To understand Piriformis Syndrome, it is necessary to have an understanding of some of the basic anatomy associated with this condition.

The Piriformis muscle is located in the buttocks area, deep underneath the gluteus maximus. The Piriformis is one of the muscles that helps to rotate the thigh bone outward, such as the movement of crossing the ankle over the knee. The muscle runs from the tail bone (the sacrum) and attaches at the hip bone (the greater trochanter of the femur). The sciatic nerve is a major nerve that begins in the low-back area and travels down the back of the thigh and continues down, branching off in the lower leg and foot. The sciatic nerve usually runs directly through the Piriformis muscle, although it may lie above or under the Piriformis.

The cause of Piriformis Syndrome is not entirely clear and may be a result of several different things. It is often associated with SI (sacroiliac) problems. Trauma, such as falling on the buttocks may incite the symptoms. Extended sitting can be a factor, as in the case of professional drivers who sit extensively in one position. Other problems, such as hip bursitis, back strains or gluteal tendonitis in the close vicinity of the Piriformis may bring on the condition.

Symptoms include pain and tenderness in the buttocks area. The problem may be on one or both sides. Sitting is often uncomfortable. Walking, running, and climbing or descending stairs is often painful. In some cases radiating pain may shoot down the back of the thigh and into the lower leg because of irritation to the sciatic nerve.

There are many treatment options for Piriformis Syndrome. Moist heat can help relieve and control pain. Ultrasound may be beneficial since it is a method of deep heating and the Piriformis is located very deep under other muscles. Certain therapeutic exercises may greatly help to recondition the muscle. There are several stretches for the muscle that can help relieve the tightness. Avoidance of, or at least decreasing, the irritating factors such as climbing stairs, sitting for extended periods of time, etc., is crucial. Manual techniques such as myofascial release or deep-tissue massage may also help. In severe cases, anti-inflammatory injections may be needed.

With proper treatment and follow through, this condition can be resolved. In some cases it will resolve quickly, while in others it may be a lengthy rehabilitation.