The Piriformis is a tiny muscle located behind the gluteus maximus in the buttocks. It starts at the end of the lumbar spine and connects to the thighbones’ upper surface (femur). The piriformis muscle is responsible for assisting the rotation in the hips and outward movement of the leg and foot. The Pyriformis Syndrome refers to a disorder where the piriformis muscle irritates the sciatic nerve. The Piriformis muscle runs diagonally, with the sciatic nerve running vertically beneath it. This can lead to pain and tingling in the buttocks and down the legs, worsening after sitting for extended periods, walking, or running.

Though medical science does not fully understand the causes of piriformis syndrome, there are many hypotheses. Doctors suspect that muscle spasms in the Piriformis due to irritation around the muscle could lead to the syndrome. Tightening or swelling of the muscle due to injury or spasms or bleeding in the region could also lead to developing the syndrome. This can lead to pain in the buttocks and if the sciatic nerve is affected, leading to pain, tingling, and numbness in the thigh, calf, and foot.

Diagnosis of the Piriformis syndrome can often be tricky. A patient may experience any of the following symptoms:

• Dull pain and aching in the buttocks.
• Pain in the calves, thighs, and feet.
• Pain during walking, running, or climbing stairs.
• Shooting pain after sitting for a prolonged period.
• Limited motion in the hip joint.

The doctor may request to see the patient’s history and perform a physical examination to diagnose it. Diagnosis is often made through the process of ruling out other possible causes for the patient’s symptoms.

X-rays and other imaging scans can also help the doctor better investigate the cause of the issue.

Physical therapy may be a possible treatment for the syndrome. Stretching exercises that concentrate on the piriformis muscle can help decrease the painful symptoms. Training of the hamstring and hip extensors will also aid in this process. Physical therapy will help the patient regain full range of motion in the body while also reducing pain and discomfort. Heat therapy and massage will also help alleviate the patient’s pain.

For more severe cases, medication may be necessary. The use of anti-inflammatory medication, such as NSAIDs, can help reduce inflammation in the Piriformis region. If the sciatic nerve pain is severe, steroids delivered straight to the area via injection may also be used. The use of local anesthetic and corticosteroids through injections may also help reduce pain and inflammation to ease physical therapy. Electrotherapy may also be a possible solution to the problem. Electrotherapy involves the application of electrical stimulation to the buttock region using a TENS or IFC unit. This can help reduce pain and muscle spasms in the piriformis region.

If you’re experiencing any of the symptoms described above for an extended period, please consult a doctor. Though not entirely curable, a doctor provides medication and therapy to alleviate the discomfort and improve your quality of life.