PIRIFORMIS SYNDROME (PAIN in the BUTT)

The Piriformis muscle (piriformis; “pear shaped“) is a tiny muscle located deep in the buttocks, underneath the gluteal muscles.  This little muscle is the most well-known of a group of muscles known as the “Hip Rotator Cuff” and is frequently the source of the pain in the butt and leg pain.

Piriformis Syndrome is a miserable condition in which the Piriformis Muscle becomes overly tight.  Although there are almost always underlying biomechanical issues to deal with (valgus / varus knees, high / low arches, etc) this pathological tightness of the Piriformis is usually the result of FASCIAL ADHESIONS, TENDINOSIS, or a nasty combination of both. 

Piriformis Syndrome can be aggravated by bending, lifting, sitting, sports, and even driving (foot on the gas pedal).  Contrary to what your M.D. might tell you, there are no drugs or surgeries that are effective for treating Piriformis Syndrome. I will warn you, in 20 plus years of practice I have never one time seen a person whose Piriformis Release Surgery actually worked. 

Piriformis Muscle Syndrome

Photo by Beth Ohara

Piriformis Syndrome is an extremely common condition, and is far more likely to be found in women than men (about 12-15 times more often).  Although I can only speculate on the reason for this, I suspect that it is a child-bearing issue. It probably also has to do with the naturally wider shape of a woman’s pelvis. This is the most likely explanation for my finding it much more frequently in women than men —- even in women who have not had children. 

As I stated earlier, Piriformis Syndrome is a major cause of sciatica (leg pain, numbness, tingling, or weakness, in any combination), hip pain, and buttock pain.  Because sciatica is so often involved, Piriformis Syndrome is usually misdiagnosed as a slipped disc, herniated disc, or a chronic low back or sacroilliac problem.

The sciatic nerve is both the largest and longest nerve in the body, and at its largest point is about the thickness of one’s thumb.  The sciatic nerve originates in the low back (lumbar spine region) and angles toward the middle of the buttock.  It then extends down through the leg, passing underneath the piriformis muscle.  Be aware that in as much as half the population, the sciatic nerve travels through the Piriformis Muscle, passes over the Piriformis Muscle, or splits in two and passes directly around the Piriformis Muscle. 

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Piriformis Syndrome

Piriformis Syndrome causes sciatica.  The sciatic nerve runs all the way to the foot

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Piriformis Syndrome Sciatica

Note the biggest part of the sciatic nerve near the top of the picture.  The muscle that runs across the page just above the sciatic nerve is the Piriformis Muscle.

The symptoms of Piriformis Syndrome usually begin as a deep aching in what women like to refer to as their “hip” area.  This pain will be found along an imaginary line that runs from the very tip top of the butt crack, to the greater trochanter of the hip bone (the bony knob on the upper and portion of the outer or lateral thigh).

A significant predisposing factor to chronic contracture and microscopic scarring of the piriformis muscle is wearing cruddy or improper footwear for your foot type (high-arched people wearing a “stability” or “dual-density” shoe). Other people predisposed to Piriformis Syndrome includes those with faulty spinal or lower limb mechanics, being overweight, having poor posture, spending too much time sitting, spending too much time on concrete, not partaking in enough physical activity (or occasionally too much exercise — over-training).  And of course, the biggie — just being female. 

Due to mechanical stresses causing chronic tightness / contracture, the Piriformis Muscle can actually become shortened over time.  This often results in microscopic scarring of the fascial sheaths that tightly surround the muscle itself.  Piriformis Syndrome is most commonly worse at rest (sitting or lying down) and is often (but not always) relieved temporarily, by moderate activity (particularly walking or stretching).

For years, I did not really understand why I had such good clinical results with so many cases of buttock / hip pain and sciatica, while other seemingly identical cases were largely unresponsive to chiropractic adjustments.  Frequently these “problem” cases would get fantastic short-term results from their adjustment, but these results never seemed to last more than a few days at the most (and often no more than a few hours).  It was not until I started doing “TISSUE REMODELING” in 2001, that I truly began to understand what was going on in many of these cases. 

Over the past decade I have come to realize that Piriformis Syndrome is literally “epidemic” in the female portion of our society.  Although I had no intention for it to happen this way, our Piriformis Syndrome Page is Destroy Chronic Pain’s #1 webpage by far.  And despite all of the new research on the subject, the medical community remains largely mystified about what it really is, or how to treat it effectively.  Again, drugs and surgery do not constitute “effective treatment” for Piriformis Syndrome.  Never assume that a “Piriformis Release Surgery” will solve your problems!

SCAR TISSUE AND ITS RELATIONSHIP TO

PIRIFORMIS SYNDROME

As you have read, scar tissue is normal, elastic tissue (think nicely combed hair here) that has been disrupted from its organized structure, into a balled-up and tangled wad of inflexible and hyper-sensitive, micro-gristle (think of a hair tangle that cannot be combed out).  When it comes to Piriformis Syndrome, this kind of microscopic scar tissue is not typically in the muscle belly itself, but in the Fascia.  Fascia is the thin, but very tough, yellowish white membranes that cover muscles.  In my neck of the Ozarks, deer hunters call these membranes, “Striffin“.

Fascia is arguably the single most pain-sensitive tissue in the body!  Fascial Adhesions will cause pain and dysfunction.  Destroy Fascial Adhesions and Destroy Chronic Pain!

Because most of these scar tissues are in the fascia as opposed to the muscle itself, they do not image on MRI.  It is my opinion that microscopic scarring of the Piriformis Muscle is the single most common cause of chronic, long-standing, Sacroilliac or buttock pain (the Sacroilliac Joints are the bony bumps that lie just up and lateral to the top of the butt crack).  It is also the most common cause of what I was calling a “butt-based” sciatica twenty years ago.

Piriformis Syndrome

Photo by Anatomist90

Piriformis Syndrome Sciatica

Photo by Anatomist90

FOR MORE INFORMATION ABOUT PIRIFORMIS SYNDROME, VISIT THE WEBSITE OF DR RUSSELL SCHIERLING

291 responses to “PIRIFORMIS SYNDROME (PAIN in the BUTT)

  1. Ian Morrison

    I’m a truck driver and have been for many years I keep reasonably fit
    One day as I was putting on my boots for work I got a small twing in my lower back so I took care driving but as the night went on I got very uncomfortable while driving especially down my left leg and went I got home and went to bed I could not settle my left leg was sore but as the week went on my back was ok but my leg was sore standing up or walking or if I crouch down the back of my left at the thigh and lower calf were very sore when I tried to stand back up and is still sore when trying to walk after it what can it be and how do I treat it

  2. veronda

    hello dr
    i am having pain in my right leg sometime numbness. The pain set in my butlock and travel throughout leg, but my knee hurt, can not stand or walk for long period i have a big knot in the back of my right knee. I made appointment with my Orthopedic but had to cancel What kind of dr should i go to. driving it hurts to drive or sit at my desk feel like a ball of pain

  3. arizabal

    I had chronic lower back pain for about six weeks last October that seemed to follow an injury in the gym I can assume only happened from over stressing muscles. I do kickboxing and at the end of a class when I was doing sit ups, every time I did a sit up I would feel pain in my left butt cheek. By a week later I had sever back pain and numbing/tingling in my arms and legs. It eventually wore off after excruiciating pain for 6 weeks. I have done kickboxing for 4-5 years and that was the first instance after not having been to the gym for a year. I assumed I exerted myself too much too soon.

    Anyway today I am slowly running and getting back to working out. However after a prolonged period of running both of my butt muscles get tight to the point that I can’t walk. If I wait a few minutes it goes away. Will this decrease the more I’m used to running? Thank you

  4. Becca

    After my second child I began have deep pain in my lower right buttock. It happened every once in awhile (I thought when I did more walking) and now it’s constant. I consider myself to have a high tolerance but I know it’s bad because little things are frustrating to me and cause me to want to lash out. The pain can run down the back of my leg and almost wrap around my ankle. It’s hurts whether sitting, standing or walking. If I put to much weight or turn quickly on that leg it’s painful. Thanks for any advice!

