Piriformis Syndrome

At Long Island Spine Rehabilitation Medicine, our doctors frequently see patients with severe sciatic pain. For some of these patients, sciatic pain — pain that radiates from the back or buttock into the leg — is caused by the compression of the sciatic nerve by the piriformis muscle located deep in the buttock. The job of the piriformis muscle is to stabilize the pelvis during motion, especially during running.

Since our physiatrists focus on nonsurgically alleviating pain and restoring function, we are well-prepared to diagnose and treat piriformis syndrome. If you are experiencing pain along your sciatic nerve, contact our offices for prompt diagnosis and effective treatment. If treated early, piriformis syndrome symptoms will usually disappear within days or weeks. Without treatment, however, it may become a chronic problem.

Symptoms of Piriformis Syndrome

The sharp, intrusive pain of piriformis syndrome may extend from the buttock all the way down to the foot, and can sometimes be disabling. Symptoms that may help to distinguish it from other sciatic pain include:

  • Sudden, severe pain in your lower back or leg
  • Sudden weakness or numbness in your back or leg
  • Difficulty sitting or putting weight on the affected buttock
  • Muscle spasm of the piriformis muscle itself
  • Pain in the piriformis muscle during a rectal exam
  • Radiating pain when the affected hip is rotated outward
  • Frequent trips or falls because of pain or numbness in the leg
  • Problems controlling your bowels or bladder (in severe cases)
  • Trouble lifting your foot off the floor.

Causes of Piriformis Syndrome

There are a number of structural and functional reasons for developing piriformis syndrome. These include:

  • Injury to the region
  • Abnormal congenital location of the piriformis muscle or sciatic nerve
  • Abnormal spine alignment (such as scoliosis) or pelvic misalignment
  • Leg-length discrepancy
  • An occupation or lifestyle that involves prolonged sitting
  • Carrying a thick wallet in a pocket directly behind the piriformis muscle
  • Having had hip surgery
  • Engaging in unusually vigorous exercise
  • Foot problems, including Morton’s neuroma.
  • Inadequate warm-up before activity, especially running

Though in many cases, no specific cause for piriformis syndrome can be identified, the condition is significantly more prevalent in women due to structural gender differences.

Diagnosis of Piriformis Syndrome

Fortunately for our patients, the doctors at Long Island Spine Rehabilitation Medicine have a well-earned reputation for excellent diagnostic skills. This is important since piriformis syndrome is one of many ailments that can be tricky to diagnose. It can, for example, be easily confused with hip bursitis, hamstring injury, or disc herniation. This is particularly true because this condition can only be diagnosed by careful physical examination. There is no imaging test or blood test for the disorder.

Treatment of Piriformis Syndrome

Because our approach is holistic and our goal is always to make you feel better as soon as possible, we often use a combination of traditional and complementary therapies which may include:

  • Customized physical therapy, with an emphasis on stretching and strengthening muscles surrounding the hips and the piriformis muscle itself
  • Exercises to improve posture, gait, and mobility (especially of the hip abductors and sacroiliac joints)
  • Over-the-counter medications for pain relief and/or prescribed muscle relaxants or anti-inflammatory drugs
  • Application of heat and ice as needed
  • Acupuncture
  • Ultrasound-guided platelet-rich plasma injection*
  • Ultrasound-guided trigger point injections to the piriformis muscle or to neighboring gluteal muscles
  • Testing for leg-length discrepancy and muscle-strength imbalances
  • Prescribing orthotics if necessary

* A clinical trial by the NIH found that ultrasound-guided PRP injections provided improvement in both pain and functional status in patients with piriformis syndrome.

Contact Our Experienced Piriformis Syndrome Doctors Today

If you have troubling symptoms that may be signs of piriformis syndrome or some related disorder, do yourself a favor and get in touch with our offices. We will provide you with effective, empathic care and get you up and running as quickly as possible. Simply enduring sciatic pain may put you at risk of permanent damage. Contact us now so we can make you more comfortable and help you heal.