Do You Really Have Piriformis Syndrome?

Piriformis syndrome is a pain in the butt, but is your pain in the butt actually from this condition? Continue reading to explore more details on this diagnosis and to learn more about your body!
Disclaimer: This post is not intended as medical advice. If you are experiencing pain, seek care from a medical doctor.
What is the piriformis?
The piriformis is a deep muscle located on the backside of your hip. It’s underneath a relatively large muscle called the gluteus maximus. (The glute max is the major muscle we think of when we think of the back of the hip.)
The piriformis muscle externally rotates the hip when it’s extended. This means when your leg is back behind you, the piriformis helps you to turn your leg so that your toes point up.
When the hip is flexed, the piriformis muscle abducts the hip. This means that if your leg is lifted up, the piriformis will help to then bring your leg out to the side.
The sciatic nerve often exits the pelvis just below the piriformis muscle, but this isn’t the case for everyone. There can be differences due to different anatomy in different individuals.
What is piriformis syndrome?
Piriformis syndrome means that there’s an issue with the piriformis muscle.
Symptoms of piriformis syndrome include pain, numbness, or tingling in the buttock. There may also be pain, numbness, or tingling down the back of the leg.
Typically, these symptoms worsen with sitting for a long time or with walking, running, or going up/down stairs.
This radiating pain occurs due to the piriformis muscles proximity to the sciatic nerve. Basically, the piriformis muscle goes into spasm or gets tight and puts pressure on the sciatic nerve causing these symptoms.
But…….piriformis syndrome isn’t the only condition that causes symptoms of pain, numbness, and tingling in the buttock and down the back of the leg.
There are other diagnoses that can cause the same types of symptoms. A common example of a condition that would cause similar symptoms is a disc issue in the lower back.

So...do you actually have piriformis syndrome?
While there is no way I can tell you through a blog post if you actually have piriformis syndrome, I can share with you some insight.
Piriformis syndrome is one of those terms that tends to get thrown at people without a thorough enough evaluation.
As you’ve already learned, you can’t diagnose piriformis syndrome based on symptoms alone. There are too many other issues that can cause the same symptoms. That’s why a thorough examination is so important.
Based on my own prior experience at an orthopedic physical therapy clinic, it was relatively uncommon for patients seeking physical therapy for symptoms like these to actually have piriformis syndrome.
Much more often, these types of symptoms were from an issue with a disc in the lower back. (Of course, piriformis syndrome and disc issues aren’t the only two things that cause these symptoms which is why it’s important to see a medical professional to make sure your symptoms aren’t coming from something more serious!)
But for this example, say someone has an issue with a disc that’s causing their symptoms. This doesn’t mean that there isn’t dysfunction in the piriformis. Oftentimes, the piriformis is actually tight but it’s usually more of a secondary issue and not the primary cause of symptoms.
If you only focus on treating the piriformis and it's not the primary cause of symptoms, improvements will be minimal.
And even if you do have piriformis syndrome, this is probably just one piece of what’s going on.
It’s so important to look at the body as a whole when working on healing. It’s unlikely that you only have a tight piriformis and that you have no other muscle imbalances in the body. When one muscle gets tight, there is often an opposing muscle that gets weak.
Interesting finding when researching for sources for this article…. I typed in just a general search for piriformis syndrome, assuming to see just general information about it. But pretty high in the search results I found an article written on webMD about how most cases of sciatica are not from piriformis syndrome. So this wasn’t just me projecting my theories on the world wide web lol!
This isn’t to say that you don’t have piriformis syndrome, it’s just to bring into question if you were actually properly diagnosed. See a practitioner who takes the time to do a thorough examination to determine what’s going on before throwing a diagnosis at you.
Please remember...
If you are having symptoms that are similar to piriformis syndrome such as pain, tingling, or numbness in your buttock or down your leg, please see a doctor! Do NOT ignore it. As you learned, there are many different things that can cause these symptoms so you should see a professional who can diagnose what’s going on to make sure it’s nothing serious.
Also, radiating symptoms and numbness/tingling are indicative of a nerve related issue. Nerve issues are NOT something that you want to ignore.
If you have these symptoms, see a doctor or a physical therapist and find one that takes the time to be thorough. If you see a practitioner that you feel isn’t helping you or isn’t taking their time with you, see someone else.
I hope you found this post helpful in learning more about your body!
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Sources
Chang, Carol, et al. Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle, www.ncbi.nlm.nih.gov/books/NBK519497/. Accessed 16 Nov. 2023.
Lightsey, Roma, and Tyler Wheeler. “Piriformis Syndrome: Symptoms, Causes, Treatments, Exercises, and More.” WebMD, WebMD, www.webmd.com/pain-management/piriformis-syndrome-causes-symptoms-treatments. Accessed 16 Nov. 2023.
