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What is Piriformis Syndrome and how can it be treated effectively?

We get many patients walk in to our clinic at Dynamic Regenerative Medicine saying - 'can you please help my piriformis syndrome?' So what is this? Piriformis syndrome, often misconceived as a standalone diagnosis, is a syndrome (syndrome meaning a collection of signs and symptoms). It is more accurately understood as a manifestation of underlying issues in neighbouring structures. These issues typically involve 3 main structural culprits - dysfunction or inflammation of the sacroiliac joint (SIJ), spinal inflammation, or dysfunction in the hip joint.

Understanding Piriformis Syndrome

Sacroiliac Joint Dysfunction or Inflammation

Sacroiliac Joint Dysfunction or Inflammation

The piriformis muscle is a deep buttock muscle, situated near the sacroiliac joint (SIJ). The SIJ is a very important joint that joins to spine to the pelvis. Dysfunction or inflammation of the SIJ is something we see very often. The piriform can often become guarded or tense in response to dysfunction or inflammation in local area, particularly the SIJ. The piriformis may contract or spasm to stabilise the joint, leading to buttock pain or even compression on nearby nerves and result in symptoms akin to piriformis syndrome. One very important nerve being the sciatic nerve, which if becomes irritated, this can cause pain down in to the leg.

Further information can be found here.

Spinal Inflammation

Spinal inflammation

Inflammation in the lumbar spine can also irritate nearby nerves, leading to protective guarding of the piriformis muscle, in efforts to stabilise local joints. This guarding aims to protect the area but can inadvertently contribute to compression of the sciatic nerve, mimicking the symptoms of piriformis syndrome. Examples of inflammation may include: disc inflammation, factory joint inflammation or ligament injury.

Further information can be found here.

Hip Dysfunction

Hip inflammation

Dysfunction in the hip joint or hip or hip bursitis is another common cause of piriformis syndrome. Hip dysfunction or inflammation can alter biomechanics and place undue stress on surrounding muscles, including the piriformis. Guarding or tension in the piriformis muscle may develop as a compensatory mechanism to stabilise the hip, exacerbating symptoms associated with piriformis syndrome.

Further information can be found here.

In addition to these structural issues, nerve root irritation in the lumbar spine can also contribute to piriformis guarding, as nerves from the lumbar spine travel through or adjacent to the piriformis muscle.

Treatment options for Piriformis Syndrome

At Dynamic Regenerative Medicine we have the approach to treatment of piriformis syndrome by addressing the root cause of the problem through manual hands-on therapy techniques and physical therapy. This may include:

Manual Therapy

We employ various manual therapy techniques in osteopathy to address dysfunction in the sacroiliac joint, low back, and hip joint. This may involve soft tissue manipulation, joint mobilisation, and stretching to alleviate tension in the piriformis muscle and surrounding structures.

Corrective Exercises

In conjunction with osteopathy and manual therapy, corrective exercises are prescribed to improve biomechanics, strengthen weak muscles, and restore balance to the musculoskeletal system. These exercises target specific areas of dysfunction identified during assessment, helping to address the underlying causes of piriformis syndrome.

Lifestyle Modifications

Our experienced musculoskeletal clincians m provide education on posture, ergonomics, and lifestyle modifications to reduce strain on the affected structures and prevent recurrence of symptoms. This may include guidance on proper body mechanics during daily activities and strategies to promote optimal musculoskeletal health.

Injection Therapy

Injection for piriformis syndrome

Aside from the conservative treatments mentioned above, in cases we may be able to offer injection therapy to reduce inflammation and stimulate repair and healing of irritated structures. Injection therapy may include: corticosteroids or Platelet Rich Plasma (PRP).

By addressing the underlying structural issues contributing to piriformis guarding and utilising a comprehensive approach to treatment, Dynamic Osteopaths can effectively alleviate symptoms and improve function for individuals suffering from piriformis syndrome.


Don’t let joint pain, joint damage, sports injuries or arthritis get in the way of allowing you to do what you want. Schedule a consultation at Dynamic Regenerative Medicine today, and let us treat your condition, provide pain relief and get you back to your full and active lifestyle. We have clinics operating out of Solihull (Henley-In-Arden) and Birmingham (Edgbaston).

Call us today on 01564330773


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