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Writer's pictureCapstone Chiropractic LLC

Problems with Piriformis Syndrome

Picture this. You're sitting at your desk, in front of your TV, driving, or trying to walk. At first you’re perfectly fine. As a few minutes pass, you start to notice a deep ache in your butt and/or numbness in your toes. You’re able to ignore it, but it continues to increase. Sometimes it even builds into cramping in the butt, back of the leg, calves, and/or feet.


Would you think most people go to a doctor or chiropractor? Well, not really. The truth is most people stop or modify whatever they were doing before they start considering going to a doctor chiropractor.

And many times this condition is mislabeled as sciatica. It is actually Piriformis Syndrome.

What is the piriformis?


The piriformis is a muscle of the hip and glutes that helps to rotate, stabilize your hips/pelvis. The muscle connects from an area on the base of your spine, aka sacrum, to your thigh bone, aka Femur. There are actually several different shapes that a piriformis muscle takes in the body.

  1. Solid muscle with sciatic nerve passing under the muscle

  2. Split muscle with sciatic nerve passing through the branches

  3. Solid muscle with one hole in the middle with sciatic nerve passing through the hole

What are the signs and symptoms of piriformis syndrome?

  • Glute pain

  • Tight hamstrings

  • Difficulty going from sitting to standing

  • Pain/numbness/tingling after sitting for any length of time in the butt and/or down the leg

  • Pain/numbness/tingling while active running, cycling, lifting, or walking

Severe cases can have

  • Cramping in the butt, feet, calves, and back of the thigh

  • Discoloration of the toes and feet.

  • Muscle loss

How does it happen?

Piriformis syndrome occurs when the muscle gets damaged, irritated, or tight and reflexively creates symptoms in the sciatic nerve. This can result from changes with the SI joint, activation of the gluteal muscles, or irritation of the hamstring muscles.

Important to note: this is not just a trigger point in the piriformis or irritation of the sciatic nerve at the piriformis only. Piriformis Syndrome is a combination of issues.

How do we treat it?

  1. Find the cause of the problems.

    1. SI joint fixation

    2. Deconditioned gluteal muscles

    3. Hypermobility of the pelvis

    4. Hamstring vs hip adductor imbalance

    5. Etc.

  2. Develop a plan of action that matches your lifestyle

    1. Correct the issue

    2. Strengthen your body

  3. Maintain overall wellness

Why it needs to be fixed ASAP…

If you or someone you know has piriformis syndrome the answer is simple. Get back to enjoying the things you love doing!


The medical reason is that if left untreated, this condition can rapidly progress to a loss of muscle, pain in other parts of the body due to injury, decrease in sports performance.


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