What Is Piriformis Syndrome?
Piriformis Syndrome is a neuromuscular condition that occurs when the piriformis muscle – a small, deep muscle located in the buttocks compresses or irritates the sciatic nerve.
This can cause pain, tingling, or numbness in the buttock and along the path of the sciatic nerve down the leg. It’s often mistaken for sciatica, but the root cause is muscular rather than spinal.
What Causes Piriformis Syndrome?
The condition can develop from a variety of mechanical or lifestyle factors, such as:
Muscle Imbalances or Overuse
- Prolonged sitting (tightens piriformis)
- Poor posture or gait
- Weak glutes and core
Repetitive Motion
- Running, cycling, or stair climbing without proper mobility
- Overtraining or sudden increase in exercise volume
Injury or Trauma
- Direct trauma to the buttocks (e.g., falling)
- Hip, pelvis, or sacroiliac joint misalignment
Common Symptoms
- Deep aching or burning pain in the buttocks
- Pain radiating down the back of the thigh (similar to sciatica)
- Pain worsened by sitting, climbing stairs, or hip rotation
- Possible reduced range of motion in the hip
Treatment Options
Conservative Approaches (First Line)
- Rest & Ice: Reduce inflammation
- Anti-inflammatory medications
- Stretching & mobility exercises
- Myofascial release or massage
- Foam rolling of glutes/piriformis area
Physical Therapy
- Correcting muscular imbalances
- Improving hip alignment and mobility
- Core strengthening
Medical Interventions (if persistent)
- Corticosteroid injections
- Surgery (very rare, for severe cases only)
Fitness Pilates – What to Do and Avoid
RECOMMENDED EXERCISES
These focus on hip mobility, glute activation, and piriformis stretching:
1 Supine Piriformis Stretch
Lying on your back, cross one ankle over the opposite knee and gently pull the thigh toward your chest.
Great for releasing piriformis tension.
2 Glute Bridges
Targets the glute max to relieve piriformis overload.
Add a Pilates ball or band between knees for engagement.
3 Clamshells (Side Lying)
Strengthens glute medius and helps stabilise the hip.
4 Pelvic Tilts/ Imprinting
Encourages spinal and pelvic control without aggravating the nerve.
5 Hip Rolls (Modified)
Gentle spinal articulation while maintaining control in the pelvis and glutes.
6 Supine Leg Slides/ Toe Taps
Safe core strengthening without excessive hip flexion.
EXERCISES TO AVOID (During Flare-Ups)
Avoid movements that may compress the sciatic nerve or overwork the piriformis:
- Deep external rotation work (e.g., extreme “figure four” holds)
- Long lever leg lifts (e.g., straight leg raises with hip flexion)
- Overstretching the piriformis aggressively
- High impact Pilates (e.g., jumping, hopping)
- Seated spinal twists with leg crossed over (may further irritate sciatic nerve)