  5. Alexa

    Hi Dr. Schierling
    Thank you for posting this article. I have been at a complete loss for the cause of my back pain…as has my GP, physiotherapist, and chiropractor.

    What kind of health practitioner should I be looking for in terms of helping me with what I believe is likely nerve entrapment from the piriformis muscle? I don’t even know where to start in terms of fixing this problem for good. I am female, 33 yrs old, on my feet a lot, suffered a spinal injury a few years ago lifting something much too heavy. Spinal cord swelled and caused vomiting and visual issues for 24 hrs. Since then, I’ve had a corticosteroid injection in my SI joint 2 years ago for constant pinching when sitting in my hip area and it worked wonders. However, I have a chronic burning pain in my lower back, from sacrum to just under the scapulae and what feels like sciatic pain from my buttock to my toes on one side. I take celebrex for anti-inflammatory relief with good effect but it is hard on my stomach and I really want to get to the underlying condition and stop with the anti-inflammatories. Xray and bone scan normal. Next step is MRI, per my doctor. However, I feel like the sciatic pain is secondary to inflammation somewhere because of the hot poker feeling in my lower back (as well as down one leg). No numbess or weakness in the leg.

    Please help…
    Thank you –!

    • Hello Alexa,

      Unfortunately, there is not a specific kind of doctor who will be able to help you with PS. The truth is, not very many people in any of the various branches of the healing arts are well versed in taking care of people with this problem.

      Sincerely,
      Dr. Russ

  6. lynn

    Hi doctor
    My name is lynn and im 25 years old, I’m a flight attendant and I do work long hours on my feet, im also 5kg over weight but for the past week I’ve all of a sudden been suffering with a nagging sharp pain from the centre of my left butt cheak all thecway down my leg and its only relieved with pain meds or if I honestly just forget its even there.

    Do you have any feed back for me that could help me because I really am in alot of pain constantly.

    Thank you

  7. jessica

    I’m 22 years old. I have had problems with my left knee since I was in 6th grade. First I damaged the cartridge on the inside of my knee. Then about 2 years ago I had tore my meniscus…. not to sure how I did that. I’m still in pain and on April 8th I’m going to have surgery on my pirformis muscle. I have been in pain for a year and a half with this leg. I have gotten a cortisone shot but it did not work at all. I also got some other shot to paralyze the pirformis muscle and it worked for about a month and I was pain free for one whole month. So I have decided to get surgery done hoping it will work. Any suggestions?

  8. Nombulelo Baba

    I am a 48 year old female in hospital in South Africa as we speak, admitted for lower back pain. They have done every test possible; urine,blood, sonar, x-ray and MRI but have not found the source of the pain. I realises yesterday aftee a physiotherapy session that the pain came more from the upper part of the buttocks than the lower back. Not sure of the exact difference though. I’ve been given all sorts of painkillers including valium and all help for a while. When the effect wanes, the pain starts all over again. There has been a difference with the two sessions of physiotherapy so far.
    I spent a lot of time sitting down an driving. The pain started last week when it became painful to sit down and again when I have to stand up. Didn’t feel it much when walking.
    Could this be the Pirifornis Syndrome?

    Thank you
    Nombulelo

  9. Jon

    I have a pinpoint pain in my left buttock. When I get out of bed in the morning, while sitting up, usually within 10-15 minutes the pain disappears but am still sore. I have a wooden peg which is oval and has a pointed extension. If I press the area manipulate the tissue, and move the peg around(quite painful)the pain also disappears. This may be helpful to others.

    Jon

  10. Jerry Jackson

    I was overcome with this problem since 1999, the year I turned 50. Until then, I could walk miles, take long trips, was an avid outdoorsman, and owned my own business. It ended my life as I knew it. 14 years later, no improvement, having taken every med in the VA pharmacy except pain pills which I cannot endure. Is there ever any hope? Hurts only when I sit.

  11. Dahn Roy

    Dr I found your website and hope it is the answer to my prayers. 36/m 24 lbs car salesman who meets every one of your causes walking on concrete, over weight, spine damage, blowing though shoes, poor posture, too much time sitting … you just described a car sales man’s life. I had a bad mva 1 years ago and there are multiple problems with my low back. Including dish degeneration, whatever it’s called when my spine slips forward at disk, S ponder SOMETHING Or Other Narrowing Of My Spine AND So on. Have seen pain specialist for last 10 years. My condition is when my leg goes to full extension there is a “pop” in my left buttocks perfectly horizontal with the top of crack bout 2 inches left of spine. I am take over 10,000 steps a day and I am fine first thing in the morning but as day goes on and I walk I get practically Paralyzed. My left leg hurts both muscle and nerve to my foot especially on the left side of leg. Best relief is curled in fetal position on bed. Tried meds, injections, mri, everything. What kind of doc do I need to see to help me.

  12. Doug

    I am a 44 year old male and suffering from major pain in my buttocks, down my leg and causes me to walk funny. I have had three hip surgeries to the same hip to repair the labrum. I had neck surgery in Oct. 2013 for two herniated disc. I have recentley had mri’s of low back and cat scan of neck. The doctors say my neck and back are fine. I have had this pain since my first hip surgery in 2009. I had a cortisone injection in the pirformis muscle thee weeks ago and felt amazing. The shot is now wearing off. What can i do?

  13. Christina O.

    My pain is deep in my left glute and hurts more in the morning and when I stand after sitting for a while (though it hurts all day). There is a dull ache when I am sitting, standing, laying and walking but a deeper and more pronounced pain when I “flex” a certain way. My lower back feels great, it’s just the glute and the back of my thigh. Could this be PS? What stretches or treatment would you recommend?

  14. Chandra

    I am 43 have aim in my right buttock in right hip down back of my leg sometimes my ankle starting to have a lot of pain in the arch of my foot (high arches) can’t sit for very long wake up constantly, I am slightly over weight I do work on my feet for long periods hardly sit excersise some, lately feel like my right leg is gonna give out when walking, not sure where to start as far as treatment or even what kind of doctor I should see.

    • Unfortunately, there is not a specific “kind” of doctor that will be able to help you with this. However, there are individuals within different fields that do a good job of taking on Piriformis Syndrome (if that is what you have — sounds like it could be).

      Sincerely,
      Dr. Russ

  15. jay

    I think this explanation pinpoints my issue. I developed this issue when deadlifting in the gym. It’s been ongoing for 4+ weeks now. Heating pads and stretching helps, for temporary relief(to shovel snow, work out, etc) but then it comes back. I’m thinking after a month of this, the pain will never go away…

  16. B.J.

    Hi Dr. Schierling, thank you for your excellent blog and follow up. I am a success case for spinal decompression. Small to medium L5/S1 bulge on right side indicated in August 2009. Started decompression on a Triton DTS that day. After the first 20 or so treatments within a couple months, I continued decompressed about once every 5-6 weeks. Fast forward almost five years to now and my life was really back to normal. But…for the past couple of weeks I have been experiencing strange sensations that started at the back of BOTH thighs while sitting; not as painful as sciatica, but annoying nonetheless. A few days after initial onset I noticed this my glutes and hamstrings were tight. Glutes have remained somewhat tight, but not every day if that makes any sense. Have done five decompression treatments in 2 weeks and I am only slightly getting better. MRI is scheduled in two days to rule out disc issues. Will randomly get odd pain at the top of my butt near the hip on the side of my body? I did the piriformis or low back sciatic test from your site, but couldn’t really reproduce pain in either one, ha! What do you think?

