Piriformis syndrome occurs when the piriformis muscle — a small but powerful muscle located deep in the buttock — compresses or irritates the sciatic nerve as it passes underneath or through it. This causes pain that mimics sciatica, often radiating from the buttock down the back of the thigh and sometimes into the leg. Patients are sometimes diagnosed with “Deep Gluteal Syndrome”. This is a broader term and includes Piriformis syndrome. They are very similar and the treatment options are broadly equal.
Typical symptoms include:
Causes include muscle tightness or spasm, postural imbalance, pelvic or hip misalignment, or trauma such as a fall. In some individuals, anatomical variations in the sciatic nerve pathway make them more prone to irritation. Because piriformis syndrome can closely resemble spinal nerve compression at a spinal level, accurate specialist diagnosis is essential to ensure the right treatment.
At Wessex Pain Clinic, diagnosis begins with a detailed discussion of your symptoms, medical history, and physical activity patterns. Our consultants perform a focused physical examination, including specific manoeuvres that reproduce piriformis-related pain and help distinguish it from true sciatica or lumbar disc problems.
We may use MRI or ultrasound imaging to assess surrounding muscles, exclude spinal causes, and check for inflammation around the sciatic nerve.
Our physiotherapists and rehabilitation specialists focus on gentle stretching, posture correction, and strengthening of the surrounding pelvic and core muscles to prevent recurrence. Hydrotherapy can be valuable for pain-free movement and muscle relaxation.
We also work with pain psychology partners to support coping strategies, improve movement confidence, and address chronic pain-related fatigue or anxiety. When appropriate, our consultants collaborate with orthopaedic or spinal surgeons for further assessment, ensuring coordinated and complete care.
At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.
We may recommend:
All medication plans are reviewed regularly for safety and effectiveness.
When pain persists, we offer ultrasound-guided piriformis injections, combining local anaesthetic and corticosteroid to reduce inflammation and relieve muscle spasm.
In chronic or resistant cases, botulinum toxin (Botox®) injections may be used to relax the muscle and relieve pressure on the sciatic nerve for longer-lasting benefit.
If symptoms are linked with secondary spinal or sacroiliac dysfunction, nerve blocks or radiofrequency treatments may be incorporated into a broader management plan.
Our management of piriformis syndrome is multidisciplinary and tailored, combining medical, interventional, and rehabilitation strategies to relieve pain, release muscle tension, and restore normal movement.
Our friendly team is on hand to support you every step of the way. Please get in touch at any time.
