Piriformis syndrome


Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).https://www.nhs.uk/live-well/exercise/exercises-for-back-pain/


  • increased pain after prolonged sitting
  • dull ache in the buttock
  • pain down the back of the thigh, calf and foot
  • pain when walking up stairs and/or down stairs
  • reduced range of movement of the first


  • MRI
  •  nerve conduction tests may be carried out to exclude other condition that can cause similar symptoms to piriformis syndrome.
  • an injection of anesthetic with or without steroids may help to confirm if the piriformis muscle is the source of the symptoms.
  •  physical assessment. Physical assessment should include an osteopathic structural examination with special attention to lumbar spine, pelvis, sacrum as well as any leg length disparities. Physical assessment should also include deep tendon reflex testing, strength and sensory testing.
  • leg length discrepancy warrants an investigation to distinguish between physiologic and anatomic causes.
  • diseases of hip, including arthritis and bursitis, as well as fracture should be considered in differential diagnosis.


  • early conservative treatment is the most effective treatment.
  • stretching of the piriformis muscle and strengthening of the abduct and adductor muscles should be included in treatment plan.
  • non-steroidal anti-inflammatory drugs and acetaminophen have been considered the medication of choice.
  • muscle relaxants are another frequently prescribed medication.
  • local steroid injections can produce an anti-inflammatory effect.
  • as a last resort, surgery has been occasionally used in cases that have failed to resolve with the use of other treatment measures.

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