A blog by runners. For runners.

Piriformis Syndrome Can Be a Pain in the Butt … Literally!

Have you ever been running and felt a sharp pain in your backside? You may have Piriformis Syndrome, and it can literally be a pain in the butt. In this blog post, Dr. Nace explains what it is, how to treat and more importantly how to prevent it.

What is Piriformis Syndrome?

Piriformis Syndrome is a condition that occurs when the piriformis muscle, which is located in the hip area, affects the sciatic nerve. This muscle is important because it helps the hip to rotate and the body to maintain balance.

This condition develops when the piriformis muscle irritates the sciatic nerve, causing it to become inflamed. This results in numbness and eventually pain that can run down the length of the entire leg. Interestingly, the pain generally starts out in the gluteus maximus region of the body. Thus, the “pain in the butt” connotation. This condition eventually affects your gait and walking.

The diagnosis can be tricky. It sometimes is confused with a strained gluteus muscle, or with back problems such as a disc herniation or sciatica. The difference is that sciatica is a pain in the nerves originating from the back, while piriformis syndrome affects the sciatic nerve as is passes close by an irritated piriformis muscle. Sometimes, it takes a trained professional to properly diagnose this condition.

Piriformis Syndrome often occurs in runners, especially those who are training for long-distance runs. Most of the time it develops in two ways: from improper stretching, improper training techniques, or prolonged repetitive activities. While the pain at first can be tolerable, eventually it could develop into a problem that can keep you from running on a daily basis. So, it is important to make sure you are aware of the symptoms.

How Is It Treated?

First, the good news is that with proper treatment Piriformis Syndrome can be alleviated, and almost never requires surgery.

Once the condition is properly diagnosed, there are a number of things that can be done to treat it:

  • A physical therapy program that focuses on stretching, stretching and more stretching.
  • Deep tissue massage
  • Anti-inflammatory medications if tolerated
  • Changes in training regiment
  • Occasionally steroid injection into the inflamed piriformis muscle

Once you are in a treatment program, you should be able to get back up and running in good order.

How Can I Prevent It?

Prevention is the key. This is an overuse phenomenon. There are a couple of basic things you can do to eliminate the risk.It all starts with proper warm-up, stretching, and training techniques. The simplest thing I can tell you is to stretch, stretch, stretch, both before and after your run.

Also, try to vary your routine. If you can add a little less running and more cross training, you won’t overuse your muscles. This can be challenging if you are training for a long distance run, but it will help you to avoid developing the symptoms that lead to this condition.

When Should I See a Doctor?

If you experience any of the symptoms above and the preventative measures don’t reduce the pain, visit a specialist. The sooner you get the problem treated, the more quickly you’ll be out and running again.