Piriformis Syndrome: Here’s why it’s a Real Pain in “That” Area

By May 17, 2021Blog
Piriformis Syndrome: Here’s why it’s a Real Pain in “That” Area

Do you experience a dull pain or ache in your buttocks when you sit down for an extended period of time or when walking upstairs? Does your hip area feel stiff with a limited range of motion? Does the pain occasionally radiate down your leg? If so, the chances are that you are battling piriformis syndrome.

The piriformis muscle is located deep in your buttock area that connects your femurs (thigh bone) at the hip to the tailbone and your lower back. It runs diagonally upward from your hip, just below the gluteal.

When piriformis muscle tightens up or spasms, you are likely to experience pain in your buttocks. This condition is commonly known as piriformis syndrome. In addition to the pain in your butt area, the sciatic nerve may become irritated or inflamed. If this happens, you may experience the symptoms of sciatica, such as pain down the back of your leg, foot, and leg. Physiotherapy clinic in Ajax provides a comprehensive treatment plan, so you might want to consider contacting us before panicking about the pain you may experience.  Before we explain how to treat piriformis syndrome, let’s find out what causes it.

Causes of piriformis syndrome

Here are some of the reasons your piriformis muscle might be in spasm and leading to dull pain in your buttocks areas.

You have a fat wallet

One of the common causes of piriformis syndrome is a fat wallet. Most men put thick wallets in the pants’ back pockets. Being creatures of habits, men put their wallets in the same pocket daily. When they sit on the thick wallet, it puts excessive pressure on the piriformis muscle and, in the worst-case scenario, shifts the pelvis. If your work involves sitting for an extended period, this may aggravate piriformis muscle problems. This may eventually cause piriformis syndrome. So, one way of treating pain in the buttocks is to put your fat wallet elsewhere.

Fall on your buttocks

Suppose you fell on your buttock recently; you might have bruised your piriformis muscle or suffered damage to the muscle’s structure. If this damage doesn’t heal appropriately, it can result in scar tissue. This can cause spasms in your piriformis muscle.

Also, a fall to the butt can slightly shift the bones in the pelvis, including the tailbone. This shift can exert unnecessary strain on your piriformis muscle because it gets forced out of its optimal length to accommodate the new resting length position. Your piriformis muscle will react to these changes by developing trigger points or spasms.

Improper sitting

For some people, sitting for extended periods can tighten the piriformis. Improper sitting could exert more pressure on one sit bone or buttock than the other side. Shifting your body to one side or crossing your legs repeatedly can tighten or put more pressure on your piriformis muscle, and eventually you end up with pain in the buttock.

Hip dysfunction

Suppose you are experiencing pain or discomfort in your sacroiliac joint or hip; your piriformis muscle might be forced to compensate or overwork to help you manage or cope with the pain or discomfort. Limping can also strain your piriformis muscle. Correcting your SIJ dysfunction or hip problem and improving the overall muscle control or balance can alleviate the excessive strain on your piriformis muscle and let it work the way it’s supposed to.

Treatment for piriformis syndrome

If you believe you have piriformis syndrome, it is time to seek medical help from a skilled and experienced medical professional, like a chiropractor, physiotherapist, or sport medical expert. He or she will determine the root cause of the pain in your buttocks and whether or not you are suffering from piriformis syndrome.

After a correct diagnosis, your physiotherapist or chiropractor will decide on the right treatment option and create a plan that includes acupuncture or manual therapy and muscle strengthening exercises. In addition to alleviating pain, physiotherapy can help strengthen your piriformis muscle and prevent pain from recurring.

Manual therapy

Your chiropractor or physiotherapist may help you work towards releasing your piriformis muscle or even mobilizing the joints that may be contributing to the tight piriformis muscle and discomfort. Some of the muscles and joints that play a crucial role in reducing pain in your butt include lower back joints, SIJ, or hip muscles and joints.


Also known as dry needling, medical acupuncture can be used to effectively stimulate the piriformis muscle and restore optimal nerve conduction to this muscle. Dry needling can also help to stimulate the sciatic nerves and improve blood flow to the nerves, bringing it back to better health. Generally, acupuncture can minimize the tension in the piriformis muscle and tight hip muscles that could be releasing tension on your nerves.


Your physiotherapist will also determine the specific muscles that may be too tight and ones that are not strong enough. These muscles may be placing excessive pressure or load on your piriformis muscle. It’s important to mention that everyone is unique, and that means any form of muscle imbalance should be addressed individually. Your physiotherapist will prescribe various exercises intended to address your unique piriformis muscle condition.

Some of the best exercises to help with piriformis syndrome include the ‘figure 4 stretch’ stretch, sciatic nerve, flossing, bird dog exercise, and squats. A trained physiotherapist can offer guided physical activity sessions to ensure that these exercises are effective in the treatment of pain in the buttocks.

What to avoid if you have piriformis syndrome

If you have piriformis syndrome, avoid the following:

  • Prolonged period of sitting
  • Crossing your legs when sitting
  • Not stretching often
  • Keeping your wallet in your back pocket
  • Not getting specialized treatment, particularly if the symptoms are getting worse

It is also possible to alleviate the pain in your buttocks (piriformis syndrome) at home. You will need to make several lifestyle changes by avoiding the habits mentioned above. It’s also essential to work with an experienced physiotherapist who can recommend and direct various exercises intended to relieve pressure on your piriformis muscle.

It takes about six to eight weeks to recover from this health condition. With a proper treatment plan and directed rehabilitation exercises, you can achieve full recovery sooner.