Piriformis Syndrome

Piriformis syndrome is a term used to describe pain and irritation around the piriformis muscle, a small muscle located deep in the buttock. Because the sciatic nerve runs very close to the piriformis muscle, irritation in this area can sometimes cause pain, tingling or other symptoms that travel into the leg.

The symptoms can feel very similar to sciatica, which is why piriformis-related pain is sometimes mistaken for a problem originating in the lower back.

The piriformis is a small, deep muscle in the buttock.

It runs from the sacrum at the base of the spine to the upper part of the thigh bone (femur).

Its main job is to help move and stabilise the hip, particularly during activities such as walking, climbing stairs and changing direction.

Why can it cause leg pain?

The sciatic nerve passes close to the piriformis muscle. In some people, irritation or increased tension around the muscle can affect the nearby nerve and produce symptoms beyond the buttock.

This is why pain may be felt in:

The buttock → back of the thigh → sometimes further down the leg

Symptoms vary from person to person, but common complaints include:

Deep pain or aching in the buttock

Pain that may travel into the back of the thigh or leg

Tingling or numbness

Increased discomfort after prolonged sitting

Pain when standing for long periods

Discomfort when walking or climbing stairs

Difficulty getting comfortable when sitting

Symptoms that may be worse on one side

Not everyone experiences the same symptoms, and pain extending into the leg does not automatically mean that the piriformis is the cause.

Piriformis-related symptoms are not limited to sports.

Everyday activities and habits can also contribute.

Prolonged sitting: Long periods at a desk, driving or travelling can place sustained stress on the buttock and hip.

Poor movement habits: Repeatedly using one side of the body or moving with altered mechanics may increase strain around the hip.

Carrying heavy bags: Frequently carrying a heavy bag on one shoulder can change the way the body loads the pelvis and hips.

Sleeping: in one position Remaining on one side for long periods may aggravate an already sensitive area.

Repetitive movements: Repeated bending, lifting, squatting or other movements can irritate the muscles around the hip.

Activities that repeatedly load the hips and buttocks can sometimes aggravate symptoms.

Running

Cycling

Hill walking or hill running

Sprinting

Gym and weight training

Repetitive lower-body exercises

Activities involving repeated twisting or changes of direction

This does not mean that exercise is harmful. In many cases, the goal is to modify the activity rather than stop moving completely.

A gradual return to normal activity is usually more helpful than prolonged rest.

These two conditions can feel very similar.

Piriformis-related pain is associated with structures around the piriformis muscle and the nearby sciatic nerve.

Sciatica generally refers to pain caused by irritation or compression of a nerve root in the lower back.

There is no single way to guarantee that piriformis pain will not occur, but some simple habits may reduce the risk of aggravation.

Keep moving

Avoid sitting for long uninterrupted periods. Stand up, walk around and change position regularly.

Build hip and core strength

Strong, well-coordinated muscles can help the hips and pelvis handle everyday loads more effectively.

Improve movement habits

Consider how you sit, stand, lift, walk and exercise.

Vary your activities

Repeating exactly the same movement for long periods can overload tissues. Variation gives the body a chance to recover.

Increase exercise gradually

Suddenly increasing running, cycling, gym work or other activities may place more load on tissues than they are used to handling.

Treatment depends on what is actually causing the symptoms.

A management plan may include a combination of:

Hands-on care

Appropriate manual techniques may be used to address painful or restricted areas around the spine, pelvis, hip and surrounding soft tissues.

Exercises

Specific exercises may be used to improve mobility, strength, coordination and tolerance to everyday activity.

Movement and posture advice

Small changes to sitting, working, lifting and exercise habits can sometimes make a significant difference.

Activity modification

You may need to temporarily reduce or adapt activities that are aggravating your symptoms while maintaining as much comfortable movement as possible.

The aim is not simply to reduce pain, but to help you move more comfortably and return to normal activities.

You don’t have to simply live with pain and hope it goes away. If your pain has not started to improve after 2–3 days of rest, simple pain relief or reducing the activities that aggravate it, it may be worth having it assessed. Getting the right treatment early can help you return to normal activities sooner, prevent the problem from becoming more persistent, and reduce the risk of compensatory strain and further irritation.

It is worth having persistent or troublesome buttock and leg pain assessed, particularly when:

It is worth having persistent or troublesome buttock and leg pain assessed, particularly when:

Symptoms are not improving

Pain keeps returning

Symptoms are becoming worse

Numbness or tingling is present

You are developing weakness

Walking or normal daily activities are becoming difficult

Pain is interfering with sleep

You are unsure whether the problem is coming from your back, hip or buttock

Seek urgent medical attention:

Severe or rapidly progressing weakness, loss of bladder or bowel control, numbness around the groin or inner thighs, or other sudden neurological symptoms require urgent medical assessment.

Whether your symptoms started after sitting at a desk, a long car journey, exercise, repetitive work or for no obvious reason, you do not have to simply put up with persistent buttock and leg pain.

At Aston Manor Chiropractors, we can assess your symptoms and movement and discuss an appropriate plan to help you manage your pain and get back to the activities that matter to you.

Start Your Recovery

WhatsApp Us

Call Us

Our office hours are 8:00-17:00, Monday to Friday

Join us on our WhatsApp channel for daily tips and information about how to live a healthier and pain-free life.

Join our WhatsApp channel here

This page is provided for general patient education and is not intended to replace an individual medical assessment or diagnosis. Buttock and leg pain can have several different causes. An appropriate healthcare professional should assess persistent, severe or worsening symptoms.