Piriformis syndrome: 3 signs it may be causing your hip and leg pain

Hip or leg pain can make everyday activities harder. You may feel discomfort while sitting, walking, climbing stairs or exercising. If the pain starts around your buttock and travels into your leg, you may wonder whether piriformis syndrome could be the cause.

Piriformis syndrome happens when the piriformis muscle in your buttock irritates or puts pressure on your sciatic nerve. This can cause pain, tingling or numbness around your buttock, hip and leg. Because several other conditions can cause similar symptoms, you may need a professional evaluation to determine what is actually causing your pain. Physical therapy with a professional at KC Rehab may help you address the problem.

Here are three common signs that piriformis syndrome may be contributing to your symptoms:

1. You have pain deep in your buttock

One of the most common signs of piriformis syndrome is aching or pain deep in your buttock. You may feel the pain mostly on one side.

piriformis is a small muscle located deep within your buttock. It runs from the lower part of your spine toward the top of your thighbone. The muscle helps you move and stabilize your hip.

When the piriformis becomes irritated, tight or swollen, you may notice pain around the muscle itself. Your discomfort may become more noticeable when you:

• Walk or run

• Climb stairs

• Squat

• Exercise

• Spend a long time in one position

Piriformis syndrome is not the only possible cause of pain in this area. Hip conditions, lower back problems and other muscle or joint issues can produce similar symptoms.

2. Your pain travels down your leg

Piriformis syndrome may cause more than pain in your buttock. You may feel symptoms traveling from your buttock into the back of your thigh or farther down your leg.

This happens because of the piriformis muscle’s relationship with your sciatic nerve. The sciatic nerve typically passes underneath the piriformis muscle before continuing down your leg. If the muscle irritates or compresses this nerve, you may develop symptoms along the nerve’s path.  

In addition to pain, you may experience:

• Tingling

• Numbness

• Burning

• Aching

• Shooting sensations

These symptoms can resemble sciatica caused by a problem in your lower back. For example, a herniated disc or spinal stenosis can also irritate nerves and produce pain that travels through your buttock and leg. Piriformis syndrome, however, involves irritation of the sciatic nerve around the piriformis muscle rather than compression originating in your spine.  

That similarity is one reason you should avoid trying to diagnose the condition based on symptoms alone.

3. Sitting for a long time makes your symptoms worse

Think about when your pain is most noticeable. If your buttock or leg pain becomes worse after you have been sitting for an extended period, piriformis syndrome could be one possibility.

Prolonged sitting is commonly associated with increased symptoms because it can place pressure around the piriformis muscle and sciatic nerve. Other activities that may make symptoms worse include walking, running and climbing stairs.  

For example, you may notice discomfort after:

• Sitting through a long meeting

• Driving for an extended period

• Working at a desk

• Traveling on a plane

• Sitting through a movie

Your symptoms may improve when you stand up or change positions, although everyone experiences the condition differently.

Talk to a physical therapist about your pain

Piriformis syndrome can be difficult to diagnose because there is no single test that confirms every case. Your symptoms may also look similar to those caused by conditions involving your lower back, hip or surrounding tissues. A health care professional may need to evaluate several possible causes before determining whether your piriformis is contributing to your pain.  

How can physical therapy help with piriformis syndrome?

If hip and leg pain is keeping you from your usual activities, a physical therapist can help you determine what may be contributing to your symptoms.

Because several conditions can resemble piriformis syndrome, your physical therapist can start by evaluating how your body moves. Your assessment may include your:

• Hip movement

• Muscle strength

• Flexibility

• Range of motion

• Walking pattern

• Posture

• Activities that increase or decrease your symptoms

Your physical therapist may also move or position your hip and leg in different ways to learn more about where your symptoms are coming from. A careful evaluation can help distinguish piriformis-related symptoms from other possible causes of hip and leg pain.  

If piriformis syndrome appears to be contributing to your pain, a professional may recommend short-term rest. Next, physical therapy may focus on improving your movement and reducing stress around the affected area. Treatment may include stretching, range-of-motion exercises and strengthening exercises based on your specific needs. You can find a few stretches and exercises here.

Your physical therapist can also help you identify activities or movement patterns that may be aggravating your symptoms and show you ways to modify them.

Find the cause of your hip and leg pain with KC Rehab

Piriformis syndrome is one possible cause of hip and leg pain, but symptoms alone cannot tell you exactly what is wrong. If your pain keeps returning, travels down your leg or makes sitting and walking difficult, a physical therapy evaluation may help you better understand what is causing your symptoms.

At KC Rehab, your physical therapist can evaluate your movement, identify factors that may be contributing to your pain and create an individualized treatment plan designed around your needs and goals. Contact our team today for more information or to schedule an initial appointment.

Frequently asked questions

What is piriformis syndrome?

Piriformis syndrome happens when your piriformis muscle irritates or places pressure on your sciatic nerve near your buttock. You may experience pain, numbness, tingling or other symptoms around your buttock, hip or leg.

Where do you feel piriformis syndrome pain?

You may feel pain deep in one side of your buttock. Your symptoms can also travel into the back of your thigh or farther down your leg because the sciatic nerve extends from your lower body into your leg.

What are the most common signs of piriformis syndrome?

Common signs can include deep buttock pain, pain that travels down your leg and symptoms that become worse after sitting for a long time. You may also experience tingling, numbness, burning or aching.

What causes piriformis syndrome?

Possible causes include overuse, repetitive activities, prolonged sitting, muscle spasms and an injury around your hip or buttock. Differences in the way your piriformis muscle and sciatic nerve are positioned may also play a role.

Does sitting make piriformis syndrome worse?

It can. Sitting for an extended period may increase pressure around your piriformis muscle and sciatic nerve. You might notice more discomfort during a long drive, workday, flight or other activity that keeps you seated.

Is piriformis syndrome the same as sciatica?

Not exactly. Piriformis syndrome can produce sciatica-like symptoms because it involves irritation of the sciatic nerve around your piriformis muscle. Sciatic nerve symptoms can also come from conditions involving your lower back, so an evaluation may be needed to identify the source.

Can piriformis syndrome cause numbness or tingling?

Yes. If your sciatic nerve becomes irritated, you may experience tingling, numbness, burning or shooting sensations in addition to pain.

How do you know if you have piriformis syndrome?

Symptoms alone may not be enough to tell. Other hip and lower back problems can cause similar pain. A health care professional or physical therapist can evaluate your symptoms, movement and physical function to help determine what may be causing them.

What exercises help with piriformis syndrome?

The right exercises depend on what is contributing to your symptoms. Your physical therapist may recommend stretching, strengthening, mobility or movement exercises based on your evaluation rather than giving you a one-size-fits-all program.

How can physical therapy help with piriformis syndrome?

Your physical therapist can assess your hip movement, strength, flexibility, walking pattern and activities that affect your symptoms. Treatment may then focus on improving movement, increasing strength or flexibility and reducing stress around the irritated area.