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Piriformis syndrome

Syndroma musculi piriformis · Syndrom hruškovitého svalu

What it is

The sciatic nerve irritated where it passes the piriformis muscle deep in the buttock — sciatica-like pain from sitting.

Symptoms & signs

  • Deep buttock pain
  • pain worse on sitting
  • pain down the back of the thigh
  • tingling in the leg

🚩 Get help if…

  • call 112 / 911 now Numbness between the legs or loss of bladder or bowel control
  • call 112 / 911 now Weakness of the leg or foot drop
  • see a doctor soon Pain that keeps getting worse or wakes you at night
  • see a doctor soon Buttock pain with fever or weight loss

Where it strikes

Medical treatment

  • Exclude a disc problem (MRI)
  • stretching and physiotherapy
  • NSAIDs
  • steroid or botulinum toxin injection
  • surgical release rarely

Natural & lifestyle

  • No long sitting, no wallet in the back pocket
  • hip-strengthening exercises
  • foam rolling

Emerging & experimental

  • Ultrasound-guided hydrodissection
  • shockwave therapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Dry needling — small studies early / small studies
  • Massage — small studies early / small studies
  • Magnesium — anecdotal anecdotal / traditional

ICD codes