Piriformis Syndrome (Deep Buttock Pain)
Piriformis syndrome produces deep buttock pain and leg pain that closely mimics disc-related sciatica — but originates from muscle irritation of the sciatic nerve in the buttock rather than from the spine. Accurate diagnosis changes the treatment approach entirely.
What Is Piriformis Syndrome?
The piriformis is a small muscle deep in the buttock that runs from the sacrum to the hip, helping stabilize and externally rotate the joint. The sciatic nerve passes either beneath or, in some people, directly through the piriformis. When the piriformis becomes tight, spasmed, or inflamed — from overuse, trauma, prolonged sitting, or underlying hip pathology — it can irritate or compress the sciatic nerve, causing deep buttock pain that can radiate down the back of the thigh and into the lower leg.
This pattern of symptoms closely resembles disc-related sciatica, which is why piriformis syndrome is frequently misdiagnosed and mistreated. Patients sometimes undergo spinal procedures or even surgery without relief because the true source of the problem was in the buttock, not the spine. A thorough examination that includes specific piriformis provocation tests — and a targeted injection when the diagnosis is uncertain — helps clarify the source before committing to any treatment.
How We Treat Piriformis Syndrome
Trigger point injections into the piriformis muscle can relieve the muscle spasm and reduce pressure on the underlying sciatic nerve. A targeted piriformis muscle injection performed under image guidance allows medication to be delivered precisely into the muscle belly, confirming the diagnosis while providing therapeutic relief.
Physical therapy focused on hip and gluteal muscle strengthening, flexibility, and movement pattern correction is an important part of longer-term management. Addressing any contributing factors — such as hip pathology, leg length discrepancy, or gait abnormalities — helps prevent recurrence. A consultation will help determine whether your symptoms are consistent with piriformis syndrome and guide the appropriate next steps.
Common Questions
Buttock Pain That Won’t Respond to Spine Treatment?
Our clinical team will evaluate whether piriformis syndrome is contributing to your pain — and develop a targeted treatment plan.