Piriformis Syndrome

Piriformis Syndrome is an nerve and muscular disorder which is typically caused by tightness and overusing of the piriformis muscle. Piriformis is a small deep muscle located in the buttocks near the top of the hip joint.We use this muscle a lot in walking and in all movements that hip rotation is involed. It helps the hip to shift our weight to the other hip during walking. It can be overused when other surrounding muscles are weak.

Signs and Symptoms:

The Sciatic nerve passes through or underneath this muscle ,therefore tightness or strain of this muscle can compress the nerve and causes some symptoms like numbness,tingling or pain in the buttocks and back of the thigh. It is also known as “Wallet Syndrome” as the condition can be caused or aggravated by sitting on a large wallet on the affected side. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time.

Runners, bicyclists and other athletes engaging in forward-moving activities are particularly susceptible to developing piriformis syndrome if they do not engage in proper stretching and strengthening exercises for the lower limbs.


There is no specific test for Piriformis Syndrom. Your physiotherapist will ask you questions to find out if it is due to a history of trauma,strain to the buttocks, repetitive movements or a prolonged posture which led to the piriformis problem.

Contributing factors:

  • Inactive gluteal muscles (that is the big muscle over buttocks)
  • Overactive hip flexors at the front of the pelvis
  • Weak hip abductors on the outside of the hip and tight hip adductors/groin muscles
  • stiffness/hypomobility of Sacroiliac joint, where the spine joins the pelvis


Conservative treatment usually begins with stretching exercises, myofascial release, and rest from of contributory activities, such as running, bicycling, rowing, long sitting etc. Physiotherapy includes soft tissue mobilization, hip joint mobilization, teaching stretching techniques, and strengthening of weak muscles. Muscle strengthening involves working on the hip abductors, external rotators and and hip extensors- all of which will help take the load of piriformis, ofcourse this needs to be done in a slow progressive manner and pain free.

The focus of stretching exercises should be regaining the normal length of piriformis to take pressure off the nerve.

 Role of Physio Savvy:

Physio Savvy has a treatment plan combination of manual techniques (releasing the involved tissues and joint mobilization) and stretching/strengthening exercises to help the patient gain the muscular balance again. This plan includes correcting and positioning the patient’s lifestyle to avoid all contributing factors. Depending on the severity of the case and nerve involvement, it can take answered from a few weeks to a few months to make a full recovery.


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Parisa Tanoori

Parisa Tanoori

Physiotherapist at Physio Savvy
Parisa is certified with a Bachelor of Science in Physiotherapy from Shiraz University of Medical Science, Iran. She is currently completing her PhD in Sports Medicine with the special interest of Kinesiology taping in Universiti Malaya.
Parisa Tanoori

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Posted in Musculoskeletal Disorders.