Piriformis syndrome: causes, symptoms and treatment
A clinically reviewed guide to piriformis syndrome — a buttock-based cause of sciatica-like pain.
Medically reviewed by D.C Matt · Lead Director
Last reviewed 1 July 2026
- The piriformis is a deep buttock muscle near the sciatic nerve.
- It can cause sciatica-like symptoms without a spinal cause.
- Most cases respond to conservative care.
What is piriformis syndrome?
Piriformis syndrome is buttock pain and sciatica-like symptoms thought to arise when the piriformis muscle irritates the nearby sciatic nerve.
It is a cause of leg pain that comes from the buttock rather than the spine. Because it can mimic spinal sciatica, careful assessment is important to identify the true source.
What are the symptoms of piriformis syndrome?
Typical symptoms are deep buttock pain, sometimes radiating down the leg, and pain with prolonged sitting.
- Deep aching pain in the buttock
- Pain or tingling that can radiate down the leg
- Pain with prolonged sitting or climbing stairs
- Tenderness deep in the buttock
How is piriformis syndrome treated?
Piriformis syndrome is treated with stretching, hip and glute strengthening, and manual therapy.
Care focuses on reducing tension around the muscle and improving hip strength and control. Distinguishing it from spinal sciatica ensures the right treatment.
The Postura approach
At Postura Wellness, care for piriformis syndrome is built around OrthoRestore™ — our signature method that combines chiropractic and physiotherapy into one coordinated plan. Depending on your assessment, it can bring together chiropractic adjustments, dry needling, muscle manipulation, Active Release Technique, and targeted exercises, supported where helpful by technology such as shockwave therapy and bioelectric therapy. The aim is to relieve symptoms while addressing the underlying causes, with a plan tailored to you.
When to seek urgent care
Get emergency medical attention for loss of bladder or bowel control, numbness around the groin or inner thighs, or sudden severe weakness in a leg. These can signal cauda equina syndrome, a rare but serious condition.
Sciatica FAQs
Is piriformis syndrome the same as sciatica?
Not quite. Both can cause leg pain, but piriformis syndrome originates in the buttock muscle, while classic sciatica usually stems from the spine. Assessment tells them apart.
Why does sitting make it worse?
Sitting compresses the buttock and the piriformis muscle, which can increase pressure on the nearby sciatic nerve.
How long does piriformis syndrome last?
Many cases improve within weeks with stretching, strengthening and manual therapy, though this varies.
Can physiotherapy help piriformis syndrome?
Yes. A programme of stretching, hip strengthening and manual therapy is the main approach.
This guide is informed by patient information from accredited medical institutions:
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