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Piriformis Syndrome is literally a “pain in the buttock.” It is a condition where the piriformis muscle-a small, deep stabiliser in the hip-spasms and compresses the sciatic nerve. It can cause deep, gnawing pain in the glute, or shooting electric pain down the back of the thigh (Sciatica).
It is often misdiagnosed as a disc problem, or simply labelled as “tight hips.” Patients are told to stretch it using the “pigeon pose.” However, for many sufferers, stretching makes it worse. Why? Because you are stretching an irritated nerve and a muscle that is holding on for dear life.
At Breakthrough Pain & Performance, we treat Piriformis Syndrome as a neurological compensation, not just a tight muscle. The piriformis doesn’t just decide to get tight; the brain tells it to tighten. Usually, it is overworking because something else isn’t doing its job. We find the lazy culprit, fix the imbalance, and convince the piriformis to let go of the nerve.
One of the most common drivers of Piriformis Syndrome is a dysfunctional Psoas muscle (hip flexor). Due to our seated lifestyles, the psoas often becomes chronically shortened and weak.
Neurologically, the psoas and the piriformis have a relationship. They both stabilise the hip and spine. If the psoas is inhibited or dysfunctional, the brain recruits the piriformis to take over the job of spinal stabilisation. The piriformis is too small for this job. It gets exhausted, hypertrophies (gets bigger), and goes into spasm.
Because the sciatic nerve runs directly underneath (or sometimes through) the piriformis, this spasm strangles the nerve. Treating the piriformis alone is temporary. We treat the psoas. We use P-DTR to reset the hip flexors. Once the brain trusts the psoas to stabilise the spine again, it releases the piriformis, and the nerve entrapment disappears.
Not all leg pain is nerve pain. The piriformis muscle (and its neighbour, the Gluteus Minimus) has a Trigger Point referral pattern that mimics sciatica perfectly.
A knot in the piriformis can send a ghost pain down the back of the leg to the knee. This is Pseudo-Sciatica. It feels like nerve pain, but there is no nerve damage. The pain is “referred” by the brain because the signals from the muscle and the leg converge in the spinal cord.
We can distinguish between the two quickly. If your nerve conduction tests are normal but your glute is tender, it is likely referred pain. We treat the trigger points neurologically. We do not need to use painful elbows or needles. We use reflex techniques to switch off the trigger point signals. The “leg pain” often vanishes instantly once the muscle in the buttock relaxes.
The piriformis attaches to the Sacrum (tailbone). Its job is to control the rotation of the Sacrum. If your pelvis is unstable-perhaps due to a previous fall, pregnancy, or weak core-the Sacrum wobbles.
To stop this wobble, the brain commands the piriformis to lock down. It acts as a clamp on the Sacroiliac (SI) Joint. You feel this as a deep ache in the dimple of your back and the buttock.
Stretching this feels good for a minute, but the brain hates it. You are removing the stability. The brain will tighten the muscle back up twice as hard to protect the joint.
We treat the instability. We use neurological activation exercises for the deep glutes and pelvic floor. We reset the mechanoreceptors in the SI joint ligaments. Once the pelvis is stable, the piriformis is no longer needed as a clamp, and it relaxes permanently.
If you have true nerve entrapment under the piriformis, aggressive stretching can damage the nerve. Nerves do not like to be stretched. They need blood flow. Stretching a compressed nerve cuts off its blood supply further.
We use nerve mobilisation, not stretching. We move the leg in a way that pulls the nerve gently through the muscle tunnel (“flossing”). This breaks down adhesions and improves the health of the nerve sheath without aggravating the symptoms.
Our clinic in Shiremoor is perfectly placed for anyone in North Tyneside suffering from hip or buttock pain. Driving can be painful with Piriformis Syndrome (the “wallet neuritis” effect). That is why we offer free parking directly outside the door. You can arrive, park easily, and walk straight into a calm environment.
Your Treatment Plan
1. The Diagnosis: Is it the disc, the nerve, or the muscle? We find out.
2. The Release: We use neurological reflexes to relax the piriformis without pain.
3. The Correction: We wake up the psoas or glute medius to restore balance to the hip.
4. The Prevention: We teach you how to sit, stand, and move to keep the muscle relaxed.
This clinic is for you if:
We provide a sophisticated solution to a literal pain in the bum.
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