Piriformis syndrome is a condition that causes discomfort and pain in your glutes, hips, and lower back. It is believed to happen when your piriformis muscle compresses or irritates your sciatic nerve. Often mistaken for sciatica – which is pain along the sciatic nerve caused by compression or irritation – piriformis syndrome is a unique condition with its own causes and remedies. Read on to learn how our in-home and virtual personal trainers help clients with piriformis syndrome without exacerbating their symptoms.

THE PIRIFORMIS AND THE SCIATIC NERVE

The piriformis is a small but essential muscle near the top of your hip joint. It plays a critical role in stabilizing your hip and facilitating movement. “The sciatic nerve runs just adjacent to the piriformis muscle, which functions as an external rotator of the hip. Hence, whenever the piriformis muscle is irritated or inflamed, it also affects the sciatic nerve, which results in sciatica-like pain” (NCBI, 2023).

Though sciatica and piriformis syndrome both involve irritation of the sciatic nerve, they stem from different causes. Sciatica is typically caused by a spinal issue, like a herniated disc or degenerative disc disease, which leads to compression of the sciatic nerve at the root in the lower back. This results in pain, numbness, or tingling that radiates from the lower back down your leg. On the other hand, piriformis syndrome is when the piriformis irritates the sciatic nerve. While both conditions cause similar pain, piriformis syndrome is thought to originate from tightness or injury of the hip or glute rather than a spinal issue. Our in-home personal trainers in Toronto work with clients dealing with piriformis syndrome and sciatica daily.

SYMPTOMS OF PIRIFORMIS SYNDROME

The most common symptom of piriformis syndrome is a deep, aching pain in the glutes, often on one side. Discomfort in the hip area, especially during movement, is also common. This pain and discomfort may cause numbness or tingling – a “pins and needle” sensation – down the legs, which is a direct result of sciatic nerve compression. Symptoms can worsen with prolonged sitting or activities that put pressure on the glutes, like driving or working at a desk. Limited range of motion or stiffness in the hip can also happen, especially when rotating your leg outward.

CAUSES OF PIRIFORMIS SYNDROME

Piriformis syndrome is often associated with activities that put strain on the hips and lower back. Athletes, especially runners and cyclists, may develop piriformis syndrome due to repetitive stress on the piriformis muscle. Sitting for long periods can also lead to muscle tightness and irritation, and a direct injury to the glute or hip area can cause inflammation that leads to sciatic nerve compression.

Lastly, weakness in surrounding muscles, particularly in your core or hips, can put additional stress on the piriformis muscle. This leads to overcompensation and strain. “While it has not been proven, the theory supported by many physicians is that when the piriformis muscle and its tendon are too tight, the sciatic nerve is pinched. This may decrease blood flow to the nerve and irritate the nerve as a result of pressure” (Very Well Health, 2024).

REMEDIES FOR PIRIFORMIS SYNDROME

Piriformis syndrome is typically treated with a combination of rest, exercise, and lifestyle adjustments. In general, it’s best to avoid activities that aggravate the condition, such as prolonged sitting or high-impact exercise. On top of this, stretching to alleviate tightness and specific exercises to address imbalances are often recommended by physical therapists. A certified in-home or virtual personal trainer can team-up with a physical therapist to design a program that suits your specific needs. Though we cannot prescribe or treat your condition, Nielsen Fitness trainers are certified to assist with management and prevention. If pain persists, we suggest using RICE (rest, ice, compression, and/or elevation of the affected area) until you can speak with your primary care provider.

EXERCISE WITH PIRIFORMIS SYNDROME

Exercise for clients with piriformis syndrome requires a careful approach to avoid worsening the condition while staying active. Our in-home and virtual personal trainers use low-impact activities that place less strain on the piriformis. We also utilize assisted stretching of the hips, glutes, and lower back (we offer in-home personal training packages that include hands-on stretching) to help relieve muscle tightness and reduce sciatic nerve pressure. Strengthening the core and hip muscles is also essential to support proper alignment. That said, you should always listen to your body. If an exercise causes pain, let your in-home or virtual personal trainer know immediately. We’ll stop and modify your routine.

PREVENTION OF PIRIFORMIS SYNDROME

“There is no reliable way to prevent piriformis syndrome. For people who have had this or other back problems, standard recommendations include home exercises and stretching, a heel lift (if the legs are of different lengths), not carrying a wallet in the back pocket, avoiding prolonged sitting, and getting treatment for other contributing conditions (such as spinal arthritis or foot problems). If triggered by vigorous exercise, reducing exercise intensity or changing activities (for example, from running to swimming) can prevent future episodes” (Harvard Health, 2022). Maintaining good posture, practicing proper form and technique during physical activities, and strengthening the muscles around the hips and core can reduce your risk. You should also warm

up before engaging in physical activity, and incorporate stretching into your daily routine. If you sit for long periods, take frequent breaks to stand and move.

CLOSING WORDS

Piriformis syndrome is a manageable condition with the right lifestyle changes. Working with an in-home or virtual personal trainer is a proactive step to alleviate discomfort; a healthy, active lifestyle goes a long way. At Nielsen Fitness, first sessions are zero pressure and always free! Book yours here.