    Take care

  17. Barry

    Thank you for answering my question. I’m still at a loss as to what my ailment is, but at least I can rule things out. Thank you for your help.
    Barry

    • Patricia

      Dr Russell, please help me with your opinion. I had surgery 15 mos ago. Herniated disc, deg disc pinching nerve, scoliosis. It got rid of the nerve pain. Now I hurt to sit, right in the center of buttocks. Have nerve pain down the center of back of right leg. Was told by a neurologist that have PS. Had two injections in hips, no help at all. Now I have pain down the outside of my left leg stopping just below my knee. I have had MRI and CT scan. Have done acupuncture, PT, massage, chiropractic. My physical therapist and my massage therapist do not think I have PS. They rotated my leg in a way that they said I wouldn’t be able to do if I had PS. I’m at a loss.

      • Hello Patricia,

        Impossible to say without looking at you, but look through the posts just prior to this one. The test for disc -vs- Piriformis Syndrome is there.

        Sincerely,
        Dr. Russ

      • Patricia

        Forgot to mention that pain goes away when lying down. Also, have been poked and prodded but can’t reproduce the pain.

  18. Annette

    Hi Dr.Russ,

    I have never had any lower back pain……but after getting successfully treated by a wonderful Chiroipractor for Costochrondritis last year……I suddenly got this burning pain in the center of the “dip” on my upper right buttock while bending down to pick up my dog (15lbs) ! It was absolutely terrible…..I could not sit down, just stand or lay down for days…I went back to my Chiro who said it was my Piriformis Muscle…..over time is has lessened….but after returning from a 10 hour flight from Europe it has started burning again…….long story short when i sit for long periods of time it comes back…just in the same area, no pain in legs…just in the one area, it burns like a red hot needle is being pushed in….I am standing as i type this…..I have a 6 hr drive tomorrow and am just dreading it…is there an easy fix….does Lazer Therapy work for this…….

    Thanks You,

    Annette

  19. Justin Clark

    Hi Dr. Russ,

    I am a 29 year old male approximately 5’9” 200lbs. For the last six months or so I have been having pain in my right hip/buttock area and also my lower back, namely the right side. To give some background I was running marathons 3 years ago (at approx. 160lbs) and developed a leg injury that I was told was peroneal tendonitis (or tendonosis after more research). This injury abruptly stopped my distance running and I switched to resistance training. It was not nearly as exciting to me as the running. So after a few months I pretty much just started leading a sedentary life. I also work in an office at a desk job for a living, so not much activity there. As I approached 200lbs in 2013 I decided I better start to try to lose some weight. I started cycling as I was still worried about the previous running injury. After a couple of months of cycling 2-3 times a week I took a break for a couple of weeks and one day hurt my back (August 2013) while doing nothing more than bending over to pick something up. At the time it felt like I had pulled or torn something in my lower back (lumbar region). I was hardly able to move and made an immediate appointment at a chiropractor to be adjusted as I had fallen out of my previous regular adjustment schedule. Within a few days I was feeling better, still sore and painful but able to move around. After a few weeks I started feeling a right side hip pain (mostly when standing from a seated position, at my desk for example). Generally I could do some stretches for a few days and the pain would subside. I decided to start getting active again thinking that it was my sedentary lifestyle that was causing the pain. What I noticed after a little while was any time I did something impactful (running or p90x for example) my hip and back would start to hurt. The most noticeable pain is always when standing from a seated position. The pain starts in the hip and seems to radiate or shoot to the right side middle of by lower back. I could generally stay on top of my stretching and the pain would lesson, but not go away entirely. When the pain is extremely bad I can’t even sit for half of the day at work without having to get up and stretch to try and help relieve it. I started to go to my chiropractor a few times recently over the last couple of months. The last time I really made it a point to mention the hip pain and how it was effecting my daily life. He did some acupuncture to the area and it has really been painful the last 5 days since he did this. In the last 2 weeks I have discontinued any impactful exercise and have started doing yoga. I felt like the pain was getting a little better until the recent acupuncture. I do like my local chiropractor, but I am not sure if he understands my issue completely. I was doing some research and came across your page. This is new to me and I wasn’t sure if my story fit into the piriformis syndrome category, so since I saw this nice comment and answer section I thought I would ask. Thank you in advance for taking the time to read this and any response that you may have.

  20. Barry

    My symptoms are almost the opposite. I cannot bear to stand in place or walk as the pain is crushing; however when I sit, the pain subsides, especially if I place my right ankle on my left thigh and press down on my right knee. Could this also be PS?

  21. Carrie Kimball-Koenig

    I’ve had a spinal fusion (T11 – L3) nearly 20 years ago. I’m a 34 year-old female with chronic performs pain on my right side. I’m now 15 weeks pregnant and can hardly walk or sleep due to the pain. I’m typically very active and would welcome any suggestions on how to manage the pain.

    • Hello Carrie,

      Honestly, when you get into fusions like this one (you do not say what it was for), all bets are off as the array of potential symptoms. It could be due to the pregnancy as well. Go to my Blog and start looking around. I just wrote a post on GLUTEN & CHRONIC PAIN. If your problem is purely mechanical, you’ll have to figure out how to fix (or at least address) it. However, as strange as it may sound, there are lots of drivers of Inflammation, and Gluten is just one of them. Follow the links within the article I linked to here to learn more.

      Sincerely,
      Dr. Russ

  22. Wendy Hebert

    Hello! So lately I have been having severe pain in my right buttock, to the point of bringing me to my knees. I had worked in fast food for 9 years, 10 hour shifts of non stop walking. The floors were concrete. Well I just got a new job working with animals, also on my feet for long hours on concrete. I have suffered lower back pain for years ( numerous hospital visits for the pain being so intense ). I still suffer lower back pain, mostly the lower right side. The pain in my right buttock started last years ago although it was once every few months and only lasted a couple minutes. Within the last two weeks, it has lasted longer and longer. Today, I almost had to leave work because I could barely walk without wanting to collapse from the pain in my buttock. What could it be and what can I do to even just ease the pain?

    • Hello Wendy,

      The first thing you do is to read the blog post I gave another poster concerning Chronic Pain. There are lots of ways to help squelch inflammation, and this is a good place for you to start.

      sincerely,
      Dr. Russ

  23. Sean Hogan

    Recently I took a 4 hour drive and after an hour of driving, pain developed in my right buttocks and into the far upper part of my thigh and became worse the longer I drove. I do not have the pain in any other situation. Now the pain seems to start to develop more quickly when I am driving – after 30 to 45 minutes I can feel slight pain. On the long drives, if I use cruise control and bring my right leg up so my foot is flat on the floor it seems to lessen the pain.

    Thoughts?

  24. James McKibbon

    I am a fit 46 year old male with no previous health issues. My job requires me to sit much of the time and the floors I walk on are a very hard surface. I have been in my profession for 20 years and admit I haven’t always worn the best footwear nor have I practiced the best posture while seated. Sometimes the chairs I would sit in at work would make my buttocks go numb from lack of padding so I would slouch to take the pressure off one area or lean to one side or another.

    Approximately 15 months ago I woke up with a strange tingling feeling in the center area of my right buttock. I found it odd as it wasn’t a sensation I had ever felt before. (Somewhat similar to a limb that fell asleep but it was more concentrated in one small area of the buttocks and didn’t go away when I began moving around). It was slightly annoying bit not really painful. The next day it was even more sensitive and was becoming somewhat painful and it felt like it was beginning to run down my right leg.

    Within a day or two I had a debilitating pain in my mid buttock which ran down my leg. The feeling was like someone had bent me over at a 90 degree angle and inserted a metal rod in the middle of my buttock and was trying to push it down and out the bottom of my foot. It was pure agony. I would put the pain at 9/10 and could only find relief if I was laying on a bed in a certain position.

    This pain lasted for two weeks at that level before it began to ease off. During that time I visited 3 doctors and a physiotherapist. The doctors really didn’t help at all and I’m not sure if the physio did or if it was just time that allowed the pain to subside.

