August 15, 2025
If you’ve ever experienced a deep ache in your buttock that radiates down the back of your leg, you may have heard someone mention piriformis syndrome. But what exactly is it? Is it the same as sciatica? Is it a muscle problem or a nerve problem?
In this post, we are breaking down what piriformis syndrome is — and what it is not, to help you better understand this often-misunderstood condition.
What Piriformis Syndrome Is
A Neuromuscular Condition Involving the Piriformis Muscle
Piriformis syndrome occurs when the piriformis muscle — a small, deep muscle located in the buttock — irritates or compresses the sciatic nerve. The sciatic nerve usually runs beneath the piriformis, but in some people, it passes through the muscle, increasing the risk of entrapment.
A Source of Sciatic-like Pain
While it’s not true “sciatica” (which is usually caused by a spinal issue like a herniated disc), piriformis syndrome can mimic sciatica, with symptoms such as:
- A deep ache in the buttock
- Pain radiating down the leg (often without back pain)
- Numbness or tingling in the leg or foot
- Pain aggravated by sitting, climbing stairs, or hip movement
Often Related to Muscle Imbalance or Overuse
Piriformis syndrome is often triggered by:
- Prolonged sitting
- Repetitive movements (like running or cycling)
- Muscle imbalances (tight hips, weak glutes)
- Direct trauma to the buttocks
It’s more common in women and often seen in people who are active but have underlying biomechanical issues.
What Piriformis Syndrome Is Not
Not True Lumbar Sciatica
True sciatica stems from the lumbar spine, typically due to nerve root compression (e.g. a disc bulge or spinal stenosis). Piriformis syndrome, by contrast, is non-spinal and originates from the pelvis/gluteal region.
Key difference:
- Lumbar sciatica usually includes back pain
- Piriformis syndrome usually does not
Not Always Easy to Diagnose
There’s no single definitive test for piriformis syndrome. It’s often a diagnosis of exclusion — made after ruling out spine-related causes. Imaging (MRI or CT) rarely shows piriformis syndrome directly. A combination of physical exams and symptom patterns is used for clinical suspicion.
Not Permanently Debilitating (If Treated)
While it can be painful and persistent, piriformis syndrome is very treatable with conservative measures, such as:
- Stretching and mobility work
- Strengthening exercises for glutes and hips
- Manual therapy or massage
- Posture correction and movement retraining
- In rare cases: injections or surgical intervention
What You Can Do About It
If you suspect piriformis syndrome, here are some simple strategies to help:
Stretch the piriformis
Try the figure-4 stretch or seated glute stretch to gently release tension.
Strengthen the glutes and core
Weak glutes can lead to overuse of the piriformis. Exercises like bridges, clamshells, and bird dogs can help.
Modify aggravating activities
Reduce long periods of sitting or repetitive hip movements until symptoms subside.
Seek physical therapy
A PT can assess imbalances and tailor a recovery plan to your needs.
Bottom Line
Piriformis syndrome is real — but it’s not the same as sciatica, and it’s not always the villain it’s made out to be.
It’s a muscular issue that can affect the sciatic nerve, causing symptoms that often mimic nerve root compression. The good news? With the right approach, it’s highly manageable and often resolves without invasive treatment.
Understanding what it is — and what it isn’t — is the first step toward relief.
If you’re unsure, talk to a healthcare provider who specializes in musculoskeletal or nerve-related conditions.