Also known as: Pseudosciatica, Wallet sciatica, Hip socket neuropathy, Pelvic outlet syndrome or Low back pain - piriformis
- Sitting for long periods
- Over exercising
- Running, walking, or doing other repetitive activities
- Playing sports
- Climbing stairs
- Lifting heavy objects
- Car accidents
- Sudden twisting of the hip
- Penetrating wounds
- Tenderness or a dull ache in the buttock
- Tingling or numbness in the buttock and along the back of the leg
- Difficulty sitting
- Pain from sitting that grows worse as you continue to sit
- Pain that gets worse with activity
- Lower body pain that is so severe it becomes disabling
- Do a physical exam
- Ask about your symptoms and recent activities
- Take your medical history
- Avoid activities that cause pain, such as biking or running. You can resume these activities after the pain is gone.
- Be sure to use proper form and equipment when doing sports or other physical activities.
- Use pain medicines such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol) for pain.
- Try ice and heat. Use an ice pack for 15 to 20 minutes every few hours. Wrap the ice pack in a towel to protect your skin. Alternate the cold pack with a heating pad. Don't use a heating pad for longer than 20 minutes at a time.
- Follow your provider's instructions for doing special stretches. Stretches and exercises can relax and strengthen the piriformis muscle.
- Use proper posture when sitting, standing, or driving. Sit up straight and don't slump.
- Get regular exercise.
- Avoid running or exercising on hills or uneven surfaces.
- Warm up before exercising. Then gradually increase the intensity of your activity.
- If something causes you pain, stop doing it. Don't push through the pain. Rest until the pain passes.
- Don't sit or lie down for long periods in positions that put extra pressure on your hips.
- Pain that lasts longer than a few weeks
- Pain that starts after you have been injured in an accident
- You have sudden severe pain in your lower back or legs, along with muscle weakness or numbness
- You have difficulty controlling your foot and find yourself tripping over it when you walk
- You can't control your bowels or bladder
Piriformis syndrome is pain and numbness in your buttocks and down the back of your leg. It occurs when the piriformis muscle in the buttocks presses on the sciatic nerve.
The syndrome, which affects more women than men, is uncommon. But when it occurs, it is a major cause of sciatica.
The piriformis muscle is involved in nearly every move you make, from walking to shifting weight from one foot to the other. Beneath the muscle is the sciatic nerve. This nerve runs from your lower spine all the way down the back of your leg to your foot.
Injuring or irritating the piriformis muscle can cause muscle spasms.The muscle may also swell or tighten from the spasms. This puts pressure on the nerve beneath it, causing pain.
Overuse can irritate or injure the muscle. Muscle spasms may come from:
Trauma can also cause muscle irritation and damage. This may be caused by:
Sciatica is the main symptom of piriformis syndrome. Other symptoms include:
The pain usually affects just one side of the lower body. But it can also occur on both sides at the same time.
Exams and Tests
Your health care provider will:
During the exam, your provider may put you through a range of movements. The point is to see if and where they cause pain.
In some cases, you may not need medical treatment. The following self-care tips can help relieve pain.
Your provider may prescribe muscle relaxants. This will relax the muscle so you can exercise and stretch it. Injections of steroid medicines into the area may also help.
For more severe pain, your provider may recommend electrotherapy such as TENS. This treatment uses electrical stimulation to reduce pain and stop muscle spasms.
As a last resort, your provider may recommend surgery to cut the muscle and relieve pressure on the nerve.
To prevent future pain:
When to Contact a Medical Professional
Call your health care provider if you have:
Get medical help immediately if:
Joseph RL, Alleva JT, Hudgins TH. Piriformis syndrome. In: Frontera: Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 58.
- Review date:
- December 07, 2016
- Reviewed by:
- C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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