    After about 6 weeks I was able to get back to most of my normal activities within reason as I didn’t push myself as I knew I wasn’t back to 100% yet. Over the following 3-4 months I could feel what I believe was my sciatic nerve running in my buttock and running down my leg but it was more like I was aware of it than in pain from it.

    The next 6 -8 months it seemed to revert back to feeling normal. Then one morning I woke to a sore lower right back. I figured I might have slept funny or tweaked a muscle as it wasn’t that painful or in the buttock area. This lasted a couple of weeks then one day as I was walking I felt my leg tingle with the feeling of the sciatic nerve. The following day it got worse and by the third day I was once again in agony.

    This time around I could feel pain in my lower back but it wasn’t unbearable. The unbearable pain was shooting from my back down my leg with the most severe part of the pain in my upper leg area. The pain wasn’t the 9/10 I had experienced before but a steady 7.5/10 spiking up to a 9/10 every few minutes. However, this time I couldn’t find a position to sit, stand or lay that would relieve any of the pain. When I bent over it felt like someone stuck a knife in my lower back and upper leg and was trying to pull out the nerve.

    After about 4-5 days of this type of pain (the Dr. Had given me no pain medication) it finally began to subside. As the next week progressed the pain lessened down my leg to about a 5/10. However, I could now feel nerve pain shooting down the outside of my outside right thigh just below the skin from my hip to about about 3/4 the way to my knee. The pain was a 5/10 but fairly constant.

    As I write this I feel a shooting pain down my outer thigh between the hamstring and quad muscle a well as the nerve from lower back about belt level down to my foot.

    I should also mention that I had aches and pains in my hips and hip flexor area for a year or two prior to my first acute sciatic issue. I somewhat ignored it as “I’m getting older” bit the areas are all close together.

    This sciatic pain has occurred twice in just over a year and it has an negative impact on my life. I would love to find a solution to this problem or someway to prevent a third episode. (Provided this second one eventually heals). I would love any advice I can get!

    • Could definitely be PS. Might be disc though. These two can be tough to tell apart. I have information for this on my BLOG.

      Dr. Russ

    • Kim

      Omg I have this Same pain how can they just let us suffer?

      • Few of the doctors people see for these sorts of symptoms really understand PS.

        Sincerely,
        Dr. Russ

      • James McKibbon

        I agree that few doctors actually understand what it feels like. For that matter I know people who have had sciatic pain but what they describe is more like moderate pain and it seems to makes them uncomfortable. I have what cannot be described as less than agony when this first occurs. Completely debilitates me to the point of near insanity. It’s been about 6 weeks since my second issue with this and the pain has subsided to the point where I am just in some pain but not agony. Now I just hope I don’t re-aggravate it!

  25. Alicia M.

    Dr. Russ:
    I am 49 years old. I have always and continue to run and weight lifted. I began experiencing the pain about 5 years ago. I could not sit or put any type of pressure on my left cheek. I could not drive because my leg would totally give out while driving. I went to the doctor and he said I had sciatica. I decided to lay off running for about 6 weeks and the pain went away. I use a sponge roller and tennis balls are my best friend, I do yoga, stretch before, during and after runs and also do pigeon pose to help stretch. It does wake me up at night sometimes and I only take meds when necessary. Not only does my left cheek get numb and very tight, but my hamstring as well. I have no pain at all in my lower back, just my left cheek and down my leg. I was told by a chiropractor that I was “crooked”. One of my hips is higher than the other. Would this also cause an issue

  26. gilles

    I have a history of low back pain and until a year ago or so meniscus in the right leg. A few months back I decided to rum for exercise, a sort of walk run mostly on front of my feet. But I suddenly woke up one night with excruciating pain in the genitals. My arches hurt as well. Presently it’s mostly my arches and my butt when I sit. I sit at the computer all day long. Most of the genital pain has subsided. I have been working on my butt with trigger point therapy, on my own, and freeze it four times a day. I also freeze my arches. The butt pain is very debilitating when sitting on my bike to work or at work. Although get pain in the butt when I work it with a ball to break down the tissue, it subsides and helps a little. I do get some relief by intensely massaging my calves.

    Is this piriformis or disc? I can’t tell either way by putting strong pressure on the lower spine or on my butt. I get no pain on the spine to speak of, and the butt, well, it doesn’t take much to fin spots to induce pain while I put therapeutic pressure with the hard ball.

  27. Kris

    Trying to make a long story short! A year ago weakness developed in right leg, physical therapy seemed to improve it very little. Shortly after right knee went out causing a fall in which, lost complete use of right leg. After mri revealed spinal stenosis, bulging discs, spondylethesis, thought about going through with back surgery until neurologist did not believe that would help getting use of leg back. He sent me to another neurologist that did an EMG nrrve study diagnosing me with lumbar plexopathy. Since then, a year later, the drop foot has not improved, but muscle atrophy in leg and right buttock has. I am now out of wheelchair and walking with walker. The main complaint I have is pain in the right buttock. My back just feels tired, but sitting in a chair hurts right buttock that radiates down right leg. I can only lay down on my back, but after laying down approximately 15 minutes the pain in right buttock starts and continues down thigh. At times it feels there is a washcloth folded up and I am laying on it. Once I lay down and the pain starts it continues to the point I have to take percocet. I want to stop taking pain meds and was wondering if this could possibly be piriformis related or if you thought it was from back. I have changed mattresses multiple times, tried different cushions, TENS unit, physical therapy etc. One Dr states it is from lumbar plexopathy which could lasst up tp 24 months, and another says nothing can do until pain is unbearable and do back surgery. Have also had CT of abdomin and right hip, but not sure if that would show area of piriformis muscle. In the past year I have come a long way, but was wondering if you had any ideas on the right buttock pain. Got a walk in bath tub and cant even sit in it with cushions. I can just touch the area on right buttock and it will start hurting and go down leg and continue until pain meds start working. Any suggestions would be greatly appreciated. Thank you in advance.

  28. Patrick

    Dr. Russell
    I’ve been experiencing pain running from my lower back to my butt down the back of my leg to my calf on my right leg. I’ve also had twitching associated with this pain. I believe this to be piriformis/sciatic related. I just started steroids for the inflammation. The pain is a dull ache with burning sometimes in my calf. What’s odd is the twitching. I’m seeing a neurologist next week for a look over. Does this sound like it’s related to piriformis compressing the sciatic?

  29. Shaan

    Dr. Russell, It’s been good month and half last time when posted here, since then Ihave gone through 2 MRI’s, lower back and scrutum, hip area. There is nothing in MRI which reveals the source for pain in buttocks or hip area. The pain is only there when I sit for couple of minutes and try to get up. the intensity is very sharp probably around 9 on scale to 10 (10 being highest). I literally bite my lips while getting off chair. Anything specific checkup you can suggest or any doctor you can recommend in NJ area. Much appreciate, it’s really getting hard to live with this pain. Thanks

  30. Jowo

    Thanks for this post doc. Mine is different, I have a pain but not really so painful in the my butt crack near the anus. it feels like it is the bone but then when i touch the bone it doesnt hurt. So i am suspecting it could be a nerve and it only hurts a bit when I am sitting or lying down. what do you think this is??

    Jowo

  31. Pierce Bruce

    Hi Dr Schierling
    I am 61 yeays old and started experiencing servers pain in my buttocks and lower back and hamstring area on the left side of my body this has been going on for about 3 weeks and has gotton progressively worse especially while walking and sleeping every move I make in bed is painful I have tried naproxen and pain pills with very little relief. Is it possible I have the condition that everyone seems to be talking about please help I can’t take this any more
    Thanks Pierce

  32. annelene

    Hi! I’m 15 weeks and have been having pain in my left buttock area that radiates down the back of my leg. Now it seems to be focusing in the buttock area especially in the center and around the groin area. Its a pretty sharp pain like and 8/9. It stops me in my track. Its most painful when I bend forward and back standing. Getting up from a chair is also painful. Is this all due to my pregnancy and is there a possibility of it going away after birth which will be a cesarean. Thanks in advance!

