Pseudosciatica; Wallet sciatica; Hip socket neuropathy; Pelvic outlet syndrome; Low back pain - piriformis
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 syndrome, which affects more women than men, is uncommon. But when it occurs, it can cause sciatica-type symptoms.
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. Beneath the muscle is the sciatic nerve. This nerve runs from your lower spine down the back of your leg to your foot.
Injuring or irritating the piriformis muscle can cause muscle spasms. The muscle may also swell or tighten from the spasms. This puts pressure on the nerve beneath it, causing pain.
Overuse can cause swelling or injure the muscle. Muscle spasms may come from:
Trauma can also cause muscle irritation and damage. This may be caused by:
Sciatica is the main symptom of piriformis syndrome. Other symptoms include:
The pain usually affects just one side of the lower body. But it can also occur on both sides at the same time.
Your health care provider will:
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 rule out other possible causes, you may have an MRI or a CT scan.
In some cases, you may not need medical treatment. Your provider may recommend the following self-care tips to help relieve pain.
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. This treatment uses electrical stimulation to reduce pain and stop muscle spasms. Also, for more severe pain, your provider may recommend physical therapy focusing on muscle and core strengthening to reduce pain and muscle spasms.
As a last resort, your provider may recommend surgery to release the muscle and relieve pressure on the nerve.
To prevent future pain:
Contact your provider if you have:
Get medical help immediately if:
American Academy of Family Physicians website. Piriformis syndrome. familydoctor.org/condition/piriformis-syndrome. Updated December 11, 2020. Accessed January 17, 2023.
Hudgins TH, Wang R, Alleva JT. Piriformis syndrome. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 58.
Khan D, Nelson A. Piriformis syndrome. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 67.
BACK TO TOPReview Date: 12/12/2022
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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06/01/2025
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