Piriformis syndrome

Hip: Piriformis syndrome


Piriformis syndrome is a neuromuscular issue, in which the piriformis muscle (located in the gluteal region, between the sacrum and the great trochanter of the femur) compresses the passage of the sciatic nerve.

This syndrome is often been associated with other problems (such as disc pathologies, myofascial retractions or vertebral blocks) and is a very frequent condition, above all due to an excessively sedentary lifestyle.

Piriformis syndrome is a condition in which this muscle is inflamed (or shortened), creating an area of ​​stenosis that can affect both the sciatic nerve and the entire hip joint.

In this condition, a spasm of the piriformis muscle can:

  • Entrap the sciatic nerve
  • Block the hip by reducing its movement
  • Create wrong adaptations of the plantar supports, of the pelvis or of the column
Piriformis syndrome
Anatomy atlas: “Sobotta: General anatomy and musculo-skeletal system”, F. Paulsen and J. Waschke

Symptoms of piriformis syndrome affect the buttock and back of the thigh.
These are mainly of a neurological and muscular nature, such as:

  • tingling and numbness along the back of the thigh, calf and foot
  • deep pain and/or stiffness in the buttock
  • difficulty in sports, walking or climbing stairs
  • difficulty maintaining a sitting position for a long time (for example, in a car)


In some cases, when the symptoms are neglected for a long time, the pudendal nerve, which controls the muscles of the bladder, may also be affected, with related groin pain and urinary incontinence.

Osteopathic treatment

After a careful evaluation and excluding a possible sciatica syndrome, the osteopath:

  • look for and treat joint blocks in the pelvis, lumbar spine or foot
  • performs manipulations to relax the piriformis muscle, the pelvic floor and the thoracic diaphragm
  • performs manipulations to work on the alignment between the piriformis and the leg
  • verifies and treats the relationships between the pelvis, back and plantar supports
Piriformis syndrome

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