Piriformis Syndrome – Bromley Sports Injury Clinic

Key Points

• Piriformis Syndrome occurs when the sciatic nerve is compressed or irritated by the piriformis muscle in the buttock.

• Symptoms mimic sciatica — pain, tingling, or numbness radiating down the leg — but the cause is in the buttock, not the spine.

• It is common in runners, gym-goers, and those who sit for long periods.

• At Bromley Sports Injury Clinic we use clinical testing and diagnostic ultrasound to confirm the diagnosis and exclude other causes.

👉 Related: Sciatica | Disc Herniation | Hip Pain Clinic

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What is Piriformis Syndrome?

The piriformis is a small muscle deep in the buttock that helps rotate the hip.

In some people, the sciatic nerve passes underneath or even through this muscle. If the piriformis becomes tight, inflamed, or overworked, it can compress the nerve, leading to leg pain and neurological symptoms.

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Symptoms of Piriformis Syndrome

• Pain in the buttock, sometimes radiating down the leg

• Tingling or numbness in the thigh, calf, or foot (sciatic distribution)

• Pain that worsens with sitting, driving, or running

• Relief when lying down or stretching the buttock

• Buttock tenderness on pressure

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Causes & Risk Factors

• Prolonged sitting (drivers, office workers)

• Runners or athletes with repetitive hip rotation

• Trauma to the buttock (fall, impact, surgery)

• Muscle imbalance — weak glutes, tight hip rotators

• Anatomical variations (nerve path differences)

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Why Diagnostic Ultrasound Matters

Piriformis syndrome mimics sciatica and other nerve conditions. Ultrasound helps confirm the cause by:

• Visualising the piriformis and deep gluteal muscles

• Detecting local inflammation, bursitis, or muscular hypertrophy

• Excluding hamstring, gluteal, or hip joint pathology

• Supporting ultrasound-guided injections if required

👉 This avoids misdiagnosis and unnecessary spinal investigations.

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Diagnosis at Bromley Sports Injury Clinic

• Osteopathic assessment – posture, gait, hip rotation testing

• Diagnostic ultrasound – imaging of piriformis and sciatic nerve in the buttock

• Differential diagnosis – ruling out sciatica from a disc herniation or spinal cause

• Referral – MRI if symptoms are atypical or persistent

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Self-Help for Piriformis Syndrome

• Stretching the piriformis and glutes daily

• Heat therapy to relax tight muscles

• Avoid prolonged sitting — stand and move regularly

• Use a cushion or adjust seating position when driving/working

• Strengthen glutes and core to support hip alignment

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Treatment Options at Bromley Sports Injury Clinic

✅ Osteopathic treatment – soft tissue release, mobilisation, nerve glides
✅ Exercise rehabilitation – hip and glute strengthening, piriformis stretches
✅ Sports massage – targeted release of buttock and hip muscles
✅ Diagnostic ultrasound – confirming diagnosis, ruling out other causes
✅ Ultrasound-guided injections – in resistant cases (e.g. corticosteroid or local anaesthetic)
✅ Training advice – technique correction for runners and gym users

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Prevention

• Regular stretching of hips and glutes, especially for runners and desk workers

• Strengthen glutes, core, and hip rotators

• Avoid prolonged sitting without breaks

• Build training load gradually

• Correct posture and ergonomics for sitting/driving

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FAQs – Piriformis Syndrome

Q: How do I know if it’s piriformis syndrome or sciatica?
Piriformis syndrome causes buttock pain with possible leg tingling, but spinal sciatica often comes with back pain. Assessment and imaging help distinguish the two.

Q: Does ultrasound help with diagnosis?
Yes — ultrasound can assess the piriformis, surrounding tissues, and exclude other buttock causes.

Q: Can it go away on its own?
Yes, with stretching, posture correction, and activity modification. Persistent cases benefit from treatment.

Q: Is surgery needed?
Rarely. Most cases resolve with conservative management.

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Book Your Appointment

Don’t let buttock pain or sciatic symptoms hold you back. Book your piriformis syndrome assessment in Bromley today for diagnosis, rehab, and peace of mind.

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📍 Bromley Sports Injury Clinic | Same-week appointments available