Piriformis Syndrome: Chronic Hip Pain, Causes and Treatment Methods

When there is hip pain radiating down the leg together with numbness, the first thing many people think of is a herniated disc compressing a nerve. However, the symptoms that occur may actually be caused by ‘piriformis syndrome’. Although it is a name that many people may never have heard of, piriformis syndrome is commonly found, especially among office workers.

Let us get to know piriformis syndrome more, along with various treatment approaches that help you say goodbye to chronic pain and return to moving freely again.

Key Takeaways

• Piriformis syndrome is caused by the piriformis muscle contracting and becoming inflamed, compressing the nearby sciatic nerve, resulting in chronic pain and numbness.
• Most cases of piriformis syndrome are caused by staying in the same position for a long time, thus it is commonly found among office workers. However, it may also occur from other causes including excessive use of the hip muscles, injury, congenital abnormalities of the hip muscles, as well as occurring together with other conditions or diseases.
• Can piriformis syndrome be cured? In most cases, treatment is conservative, including the use of pain-relieving medications, physical therapy, and behavioral modification. However, if symptoms are severe and do not improve, surgical treatment may be considered.

Get to Know ‘Piriformis Syndrome’: A Cause of Hip Pain Radiating Down the Leg That Is Unfamiliar but Common

Piriformis syndrome is hip pain radiating down the leg that may be accompanied by numbness. Medically, piriformis syndrome is called ‘Piriformis Syndrome’ because the pain occurs from the piriformis muscle contracting and becoming inflamed, compressing the nearby sciatic nerve. The sciatic nerve plays a role in controlling movement and sensation of the lower body. When it is compressed, it causes abnormal signal transmission, resulting in pain, numbness, or weakness.

What Causes Piriformis Syndrome?

Piriformis syndrome is caused by the piriformis muscle contracting, becoming inflamed, and compressing the sciatic nerve. The causes that lead to contraction or inflammation of the piriformis muscle are as follows:

• Staying in the same posture for a long time, causing the muscle to lose flexibility and contract.
• Repeated use of the hip muscles until the muscles enlarge and compress the sciatic nerve.
• Inflammation of the piriformis muscle from incorrect movement or injury from an accident.
• Congenital abnormal positioning or shape of the piriformis muscle or the sciatic nerve.
• Occurrence together with other conditions or diseases such as spinal stenosis, herniated disc compressing a nerve, hip joint capsule inflammation, cervical cancer, etc.

What Symptoms Are Called ‘Piriformis Syndrome’?

The main characteristics indicating piriformis syndrome are as follows:

• Lower back pain and buttock pain radiating down the leg.
• Deep pain in the buttock muscles, hip, and waist.
• Tender points in the hip area.
• Increased hip pain when sitting for a long time or when the piriformis muscle is stretched.
• In some cases, there may be numbness and weakness.

Who Is at Risk of Piriformis Syndrome?

Piriformis syndrome may not be a distant issue. People with the following behaviors or lifestyles are at higher risk of developing piriformis syndrome:

• Those who must remain in the same posture for a long time, such as office workers or those who sit driving for long periods, who are also at risk of developing office syndrome.
• Those who excessively use the hip muscles, such as people who exercise focusing on building hip muscles or athletes.
• Those who lack exercise, causing the hip muscles to lose flexibility.
• Those who experience accidents causing severe impact to the buttocks and hips.
• Those who regularly lift heavy objects.

Recommended Exercises for Piriformis Syndrome to Reduce Hip Pain by Yourself

Exercising the hip muscles to increase flexibility helps strengthen the muscles, reduce muscle tension, and effectively reduce hip pain. The hip muscles can be exercised with the following positions:

• Side-lying position: Start by lying on your side, then lift the leg and push the same leg backward before lowering it. Do 10 repetitions, counting as 1 set. Perform 3 sets before switching sides to perform the same movement.
• Supine position: Start by lying on your back, raise both knees perpendicular to the floor, then place the left ankle on the right knee. Then pull the right knee toward the body as much as possible. Hold for 10–15 seconds, counting as 1 set. Perform 3 sets before switching sides.
• Standing position: Start by standing facing a table at waist height. Bend the left knee and place it on the table. Then slowly lean forward as much as possible. Hold for 10–15 seconds. Perform 3 sets before switching sides.
• Seated position: Start by sitting, place the left leg on the right thigh, then slowly lean forward as much as possible. Hold for 10–15 seconds. Do 10 repetitions, counting as 1 set. Perform 3 sets.
• Self-massage for piriformis: Use a tennis ball placed on the floor and sit on it, then gently roll.

Treatment Methods for Piriformis Syndrome

Piriformis pain radiating down the leg can be treated with medications, surgery, and physical therapy. The choice of treatment depends on the suitability of the patient’s symptoms.

Medication Treatment

Initially, piriformis syndrome pain can be relieved with oral NSAIDs or muscle relaxants to reduce inflammation of the piriformis muscle.

Steroid Injection Treatment

If taking medication does not relieve the pain, the doctor may consider injecting steroids into the piriformis muscle so that the medication can directly reduce inflammation in the muscle. In cases of muscle tightness, botulinum toxin injection into the piriformis muscle may be used to help the muscle relax as well.

Physical Therapy Treatment

Even with conservative treatment or after surgery, physical therapy is still necessary to restore muscle strength, reduce pain, and prevent recurrence in the future. This can be done through exercise as recommended by a physical therapist or using medical tools such as shockwave therapy, ultrasound therapy, acupuncture, etc.

Surgical Treatment

Surgical treatment for piriformis syndrome is used in cases where conservative treatment does not yield satisfactory results. The surgery involves repositioning the piriformis muscle that compresses the nerve to prevent compression. After surgery, pain and numbness from nerve compression by the piriformis muscle will improve.

Do Not Endure Piriformis Syndrome Pain — It Can Be Treated at Praram 9 Hospital

Although hip pain radiating down the leg from piriformis syndrome is not life-threatening, it greatly affects quality of life. Whether sitting, walking, or standing, it can be uncomfortable, causing loss of many opportunities in life.

Do not let piriformis syndrome pain disturb daily life. Receive diagnosis and treatment at the Orthopedic Center, Praram 9 Hospital, providing services by orthopedic specialists along with modern medical equipment for accurate diagnosis and treatment. Patients can recover from piriformis syndrome pain and receive rehabilitation care to restore normal movement and prevent recurrence in the long term.

For more information

• Facebook: Praram 9 Hospital International & Expats
• Line: @Praram9Hospital
• Tel. 1270

Frequently Asked Questions about Piriformis Syndrome

1. Can piriformis syndrome be permanently cured?

Piriformis syndrome can be permanently cured by strengthening and increasing flexibility of the hip muscles to prevent nerve compression. However, it may recur if inappropriate behaviors that cause muscle tightness or inflammation continue.

2. How can piriformis syndrome be prevented?

Avoid sitting, standing, or lying in the same position for long periods. Change posture every 30–60 minutes, avoid lifting heavy objects or excessive use of the hip muscles, and regularly stretch the hip muscles to maintain flexibility and strength.

References

Hicks BL, Lam JC, Varacallo MA. Piriformis Syndrome. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448172/

Lightsey, R & Ellis, RR. (2024, February 25). Piriformis Syndrome: What Is It? WebMD. https://www.webmd.com/pain-management/piriformis-syndrome-causes-symptoms-treatments

Piriformis syndrome. (n.d.). healthdirect. https://www.healthdirect.gov.au/piriformis-syndrome