5 Important Facts About Piriformis Syndrome

If you have pain in your buttocks and legs that gets worse when you sit, you could have piriformis syndrome. This painful condition results when the piriformis muscle in your buttocks compresses your sciatic nerve.

Piriformis syndrome often gets misdiagnosed as sciatica, but these conditions need different treatments. At Anthony Echo, MD, with multiple offices in Houston, Texas, we offer specialized care for patients with this nerve condition.

Our nerve specialist expertly diagnoses your condition and creates a customized piriformis treatment plan for you. To help you better understand piriformis syndrome and how we can help, we’ve put together this helpful guide.

Take a moment to learn five important facts about piriformis syndrome and the treatments available.

1. Piriformis syndrome and sciatica are not the same

Piriformis syndrome and sciatica are two different health conditions, but they're often mistaken for one another. This is because piriformis syndrome can cause sciatica-like symptoms.

Both piriformis syndrome and sciatica affect the way your sciatic nerve functions. The sciatic nerve is the largest nerve in your body. It starts in your low back and covers your hips, buttocks, and legs.

When your spine puts pressure on a nerve root in your lower back — often due to a herniated disc — you can develop sciatic neuritis (sciatica). When your piriformis muscle in the buttocks puts pressure on your sciatic nerve, you can develop piriformis syndrome.

Since the two conditions have different underlying causes, it’s important to get an expert diagnosis.

2. Symptoms of piriformis syndrome may resemble sciatica

Because piriformis syndrome means your sciatic nerve is compressed, the symptoms may resemble sciatica. Although everyone is different, the most common piriformis syndrome symptoms include:

Acute tenderness or a dull ache in the buttock
Sciatica-like pain running down the leg
Pain that gets worse going uphill or up stairs
Pain that gets worse after sitting for an extended time
Reduced range of motion in your hip

Symptoms of piriformis syndrome typically get worse with physical activity or prolonged sitting and improve when you lie down on your back.

3. The cause of piriformis syndrome is unknown

Researchers are still investigating why some people get piriformis syndrome. They know it results when the piriformis muscle compresses the sciatic nerve, but they don’t know exactly why this happens.

When you injure or irritate your piriformis muscle, the muscle can spasm, swell, or get very tight. Any of these conditions can put pressure on the sciatic nerve beneath the muscle, triggering piriformis syndrome.

The conditions or factors most closely linked to the development of piriformis syndrome include:

Injury or trauma to the piriformis muscle (e.g., surgery, car accident, bad fall)
Running and other repetitive actions involving the legs
Sitting for prolonged periods
Lifting heavy objects
Having to climb lots of stairs

Researchers also suspect that overuse of the piriformis muscle from exercising too much could also be linked to the condition. Your risk increases if more than one of the factors above apply to you.

4. There is no definitive test for piriformis syndrome

There’s no single test that can tell you that you have piriformis syndrome. Seeing a doctor who specializes in nerve pain is key for treatment. Dr. Anthony Echo has specialized training in diagnosing and treating nerve conditions, and he can tell whether your spine or piriformis muscle is causing your symptoms.

Dr. Echo examines your back, hip, pelvis, and sacroiliac joint and checks the way you walk (gait), the length of your legs, and your posture. He may use other tests to check your reflexes and rule out other conditions.

5. Piriformis syndrome is treatable

Once you have an accurate diagnosis of piriformis syndrome, there are treatments that can help. Dr. Echo always begins treatment with the most conservative therapies, and progresses to more involved therapies as required.

Treatments for piriformis syndrome depend on your symptoms, current health, and medical history. Your personalized piriformis treatment plan may include one or more of the following:

Heat and ice therapy
Over-the-counter or prescription medications
Physical therapy
Therapeutic massage
Botox® injections
Corticosteroid injections
Transcutaneous electrical nerve stimulation
Surgery to decompress the nerve

Dr. Echo recommends surgery when your symptoms persist despite other treatments. The surgery involves making an incision in the piriformis muscle to release it and the tendon causing nerve compression.

To schedule a consultation about piriformis syndrome or for more information, contact the Anthony Echo, MD, office in Houston, Texas, nearest you. You can also request an appointment online.