What is it?
Piriformis syndrome occurs when the piriformis muscle (deep in the buttock) irritates or compresses the sciatic nerve, causing buttock pain and sciatica-like symptoms. It is often misdiagnosed as lumbar disc herniation. Unlike true sciatica, piriformis syndrome pain is typically located in the deep buttock.
Common causes
- Direct trauma to the buttock
- Prolonged sitting on hard surfaces
- Anatomical variation — the sciatic nerve passes through the piriformis in some people
- Overuse in runners, cyclists, and sedentary workers
- Hip muscle imbalance and weak glutes
Signs and symptoms
- Deep buttock pain, often worse with sitting
- Pain radiating down the back of the thigh (similar to sciatica)
- Pain with hip rotation, especially internal rotation
- Tenderness deep in the buttock on palpation
- Relief when standing and walking briefly
Physiotherapy treatment at VPARC
- Stretching the piriformis: figure-4 stretch in lying and sitting
- Hip strengthening — especially glutes and hip abductors
- Manual release of the piriformis and surrounding muscles
- Dry needling to the piriformis trigger points
- Correction of sitting posture and duration
What you can do at home
- Perform the figure-4 stretch: cross one ankle over the opposite knee and gently press the knee down — hold 30 seconds, 3 times each side, twice daily
- Avoid sitting on hard surfaces for prolonged periods
- Use a cushion with a coccyx cutout if you must sit for long periods
- Strengthen glutes: bridges and clamshells daily
When to visit VPARC
Visit VPARC if buttock or leg pain has persisted more than 4 weeks. Differentiating piriformis syndrome from lumbar disc problems requires clinical assessment — the treatment is very different.
Call +91 98896 78838 or read more on our Sciatica Treatment in Varanasi page. This leaflet is general information and does not replace a medical assessment.