Piriformis Syndrome or Just a Pain in the Butt?

12 Nov 2018 / 0 Comments

In our clinic we treat the piriformis muscle practically every day for a multitude of reasons and causes across all age groups. This muscle is poorly understood amongst the fitness trainers and therefore is often not very well stretched or treated.

The muscle is attached to our sacrum and runs diagonally, deep beneath our main buttock muscle, gluteus maximus, to attach to the side of our upper thigh on the greater trochanter of the femur (see image).

The role of this muscle is to rotate the hip laterally or outwards, it also helps stabilise the hip joint and maintain balance.

The sciatic nerve arises from spinal nerves in the lumbar and sacral spine and passes through the pelvis in front of the piriformis muscle and down the back of the thigh. It then divides into two and continues down to supply the foot.

The sciatic nerve is the largest nerve in the body, it runs in front of and very close to the piriformis muscle or in around 15% of us a branch of this large nerve passes right through the muscle. 

Sciatica is caused by irritation of the nerve, often associated with a disc prolapse in the low back. However as with any nerve in the body it can be irritated anywhere along its path. If the sciatic nerve passes through your piriformis on one side or the other, an inflamed or especially tight piriformis can squeeze the nerve and irritate it causing symptoms including pain, numbness, tingling and weakness in the buttock, down the back of the thigh the calf and foot. This is called piriformis syndrome.

We as osteopaths are generally able to diagnose and differentiate between the varying causes of sciatic like pain using the case history and clinical tests. 

Piriformis syndrome is often over diagnosed in my opinion. The piriformis muscle when tight or inflamed can also refer pain into the buttock, groin and down the back of the thigh. Referred pain is pain experienced in a different area of the body from the actual source of the problem.

Pain in the Butt caused by a tight or spasmed piriformis  muscle can be treated locally with massage, inhibition or acupressure, trigger point needling & stretching techniques. Ice or anti inflammatories may be prescribed if we feel that there is inflammation. 

The cause of a tight and painful piriformis may be due to a number of reasons and therefore we need to investigate further to prevent it returning.

Causes can include:

* Prolonged sitting on hard surfaces
* Weak gluteal muscles
*Tight hip flexor muscles
* Overuse of the muscle due to an activity where the thigh is rotating outwards or standing with a laterally rotated hip.
*Low back/pelvic stiffness or imbalance.
* Over pronation of the foot/poor gait.

If you suspect that you amy have any of these symptoms or experience tightness in your low back or buttocks it may be wise to come in for a maintenance treatment and we can also give you some useful stretching techniques to help ease and prevent A Pain in the Butt.


Lisa Opie MBE, MOst, BSc hons

Jeremy Jones-Bateman BOst.


07956 954093


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Lisa & Jeremy

If you have any queries or want to book an appointment, please use the following options:

Call Lisa

07956 954093

Call Jeremy

07834 905275


Mrs Pauline Lamb
Mrs Pauline Lamb

I am 83 years old and am still able to live an active life which includes playing golf twice a week. I am sure this is largely due to Lisa Opie, my osteopath, who I visit regularly. She works on my body, deep massaging my legs, feet and back for 45 minutes of friendly chatter

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