Piriformis syndrome is one of the more commonly missed causes of buttock and leg pain, largely because its symptoms closely resemble sciatica and the two conditions are frequently confused. Both produce radiating pain, numbness, or tingling down the leg. Both can make sitting painful and limit mobility.
The difference is where the sciatic nerve is being compressed. In true sciatica the compression occurs at the nerve root level in the lumbar spine. In piriformis syndrome the sciatic nerve is being compressed or irritated by the piriformis muscle itself, deep in the buttock, below the spine entirely.
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That distinction matters because the treatment is different. Adjusting the lumbar spine addresses disc and joint-related nerve root compression. It does not directly address a tight or spasming piriformis muscle compressing the nerve below it. Patients who have been treated for sciatica without improvement sometimes have piriformis syndrome that has gone unidentified throughout their care.
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The piriformis is a small muscle that runs from the sacrum to the top of the femur, directly over the path of the sciatic nerve. In a significant percentage of the population the sciatic nerve actually passes through the piriformis muscle rather than beneath it, making those individuals more susceptible to compression when the muscle tightens. The piriformis can become hypertonic from prolonged sitting, direct trauma to the buttock, overuse in running or cycling, or compensatory tightening from hip or lumbar dysfunction.
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Symptoms of piriformis syndrome include deep buttock pain that may radiate down the back of the thigh and into the leg, pain that worsens with sitting for extended periods, discomfort when climbing stairs or rising from a seated position, and tenderness to pressure directly over the piriformis muscle in the buttock. A thorough physical examination can differentiate piriformis syndrome from lumbar radiculopathy in most cases, though the two can also occur simultaneously.
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At Lagoni Chiropractic, Dr. Jay evaluates both the lumbar spine and the piriformis muscle when a patient presents with buttock and leg pain to ensure that the correct source of compression is identified and addressed. Treatment for piriformis syndrome may include soft tissue work and stretching directed at the piriformis and surrounding hip musculature, chiropractic adjustments to the sacroiliac joint and lumbar spine to address contributing mechanical factors, low-level laser therapy to reduce muscle inflammation, electric muscle stimulation, and a home exercise program targeting piriformis flexibility, hip strength, and the movement patterns that contributed to the problem.
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If you have been dealing with buttock pain or leg symptoms that have not responded to treatment, or if you have been told you have sciatica but the care has not helped, call us at (765) 778-4095 or fill out the form on our New Patient page.
Serving Pendleton, Anderson, Fortville, Lapel, and the surrounding area. Most major insurance accepted.