Piriformis Syndrome – painful irritation of the sciatic nerve

Piriformis syndrome is a painful condition that involves irritation of the sciatic nerve in its passage through or near the muscle called piriformis. Sciatic nerve inflammation, which is also called sciatica, causes hip pain, which often spreads through the entire leg.

Piriformis muscle is located deep in the pelvis and allows rotation of the leg outwards. Sciatic nerve travels from the lower spine into the legs passing through or immediately next to the piriformis. If this muscle is unusually short, or bent, the nerve can be irritated or inflamed. Likewise, the piriformis syndrome can be the result of intensive running downhill.

With diagnosis it is important to establish how the pain started, because sciatica may have the entire range of other causes. As nerve itself is composed of nerve fibers in the lower spine, most frequently its irritation is caused by herniated disc or by pressing another soft tissue or bone. Tests for piriformis syndrome may indicate the cause, but it is sometimes necessary to do a detailed diagnostics that will rule out other causes, such as X-rays, CT or MRI.


Piriformis syndromeBasic symptom of piriformis syndrome is a pain deep in the buttocks, which can mimic stinging or irritating heat. Usually the pain travels down the entire length of the legs, and can increase with inner rotation of the hip (for example, when sitting cross-legged). Other piriformis syndrome symptoms include:

  • Tingling and numbness along the sciatic nerve that runs down the back region of the thighs and legs.
  • Reduced range of motion of the hip joint with inner rotation.
  • Weak and limited hip guidance.

Piriformis Syndrome Treatment

Piriformis syndrome treatment is relatively simple. Ice packs are used several times a day for pain relief, as well as deep massage to relax present muscle spasm or leg cramp. Magnetic therapy and a thermal procedure may also be useful at a later stage at the same purpose. Leg rest is also important, especially in the first days of treatment of piriformis syndrome.

In an extremely painful situation, the drugs will not do any harm, especially those that relax the muscle cramp. Pain killers will also be useful, preferably taken within a short period of time. But what really heals the condition is exercising and stretching. Only flexible piriformis will not cause problems in the near or distant future.

Symptoms themselves can last from several days to several weeks, even months, all depending on the severity of nerve irritation, muscle spasms or leg cramp, treatments, and the patient’s behavior. Specifically, it is very important to avoid activities that cause pain. Otherwise, treatment can prolong, or already disappeared symptoms may recur. It is also important to establish a full range of motion in the leg that is attacked by this syndrome, possibly to strengthen weakened muscles, and achieve a completely painless walk before returning to the normal level of daily activity. Primary prevention of piriformis syndrome consists in maintaining adequate flexibility through a regular practice of stretching exercises.

The recent example of a young patient illustrates how important it is to recognize the piriformis syndrome in time. The patient suffered from pain in his right leg for months. X-rays showed mild scoliosis of the lower spine and this was blamed for the current pain.

All sorts of treatments, the whole arsenal of physiotherapy to various types of massage and chiropractic were applied on him, but without any success. The shortening of the piriformis muscle was only later established, so with proper stretching, leg workout and some acupressure the symptoms were resolved in a period of two weeks.

Piriformis Syndrome – painful irritation of the sciatic nerve
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