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Piriformis Syndrome

The piriformis muscle is a pyramid-shaped muscle that starts from the lowest point of your spine (the sacrum), travels below the sacroiliac joint (where the sacrum connects to the pelvis) and posterior ileum (largest pelvis bone), and attaches to the greater trochanter of the femur (the top of the thigh bone).

The piriformis muscle allows you to rotate your leg outward and helps your stability when walking. The sciatic nerve, a large nerve that runs down the back of your leg, often runs under this muscle. In a small number of patients, the sciatic nerve may run through the muscle, making it particularly susceptible to compression when the muscle is inflamed.

Symptoms

Patients with piriformis syndrome often suffer from buttock pain that may radiate down the leg. The pain is often worse with prolonged sitting or rising from a sitting position. 

Possible Causes

Piriformis syndrome is thought to be due to the inflammation, irritation or compression of the sciatic nerve by the piriformis muscle. The piriformis muscle may be inflamed from trauma or overuse. Risk factors include muscle spasms, leg length discrepancies, obesity, and anatomic abnormalities of the piriformis muscle or sciatic nerve. 

Treatment

We will work with you to determine the best treatment plan for your unique case based on an accurate diagnosis. One of our physicians will conduct an initial evaluation that includes a thorough review of your history, a complete examination, and review or acquisition of appropriate imaging.

Conservative treatment of piriformis syndrome includes analgesics, muscle relaxants, anti-inflammatory medications or physical therapy. Minimally invasive procedures such as steroid injections into the piriformis muscle joint may provide relief.