Despite its prevalence, piriformis syndrome is widely misunderstood. To help get you up to speed, here is what you need to know about the anatomy of your piriformis muscle and the pain associated with it:

What is your piriformis muscle?

The first thing you need to know about your piriformis muscle is that it is located in your buttock. More specifically, the muscle starts in your lower spine and passes through your greater sciatic notch. It then attaches to the upper part of each of your femurs (you have a piriformis muscle on either side of your body).

Your piriformis muscle runs diagonally, and your large sciatic nerve runs below it. However, for some people all or part of their sciatic nerve runs through their piriformis muscle.

Your piriformis muscle has 2 main functions. First, it helps enable your hip to rotate. Second, your piriformis muscle allows your leg and foot to turn outward.


Why does it hurt so much?

Piriformis syndrome is defined as a condition in which your piriformis muscle spasms and causes pain in your buttock. This spasming may also aggravate a nearby sciatic nerve root, which in turn sends sciatica-like symptoms racing down your large sciatic nerve.

See Sciatica Symptoms

There are a number of possible reasons your piriformis muscle may spasm, including:

  • The irritation of your piriformis muscle or your sacroiliac joint
  • An injury that causes your piriformis muscle to tighten
  • An injury that causes your piriformis muscle to swell
  • Bleeding in the area around your piriformis muscle

See Is Piriformis Syndrome the Same Thing as Sciatica?

Common symptoms of piriformis syndrome include:

  • A dull pain in your buttock
  • Increased pain when walking up an incline
  • Increased pain after sitting for long periods of time
  • Pain, tingling, or numbness in your thigh, calf, or foot

Read more: Symptoms and Diagnosis of Piriformis Syndrome

Symptoms felt along your large sciatic nerve are not catergorized as sciatica. This is because your piriformis muscle is not located in your lumbar spine, but rather your buttock. This distinction is important because treatments may differ for piriformis syndrome compared to sciatica (which is caused by a variety of lower back conditions).

Part of the diagnosis process for piriformis syndrome is ruling out other possible disorders that can mimic piriformis syndrome symptoms, including sacroiliac joint dysfunction or lumbar disc disease. In light of this, if you suspect you have piriformis syndrome it is important you do not self diagnose, but rather schedule an appointment with your doctor.

Learn more:

Piriformis Muscle Stretch and Physical Therapy

Piriformis Syndrome Treatment

Dr. Jeffrey McConnell is an orthopedic surgeon, and for more than 25 years he has specialized in spine surgery. In addition to his clinical career, Dr. McConnell has been actively involved in research to advance the field of spine surgery.