Commonly, patients with piriformis syndrome complain about a deep pain in a buttock, but aren’t able to describe exactly where the pain is coming from. Sitting, climbing stairs or performing squats can make the bothersome, achy pain even worse.

Because the sciatic nerve supplies nerve function to the leg, patients may also experience pain that moves to the outside of the thigh or even as far as the foot. For that reason, piriformis syndrome is classified as a type of sciatica, which is a category of conditions that cause tingling sensations, burning sensations, shooting pain, prickling and even numbness along the lower limb.

When there’s no pain, people usually take piriformis muscles for granted, and don’t realize that they’re responsible for an extremely important movement: external hip rotation. To understand how the muscles work, picture a soccer player trying to kick or pass a ball with the inside of his foot. To perform this motion, he must rotate his leg about 80 degrees, so the foot is pointing outwards.

Without the piriformis muscle, this movement would be impossible. But a number of factors can interfere with the muscle, hindering performance and causing great pain. These include trauma to the sacroiliac joint (a joint in the pelvis that’s comprised of two bones: the sacrum and the ilium), sitting with one leg crossed over the other, having one leg that’s longer than the other, sitting or driving while one leg faces outward, improper walking, poor posture and faulty spine mechanics.

Hormones can also be a factor, and for that reason women are more prone to piriformis syndrome because they experience constant hormonal changes, such as those caused by menstruation, oral contraceptives, pregnancy and menopause. During pregnancy, for example, the body produces a hormone called relaxin to loosen ligaments around the pelvis in preparation for birth. The muscles around the pelvis, including the piriformis muscles, react by tightening up, forcing the piriformis muscles to work harder to stabilize the area.

With all these complications, and mostly because piriformis syndrome produces symptoms that are similar to other forms of sciatica, the condition can be very difficult to diagnose. Once your healthcare practitioner determines the correct cause, however, he or she can provide effective care.

Your chiropractor can prescribe a number of stretches that can improve the muscle’s functioning, and he or she may also recommend strengthening exercises that focus on the areas surrounding the piriformis. These exercises can help increase blood flow, strengthen weak structures and remove toxic blood products like lactic acid.

In the initial stages, rest and ice can also be helpful. By resting and avoiding activities that exacerbate the pain, you allow the muscle time to heal. By applying ice to the muscle, you help reduce swelling and decrease the amount of painful inflammatory chemicals in the area.

In conjunction with stretching and strengthening, your chiropractor may also use spinal manipulative therapy, also known as adjustment or manipulation. This can help correct spinal joint dysfunction (SJD) in the pelvis and low back. Evidence suggests SJD causes or contributes to tight piriformis muscles and a dysfunctional pelvis.