Piriformis Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Piriformis Syndrome?
A primary care doctor or a sports medicine doctor (a doctor who treats muscle and joint injuries) often treats piriformis syndrome. A physical therapist may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is piriformis syndrome?
Piriformis syndrome is pain and numbness in your buttocks and down the back of your leg. It occurs when the piriformis muscle in the buttocks presses on the sciatic nerve.
The piriformis muscle is involved in nearly every movement you make with your lower body, from walking to shifting weight from one foot to the other. The sciatic nerve runs from your lower spine, around your buttock, and down the back of your leg to your foot.
The syndrome is uncommon, and it affects more women than men. When it occurs, it can cause sciatica-type symptoms. Sciatica is a symptom of a problem with the sciatic nerve, the largest nerve in the body.
Symptoms
Sciatica is the main symptom of piriformis syndrome. Other symptoms of piriformis syndrome include:
- A dull ache or tenderness in the buttock.
- Tingling or numbness in the buttock and along the back of the leg.
- Difficulty sitting.
- Pain from sitting that grows worse as you continue to sit.
- Pain that gets worse with activity.
The pain usually affects just one side of the lower body. But it can also occur on both sides at the same time.
Causes and who gets it
Injuring or irritating the piriformis muscle can cause muscle spasms (sudden tightening of the muscle). This puts pressure on the nerve beneath it, causing pain.
Overuse can cause swelling or injure the muscle. Muscle spasms may come from:
- Sitting for long periods.
- Over exercising.
- Running, walking, or doing other repetitive activities.
- Climbing stairs.
- Lifting heavy objects.
Trauma can also cause muscle irritation and damage. This may be caused by car accidents, falls, sudden twisting of the hip, or penetrating wounds.
How doctors diagnose it
Your provider will do a physical exam, ask about your symptoms and recent activities, and take your medical history. During the exam, your provider may put you through a range of movements. The point is to see if and where they cause pain.
Other problems can cause sciatica. For instance, a slipped disk or arthritis of the spine can put pressure on the sciatic nerve. To check for other possible causes, you may have an MRI or a CT scan (imaging tests that take detailed pictures inside the body).
Treatment
In some cases, you may not need medical treatment. Your provider may recommend self-care tips to help relieve pain. These include:
- Avoid activities that cause pain, such as biking or running. You can start again after the pain is gone.
- Use pain medicines such as ibuprofen, naproxen, or acetaminophen.
- Try ice and heat. Use an ice pack for 15 to 20 minutes every few hours, wrapped in a towel to protect your skin.
- Follow your provider's instructions for doing special stretches, which can relax and strengthen the piriformis muscle.
Your provider may prescribe muscle relaxants. This will relax the muscle so you can exercise and stretch it. Injections of steroid medicines into the area may also help.
For more severe pain, your provider may recommend electrotherapy such as TENS, which uses electrical stimulation to reduce pain and stop muscle spasms.
As a last resort, your provider may recommend surgery to release the muscle and relieve pressure on the nerve.
When to see a doctor
Contact your provider if you have pain that lasts longer than a few weeks. Also contact your provider if the pain starts after you have been injured in an accident.
Call 911 or go to the emergency room if you have sudden severe pain in your lower back or legs, along with muscle weakness or numbness. Go right away if you have difficulty controlling your foot and find yourself tripping over it when you walk, or if you can't control your bowels or bladder.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms, do an exam, and help check for other causes of sciatica. They can also help you plan physical therapy or a visit with a specialist.
Common questions
Is piriformis syndrome the same as sciatica?
No, sciatica is a symptom, and piriformis syndrome is one possible cause of it. Other problems, such as a slipped disk or arthritis of the spine, can also put pressure on the sciatic nerve.
What does the piriformis muscle do?
The piriformis muscle helps with nearly every movement you make with your lower body.
Can piriformis syndrome be prevented?
Some habits may help prevent future pain. Get regular exercise. Warm up and stretch before exercising, and then slowly increase how hard you work out. Avoid running or exercising on hills or uneven surfaces. If something causes you pain, stop doing it and rest until the pain passes.
When is surgery used for piriformis syndrome?
Surgery is only a last resort. Your provider may recommend it to release the muscle and relieve pressure on the nerve.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
