The Piriformis Muscle (piriformis means “pear shaped“) is a tiny muscle located deep in the buttocks, underneath the gluteal (butt) muscles. This little muscle is the most well-known of a group of muscles known as the “Hip Rotator Cuff” and is frequently the source of pain in the butt and associated Sciatica. I have had several people come to me for Spinal Decompression Therapy that actually had Piriformis Syndrome. Yes, we saved them a lot of time, grief, and money. Spinal Decompression Therapy does not help Piriformis Syndrome!
Piriformis Syndrome is a miserable condition in which the Piriformis Muscle becomes overly tight. Although there are almost always underlying biomechanical issues to deal with (bow legged or knock knees, high / low arches, a history of PULLED MUSCLES around the pelvis, etc) this pathological tightness of the Piriformis is usually the result of FASCIAL ADHESIONS or TENDINOSIS.
Piriformis Syndrome can be aggravated by bending, lifting, sitting, sports, and even driving (foot on the gas pedal). Contrary to what your M.D. might tell you, there are no drugs or surgery that are effective for treating Piriformis Syndrome. I will warn you, in 20 plus years of practice I have never one time seen a person whose Piriformis Release Surgery actually worked.
Piriformis Syndrome is an extremely common condition, and is far more likely to be found in women than men (about 12-15 times more often). Although I can only speculate on the reason for this, I suspect that it is a child-bearing issue. It probably also has to do with the naturally wider shape of a woman’s pelvis. This is the most likely explanation for my finding it much more frequently in women than men — even in women who have not had children.
PIRIFORMIS SYNDROME CAUSES SCIATICA
As I stated earlier, Piriformis Syndrome is a major cause of sciatica (leg pain, numbness, tingling, or weakness, in any combination), hip pain, and buttock pain. Because sciatica is so often involved, the problem is often misdiagnosed as a HERNIATED DISC, DEGENERATIVE DISC, or sacroilliac problem (sometimes chronic sacroilliac problems are related to problems in the Piriformis Muscle).
The SCIATIC NERVE is both the largest and longest nerve in the body, and at its largest point is about the thickness of one’s thumb. The sciatic nerve originates in the low back (lumbar spine region) and angles toward the middle of the buttock. It then extends down through the leg, passing just underneath the piriformis muscle. Be aware that in as much as half the population, the sciatic nerve travels through the Piriformis Muscle, passes over the Piriformis Muscle, or splits in two and passes directly around the Piriformis Muscle.
Be aware that much of what is called Piriformis Syndrome is actually a Piriformis Tendinopathy. See our TENDINOSIS PAGE for more information. Usually this pain will be worse at the hip joint itself (lower, outer buttock region).
The symptoms of Piriformis Syndrome usually begin as a deep aching in what women like to refer to as their “hip” area. This pain will be found along an imaginary line that runs from the very tip top of the butt crack, to the greater trochanter of the hip bone (the bony knob on the upper and portion of the outer or lateral thigh).
