Dr. Vaishali Suri (P.T.)
Piriformis Syndrome: The 'Pseudo-Sciatica'
The piriformis is a small muscle deep in the buttock that rotates the hip externally. The sciatic nerve runs immediately beneath (and in 15% of people, through) the piriformis muscle. Piriformis syndrome occurs when the piriformis muscle becomes tight, spasmed, or inflamed, irritating the sciatic nerve and causing symptoms that mimic disc-related sciatica: deep buttock pain, hip pain, and sometimes radiating leg pain.
Distinguishing Piriformis Syndrome from Disc Sciatica
Piriformis syndrome differs from discogenic sciatica in several ways: pain is typically in the buttock rather than the lower back, symptoms may worsen with sitting (pressure on piriformis) and improve with walking, pain often worsens with activities involving hip internal rotation (sitting cross-legged on the floor), and there is typically tenderness directly over the piriformis muscle deep in the buttock. A physiotherapy assessment reliably differentiates the two conditions.
Physiotherapy Treatment
Piriformis Stretching
Specific piriformis stretches reduce muscle tension compressing the sciatic nerve. The most effective are: figure-of-four stretch (lying or seated), pigeon pose modification, and supine hip external rotation with knee to opposite shoulder.
Dry Needling
Dry needling of the piriformis trigger point provides rapid pain relief and is one of the most effective treatments for piriformis syndrome. The muscle is accessed through the gluteal tissue.
Hip Strengthening
Weakness of the hip abductors and external rotators (of which piriformis is one) — paradoxically — causes piriformis overload as it compensates for weaker muscles. Strengthening the entire hip external rotator group reduces piriformis overuse.
Neural Mobilisation
Sciatic nerve mobilisation techniques reduce neural tension and improve sciatic nerve gliding through the piriformis region.
Piriformis Treatment in Faridabad
At Realign Rehab Clinic, NIT-5, Faridabad, we accurately diagnose and treat piriformis syndrome. Book your assessment today.