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Piriformis Syndrome Specialist

Anthony Echo, MD -  - Plastic Surgeon

Anthony Echo, MD

Plastic Surgeon & Reconstructive Surgeon located in Houston, TX

Piriformis syndrome may begin as pain in your buttocks, but it’s better known for causing intense, radiating leg pain and other symptoms of sciatica. Anthony Echo, MD, understands the severity of your pain and creates a treatment plan that gets you back into action, including surgery to decompress the nerve. Dr. Echo has advanced training in peripheral nerve surgery and extensive experience performing minimally invasive procedures to relieve piriformis syndrome pain. If you need help with chronic pain, schedule an appointment online or call one of the offices in Houston Methodist Hospital or the Willowbrook neighborhood of Houston, Texas.

Piriformis Syndrome Q&A


What is piriformis syndrome?

Piriformis syndrome occurs when the sciatic nerve is compressed by the piriformis muscle in the buttocks. The sciatic nerve is the largest nerve in the body innervates the muscle of the hamstrings in the thigh and all of the muscles below the knee.

On its way through your buttocks, the sciatic nerve runs underneath the piriformis muscle. In some people, it can run through the muscle. However, in most cases, the piriformis tendon is thickened and creates a tight band over the nerve causing severe buttock and leg pain. This pain can mimic sciatica, which is due to a spine problem.

Patients who have persistent pain despite being evaluated for a spinal problem might be suffering from piriformis syndrome.  

There are several causes for this syndrome including: 

  • Overuse injuries
  • Muscle irritation
  • Blunt trauma to the buttocks
  • Muscle tightening or swelling
  • Bleeding in the area of the muscle

What symptoms develop due to piriformis syndrome?

Piriformis syndrome causes pain in your buttocks, especially when you sit for a long time. It can also affect your hip movement.

When the sciatic nerve is compressed, whether by the piriformis muscle or due to a spinal condition, it causes a cluster of symptoms called sciatica. 

You may experience one or more of the following:

  • Sharp, electric-shock pain radiating down your leg and into your foot
  • Numbness and tingling in your leg and foot
  • Muscle weakness in the leg
  • Increased pain after sitting
  • Pain when climbing stairs

Though the severity of your sciatica symptoms may vary, most patients struggle with severe pain that becomes debilitating.

How is piriformis syndrome treated?

Treatment for piriformis syndrome begins with conservative options such as ice packs, heat therapy, anti-inflammatory medications, and corticosteroid injections. 

Physical therapy that includes stretching exercises, range-of-motion exercises, and therapeutic massage also helps to relax the muscle and release the nerve.

If your symptoms continue, you may get pain relief from transcutaneous electrical nerve stimulation. Dr. Echo may recommend Botox® injections to stop muscle contractions and relieve your symptoms.

When you continue to have symptoms despite conservative therapies, Dr. Echo may recommend surgery to decompress the nerve. He often performs piriformis release surgery through an incision on the buttock to release the muscle and tendon to decompress the nerve.

It takes a few months to heal after piriformis syndrome surgery.

During your recovery, you may need physical therapy to prevent muscle spasms, and promote healing. 

When you need peripheral nerve surgery for piriformis syndrome, call Anthony Echo, MD, or book an appointment online.