  33. Nancy

    I am at my wits end. My husband is 55, suffered a cardiac arrest and subsequent brain injury 16 months ago. In September he started complaining of pain in his bottom- constantly . He has suffered some loss of function on his right side and has a hitch in his gait. He’s had all the tests, all negative. The doctor has tried several different meds – prednisone, clonidine, albuterol, and nothing has worked. He can’t take NSAIDs because of his cardiac history. We don’t want to try narcotics, his cognitive skills are impaired enough. So we’re stuck with Tylenol. He needs to sit on a donut all the time, he walks about 2 miles/day, and gets some relief when he is not sitting. The pain does not radiate anywhere . Thoughts?

  34. Jolene

    Hello,
    I have a pain under my right butt cheek where my buttocks and leg meet??? It’s been there now off and on for almost a year now. I get some relief from a Tens Machine but it’s temp. It at times hurts so much I have started to limp a little and now I’m having lower back pain. I’ve seen a “pain management doc” and after one visit, they think it’s Piriformis Symdrome and want to do some injection needle in my back and/or in my Piriformis muscle!!??? HELP! What is this pain caused from and how can I help stop this pain?

  35. Erik Johnson

    Hello, my name is Erik and I am a athlete experiencing problems similar to these. I’ve had X-ray done of my spine and hip and mri done only of my spine. They found a cyst in my spine that’s pinching the nerve. They say the only way to fix it is surgery but the pain is only in my hip/gluteus medius region. My back feels good. I’m scared that surgery will end my basketball playing days. I’m experiencing all the symptoms of piriformis. Could it just be piriformis that’s causing all if this and not the cyst?

  36. Danielle

    I am a 26 y/o female and student. I recently started have pain in my top left inner buttock. During the day, I would say the pain is a dull aching “2,” max “3,” if at all. However, when I go to sleep at night, I wake up from moving in my sleep to severe pain at around a “9″ and it takes me almost two minutes to flip over. I can’t get out of bed in the morning without help or holding on to something. It’s now at the point that I cannot lie down unless I’m going to sleep because if I stay awake too long and the pain sets in, I can’t even get to sleep. After walking around and showering, the pain lowers itself back to the dull ache. I’ve tried taking NSAIDS before bed with no luck. I just went to my primary care physician and he thinks it may be my SI joint, but I’m not sure. He did an XRAY and some lab work to check infection. I don’t really have the “shooting down the leg” pain, it mostly stays in my buttock. Just any advice or suggestions would help so maybe I could bring them up with my doctor.

  37. Marla Bauer

    I believe I have Piriformis Syndrome. Oct 24, 2013 I had a back fusion L4, L5 & S1. The X-rays at my follow up appt with the Doctor came back good. Doc said everything was progressing along as it should. It was now time to follow up with physical therapy. Right about this time I began to experience this sharp pain in the my right buttock which radiates around to my hip and goes into my thigh. The PT diagnosed my piriformis muscle and gave me some stretching to do to help it. Well this only seems to make it feel worse. I have not been going to PT regularly due to bad weather, got the flu and to be honost the cost. Just got done paying for my surgery. My back feels pretty good. I have an appt with my family Dr on Feb 6, 2014 and I’m going to get his advise on what I should do next. I’m asking you also do you think I have PS and if so should I go to PT, a chiropractioner or something else. I am a 53 yr old female. I work in a office environemnt. I don’t have a regular exercise program. I am probably 50 lbs overweight. Also do you think this surgery could have brought this condition on? Thank you for any advise you can help me with.

  38. Carolyn Edel

    So, have any of you done any weight lifting to strengthen the gluteus maximus muscles at all? It is the largest muscles in our body, as we age it becomes weaker and if not exercised in its entirety, meaning outside as well as inside pelvis especially us women and childbearing it becomes weaker and because we use our legs and all muscles attached things happen. How do I know….I have a fusion in my back of the L4- L3 vertebra. I have 4 rods in my back. I am a weight lifter as well as a runner and I walk my dogs a lot. I also came to learn, listening to my physical therapists as they do know what they are talking about, that I am right leg dominant meaning that it does a lot of my work and my left leg and glute muscle had become weak and I do mean weak…..then the piriformis hurt bad. I was told that I had to strengthen my glute muscles more and concentrate my leg workouts to single leg isometric workouts to strengthen the left side. Well, no meds, listened intensly to my massage therapist and physical therapist and 6 years later I have no more of the pirformis issues….I do suffer from tight muscles that cause back pain but, like I said, I listen to the people that have degrees and know what they are talking about in terms of strengthening the muscles in order to aleviate the problems. The pirformis muscle is responsible for the outer and inner rotation of the hips, no medicine will make this better…..trust me I know! strengthen your core and glutes and things do get better. definitely keep up with the chiro and massage…meds are all that a doctor can help with and that is the truth, oh and surgery! Which yes I had but my vertebra was slipping and if I didn’t then my back would of become completely broken! My muscles I get massaged and my back is very good and it is a lot better then suffering from pain in the largest muscle in our bodies! Just telling it like it is!

    • Hello Carolyn,

      Thanks for the response. Indeed, strengthening muscles can be of tremendous benefit to people with all sorts of problems, including Piriformsis Syndrome. Be aware that while the strengthening approach will work for some, in many PS sufferers, it will fire things up to the point of misery. Many people can do Yoga or exercises like “The Founder”. These can help (The Founder is a big help to me personally). However, I deal with many people who have tried virtually everything, including radical dietary changes, to no avail. Unfortunately, there is no ‘magic bullet’ for PS. What helps one person might ruin another. I myself have a host of exercises I do. When I go overboard, I fire off several days of spasms in my Piriformis Muscle. I am on the back end of one such episode. Stupid me tried to do too many Kettle Bell Swings and ended up stirring things up a bit. Thanks for your input.

      Sincerely,
      Dr. Russ

  39. Angie kijjo

    Hello Dr, I am 35 mother of two. I started feeling pain deep in my right buttock a year after the birth of my second child (Caesarian). I thought it was due to the many injections I have had over the years. Two years down the road the pain is in both buttocks. Every morning when I wake up, my feet hurt and I walk with difficulty. The moment I bend to do anything, it’s worse and standing up with difficulty also. It’s what I go through every day. I live in Uganda where I don’t think such diagnosis can be made let alone treatment. Can you help me.
    Thank you.

    Angela.

  40. Amy

    I am 36 yrs old, good health and excercised regularly until July 2012. While swimming in a pool, I tried to upright myself to walk out and wham… EXTREME BUTTOCK PAIN, right at the crack of my buttocks. Couldn’t walk, stand, sit or anything. Went to urgent care and dr says PS, gave me pain meds and sent me on my way. They worked for a few days but it didn’t go away. Went to my reg doc and he Rx Etodolac. I took that for about 8 months and it helped greatly but started to not work after awhile. Went back had MRI showing DDD of L5/S1 but not much else. I’ve done PT, injections which worked for a day or two, accupuncture, chiropractic adjustments… nothing works. The pain is so unbearable. Pain Managemeng doc suggested Dekompressor Discectomy after doing a discogram, where he thought my disc was bulging and leaking fluid causing the pain. He did it and now I am worse than when I started. So now, I take pain meds, Etodolac and started Lyrica and I get about 3-4 hours of relief out of 24. It feels better to lie down and heat definitely helps, not ice. I’ve quit my job and my family is trying to support me while I figure this out. Went to 2 Neuros, one says do a fusion, the other says disc replacement. But the three MRI’s don’t warrant this kind of surgery. PM doc says I don’t need surgery, that I need to work it out biologically. Nothing is working, my life is hell and this pain is so intense that I’ve lost everything in my life. I can’t sneeze, cough or look a weird way without pain. There are two pains. One band across lower lower back, that comes and goes. The butt pain, that is deep in the cheek, runs down the back of my left thigh (dull and achy stabbing pain) to just before my knee is CONSTANT And now I feel aching down to my ankle. All I know is, as soon as I get out of bed, it all starts, it’s definitely compression induced. I can’t live this way anymore and am at my wits end. Please help.

