Have you ever had a deep ache in your buttock that seems to travel down the back of your leg? It can be difficult to know whether the pain is coming from your back, hip or somewhere else.
Piriformis syndrome is one possible cause of this type of pain. Understanding what may be contributing to your symptoms is an important part of finding the right approach to recovery.
What is piriformis syndrome?
The piriformis is a small muscle located deep within the buttock. It helps control movement of the hip and works alongside the other muscles around the pelvis.
Piriformis syndrome is a condition where irritation, increased tension or spasm of the piriformis muscle may affect the nearby sciatic nerve, causing pain in the buttock and potentially further down the leg.
The sciatic nerve runs very close to the piriformis, meaning irritation around the muscle can sometimes produce sciatic-type symptoms. However, pain in this area can have several different causes, so the piriformis is not always responsible.
What does piriformis syndrome feel like?
Symptoms can vary from person to person, but pain is often felt deep within the buttock. It may become more noticeable during certain activities or after staying in one position for a prolonged period.
Common symptoms can include:
- A dull or aching pain deep in the buttock
- Pain travelling down the back of the thigh
- Pain that may extend into the calf or foot but regularly stops behind the knee
- Increased pain after prolonged sitting
- Discomfort when walking, particularly up stairs or an incline
- Reduced or uncomfortable hip movement
What can cause piriformis syndrome?
Piriformis syndrome can develop for a number of reasons. Irritation or injury to the piriformis muscle can cause it to tighten or go into spasm, contributing to symptoms.
Factors that may contribute include:
- Irritation of the piriformis following an injury
- Muscle spasm or increased tension
- Irritation from nearby structures, such as the hip or sacroiliac joint
- Changes in activity, such as increased walking, running or exercise
- Spending more time sitting than usual
Sometimes symptoms develop without an obvious single event that explains why they have started.
How can osteopathy help?
An osteopathic assessment can help look at the wider picture rather than focusing solely on the area where the pain is felt. This may include assessing the movement of the:
- Spine and lower back
- Pelvis
- Hip
- Surrounding muscles and joints
Understanding what movements or activities reproduce your symptoms can help identify factors that may be contributing to the problem.
Depending on the individual presentation, osteopathic treatment may include soft tissue techniques, mobilisation and stretching around the hip, pelvis and surrounding tissues. These techniques can be used to help improve comfortable movement and reduce discomfort.
Treatment can also work alongside appropriate exercises and changes to activity. Gradually building your tolerance to movement and the activities that may have been aggravating your symptoms can help you return to normal activity with greater confidence.
How long does piriformis syndrome take to recover?
There is no single recovery time for piriformis syndrome. How long symptoms last can depend on:
- What is contributing to the symptoms
- How long they have been present
- Your current activity levels
- How your symptoms respond to changes in activity and rehabilitation
Gradually returning to normal movement and building your tolerance can be more useful than simply avoiding activities for a prolonged period. Your recovery should be guided by how your symptoms respond and what your individual assessment shows.
When should you get assessed?
Pain travelling down the leg can have several possible causes, so persistent or worsening symptoms should be assessed rather than automatically being attributed to piriformis syndrome. An assessment can help determine whether the symptoms are more consistent with the piriformis, the lower back, the hip or another structure.
You should seek further medical assessment if you experience concerning symptoms alongside your pain, such as:
- Significant or worsening weakness
- Progressive neurological symptoms
- Changes in bladder or bowel function
- Numbness of your saddle area or genitals
- Other sudden or unexplained changes in your health
The takeaway
Piriformis syndrome can cause deep buttock pain and sciatic-type symptoms, but it is not the only possible explanation for pain travelling down the leg.
Understanding what is contributing to your symptoms is an important first step towards choosing the right approach to recovery.
Clinic locations
Looking for appointment information? Cameron Hayward Osteopathy offers appointments at The Cedars Practice in Caterham and with Newhill Osteopathy in Horley.
Find clinic details, directions and contact options for osteopathy in Caterham or osteopathy in Horley.