Updated: Feb 10
The piriformis is a flat, band-like muscle that is located in th buttocks near the top of the hip joint. It runs from the lower spine through the butt to the top of the thighs. The main function of the piriformis is to stabilize the hip joint and to lift and rotate the thigh away from the body. It is a vital muscle for lower body movement because it enables us to walk, shift our weight from one foot to another, and maintain balance. In essence, it is involved in almost every motion of the hips and legs. Piriformis syndrome occurs when the piriformis muscle presses on the sciatic nerve and results in inflammation. There may be numbness or pain down the back of the leg and it can happen on one or both sides of the body. The sciatic nerve most commonly runs underneath the piriformis and it travels from the spinal cord, through the buttocks, down the back of each leg to the feet. It is the longest, largest nerve in your body.
There are a few differences between piriformis syndrome and sciatica. Sciatica can be caused by a herniated disc or spinal stenosis (a narrowing of the spaces in the spine) and tend to affect the lower back and can travel down the buttocks to the leg. Piriformis syndrome only involves the piriformis muscle pressing on one area of the sciatic nerve in the buttock. It can feel like sciatica but in a more specific area. Some common signs and symptoms of piriformis syndrome include:
pain in the buttock
pain down the back of the hamstring
pain when sitting
pain when walking up stairs or inclines
decreased range of motion at the hip joint
Issues with the piriformis can result from climbing stairs, walking, or running with weak piriformis muscles, having tight muscles due to lack of physical activity, improper lifting technique, not warming up before physical activity or stretching properly afterward, overexercising, or sitting for long periods of time. Sometimes it can be due to abnormal anatomy. Symptoms of piriformis syndrome include:
Piriformis syndrome is usually treated with rest, home exercises to stretch or strengthen the piriformis, NSAIDs, massage, medications that relax the muscles, steroid injections, or even Botox injections. There are ways to prevent piriformis syndrome, the following are a few suggestions:
keep muscles healthy by exercising regularly
focus on good posture, especially when sitting, driving, or standing
lift things properly by bending your knees and squatting, keeping your back straight.
warm up before physical activity and stretch after
when sitting for long periods of time, take breaks by standing, walking, or stretching
Piriformis syndrome usually resolves fairly quickly after making lifestyle changes or simple treatments. Make sure to check with your doctor if symptoms persist or come back frequently.
Here are a few exercises and stretches that you can try for piriformis syndrome.
Knee-to-shoulder piriformis stretch: lie flat on your back with your legs straight. Lift your leg and bend your knee. With your opposite hand, pull your knee toward your opposite shoulder. Hold for 30 seconds. Do the stretch three times on each side, twice a day.
Ankle-over-knee piriformis stretch: lie flat on your back with both knees bent. Cross your Anke over your opposite knee. Grab the back of your thigh area behind your opposite knee. Gently pull your thigh straight toward your chest. Hold for 30 seconds. Do this on each side three times, twice a day.
Bridge: lie flat on your back with both knees bent. Contract your core and sift your hips off the floor. Squeeze your buttocks at the top of that motion. Slowly lower your hips to the floor. Repeat 10 times per set. Do 3 sets once or twice a day.
Side leg lifts: lie on your side with your ankles stacked on top of one another - rest your head on a pillow or on your arm. Tighten your top thigh and lift your leg slowly, keeping your knee locked. Slowly lower your leg to the original position. Repeat 10 times on both sides per set. Do 3 sets, once or twice a day.
Clamshell: lie on your side with your ankles stacked and your knees bent in an "L" shape. Keeping your heels together, lift your top knee as if you were opening a clamshell. Slowly lower your knee to the original position. Repeat 10 times on both sides per set. Do 3 sets, once or twice a day.
Some other ways to help relieve piriformis syndrome include:
Cardio exercises: aerobic exercise is good for th hip muscles. The best exercises for piriformis syndrome are walking or using an elliptical machine
Core exercises: A strong core will help support the piriformis. Planks and leg lifts are two examples.
Foam roller: a foam roller or a tennis ball can be used to release trigger points in the piriformis muscle.
Yoga and Pilates: The emphasis on flexibility and core strengthening are effective for helping treat piriformis syndrome.
Try these exercises and stretches in
the "Healthy Hips" video from the Kore Fitness Video Library