Sciatica Due to Piraformis Syndrome

Sciatica can be a real pain in the butt. The sciatic nerve begins in the lower back and then runs through the gluteal muscles near the piraformis muscle and then continues down the back of the leg. Literally.  With piraformis syndrome, the piraformis muscle (a deep lateral rotator in the gluteal region) is tightly held, thus pressing on the nearby sciatic nerve which goes down the back of the leg, causing numbness, tingling and pain in either just the buttock or the entire length of the leg. 

Now, not all sciatica is due to a tight piraformis muscle, but in a lot of cases it is.  And there can be help if it is from a tight piraformis muscle.  Massage therapy can be of help.  We have seen many people with sciatica due to piraformis syndrome and have seen excellent results from massage therapy treatments alone.

Symptoms of piraformis syndrome include the following: numbness or tingling in the buttock region or the leg, pain when walking (and more so when walking up the stairs), increased pain after prolonged sitting, reduced range of motion when trying to turn out the leg, etc.

We encourage clients to see a doctor to get a primary diagnosis so that we know that the pain in the buttock or leg is indeed due to the piraformis muscle rather than something more serious such as a disk issue.  X rays may be performed and diagnostic muscle tests are performed by either a doctor or a physical therapist to determine the exact cause.

Stretches for piraformis may bring some immediate relief.  Lie on your back with both knees up.  If working on the right piraformis muscle, cross that leg over the left leg.  Once the leg is crossed then bring your left leg up towards your face (your right leg will also move towards your face, thus stretching the piraformis muscle, associated fascia and other deep lateral rotators and gluteal muscles.

Massage therapy for piraformis muscle.  This starts with myofascial release to the fascia of the lower back (the thoracolumbar aponeurosis) and gluteal fascia.  Then effleurage and petrissage (Swedish strokes)are performed to warm up the area.  Muscle stripping is indicated to bring targeted blood flow to the piraformis muscle and associated muscles.  Deep trigger point therapy is performed to bring relief to irritated trigger points in the muscle and surrounding muscles.  Passive stretching is indicated to physical separate the sarcomeres to aid in pain relief.