What's Happening

The piriformis is a small muscle deep in the buttock that helps rotate the hip. In some people, the sciatic nerve runs directly beneath or even through it — so when the muscle becomes tight, inflamed, or spasms, it can irritate the nerve and cause pain, burning, or numbness down the back of the leg.

By the Numbers

0.3–6%

of low back/sciatica cases involve the piriformis

1:6

men to women affected

1–3 wks

typical relief with consistent exercise

Piriformis Syndrome vs. Disc-Related Sciatica

The distinction matters for treatment: disc-related sciatica originates in the low back and often comes with back pain, while piriformis syndrome tends to start and stay localized to the buttock and hip, worsened by sitting, climbing stairs, or hip rotation — without significant low back pain. A thorough exam is what tells the two apart.

What Contributes to It

  • Prolonged sitting — commuting, desk work, cycling

  • A sudden increase in running, hill work, or hip-rotation activity

  • Muscle imbalance or weakness in the hip and glutes

  • Direct trauma to the buttock, or anatomical variation in how the sciatic nerve runs near the muscle

How We Treat It

  1. Calm the irritation — activity modification and manual therapy to reduce muscle spasm and nerve irritation.

  2. Restore flexibility — targeted stretching of the piriformis and surrounding hip muscles.

  3. Rebuild hip and glute strength — correcting the imbalances that overload the piriformis in the first place.

  4. Return to activity gradually — most people see meaningful relief within a few weeks of consistent exercise.

Bottom line: Piriformis syndrome is uncommon but very treatable — most people improve substantially within a few weeks with the right combination of mobility and strengthening work.