Piriformis syndrome results from compression of the sciatic nerve as it passes underneath a muscle in your buttock called the piriformis. Your piriformis muscle attaches from the lowest part of your spine (sacrum) and travels across to your hip. The muscle helps to rotate your leg outward when it contracts. In most people, the sciatic nerve travels deep to the piriformis muscle. When your piriformis muscle is irritated or goes into spasm, it may cause a painful compression of your sciatic nerve. Approximately ¼ of the population is more likely to suffer from piriformis syndrome because their sciatic nerve passes through the muscle.
Piriformis syndrome may begin suddenly as a result of an injury or may develop slowly from repeated irritation. Common causes include: a fall onto the buttocks, catching oneself from a “near fall,” strains, long distance walking, stair climbing or sitting on the edge of a hard surface or wallet. In many cases, a specific triggering event cannot be pinpointed. The condition is most common in 40-60 year olds and affects women more often than men.
Symptoms of piriformis syndrome include pain, numbness or tingling that begins in your buttock and radiates along the course of your sciatic nerve toward your foot. Symptoms often increase when you are sitting or standing in one position for longer than 15-20 minutes. Changing positions may help. You may notice that your symptoms increase when you walk, run, climb stairs, ride in a car, sit cross-legged or get up from a chair.
Sciatic arising from piriformis syndrome is one of the most treatable varieties and generally is relieved by the type of treatment provided in this office. You may find relief by applying an ice pack to your buttock for 15-20 minutes at a time, several times throughout the day. The home stretching exercises described in this handout are an important part of your recovery.