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Piriformis Muscle: Low Back, Hip, Buttock, Pelvic, Thigh Pain

(Last Updated On: August 10, 2018)

Piriformis Pain Referral: Pain in the low back, hip, hip joint, pelvis, buttock and occasionally pain going down the back of the thigh indicate piriformis dysfunction.

Piriformis Muscle Pain: Signs and Symptoms

  • Low back pain at the base of the spine
  • Buttock pain
  • Hip pain around the hip joint
  • Aching pain, burning or tingling sensations down into the back of the thigh which occasionally extends into the lower leg and/or sole of the foot
  • Pelvic pain
  • Walking is painful. You will tend to have a shortened stride
  • Difficulty or inability to cross your legs
  • Difficulty or inability to spreading leg(s) side to side
  • Difficulty or inability to step out widely when walking/running
  • Sitting for long periods of time increases pain and discomfort in the hip and/or back of the thigh. You will have a tendency to squirm and shift around because of the discomfort.
  • Lying down may help diminish pain but will not totally alleviate it

Where is the piriformis muscle?

The piriformis muscle connects the sacrum (base of the spine) to the ball of the hip (greater trochanter).

What movements does the piriformis muscle control?

  • Twists the thigh away from the body
  • Moves the thigh away from the body
  • Straightens the thigh

Activities that cause piriformis pain and symptoms:

Slipping on a slick surface and trying to stay on your feet

  • Sitting excessively
    • Tendency to sit with more weight on one hip
    • Sitting with leg tucked under the hips
  • Hip Injury
    • Hip Replacement
    • Hip Fracture
    • Hip Pointer
  • Twisting while lifting
  • Golfers are prone to piriformis muscle problems because of the twist of the body when swinging
  • Activities and sports requiring quick abrupt changes in directions
    • Tennis
    • Football
    • Soccer
    • Basketball
  • Ankle and foot injuries can affect the piriformis muscle
    • Sprained, broken, and dislocated ankle
    • Plantar Fasciitis
    • Heel spur
    • Achilles tendon injury
Piriformis Muscle Origin, Insertion, Actions, Innervation

You use the piriformis muscle when you twist your thigh outward away from the body.

Interesting facts about the piriformis muscle:

  • Piriformis Syndrome

The sciatic nerve runs under the piriformis. The piriformis muscle will sometimes agitate the nerve causing symptoms of sciatica which include pain, tingling, and numbness in the buttock, hip, back of the thigh, and occasionally into back of the calf which sometimes extends to the bottom of the foot. This is known as piriformis syndrome. In approximately 15% of the population, the sciatic nerve runs directly through the piriformis muscle. These people are more like to have symptoms of sciatica.

  • Women are 6 times more prone to problems with piriformis muscle pain.

Piriformis Muscle Pain and Symptoms Can Be Similar To, Contribute To, and Be Affected By These Medical Diagnosis:

  • Sacral nerve compression
  • Sacroiliac joint displacement
  • Sciatica
  • Hip pointer
  • Hip dislocation
  • Trochanteric bursitis
  • L4 or L5 radiculopathy
  • Intervertebral stenosis
  • Ankylosing Spondylitis
  • Deep vein thrombosis
  • Pelvic floor syndrome
  • Cauda equina syndrome
  • Injury of the ankle
  • Injury of the hip
  • Injury of the Achilles tendon
  • Plantar Fasciitis
  • Bone Spur in the heel
  • Tensor Fasciae Syndrome

Other muscles that should be considered and examined in conjunction with the piriformis muscle:

Satellite trigger points associated with the piriformis muscle:

  • Gluteus minimus
  • Obturator internus
  • Gemellus superior
  • Gemellus inferior

For detailed anatomy information:  Piriformis Anatomy

Piriformis Muscle Pain Relief Recommendations

TENS Unit To Relieve Piriformis Pain

Piriformis muscle pain can be uncomfortable whether you are standing, sitting, or laying down. Doctors and physical therapists often recommend TENS unit to help relieve this pain. The HealthmateForever TENS unit is an affordable unit that offers not only TENS treatment but also various massage settings. A great choice for those on the go or as an introduction to TENS.

Cold Therapy Gel For Piriformis Low Back, Hip Injury and Pain

Biofreeze Pain Relieving Gel is a cold therapy gel that provides pain relieve for new injuries and is great as a maintenance treatment for overuse and repetitive use injuries. Cold therapy should be used on new and recent injuries instead of heat as it cools the area much like ice and does not promote swelling. A recent study showed that Biofreeze decreased pain 2 times more than ice and the pain relief lasts 9 – 10 longer. If  your pain is from a recent injury caused by twisting or lifting a heavy object or tight piriformis, I would recommend applying Biofreeze across the low back, top of the hips, entire buttock, down the outside of the hip and into the outside and the back of the upper thigh to treat piriformis symptoms.

Warm Therapy Gel For Low Back, Hip and Thigh Pain

Sombra Warm Therapy Pain Relieving Gel is a pain relieving gel that I use both personally and professionally in my massage therapy practice. Unlike other over the counter heating creams, it provides warmth without burning heat.  Applying Sombra to the muscles across the lower back and down into the hips, buttocks and back of the thighs can help reduce pain and tightness caused by the piriformis muscle. I recommend Sombra for chronic pain and pain from arthritis.

Hot Cold Pack For Low Back, Buttock, Hip Pain

CorPak Soft Comfort Hot & Cold Pack Wrap is a versatile pack that can be used to treat the low back, buttocks and hips, as well as other areas of the body. The pack is filled with pliable gel and has a soft frost free cover that will not irritate your skin. For recent injuries, use it cold to reduce swelling. For older injures or chronic pain use heat to relax the muscles and increase circulation. The pack works well for piriformis pain because it is large enough to cover the muscle and affected area.

Trigger Point Self Treatment For Hip, Buttock, and Thigh Pain Due to the Piriformis Muscle

Do you know that muscle 'knots' in the piriformis muscle can cause pain throughout the hips, buttocks, and down the backs of the thighs? It also occasionally contributes to low abdominal, pelvic and groin pain.

If you are interested in treating back and hip pain caused by trigger points I  recommend you purchase Claire Davies  The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. Mr. Davies explains the trigger point phenomenon and muscle pain in everyday language.  But what makes this book worth its weight in gold are the individual muscle trigger point treatments that Davies has compiled. His diagrams and step by step instructions help you locate which muscles are contributing to your pain,  how to find the trigger point and treat it.  If you suffer from unresolved back, hip, buttock, and leg pain I highly recommend this book. It takes time and practice to master finding trigger points, but once you learn you have a tool and method to help relieve muscle pain throughout the body. Relieving trigger points in the piriformis muscles has helped many people reduce or even resolve their low back, hip, and thigh pain issues. This book is a must-have for anyone interested in finding the cause and treating muscle pain.

Thera Cane To Easily Treat Low Back, Buttock, and Upper Thigh Pain

The Thera Cane Massager is my first choice of purchase with the workbook for two reasons: First, you can easily reach your back, buttocks, and upper thigh without the need to bend or contort your body. Secondly, once you understand trigger points, you will find that you will want to treat other muscles and you may need help accessing the muscles. The Thera Cane allows you to easily treat all muscles of the body. If you have weak or arthritic hands, you may need a tool to help you use and hold the pressure required for trigger point treatment.  If you are buying the workbook, the Thera Cane is worth the investment!

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