Piriformis Syndrome – A Literal Pain in the Butt

Spine, Lower Back, Hip, Blog, / By Winsen Citra

A friend of mine came to me a while ago complaining about having pain that radiates down her right leg. She was at her wits’ end because of her pain. Sitting for a long time and focusing on work was impossible. She has had her condition checked out and had an MRI scan which showed that there was nothing wrong with her back. When she came to me for advice, she wanted to know if there was anything that she could do.

After examining her, I found out that what she had was actually something called a “pseudo-sciatica”, a condition also known as piriformis syndrome. It presents almost like a sciatic pain that is caused by a bulging disc in the lower back. Therefore, this diagnosis is often missed and treatment for sciatica don’t usually work. 

What is Piriformis Syndrome?

Piriformis Syndrome
Figure 1. Piriformis Syndrome

The piriformis muscle is located quite deep underneath your gluteal muscles.It goes from your tail bone and attaches itself to the top part of your thigh bone. It is not a big muscle and what it does is rotate your hip outwards or inwards depending on your position.

Piriformis syndrome is a disorder that occurs when your sciatic nerve is compressed and/or irritated by the piriformis muscle as it passes deeply through your buttock, resulting in pain. This pain is very similar in presentation to the sciatic nerve pain that is caused by a bulging disc in the lower back.

Symptoms may start as an intense, burning pain deep in the buttocks. The pain gets worse during activities that cause the piriformis muscle to press against the sciatic nerve, such as sitting, walking up stairs, or running.

What Causes Piriformis Syndrome?

Piriformis Syndrome is caused by overwork to the muscle. This is usually due to:

  • Some disfunction at the hip joint or sacroiliac joint
  • Poor hip stability
  • Flat footedness which cause overpronating gait


If you are seeing a physiotherapist, they will determine the root cause of your condition and treat you accordingly. Usually the treatment will involve mobilisation, stretching program, dry-needling, and hip stabilisation exercises.

Here are some things that you can do at home:

  • Learn the self massage technique that we have included in a video below
  • Temporarily stop doing activities that cause pain, such as running or bicycling.
  • If you have to sit for a long period of time, take regular breaks to walk around and stretch.
  • Do exercises to stretch the piriformis muscle

Thank you for reading. We hope this has been useful for you. If you have any concerns about your condition or a question for us, feel free to contact us. Follow us on our blog and YouTube channel for more useful tips for various condition.