From the Research
Piriformis syndrome typically presents as pain in the buttock that may radiate down the posterior thigh along the sciatic nerve distribution, with symptoms worsening with prolonged sitting, climbing stairs, or squatting, as reported in the most recent study 1. The presentation of piriformis syndrome can vary, but common symptoms include:
- Deep, aching pain in the gluteal region
- Pain radiating down the back of the leg
- Tenderness upon palpation of the piriformis muscle
- Pain intensifying with activities involving hip rotation, particularly internal rotation
- Paresthesias (tingling, numbness) in the affected leg, similar to sciatica symptoms
- Morning stiffness in the buttock region
- Antalgic gait to compensate for the pain Physical examination often reveals positive findings on specific tests such as the FAIR test (Flexion, Adduction, Internal Rotation), Freiberg's sign, or Pace's sign, as noted in 2, 3, 4, 5. The syndrome results from compression or irritation of the sciatic nerve by the piriformis muscle, which can occur due to muscle spasm, hypertrophy, or anatomical variations where the sciatic nerve passes through the muscle rather than beneath it, as discussed in 1. Trauma, overuse injuries, or biomechanical abnormalities may trigger the condition, making it particularly common among runners, cyclists, and individuals who sit for prolonged periods, as mentioned in 2, 4.