You’ve been noticing a pain in your buttocks that runs down your leg after some strenuous exercise and it has persisted for a few days. It could be a pinched sciatica nerve or its anatomical neighbor, an irritated piriformis muscle causing Piriformis Syndrome.

Tricky to diagnose, Piriformis Syndrome affects the narrow muscle by the sciatic nerve, located in the buttocks but can be felt also along the hip or leg and into the foot on a path along the sciatic nerve, a thick nerve running from the base of the spine through the gluteal muscles down the back of the legs. It’s usually the result of a flexibility issue, muscular imbalance, or foot dysfunction. Or, the cause may stem from:

  • Misalignment of the pelvic bones
  • A stuck joint which can restrict free muscle movement resulting in spasm, nerve pain or other nerve dysfunction
  • The result of a spinal problem such as a herniated disk

Risk Factors and How to Recognize it

So where is this little muscle and what are the risk factors for this pesky syndrome? The piriformis muscle lies deep in the buttocks, below the gluteus maximus muscle and attaches from the tailbone to the thigh bone. It functions to assist in rotating the hip and turning the leg and foot outward. In a small percentage of people, the sciatic nerve runs through the piriformis muscle, making it vulnerable to muscle spasms.

When it becomes tight it can spasm, become inflamed, and put pressure on the sciatic nerve, causing pain, tingling, or numbness. The inflammation may cause scar tissue and adhesions, which can trap and irritate the sciatic nerve. The most common symptoms are pain in the lower back and/or pain that radiates from the buttocks on down the leg.

The discomfort may get worse after sitting for long periods of time (because when we sit, we’re doing so directly on this muscle), climbing stairs, walking, running, performing weight-bearing activities, or externally rotating the hip for extended periods of time. This makes it a common malady of athletes – in particular, runners, weight lifters, and dancers. If you walk with your feet turned outward you may also be at risk for Piriformis Syndrome.

In fact, foot dysfunction is the most common cause of Piriformis Syndrome. It’s mostly a result of overpronating, the excessive rolling-in of the feet as a result of dropped arches.  This occurs when the piriformis muscle, which is designed to prevent the legs from collapsing inward during walking, has to work overtime to counter the overpronation of the leg. The result is that the piriformis muscle is fatigued from overwork.

Diagnosing Piriformis Syndrome

Evaluating your spine and pelvis and the related musculature by a chiropractic physician is the best way to determine if in fact you are experiencing Piriformis Syndrome. That includes direct palpation to detect tight and tender muscles and trigger points that cause referred pain down the leg. A resisted external or passive internal hip rotation that causes increased pain also helps point towards the syndrome.

Chiropractic Treatments

Treatments for Piriformis Syndrome include myofascial release (pressure applied to specific sensitive muscle areas) along with passive stretching, strengthening exercises, massage, spinal manipulation and/or K-Laser treatments. Posture and ergonomic advice such as core muscle exercises may be prescribed. If a fallen arch or another foot dysfunction is the problem, you may need a prescription for custom foot orthotics.

Piriformis Syndrome can literally be a pain in the butt. However, it is correctable with proper treatment and post-treatment care. Don’t delay when you’re having pain, tingling, or and numbness lasting more than a few days. Make an appointment with Dr. Michael Masterman of Chiropractic Physicians at Bitmore Park in Asheville today and move pain-free and with ease in all your activities.

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