Piriformis Syndrome

Piriformis Syndrome is a condition that occurs when the piriformis muscle puts pressure on the sciatic nerve and causes pain. The pain can be very mild or extremely intense. It can also cause the tingly, numb, and electrical ‘pins and needles’ down the leg, following the sciatic nerve.

Piriformis Syndrome is usually diagnosed when no spinal or vertebrae damage has been observed. When there is no bulging, herniated, or degenerative discs but there is sciatic nerve pain, piriformis syndrome is one of the prime suspects.

Piriformis muscle pain can be caused by overuse, strain, inflammation, trigger points (muscle knots), or muscle tightness or weakness due to underuse or muscle imbalances. Diagnoses is often difficult, but it is certainly a possibility when there is sciatic nerve pain without damage to the discs or spine.

Inactive gluteus minimus and medius muscles can also lead to the development of piriformis syndrome. The gluteal muscles are important in both hip extension and in aiding the piriformis in rotating the leg. A major cause for inactive gluteal muscles is short and tight hip flexors. When someone sits with their hips flexed (sitting all day at work) this deprives the gluteals of activation, and the hamstrings, adductor magnus, and piriformis then have to perform extra roles they were not designed to do. This results in overuse of the piriformis.

Piriformis Stretches

There are several stretches you can do to stretch the piriformis muscle if it is tight. The videos below show some of the possible stretches that you could try. If any of these stretches cause pain you should ease off. Start slow and be careful. If it hurts, stop.

Seated Piriformis Stretch – Figure 4

Piriformis Stretch – Sciatica Super Stretch

When piriformis syndrome is caused by weak abductors combined with tight adductors, a highly effective and easy treatment includes stretching and strengthening these muscle groups. An exercise routine targeting the gluteus medius and hip adductor muscle groups can help with symptoms of piriformis syndrome in just a few days.

Treating Piriformis Trigger Points (Muscle Knots)

Another contributing factor to piriformis muscle pain is trigger points in the piriformis region. Getting to the piriformis trigger points can be a little tricky, but the videos below will show you how to find piriformis trigger points.

Locating and Treating Trigger Points (knots) In the Piriformis Muscle

Treating Piriformis Trigger Points

Gluteus Minimus & Piriformis Trigger Points

Save Yourself from Low Back Pain & Trigger Points

Trigger Point Home Treatment Kit

Who Is Susceptible to Piriformis Syndrome?

Runners, bicyclists and other athletes engaging in forward-moving activities are especially susceptible to developing piriformis syndrome if they don’t make sure they stretch and strengthen their muscles properly. When not balanced by the legs, repeated forward movements can lead to muscle imbalances, weak hip abductors and tight adductors. Thus, disproportionately weak hip abductors/gluteus medius muscles, mixed with tight adductor muscles, causes the piriformis muscle to shorten and contract. Upon a 40% increase in piriformis size, sciatic nerve impingement is inevitable. This means the abductors on the outside cannot work properly and strain is put on the piriformis.

Other Complications Related to Piriformis Syndrome

Piriformis muscle spasms can impinge more than just the sciatic nerve, it can also impinge upon the pudendal nerve. The pudendal nerve controls the muscles in the bladder and bowels. Symptoms of pudendal nerve entrapment include tingling and numbness in the groin and saddle areas, and can lead to urinary and fecal deposits in the underpants.

Another cause of piriformis syndrome is stiffness or hyper mobility of the sacroiliac joints (S.I. joints). The result is compensatory changes that result in shearing of the origins of the piriformis and maybe some of the gluteal muscles too, resulting not only in piriformis malfunction but in other low back and hip pain syndromes as well.

Piriformis syndrome can also be caused by overpronation of the foot. When a foot overpronates it causes the knee to turn, causing the piriformis to activate to prevent over-rotating the knee. This causes the piriformis to be overused and it gets extra tight, eventually leading to piriformis syndrome.

Piriformis syndrome can also be associated with a falling injury.