Deep pain in the buttock that runs down the back of the leg, flaring with prolonged sitting or driving? Treated for “sciatica” with no result? It could be piriformis syndrome — a cause frequently confused with a herniated disc, but with a different treatment.
What is piriformis syndrome?
The piriformis is a deep buttock muscle, right above the sciatic nerve. When it tightens or inflames, it can compress or irritate the nerve — reproducing “sciatica” symptoms, but with the source in the muscle, not the spine. This is why differentiating it from a herniated disc is essential for correct treatment.
Common symptoms
Deep buttock pain (not in the lower back), radiation down the back of the thigh and leg, worse with prolonged sitting, driving, stair climbing and certain hip rotations, tenderness deep in the buttock.
How is it distinguished from disc sciatica?
In piriformis syndrome, low back pain is absent or minor, the source is clearly in the buttock, and specific piriformis-tension tests reproduce the symptoms. In a herniation, pain typically starts in the lower back. Careful clinical assessment makes the difference.
Common causes
Prolonged sitting (especially on a wallet in the back pocket!), running or sports overload, gluteal imbalances, buttock trauma and poor posture.
Can it be treated without surgery?
Yes, almost always: relaxing and lengthening the piriformis, manual therapy, dry needling for the deep muscle, strengthening weak glutes and correcting sitting posture. Surgery is extremely rare.
How we treat piriformis syndrome at Medicine Park
We clearly differentiate it from the lumbar spine, then build the plan: manual therapy and dry needling for the piriformis and deep rotators, specific stretching, gluteal strengthening, nerve mobilisation and sitting/driving adjustments. All in English.
How long does recovery take?
Recent cases: 3–6 weeks. Chronic ones: 6–8 weeks of consistent work.
When to seek help
If your “sciatica” is not responding to usual treatment or the pain is clearly in the buttock, the piriformis is worth testing. Your first assessment at Medicine Park is free.
