Lower back pain is very common and can be the result of a variety of causes. One of these isn’t usually the primary suspect but it occurs more often than one might think: constriction of the piriformis muscle.
This small slim muscle is behind the gluteus maximus, connecting the spine to the top of the femur. If the piriformis muscle tightens, gets pulled, becomes inflamed, or spasms, an effective piriformis stretch can restore muscle function and relieve pain.
What is the Piriformis?
The piriformis is a difficult muscle to get to—the largest muscle in the body is in front of it.
The piriformis allows movement of the hip, upper leg, and foot outward from the body. This muscle covers the sciatic nerve (the largest in the body) that runs from the lower back down into the legs.
In some people, the sciatic nerve runs through this muscle. Sciatica is a condition in which the sciatic nerve is pinched in some way, causing pain.
The piriformis is not only important for hip and leg movement but it is a key part of our overall balance while upright. One end of the piriformis is attached to the front part of the sacrum, the triangular bone at the base of the spine. It’s the only pelvic muscle that attaches to the front of the sacrum, providing balance between the pelvis and legs.
Its counteraction with the psoas muscle at the front of the pelvis and the gluteus maximus at the back maintains stability. An impeded piriformis limits both mobility and balance.
What Causes Piriformis Syndrome?
Surprisingly, a piriformis syndrome diagnosis is a somewhat controversial condition in medical circles. It seems that medical and health professionals can’t determine a cause of piriformis syndrome, so they have trouble defining and diagnosing it. It is unsurprising then, that there is disagreement on the best way to treat piriformis syndrome.
One reason for the lack of consensus in the diagnosis and treatment of this increasingly common condition is the location of the problem. Nerve pain and nerve compression are tricky conditions to begin with if you have a clear view from magnetic resonance imaging (MRI). The piriformis is unfortunately difficult to see, even with MRI scans.
The term for a collection of sciatica conditions coined in 1947, “piriformis syndrome” wasn’t identified as a specific problem. Since then, lower back pain caused by an impinged piriformis muscle has been determined a true condition in itself and accounts for 6-8 percent of experiences of lower back pain. (1)
Common symptoms such as numbness, tingling, and/or severe radiating pain can occur if the piriformis puts pressure on the sciatic nerve. Irritation of the sciatic nerve can manifest itself as a dull ache or shooting pain in the buttocks, back, hips, and legs. (2) Also, a misaligned or inflamed piriformis can cause difficulty and pain while sitting and when changing positions (e.g., from sitting to standing).
Don’t have a diagnosis of piriformis syndrome, but you’re experiencing several of the symptoms? Many of the stretches recommended in this article can help prevent piriformis syndrome from developing. An active lifestyle, of course, is also helpful.
In severe cases, diagnosis and treatment of piriformis syndrome may require professional physical therapy. Luckily, there are several effective physical medicine approaches to piriformis syndrome treatment for pain management before it gets to that point. Surgical intervention is rare.
In modern society, decreased physical activity levels, prolonged sitting in office jobs, and collectively expanding waistlines, health problems such as sciatica are continually on the rise.
If you’re experiencing sciatica pain, the recommended course of rehabilitation for piriformis syndrome may do wonders for you -- even without an official diagnosis. Other conditions that can benefit from these stretches and exercises include chronic low back pain, spinal stenosis, rheumatoid arthritis (especially in the hip joint), buttocks pain, knee pain, and muscle spasms in your bottocks.
Consult with a healthcare professional before attempting the below stretches in this article if you have been diagnosed with any of the following: spinal cord damage, prostate cancer, colorectal cancer, herniated discs, degenerative discs, or another chronic pain syndrome. Physical medicine and rehabilitation are treatment options that may require supervision in such cases.
What a Healthy Piriformis Can Do For You
Because of its key function in hip and leg mobility, a fully functioning piriformis will not only reduce the potential for sciatica but will keep you mobile. In fact, walking, cycling, running, dancing, and many other activities require a healthy piriformis.
“Here is a way to feel the piriformis muscle at work. Stand with your feet together, your knees bent and your butt stuck out a little. Put your hands on your butt and draw your knees apart slightly. Your piriformis muscle should be working beneath your big gluteal muscles,” writes Core Walking (3)
Exercising and stretching the piriformis takes a conscious effort but it’s worth it for both prevention and pain relief. The following are some stretches you can do to give this often-overlooked muscle some attention:
How To Get a Deep Piriformis Stretch With These 12 Exercises
Click Page below to see a detailed description & video of each of the 12 piriformis stretches: