What is Piriformis Syndrome?

“Estimates suggest that about 5% of cases of sciatica (irritation of the sciatic nerve causing radiating pain from the back or buttock into the leg, calf and foot) are due to piriformis syndrome. It seems to be more common among women, although the reason for this is not known” [1].

Piriformis Syndrome is a relatively common, excruciating condition. It is generated when the sciatic nerve (which is located near the piriformis muscle), becomes irritated or compressed. So in order to understand this scenario, let’s take a brief look at the anatomy in question. This muscle links the bottommost vertebrae to the upper area of the leg whenever it travels a pathway known as the “sciatic notch.” The latter refers to an opening in our pelvic bone. – This enables the sciatic nerve to travel into the leg; and since the muscle and nerve are side by side, it is easy for problems to develop [1].

So What Signs & Symptoms Should I Look Out For?

Most piriformis syndrome patients complain of “sciatica.”- This can be described as a severe, sharp pain which radiates from the buttock or lower back, down the back of the leg, and on to the thigh, calf, and foot. And while disc herniation (“a slipped disc”) or hip bursitis, are frequently attributed to the cause of the syndrome, it is however, important to note that in many cases the root problem cannot be identified. To that end, having a consultation with an experience Pain Specialist is nonetheless essential, as there are various other important elements linked with piriformis syndrome, which have to be taken into consideration [1]. These include:

•Finding it difficult to put weight on the buttock on one side

•Piriformis muscle spasm

•Feeling pain in the piriformis muscle when the doctor is undertaking a rectal exam

•Feeling sciatica-type pain if the hip is rotated and moved outwards against resistance [1].

Putting a Spotlight on the Causes of Piriformis Syndrome

Thus far, the main recognised relate to:


•Abnormal spinal alignment (for example, scoliosis)

•Abnormal location or development of the sciatic nerve or piriformis muscle

•Different leg length

•Sitting for prolonged periods of time (particularly when someone keeps a thick wallet in a trouser pocket that is aligned directly behind the piriformis muscle)

•Foot issues such as Morton’s neuroma

•Unusually strenuous exercise

•Previous surgery on the hip [1].

Getting a Diagnosis

“The duration of piriformis syndrome is variable. Often, it is brief in duration, especially if proper treatment begins soon after symptoms appear” [1]

When you book an appointment with a Pain Specialist at the London Pain Clinic, he/she will review your medical history, and ask you about your symptoms, how long you have had them, and when they occur. (For this reason, it is a good idea to make a “Pain Diary”, which you can take with you). You specialist will then conduct a comprehensive examination, and discuss their findings in laymen’s terms. Further, you are encouraged to ask any questions, or discuss any concerns that you may have.