As our well known Pain Doctors here at the London Pain Clinic, regularly explain to the patients we help: piriformis syndrome is an uncommon disorder which involves the nerves and muscles. If you have this condition, it means that your piriformis muscle (which is a band-like flat muscle found in your bottom close to the top of your hip joint) is pressing on the sciatic nerve. (The latter is a key nerve which extends from the lower part of the spinal cord down the back of the thigh and above the knee joint where it divides into two. The sciatic nerve has the largest diameter within the body). This pressure on the sciatic nerve can generate pain, tingling and numbness along the back of the thigh and leg (rather like sciatica).
Are You Experiencing Buttock Pain?
Piriformis syndrome generates pain deep in your buttocks region. “The feeling may be described as an aching, burning, throbbing, or shooting pain that often worsens following physical activities, such as sitting, walking, running, or cycling, or any activity that involves repetitive hip and thigh motion. The pain may also worsen after being inactive for extended periods, such as while working a desk job or driving” [1].
Are You Feeling Weakness or Having Trouble Moving Your Leg?
Your leg on your affected side might feel stiff or heavy, and you may experience difficulty moving it in certain directions or find it difficult to lift [1].
Do You Have Trouble Sitting For a Long Time (Especially on Uneven/Hard Surfaces)?
This challenge could be due to tenderness and pain in the buttocks [1].
The Importance of the Piriformis Muscle
As you can probably imagine, this particular muscle is crucial for lower body movement. In fact, it serves to stabilise our hip joints and rotates and lifts our thigh away from the body. And these actions empower us to keep our balance and move our weight from one foot to the other when we walk, etc. In a nutshell, we need the piriformis muscle in order to carry out virtually every motion legs and hips make [1]. To that end, if you are experiencing symptoms, it is crucial to book and in-person or online consultation with one of our renowned Pain Specialists as soon as possible.
What Happens on My Piriformis Syndrome Consultation?
As soon as your Pain Doctor has reviewed your medical history, and arranged for any necessary tests or scans, they will be able to ascertain an accurate diagnosis based on your signs and symptoms. After this, your Pain Specialist will devise a Holistic Personalised Treatment Plan which you can get started on right away. This is likely to include conventional and the latest state-of the art therapies and injectables.
So What Causes Piriformis Syndrome?
“While there are multiple factors potentially contributing to piriformis syndrome, the clinical presentation is fairly consistent” [2]
Generally speaking, piriformis syndrome comes about:
- After you have experienced a direct injury to your buttock region, or
- After continual trauma on the piriformis muscle which comes about from: bad posture or exuberant physical activity, both of which render the muscle inflamed, overused, tight and weak
- Anatomical causes including: a transformation of the pelvic bones, degenerative changes, and infection [1]
What Piriformis Syndrome Symptoms Should I Look Out For?
- Symptoms can range from slight discomfort to harsh debilitating pain within the buttocks
- If the piriformis muscle is exerting pressure on the sciatic nerve, then the symptoms can also travel down the thigh and leg
- As your Pain Consultant will advise you: symptoms from piriformis syndrome can stay consistent all day long, or flare up when you undertake certain physical leg and hip actions such as twisting, climbing the stairs, walking, and sitting down [1]
References
[1]. Patel, A. (2023). “Symptoms and Diagnosis of Piriformis Syndrome.” Spine Health. https://www.spine-health.com/conditions/sciatica/symptoms-and-diagnosis-piriformis-syndrome
[2]. Hicks BL, Lam JC, Varacallo MA. Piriformis Syndrome. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. https://www.ncbi.nlm.nih.gov/books/NBK448172/