  41. Patty

    I am a 52 female I have right side only buttock, hip and groin pain now for just about 6 yrs. I started with it all when I was at my healthiest weight and eating healthy walking 4-5 miles a day about 4-5 days a wk. Pain sometimes goes down my leg, back and outer side and into my knee, ankle and right side of foot and underneath 2 sm. toes also top of that area and it goes numb and sometimes tingly. (Buttocks sometimes feels numb, burning & tingly) It also hurts when foot is on peddle while driving and walking. Standing & sitting too long makes it worse also bringing my knee upwards (like marching) while doing pool exercises makes it worse & stairs & hills. I have had x rays mri and mylogram seen different drs. Pt many times, chiro. (Which totally aggravates it) acupuncture, injections you name it I’ve tried it. I also have fibro which hasn’t bothered me in yrs. and when it did only in my neck shoulder area. car accident a yr. after all other pain started. So I don’t believe its fibro. (the lower pain). I am determined to find out what is going on! Depression has taken over me and just like all want my life back. I so appreciate it if you could get back to me. Thank you very much, Patty

  42. Jeanice lewis

    I, like some of the other ladies, have serious pain when sitting and lying down in my butt which radiates to my hips. I have Graves’ disease and Hashimotos. Rare but both. Since my thyroid problems, this has occured. The doctors had put me on steroids for nine months which cause serious weight gain. I was 5′ 5 and 123 now after weight lose, I am 140 pounds. I quit exercising regularly, and I was a serious athlete. Will yoga stretching over time fix this? I have decided I am going to heal my body this year! I am in a water fast under md care and am in serious pain in my butt and hip area now? Why is this happening so severely? Any answers to my issues?

  43. craig cooley

    Thanks for replying…I’ll check em out!!

  44. cc

    My pain started about 7 years ago. The first time I felt an pain was after a fall. It hurt for a few days then stop. A month or two later it bothered me again, but again stopped. It did this periodically for a couple of years. As time went on the pain increase and lasted longer each time. I now experience the pain on a daily basis. It does not bother me during activity. It keeps me awake at night — or wakes me up — and sometimes while sitting, but only about 5 percent of the time. I had xrays, an MRI, and a bone scan of my lower spine. Nothing showed up. Upon doing my own research its appears to possibly be my piriformis muscle causing the problem. The only thing is, the movement used to help diagnose this does not cause me any pain. I should add, there is no position that either worsens the pain nor makes it feel better at night when lying down.
    I am a 49 year old female, healthy, have gone from exercise, to no excercise, back to exercise, and it seems to make little difference. It bothers me more after exercising, but not during. It is a deep dull ache, more like a tooth ache. It is right in the dead center of my buttocks. The pain does NOT radiate. I have NO pain down my leg. Laying on a tennis ball used to help, but no longer. Ice used to help, but not as much anymore. Opioids are the only real relief, but I do not use them. This is ruining my quality of life. I can’t take the pain anymore and I walk around tired all the time. I hope you might have some answers.
    Thank you

  45. gemqueen007

    I am a 52yr old female, about 18mths ago, i noticed that the back of my legs were painful and stiff, and it hurt to walk – i had to change the length of my stride. I put this down to getting older. Recently I have very sharp buttock pain, and this radiates through my hamstrings, – it is still difficult to walk due to pain and stiffness, and it seems any kind of pressure no matter how small causes pain. I now have issues sitting, my buttocks are in constant pain, and very painful when sitting. if i do try and sit, i need to position myself and hold onto something before lowering my self down (still painful). I am not athletic, my job is fairly static, not much moving around. If i sit too much the pain is more of a dull sensation and i have to get up.. and then i am back with the cycle of pain. I have started some stretching and I think it helps – its too soon to evaluate. I am also on Simvastatin – I stopped these due to the issue of muscle pain – however i do not think this is causing my issue. Thank you very much. I am not sure if this is disc or a piriformis issue – would appreciate any feedback

  46. Daniel

    Have had pain from June 2013 to present nothing helps . Pain runs from top of butt crack down right legs hurts in hip and the most pain is behind knee and the ankle. I can push behind knee and can’t hardly take the pain . Please someone help . Stopped taking narcotics scared to get addicted . I found Bayer back and body works better than anything to ease the constant pain. I can’t put my socks on for months now . Help. Sorry I’m a male

  47. Wandres

    Hi I am 28 years old and I have been in pain for a month now. I started experiencing pain after a game of basketball in which I did not experience any fall or other form of collision to my body. It simply started hurting since that day and it is still on going.

    About me:
    - overweight
    - flat footed
    - bad posture
    - not very active but when I do play basketball I am usually sore for a week
    - job does not require sitting as I am on my feet all day
    - I have dealt with a herniated disc in the past

    Symptoms:
    - can’t sit at all
    - unlike my previous herniated disc in years past, I have no numbness or constant tingling yet. It does go numb or tingles occasionally when I force myself to sit through the pain.
    - sharp pain on my left hip, butt and lower back area. Mainly around the top left side of my butt
    - walking over time seems the best as it does stretch out and slowly it allows me to sit
    - can’t bend to my left
    - when I wake up I can see my upper torso and the lower torso being misaligned. The top part is leaning to the right while the left hip is sticking way out to the left.
    - most pain is after I wake up after being in one position too long

    Doctor, please diagnose me as I am trying to see if this is Ps, bursitis or another herniated disc. Thank you.

    - Wandres

  48. Kim

    I’m a 47 yr old female and have been dealing with pain in my lower butt where it meets my leg and radiates to the hamstring area. In the past it wa just on my right side and now my left side is beginning to get the pain. I use to be a runner until this started. I continue to exercise and just deal with the pain. I think I hurt worse the day after any exercise activity. I do sit at a desk all day. It just feels like I need to stretch but it doesn’t help. I have gone a month or two without exercise and it feels better but as soon as I start activity, it comes back. IB Profen therapy does help a lot and the pain goes away but I don’t want to take meds all the time. I get lower back soreness also and had an MRI on my lower back but it really didn’t show anything. Does this sound like it could be PS? I’m so tired of hurting!
    Thank you,
    Kim

  49. Shaan

    Dr. Russ, I read the entire site and comments, I couldn’t make up my mind if I am in the same boat as others. I am 43 year old male. I am not over weight and do moderate work out on regular basis. I have severe sharp pain in buttocks and center joint(close to crack) when I am trying to stand up from chair, regardless how long I sit. I could be sitting for 2 minutes and if I try to get up it’s pretty sharp pain. I have no other symptoms such as pain in legs, or numbness.
    Much appreciate your response

  50. Star

    Hello!

    I am a college student and last quarter I noticed my buttocks starting to hurt when I sat. As time progressed, it has become difficult for me to sit and even lay. Right now, my butt, my hip area and lower back ache each day. I cannot sit as it is too painful to do so but have to in class. I can’t sleep on my back or sides anymore because it hurts my butt and hips to much.
    I don’t get much excersise- about 6 hours per week.
    At first it hurt only to sit on hard chairs and such but now even sitting in the couch (although not as much) or bed is too painful. I often times have to wake up during the night to readjust my sleeping position or sleep on my stomach (which is bad for me since I have dislocated disks).

