Piriformis Syndrome – Pain in the butt

Piriformis Syndrome

Pain in the butt is a commonly used idiom, but it actually can be a real pain to many as piriformis syndrome. It is commonly seen in people who spend long hours sitting, such as desk bound jobs, long distance driving or riding a motor bike. Many long distance runners, cyclists, and skiers are at a high risk of getting Piriformis Syndrome as well. Symptoms are usually unilateral and are present as pain in the buttock or hamstring area. Affected side may experience neurogenic (nerve related) symptoms such as pins and needles, loss of sensation and weakness down the limb. Symptoms generally get worse with sitting or activities involving running. Many patients also report a feeling of a pebble under the affected buttock while sitting.piriformis-syndrome

Piriformis muscle is found deep under the big gluteal muscles. It runs across the pelvis area outwards and attaches to the femur (thigh bone). It serves as a rotator of the hip joint. It is an external rotator when the hip is extended and an internal rotator when the hip is flexed. Piriformis is very closely related to the sciatic nerve which runs down the leg from the lower back area. Piriformis muscle sits across and over sciatic nerve. In certain people, the sciatic nerve actually passes through the piriformis muscle itself. Any injury, irritation or tightness to the muscle may irritate the sciatic nerve and lead to neurogenic symptoms down the limb.



  • Injury to the muscle – from a fall
  • Limb length discrepancy
  • Jobs involving prolonged sitting
  • Poor sporting technique
  • Muscle imbalance around Lumbopelvic area (lower back and pelvis)
  • Piriformis compensating for weak gluteal muscles
  • Tight hip flexors and adductors
  • Overpronation(flattening) of foot  – causing internal rotation at hip
  • Altered gait biomechanics
  • Any pyogenic infection

Treatment options – Next Page

Move your nerves and relieve your pain



After a long day at work or prolonged sitting, people experience stiffness in the joints and muscles. Then a simple stretch gives so much relief, however many times a nagging discomfort stays there no matter how nicely you have stretched your muscle. The tight muscle which is not responding to your stretch might actually be a nerve. Like our muscles, nerves also get tight from staying in a certain position for too long or tightening of muscles around the nerve.

The key to relieve discomfort coming from nerves is simple – stretch it – floss it or glide it. Nerves also get blood supply and this supply can be increased from these simple techniques. It also helps in improving the movement of the nerve along the joints and muscles by improving their ability to glide.

Below are few simple ways to stretch or floss the nerves. There are many variations to it depending upon location of tightness, symptoms and limiting factors such as joint mobility or any existing conditions.

Upper body nerve stretch

Three main nerves that need to be stretched in the upper body are median nerve, radial nerve and ulnar nerve. To stretch theses nerves is simple and fun as the movement is quite similar to dancing.

Median nerve – (on a call position) Place open palm on your ear as if you are on a call and elbow out and in line with shoulder. Now straighten up your elbow while keeping the wrist in same bend position feel the stretch and come back to starting position. The stretch feel would be in your arm and palm.

median nerve stretch

median nerve stretch


Combined nerve stretch

Next page – Ulnar nerve and Radial nerve Stretch