Piriformis syndrome is a problem that can happen when a muscle deep in the buttock presses on a nerve. This muscle is called the piriformis muscle and the nerve is called the sciatic nerve. You use the piriformis muscle to turn your thigh outward. The sciatic nerve passes through or next to the piriformis muscle as it travels from your back down into your leg. Pressure on the sciatic nerve can cause pain or tingling in the back of the hip and in the leg.
What is the cause?
Spasm, or tightening, of the piriformis muscle can put pressure on the nerve. This may happen, for example, if you have been doing a lot of downhill running, kicking, or sitting on hard surfaces.
What are the symptoms?
The main symptom is pain deep in your buttock. The pain usually goes down across your lower thigh. You may feel tingling or numbness in the back of your hip and leg. You may have more pain when you turn your thigh outward, like when you sit cross-legged.
How is it diagnosed?
Your healthcare provider will ask about your symptoms, activities, and medical history and examine you. Tests may include:
CT scan, which uses X-rays and a computer to show detailed pictures of the back
MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the muscles and nerves
Nerve conduction studies, which use small wires that are taped to your skin to send mild electric signals and check how well your nerves work to carry signals to your muscles
How is it treated?
You will need to change or stop doing the activities that cause pain. Your healthcare provider may recommend stretching and strengthening exercises and other types of physical therapy to help you heal.
A mild injury may heal in a few weeks, but a severe injury may take 6 weeks or longer.
How can I help take care of myself?
To help relieve swelling and pain:
Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the area every 3 to 4 hours for up to 20 minutes at a time.
Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you donâ€™t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
Moist heat may help relax your muscles and make it easier to move your hip and leg. Put moist heat on the area for 10 to 15 minutes at a time before you do warm-up and stretching exercises. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or a hot shower. Donâ€™t use heat if you have swelling.
Follow your healthcare provider’s instructions, including any exercises recommended by your provider. Ask your provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
How can I help prevent piriformis syndrome?
Warm-up exercises and stretching before activities can help prevent this problem.
Follow safety rules and use any protective equipment recommended for your work or sport.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-08 Last reviewed: 2014-12-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Piriformis Syndrome: References
DeLee, Jesse C., David Drez, and Mark D. Miller, Orthopaedic Sports Medicine: Principles and Practice, Saunders; 3rd ed. 2009.
Frontera, Walter R., Julie K. Silver, and Thomas D. Rizzo, Jr. Essentials of Physical Medicine and Rehabilitation, Saunders, 2nd. Ed. 2008.
Greene, Walter B., M.D., Griffin, Letha Y. (Ed), Essentials of Musculoskeletal Care, 4th ed. Amer Academy of Orthopaedic. 2010.
Kisner, Carol, and Lynn Colby, Therapeutic Exercise: Foundations and Techniques, F. A. Davis Company; 6th ed, 2012.
Mellion, Morris B., W. Michael Walsh, Christopher Madden, Margot Putukian, and Guy L. Shelton, The Team Physician’s Handbook, Hanley & Belfus; 3 ed, 2001.
Micheli, Lyle J. and Mark Jenkins, The Sports Medicine Bible: Prevent, Detect, and Treat Your Sports Injuries Through the Latest Medical Techniques, HarperCollins, 1995.