    If I took up exercising, do you think it would help?
    Also, I am not overweight

  51. Kendra

    I’m a 36 y.o. female, overweight with desk job. Went to my GP today after 3 days of excruciating pain originating in my right buttock radiating down my leg into the side of my calf. Standing and walking are extremely painful and the pain is quickly relieved by sitting or lying down. No trauma experienced prior to the onset of pain. Naproxen (375mg), ibuprofen (800mg) and cyclobenzoprine (10mg) have all been ineffective in reducing the pain. (FYI Naproxen and Ibuprofen were not taken together)

    Post examination, my doc suspects PS and has prescribed gabapentin (300 mg) and dicoflenac (50mg) for the pain. I don’t feel comfortable talking an anticonvulsant with so many side effects (thoughts of suicide, blurred vision and involuntary eye movements top the list) and so little clinical proof of alleviating nerve pain.
    During my exam doc checked reflexes, strength and mobility (reaching for floor, leaning side to side, walking on heels/toes)- which are all still good. I had tenderness in the buttock area with palpation- no other areas of tenderness. I have a history of intermittent lower back tension and discomfort (why I had cyclobenzoprine on hand). If the pain I am experiencing is primarily while standing and walking and not sitting, do you agree with the doc’s Dx of PS or is this more likely a disc or other problem? I would like to find a way to treat this without the use of potentially harmful medications.
    Thanks for your insight!
    Best,
    Kendra

  52. Rachel

    Ive been suffering for 6 years with what was thought a sacrioliac problem, only to find it was a trapped piriformis muscle after been treated by a trained sports therapist and paid for, the NHS after 6 years were no help at all

  53. k borbely

    I’ve been waking up several times a night to reposition due to serious pain in the middle buttock area that you describe in your post. The pain tends to subside by mid-day. Sitting does not seem to be a problem. Being unable to sleep due to the aching is concerning and not sustainable. Any suggestions for dealing with the pain that develops during the night?
    Thanks for your advice.

    • Unfortunately, that’s not a lot of information to go on.

    • craig cooley

      Howdy!! About 6 years ago I began having extreme stiffness in knees…podiatrist said go put spenco orthotics in your work shoes (not your running shoes) your arches have fallen. I did and 24 hours later it was gone.. never looked back. About a year ago I had archcrafters make custom ones, thought they’d last longer. It was great, then a year later knee stiffness/pain returned. I figured, well, they didn’t last very long and I tried to just use spenco ones again.. no dice.. 4 months later I’ve tried every orthotic/shoe combo I have and its worse… can’t run at all. I do custom tattoo work for a living… I began having “sitting on a burning marble” pain under right buttock.. started piriformis stretches, and…it disappeared!! But, now pain in right leg, calf tightness top of foo, shin splint type feelings, cant run, etc.. Can arch /orthotics issues cause PS, and if so, suggestions?

  54. jay

    Hi. I have had persistent pain in the center of my left buttocks for about three to five months. I recently had a hernia operation on the left ignual from working out. Im a 32 year old active male and work out regularly. The pain in almost constant and increases drastically when sitting or lying down. I have also had pain in the left foot which felt like i was standing on a roll of dimes. I also have a job where I am seated in a vehicle 10 to 12 hours 5 days a week. I have had xrays of both my foot and buttocks with no results. Do you think this could be as you’re ddescribing?

  55. Cherese

    I have been experience pain in my buttocks and so I came across your website. My pain originates deep within the buttocks close to the hip. As a result I have experience mild pain and numbness down to my toes. Is this consistent with piriformis syndrome? I am hoping to rule out neuropathy.

  56. Antonio

    Hi, two weeks ago I sat on the floor for about 2 hours. When i stood up I felt my left leg numb and weak. by the night some back pain started. The next day I felt some disconfort when sitting and some pain on the buttock.
    The pain in the buttock has, lessened a little. Right now I only have it when sitting, sometimes, but now I have so severe disconfort on the buttcrack all the time, specially when I lie down. The leg stills with some weakness and numbness but I dont have any pain when walking. Could it be PS? A disc problem? Sorry for my english,

  57. Angela

    Hi. My ten year old daughter has deep pain primarily in upper right butt check for past 7 months. She is constantly rubbing the area. She sometimes has lower back pain but the worst pain is in the upper butt. Tried rest, PT, braces, and have had MRIs and bone scan to rule out stress fracture and disc issues. Thinking of trying dry needling and/or chiropractic care. Btw, she was a competitive gymnast and now just plays soccer and lacrosse.

  58. Missy

    I am a 40 year old woman. I’ve had on-and-off pain deep in my left buttock for the past 1 1/2 years. For about 10 years before that I had similar pain in that region but it would go away if I laid on my back with feet flat on floor, raised my hips, and dropped them to “pop” my hip back in place. Sometimes it would help if I laid on my back and someone pulled on my left leg and gave it a shake, or if they held me in a Heimlich-like position and “shake” out my spine. Chiropractic always helped- for a few days. The situation became worse during each of my 3 pregnancies (I gained about 60 lbs each time).

    More recently, I’ve been pain free until 1 1/2 years ago. I was hiking up hill and broke into a jog, and in that moment it felt like my “pinched nerve” had returned. The pain has lingered longer, and stronger, ever since. I used to run marathons, but now I sit at my computer for long periods of time. I also have pain in my knees and heels, poor balance, and remnants of tibial torsion from when I was a child. I believe all these pains are connected to the way I carry my skeletal structure. I tend to stand on leg or the other, jutting my hips out a lot, or jutting my hips back for an overly arched back. I am working to correct my posture.

    Yoga stretches and getting up from my chair to stretch bring temporary relief, but only sometimes. Even driving hurts. My local orthopedist couldn’t find anything wrong via x-rays and MRI. Neither could the specialist at Stanford. The x-rays and MRI *did* reveal a bone spur (I’m calling it a spur but it may have another name- it was like a “nubbin” near my left SI joint), but the doctor concluded it was an uncommon, but harmless, bone abnormality that didn’t contribute to the pain.

    They have me on physical therapy now, doing exercises to strengthen my core muscles and buttocks. I hope it works, but I’m a bit skeptical that this will improve the situation for the long term, since I did similar stretches in yoga for 6 months with no long-term improvement in pain. One massage therapist who was also a physical therapist observed that my left buttock muscles were atrophied in comparison to the right side.

    While the pain does travel along that imaginary line you described above, I only notice the line of pain when I press on the area. When I’m sitting (and sometimes walking or even lying down), and when I’m not touching the area, it feels like an acute sharp pain in one spot. The feeling is as if there’s a pinched nerve, and like it’s a bone out of place that just needs to be forcefully pushed back into position. The MRI showed no signs of inflammation around the SI joint, yet it hurts almost all the time now.

    I was rough on my body when I was younger, and I easily could have acquired this condition through an injury. One time I jumped off a 60 ft. cliff into water and I landed perpendicular. My spine was seriously impacted when it hit the water’s surface. I was paralyzed for a few moments and floated to the surface, where people pulled me back into the boat. I regained the ability to move my limbs after a couple of minutes. I remained very active in contact sports and long distance running for years after that.

    I just learned about Piriformis Syndrome today. Does my description of symptoms sound like PS to you? I am very impressed with all the information you’ve shared on the internet, and with the time it must take for you to read and respond to each of our questions. Thank you!

