A deep, nagging ache in the buttock that sometimes shoots down the back of the leg is easy to mistake for a back problem. Often, the real culprit is a small muscle called the piriformis. At Stiso Chiropractic, Acupuncture & Massage Therapy, Dr. Frank Stiso helps patients from Manasquan, Wall Township, and across Monmouth County find the true source of their pain and get relief with conservative, drug-free care.
What Is Piriformis Syndrome?
The piriformis is a small, pear-shaped muscle that sits deep in the buttock. It connects the base of the spine to the top of the thigh bone and helps rotate your hip outward. The sciatic nerve, the largest nerve in the body, passes directly beneath it, and in some people it passes right through it.
When the piriformis becomes tight, overworked, or irritated, it can squeeze or aggravate the sciatic nerve. The result is piriformis syndrome: pain in the buttock, and often pain, tingling, or numbness that travels down the leg.
Piriformis Syndrome vs. Sciatica: What Is the Difference?
Sciatica is a symptom, not a diagnosis. It describes pain that follows the path of the sciatic nerve. The most common cause is a problem in the lower back, such as a disc herniation. Piriformis syndrome is another possible cause, where the nerve is irritated in the buttock instead of at the spine.
The two can feel remarkably alike, but they are not treated the same way. Piriformis syndrome often comes with less low back pain and more pain while sitting. A careful exam is how we tell the difference, so you get the right care the first time. If you want to learn more about nerve pain that starts in the spine, see our page on sciatica treatment.
Common Symptoms of Piriformis Syndrome
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A deep ache in the middle of the buttock
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Pain, tingling, or numbness down the back of the thigh, sometimes into the calf or foot
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Pain that gets worse after sitting for a long time, especially on hard surfaces or while driving
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Pain when climbing stairs, running, or cycling
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Tenderness when pressing into the buttock muscle
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Pain with crossing your legs or rotating the hip
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Tightness or stiffness in the hip
What Causes Piriformis Syndrome?
Piriformis syndrome usually develops when the muscle is overloaded or the joints around it are not moving well. Common contributing factors include:
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Sitting for long hours at a desk or in the car
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Sitting on a thick wallet in a back pocket
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Running, cycling, or other repetitive lower body activity
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A sudden increase in exercise or training intensity
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A fall or direct blow to the buttock
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Stiffness or poor movement in the lower back, pelvis, or sacroiliac (SI) joints
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Weak gluteal muscles that force the piriformis to work overtime
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Differences in how you walk or stand that put uneven stress on one hip
How Chiropractic Care Helps Piriformis Syndrome
The piriformis does not work alone. It is part of a chain that includes your lower back, pelvis, SI joints, and hips, and a problem in any of these areas can leave the muscle overworked. Dr. Stiso evaluates the whole chain rather than just the sore spot.
Your care plan may include:
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Chiropractic adjustments to the lower back, pelvis, SI joints, and hips to improve motion
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Soft tissue techniques for the piriformis and surrounding gluteal muscles
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Stretching and strengthening exercises to improve hip mobility and glute support
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Ergonomic advice for your desk, car seat, and daily habits
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Guidance on a safe return to running, cycling, or sports
Because we offer massage therapy under the same roof, our licensed massage therapists can work on deep hip and glute tension as part of a complete plan.
What to Expect at Your First Visit
Your first visit starts with a conversation about your symptoms, when they started, and what makes them better or worse. Dr. Stiso will examine your lower back, pelvis, and hips, and test how the muscles and nerves are responding. If imaging or a referral is needed to rule out other causes, we will let you know. If chiropractic care is not the right fit for your situation, we will tell you and point you in the right direction.
We accept most major insurance plans for chiropractic care, and our staff will verify your benefits before your first appointment.
Simple Tips for Piriformis Pain Relief at Home
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Stand up, walk, and change positions at least every 30 minutes when sitting
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Take your wallet out of your back pocket before you sit
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Try a gentle piriformis stretch, such as lying on your back and pulling one knee toward the opposite shoulder, and stop if it increases your leg symptoms
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Apply heat to a tight, achy buttock muscle
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Ease back into running, cycling, or sports gradually
When to Seek Prompt Medical Attention
Most cases of buttock and leg pain are not emergencies, but go to the emergency room right away if you have leg pain along with loss of bladder or bowel control, numbness in the groin or inner thighs, or leg weakness that is getting worse. See a medical provider promptly if you have severe pain after a fall or injury, fever, or pain that is not improving after several weeks.
Piriformis Syndrome FAQs
What does piriformis syndrome feel like?
Most people describe a deep ache in the buttock, sometimes with tingling, burning, or numbness that travels down the back of the leg. It is usually worse after prolonged sitting and may ease when you stand or walk.
What is the difference between piriformis syndrome and sciatica?
Sciatica is the term for pain along the sciatic nerve, and it has several possible causes. Piriformis syndrome is one of them, caused by irritation of the nerve in the buttock rather than at the spine. A proper exam helps determine which one is behind your symptoms.
Can a chiropractor help with piriformis syndrome?
Yes. Chiropractors evaluate the lower back, pelvis, and hips, which all influence how the piriformis functions. Care often combines joint adjustments, soft tissue work, and targeted exercises.
How long does piriformis syndrome take to heal?
Recovery varies from person to person. Many people notice improvement within a few weeks of starting care, while longstanding cases can take longer. Consistency with your care plan and home exercises makes a big difference.
Do you accept insurance for piriformis syndrome treatment?
We accept most major insurance plans for chiropractic care. Call us at (732) 528-7746 and our staff will verify your benefits before your first visit.
Piriformis Syndrome Relief in Manasquan, NJ
You do not have to keep working around the pain every time you sit down. Call Stiso Chiropractic, Acupuncture & Massage Therapy at (732) 528-7746 or request an appointment today, and let us help you get back to sitting, moving, and training comfortably.