Piriformis Syndrome

What is Piriformis Syndrome?

Piriformis Syndrome is a fairly disabling neuromuscular condition.  The piriformis muscle plays a key role in mobility – everything from walking to maintaining gait and balance to supporting the axial skeleton.   On a ratio of 6:1, the majority of cases are reported in females.

Piriformis Syndrome accounts for almost 6% of all cases of sciatica.

The pyramid–shaped, obliquely-placed piriformis muscle serves as the external rotator of the hip when the hip joint is extended or flexed and is located in close proximity to the sciatic nerve.

Signs and symptoms of Piriformis Syndrome:

Almost all aspects of mobility are affected with a diagnosis of Piriformis Syndrome. The main signs and symptoms are:

– pain felt in the region of buttocks or thigh;

– pain that is, at times, sharp and shooting as with sciatica and may involve the leg or calf and the foot;

– pain radiates into hamstring and calf muscles;

– a tingling sensation that may be associated with numbness;

– increase in the severity of pain after activities such as climbing stairs; prolonged hours of sitting; or an increase of pressure on the buttock;

– limitation in the range of hip motion;

– improvement in symptoms after rest.

How does it develop?

The piriformis muscle is a band-like muscle that attaches the femur or thigh bone to the hip bone.  In 10% of the population the sciatic nerve actually passes through the piriformis muscle.  In the other 90%, the nerve runs in close proximity to the muscle.  Any trauma, over-use or long period of inactivity may cause the muscle to spasm and trap the nearby sciatic nerve beneath the muscle.  Conditions that give rise to Piriformis Syndrome include but are not limited to:

– tissue injury or spastic conditions of the piriformis muscle normally seen in cases of tissue rupture or injury;

– inflammatory conditions of the piriformis muscle or of the neighboring joints or tissues (i.e. the sacro-iliac joint);

– high tension or stress in the adductor muscles of the hip joint that over-stretches piriformis muscle;

– hematoma formation in the region of piriformis muscle or in the vicinity that may press upon piriformis muscle.

Factors associated to an increased risk of developing Piriformis Syndrome include:

– professional sports, specifically running;

– occupations that involve long periods of driving, sitting on hard surfaces or extreme and strenuous physical activity;

– surgeries involving the hip joint (i.e. total hip arthroplasty);

– lumbar spinal issues and injuries that lead to fibrodysplasia.


  • Sharon Gabison

    Registered Physiotherapist BSc, BScPT, MSc, PhD: A graduate of the University of Toronto in Human Biology, Sharon completed her Bachelor of Science in Physical Therapy at the University of Toronto. She went on to pursue further graduate work, completing her Master of Science from the Rehabilitation Sciences Institute and a PhD from the Institute of Medical Science both from the University of Toronto. Her interest in Physiotherapy originated while pursuing her first undergraduate degree while struggling with postural challenges and seeking physiotherapy treatment. Her interest in medicine, working with people, and developing and adhering to therapeutic plans inspired her to pursue a career in Physiotherapy. Her interest in research, orthopaedics, neurology, therapeutic agents and pressure injuries (bed sores) lead her to pursue graduate work. Sharon emphasizes a holistic approach to rehabilitation. Her experience of raising a son with a disability has continued to inform her career that has spanned over 25 years. She is able to appreciate the rehabilitation process not only from the professional perspective, but from the client perspective. Her extensive knowledge of biomechanics, orthopaedics, exercise prescription, electrophysical agents with a strong background in research enables her to provide evidence based treatment when designing and implementing rehabilitation plans. With a special interest in patient and family engagement through her volunteer work, Sharon is able to ensure that treatment that is provided takes into consideration the unique challenges that individuals may experience when adhering to treatment recommendations in their busy lives.

Share this post