Piriformis Syndrome : A Lesser Known Cause of Buttock Pain & Sciatica

Piriformis muscle is located deep in the buttock and helps to rotate the leg outwards. It extends from the side of sacrum and tailbone to the upper part of thigh bone. Most patients present with buttock and leg pain which is worse on sitting and with hip movements. Pain is described as a dull ache, shooting or burning sensation associated with buttock tenderness. Most patients sit with the affected side tilted upwards. Some patients complain of a swelling, sausage shaped lump sensation in the buttock. Pain commonly radiates towards hip or down the back of the thigh, leg. Walking upstairs or on inclines can increase pain, with relief on lying down. Sometimes when pain is severe it may cause individuals to limp while walking. In females there may be pain during sexual intercourse (dyspareunia). Treatment involves a combination of the following; · Short term rest and activity modification · Lifestyle modification · Physical therapy including stretching exercises of the piriformis, hamstring muscle and strengthening of the abductor and adductor muscles · Medications including anti-inflammatories, muscle relaxants, neuropathic medications (ones used for nerve pain).