NYC Gazette

Piriformis syndrome is a condition that can cause discomfort ranging from mild to severe pain, often affecting runners and cyclists but potentially impacting anyone. The syndrome arises when the piriformis muscle, located deep in the buttock, compresses the sciatic nerve. This compression results in pain radiating down the leg, which can intensify with activities such as prolonged sitting, climbing stairs, or squatting.

The sciatic nerve is the largest nerve in the body, originating at the base of the spine and typically running from the pelvis underneath the piriformis muscle down each leg. In some individuals, this nerve passes through or above the piriformis muscle, increasing their likelihood of experiencing piriformis syndrome.

Symptoms include deep pain in the buttocks and sensations like tingling, numbness, or burning along the back of the leg. Diagnosis often involves identifying these symptoms and using an MRI to rule out a pinched nerve in the lumbar spine. Ultrasound may also be used to visualize pressure on the nerve for confirmation.

Treatment recommendations by Dr. Barbuto include specific exercises such as:

- **Piriformis Stretch**: Lying flat on your back with legs straight out; lift your affected leg’s knee to your chest and gently pull it toward your opposite shoulder.

- **Figure 4 Stretch**: Lying flat on your back with both feet flat on the floor; place the ankle of your affected leg across your other thigh and gently pull that thigh toward your chest.

Dr. Barbuto advises against relying solely on online videos for exercise guidance, preferring patients receive instruction from professionals like physical therapists before practicing independently.

For severe cases unresponsive to these methods, treatments may escalate to trigger point injections or Botox injections. If necessary, surgery known as piriformis release or sciatic nerve decompression may be performed by specialists.