Piriformis Syndrome: Deep Buttock Pain and What Can Help

Some people describe it as a deep ache right in the middle of one buttock. Others feel it as a tight knot that gets worse when they sit in the car, climb stairs, or cross their legs, and sometimes it sends pain or tingling down the back of the thigh. One possible cause of this pattern is piriformis syndrome. At Lake Hamilton Family and Sports Chiropractic in Hot Springs, we often help people sort out whether their buttock pain is coming from a muscle, a joint, or the lower back.

What Is the Piriformis Muscle?

The piriformis is a small, flat muscle deep in the buttock. It runs from the base of the spine (the sacrum) to the top of the thigh bone and helps rotate the hip outward. The sciatic nerve passes very close to it, and in some people it runs right through or beside the muscle. When the piriformis is tight, irritated, or in spasm, it may irritate the nearby nerve and cause sciatica-like symptoms.

Common Symptoms

• A deep ache or tenderness in one buttock
• Pain that is worse after sitting for a while, especially on hard seats or in the car
• Discomfort when climbing stairs, running, or getting up from a chair
• Pain, tingling, or numbness that may travel down the back of the thigh
• Some relief when walking or lying down

Piriformis Syndrome or Something Else?

Buttock and leg pain can come from several sources, including a herniated disc in the lower back, SI joint irritation, hip problems, or spinal stenosis. Piriformis syndrome is a debated diagnosis among researchers, and it is often identified by ruling out these other causes. That is why a hands-on exam matters more than guessing from a list of symptoms.

What Can Cause It?

There is often no single cause, but common contributors include:

• Prolonged sitting, including long drives or desk work, or sitting on a wallet in your back pocket
• Overuse from running, cycling, hiking hills, or sports with lots of cutting and pivoting
• A fall or direct hit to the buttock
• Weak hip and core muscles that make the piriformis work harder
• Changes in how you walk because of a sore foot, knee, or back

Home Care That May Help

• Take breaks from sitting. Stand and walk for a few minutes every half hour.
• Move your wallet out of your back pocket.
• Try gentle stretching. A common one is lying on your back, crossing the sore-side ankle over the opposite knee, and gently pulling the knee toward your chest until you feel a stretch. Stop if it causes sharp pain or tingling.
• Use heat on tight muscles, or ice if it feels better after activity.
• Ease off aggravating activities for a short time rather than stopping all movement.

How Chiropractic and Hands-On Care May Help

At our office, an evaluation usually looks at your lower back, pelvis, and hips together. Depending on what we find, care may include chiropractic adjustments for the lower back and pelvis, soft tissue work or massage for the tight muscles of the hip and buttock, and stretching and strengthening exercises you can do at home. The goal is to reduce irritation and address the habits or weaknesses that keep the problem coming back. Results vary from person to person, and if your symptoms point to something that needs other care, we will tell you.

When to Seek Care Right Away

Get prompt medical care if leg weakness is getting worse, you have numbness in the groin or inner thighs, you lose control of your bladder or bowels, or the pain follows a serious fall or comes with fever.

Frequently Asked Questions

Is piriformis syndrome the same as sciatica?

Not exactly. Sciatica describes pain along the sciatic nerve, and it has several possible causes. Piriformis syndrome is one possible cause, but disc and joint problems in the lower back are also common causes.

How long does piriformis syndrome last?

It varies. Many people improve over weeks with activity changes, stretching, and hands-on care, while others take longer, especially if the underlying cause is not addressed.

Can massage help piriformis pain?

Many people find that massage and other soft tissue work help relax a tight piriformis and the surrounding hip muscles, especially when combined with stretching and strengthening.

Schedule a Visit

If deep buttock or hip pain is keeping you from sitting, walking, or sleeping comfortably, our chiropractic office in Hot Springs can help you understand what is going on and what your options are. Learn more about our massage therapy, or book an appointment online.

Our Hot Springs office is at 1880 Airport Rd Suite B, Hot Springs, AR 71913, (501) 762-9648, open Monday through Friday, 8:30am to 5:30pm. Our Ashdown office is at 370 W Main St, Ashdown, AR 71822, (870) 898-5037, open Tuesdays only, 8:30am to 4:00pm.

This article is educational and is not a substitute for individual medical advice. If you have severe or sudden pain, numbness or weakness, loss of bladder or bowel control, fever, chest pain, or pain after a serious fall or accident, call 911 or go to the nearest emergency room.