Resolving Posterior Pain: Piriformis Syndrome

The piriformis muscle is located in the buttock area. It is a small cylindrical muscle that fixes to the sacrum or tailbone. It then runs diagonally through buttock and fixes to the lateral side of the femur or thigh bone. Typically, a chronically tight muscle wouldn't be complicated enough to warrant the classification of a "syndrome." Nonetheless there happens to be one key component to piriformis syndrome. The sciatic nerve runs a line right under the piriformis. When the muscle is chronically restricted, the sciatic nerve becomes irritated. When a nerve becomes aggravated, it becomes swollen. Since swelling is a pain generator, and nerves are highly sensitive, piriformes syndrome can be very agonizing. Even though this syndrome is basically merely a chronically tight muscle, evaluating piriformis pain often involves a difficult diagnosis.

There are many different options to treat piriformis, but piriformis syndrome treatment depends on the cause of the piriformes muscle contracture.

Stretches for Lower Back Pain

If the cause of the piriformis syndrome is due to incessant usage of the piriformis, which is common in track athletes, rest together with committing to a routine of stretches for lower back pain is the only treatment.

Invasive Piriformis Pain Treatment

If the syndrome is persistent enough, scar tissue will develop to replace normal muscle fibers due to enduring levels of local irritation. In these cases, the only available piriformis syndrome treatment is conservative myofascial release therapy or the more aggressive injectable treatment.

While all treatments above are effective remedy responses for the condition, the main concern is why the muscle contracted to start with.

Piriformis Syndrome Treatment Through Chiropractic Care

In my experience, over 75% of all piriformis pain is due to a structural aberration of the pelvis, especially the sacrum or tailbone. If the bones which make up the pelvis aren't correctly articulating, the muscles that attach to those bones will become stressed, and understandably limited. A chiropractor can appraise bone structure issues that might be impacting on the condition. By correcting the structure and alignment of the pelvis through both regular stretches for lower back pain, and with the help of chiropractic adjustments, one is able to provide a treatment at the true cause.


Dr. Andy Thomas of Village Chiropractic in The Woodlands, Texas addresses Piriformis Syndrome treatment options. Piriformes is commonly resolved simply with stretches for lower back pain, but often nothing helps effectively. It depends on the cause of the Piriformis Syndrome as to what works, and Dr. Thomas reviews the differences here.