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  • Northwoods Health Centre

A real pain in the butt!

If you’ve ever experienced pain in the centre of your buttock, pain down the back of your leg, or pain in your hip, you may have been suffering from Piriformis syndrome.

The Piriformis muscle is a small muscle which is located in the buttocks. Its primary function is to allow the hip to rotate, or turn. In addition, this muscle allows you to balance while the foot is off the ground (as in walking) and stabilizes the pelvis. This little muscle works overtime in those of you who walk regularly or run.

Where does the pain come from?

This muscle is a very good candidate for the repetitive motion injuries (RMI). RMI occurs when a muscle is asked to perform above and beyond its capabilities, while not being, given enough time to recover before working again.

The typical muscular response in such a situation is to tighten in defense and cause irritation in the following manner: muscles are innervated by nerves, which surround or lie within them. The piriformis muscle lies over the ever-popular Sciatic nerve. When this muscle tightens, it can place pressure on the sciatic nerve and cause excruciating pain in the buttock, hip or back of the thigh.

In the case of the piriformis irritating the sciatic nerve, one may actually experience tingling or numbness, which arises when a nerve is compressed.


Any muscle that is continuously used needs an opportunity to recover. Since the muscle is tight because of overuse, one needs to rest, as continued use will only make the situation worse!

A little R&R is great as this will allow the muscle to relax and heal. Applying ice your poor buttock will reduce the inflammation/irritation and actually cause the muscle to relax.

The timing for the ice therapy is 15-20 minutes several times throughout the day. Once the swelling and inflammation have decreased, it is important to work out trigger points (as treated by a registered massage therapist or chiropractor) and stretch the muscle.

It is very important that you seek professional care from a physical therapist, chiropractor or medical doctor if you suffer from Piriformis syndrome.

If you stretch too soon, the sciatic nerve may get further irritated and damaged. If you massage too soon, the muscle will further inflame and cause more excruciating pain.

I recommend that you see a chiropractor to get the problem diagnosed and treated promptly. A chiropractor will ensure that the nerves that innervate the muscle function properly to allow a rapid, reassured recovery. In addition, chiropractors are famed for treating sciatica, which can arise if piriformis syndrome is left untreated. If this remains untreated, it can cause postural alterations which may cause back and other joint pain.

Remember, the sooner you address the problem the faster the recovery!

Article by Dr. Virinder Kasbia Miramichi Lodge

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