rectangle logo

Piriformis Syndrome


Piriformis Syndrome

Piriformis Syndrome is a condition that causes pain in the buttocks and hip area. Yes, we said it, PAIN IN THE BUTT! This condition stems from the compression or irritation of the sciatic nerve by the piriformis muscle. This muscle is located in the hip region that helps to rotate the hip and stabilize the joint.

When the muscle tightens, it can put pressure on the sciatic nerve, causing pain that radiates down the leg and into the foot. Moreover, the pain can range from a dull ache to a sharp burning sensation. Symptoms that accompany the pain include numbness, tingling, and weakness.

On this page, we will detail the clinical presentation of piriformis syndrome as well as the causes of this disease. We will also decipher the scientific research that investigates the effects of chiropractic care in the management of piriformis syndrome.

What are the causes of piriformis syndrome?

There are several causes and risk factors of piriformis syndrome, including:

Traumatic injuries

A direct blow to the hip or buttock area can cause muscle spasms and trigger the development of piriformis syndrome.

Overuse of the muscles

Overuse of the piriformis muscle from prolonged sitting or repetitive motions (e.g., running, cycling) can cause the muscle to spasm and irritate the sciatic nerve.

Tightened muscles

Weakness in other muscles of the pelvis can cause the piriformis muscle to overcompensate and become tight, ultimately precipitating piriformis syndrome.

Low-grade inflammation

Inflammation in the hip irritates the piriformis muscle and compresses the sciatic nerve.

Degeneration of the spine

Degenerative changes in the spine, such as spinal stenosis or herniated discs, can put pressure on the sciatic nerve and compress it.

Structural abnormalities

Structural abnormalities triggered by a tilted pelvis and a difference in leg length put extra stress on the piriformis muscle.

Various medical conditions

Other medical conditions, such as rheumatoid arthritis, diabetes, or spinal cord injuries, can increase the risk of developing Piriformis Syndrome.

What are the signs and symptoms of piriformis syndrome?

Every patient with piriformis syndrome presents with various symptoms. However, the vast majority of patients will experience pain.

Here is a detailed list of the signs and symptoms of piriformis syndrome:

Buttock pain

The most common symptom of piriformis syndrome is a pain in the buttocks.

Sciatica-like symptoms

Pain that radiates down the back of the leg and into the foot is often referred to as sciatic pain. Moreover, this symptom is also common in patients with piriformis syndrome.

Learn more about sciatica by clicking on this link (insert a link).

Decreased range of motion

The pain and muscle tightness associated with piriformis syndrome can limit mobility and flexibility, diminishing your range of motion in the articulations of your hip and pelvis.

Muscle spasms

The piriformis muscle may become too tight, causing pain and discomfort in the hip area.

Difficulty sitting

Prolonged sitting can exacerbate the pain and discomfort associated with piriformis syndrome.


Stiffness in the hip may be present, especially after periods of inactivity.


Weakness in the hip may be present, especially when walking or performing physical activities.

The complications of piriformis syndrome

The complications of piriformis syndrome may occur when the condition is left untreated. Unfortunately, some of these symptoms are severe enough to interfere with your quality of life.

Make sure to consult with a chiropractor before any of these complications develop:

Chronic pain

The pain associated with piriformis syndrome can become chronic, leading to ongoing discomfort and disrupted quality of life.

Decreased mobility

Prolonged stiffness and decreased range of motion in the hip make it difficult to perform day-to-day tasks and move around comfortably.

Muscle imbalances

The pain and tightness of piriformis syndrome lead to muscle imbalances in the hip, which can affect overall stability and increase the risk of injury.

Sciatic nerve damage

The compression of the sciatic nerve by the piriformis muscle might damage the nerves in the long run. Sadly, this might precipitate permanent weakness or numbness in the hip muscles.

Increased risk of injury

The weakness and instability associated with this condition increase the risk of injury, especially during strenuous activities.

Decreased work performance

The symptoms of piriformis syndrome can also impact work performance, making it difficult to perform job tasks. Additionally, you may need to take a lot of days off when the pain is insupportable.

Weight gain

Decreased mobility will lower your energy expenditure and place you in a mandatory sedentary lifestyle. After a few weeks or months in this situation, you will most likely put on a few pounds.

Increased healthcare costs

The cost of treating piriformis syndrome, including medical evaluations, physical therapy, and pain management, can add up and lead to increased healthcare costs over time.

Chiropractic care for the management of piriformis syndrome (evidence-based)

Studies showed that chiropractic care with other treatments, such as exercise and physical therapy, can be effective in reducing the symptoms of piriformis syndrome. For instance, a 2012 case study of an U.S. army veteran with piriformis syndrome who received chiropractic care as part of his treatment plan. Results showed that he reported significant improvement in his symptoms after a few treatment sessions.

Another study found that spinal manipulative therapy is effective in reducing pain and improving function in patients with piriformis syndrome. The review included 129 patients. Researchers concluded that most patients experienced significant pain relief after just a few weeks of treatment.

Aside from these studies, there are also many case reports and anecdotal evidence that support the effectiveness of chiropractic care for the management of piriformis syndrome.

Takeaway message

The symptoms of piriformis syndrome can be debilitating, especially when left untreated. Opting for pharmacological drugs may make things worse. Luckily, chiropractic care is a safe, effective approach that mitigates the symptoms of piriformis syndrome.

We hope that this article managed to highlight the role of chiropractors in the treatment of piriformis syndrome.

Reach out to us via the contact us page (insert link) for tailored advice about how our clinic can help you with piriformis syndrome.