment, your doctor may refer you to a physical therapist or inject a steroid medicine where the piriformis muscle and the sciatic nerve meet. This may help reduce your pain. If you have severe piriformis syndrome, you may need surgery to relieve the pressure on your sciatic nerve.
Living with piriformis syndrome
You may find that piriformis syndrome comes and goes, depending on your activity level. Try to recognize the activities that seem to trigger it. That way, you can be sure to do exercises to stretch the piriformis muscles before and after those activities.
Questions for your doctor
- What is the likely cause of my pain?
- Do I need any tests to confirm piriformis syndrome?
- Is it safe for me to exercise? What kind of exercise should I do?
- Will alternative therapies such as yoga or massage help relieve my pain? Do I need to take any medicine?
- What should I do if my pain doesn’t go away?
National Institutes of Health, MedlinePlus: Piriformis syndrome
National Institute of Neurological Disorders and Stroke: Piriformis Syndrome
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.