  59. Jan

    Hi

    I am experiencing pain in my butt, which travels to side, top of leg. I get a tightening sensation round top of leg going towards groin area. Also aching in lower front of leg. I’ve been to a physiotherapist and got exercises to do, but no improvement. Any ideas as I don’t get a shooting pain down back of leg. Thanks

  60. Sasha Bryant

    Hello, I suffer from pain in my right hip (although I have an old pelvic fracture injury on the left side) I stand for a living (hairdresser)&am afraid I’ve been favoring my left side but putting weight on my right. I was diagnosed 3yrs ago w herniated disc’s L-4,L-5,S1 .. Now I fear w this chronic butt&hip pain this seems to be a piriformis issue, w extreme fascia/scar tissue. Is this a logical diagnosis. I’m with out health insurance right now,but honestly another doc visit or MRI isn’t really going to help either way. Let me know what you think&what I can do for this chronic pain? Yoga/massage? Thank you, Sasha Bryant

  61. Ann

    on december 6th, while walking to my office i experienced the worst cramp in my upper left butt cheek. the pain got progressively worse on sunday december 8th. the pain went from my upper left butt cheek down to my toes. it was a radiating sensation that prevented me from walking. i was literally in tears. on monday december 9th, the pain had subsided and by the time i got to work, the pain was all gone. i went the entire week with no pain, feeling great, then i woke up on friday december 13th with the same pain and today, december 12th, still in pain. i have to admit that this time around the pain isn’t as severe as the first episode….what could this be? i’m not an athlete, i work out periodically, but not much. i just need a solution to this issue. i can’t imagine dealing with severed cramps in my buttock area forever. your advice is appreciated

  62. woodz1491

    Hello, It all started about 1 week ago….
    I was in the gym and had just completed various lifting exercises with no pain. I decided to get on the rowing machine (maybe knock out 2000 meters for ol’ time sake). After i secured my feet in place, i bent forward to grab the handle and boom! It felt like a burning lightening strike from my glute to me toes (right side). Well, for the past week it has hurt so bad i cant sleep. The pain has subsided a little and is now localized in my glute but i cant sit for very long nor walk easily. I have also experienced extreme weakness in my calf muscle(to the point of limping soley from weakness, not glute pain) and my hamstring is getting weaker by the day. besides seeing a doctor, most likely happening soon, any suggestions or cursory diagnoses?

    thanks

  63. Steve D.

    I was playing soccer with my kids one night a little over a year ago (I was also in the middle of training for a marathon) and as I started to run quickly, I felt a little snap in my left hamstring. I immediately stopped running because it hurt obviously. I took a week off from training and everything felt normal so I went back to training. Through the next bunch of weeks,I would have a little pain and numbness in my buttock running down to my knee but it wasn’t incredibly painful so I kept running. I ran the marathon with the pain and numbness, and continued running thereafter. Soon after the marathon, I started getting some pains in my opposite ankle. So about 6 months after the marathon, the ankle got so bad that I had to stop running. And of course the pain in my left leg and buttocks is still there – deep down and hurts when I sit for long periods.. Any thoughts?

  64. katie

    Hello,

    Im a 28 yo female. I ran my first full marathon in May and got some butt hip pain but made my way thru it. I just ran a half 3 weeks ago and my pain is back. That line you talk about from the top of my butt to the boney part on the side of my hip, the pain is right in the middle and deep. Is this what you’re talking about?

    When I lay on my back and do that stretch it feels a.m.a.z.I.n.g. after the 1/2 a med student suggested me to look into my piriformus and consult my doc who said it was i.t band pain. But I feel like my doc won’t listen to me. What do you think, and where should I go?

    I don’t want surgery. And I want to run a 1/2 may 2014. The pain comes on strong like clock work at 4-6 miles into my runs. I can do less then that with little to mild tenderness.

    Thanks

  65. Desiree Blazek

    Hi, I’m having a pain on my left side where the butt meets the thigh and it goes down my thigh to my knee. Could it be Piriformis Syndrome? Its only been going on for a week now, but I work in a factory and i do a lot of bending/ squat like movement. Just worried that work could worsen it?

  66. Bill

    I am relatively confident that I have piriformis…my solution … straight leg raises and celebrex works wonders.

    • Hello Bill,

      I would doubt you have Piriformis Syndrome. But regardless, Celebrex is dangerous stuff. It was temporarily taken off the market at the same time as was Vioxx — but put back on after determining it was somewhat less dangerous and deadly than Vioxx. Drugs sometimes work, although there is often a serious price to pay for using them.

      Sincerely,
      Dr. Russ

  67. Mackenzie

    So I’ve never had hip pain however I do have pain in my buttocks. It hurts to stand up from a sitting position and hurts to lay on my back and move from side to side when laying down as well. I don’t have any leg pain. Could this be PS?

  68. Daryl

    Dr. Russell, is it painful to get an adjustment in general?

  69. sue

    hi I have a pain on my left glute only. does not radiate to my legs or lower back. Been on-going for a year.

  70. Joe Ali

    Hello Dr. Russ:

    While browsing for PAIN in the BUTT in the web I found this site. About three months back I had sore throat and infection. Dr. gave me Amoxicillin for 10 days twice each day. It caused me five to six times bowel movement for about last 7 days. After completion of medicine, I am feeling strange thing like “Pain in the butt” if I sit for more that 15 min in one setting. But when I stand, walk and work no problem at all. The pain goes away in few minutes.

    Now I wonder whether it is the symptoms of Sacroiliac Joint ache or Piriformis Syndrome. What should I do? Please suggest. Any medication or any life style change or physical exercise or any rubbing cream to apply?

    Joe Ali

  71. Laura

    Hi Dr. I finally have cured my Sciatica/piriformis. My pain started about the time my husband bought me a Ford Edge. I had slight pain before I got my car most likely from driving my daughter’s Ford Focus. I changed my office chair to an exercise ball which helped a little. When I changed my Edge with my son’s Impala my pain was got within 3 weeks. I just had to find what triggered my pain and it took about 8 long painful months.

  72. Hi Dr, I just wanted to know about 6 months ago I got a cold that caused severe coughing and towards the end of my cold when I coughed it would feel like I was being bent backwards because it would cause severe pain in my buttock closer to the middle than the outer… there was no pain in my back it just pulled very painfully in my buttock and down the back of my R leg..would this be PIRIFORMIS SYNDROME? it continues to hurt but my cold is finished ..

  73. faryal akhtar

    hey Dr. RUSSELL i was searching on net about deep pain in buttock when i found your page . i myself am a medical student but couldnt diagnose it by myself…. i just want to know how can i make a confirmative diagnosis that i have this…. please help

    • Hello Dr. Akhtar,

      Although there are a whole bunch of newer technologies (a new way of doing EMG’s, MRN’s, etc) the diagnosis is still largely clinical. In other words, the people who know anything about this problem are so few and far between, you’ll have to make the dx via your exam findings.

      Dr. Russ

  74. Daryl

    Hi again Dr.,

    Thank you for my last reply. One more question if you don’t mind.

    What should I expect the Dr. to do to differentiate between a disc or PS? What would you do?

    I don’t live anywhere close to you. If I could come to see you, I would.

    Thank you,

    Daryl

    • This can be a real challenge and then some. Go read my posts on DoctorSchierling.com about Asymptomatic Disc Bulges and the similarities between PS and Disc. You will understand why it can be nearly impossible. I have had several people that looked just like PS but was Disc. Have seen hundreds diagnosed as Disc that were PS.

      Dr. Russ

  75. Irene Nkanta

    Can this Piriformis Syndrome cause late period? Because this is the first time I am experiencing this.I have done pregnancy test and the result is negative. The pain on my butt is so severe. Could this be the cause?

  76. Mike Ferrera

    Hi Dr.

    I have been dealing with back issues over the last 8 months. Went saw my dr and he gave me some steroids. My back issue has cleared up but now this pain in my left buttocks is still there. Really really tight in the mornings when i wake up and i also cant stand up straight. Its almost like im indented at my left hip because it is so tight and when looking at myself in the mirror i form an S shaped and hunched over cuz its so tight in that area. You think this could be PS? As the day goes on it loosens up and i can straighten myself out better. When i went to the doctor they performed an x-ray and it came back negative. In fact my dr said my spine looked “perfect”. Im just so sick of this tightness pain in my buttocks area and i don’t know what to do? Back to the dr? chiro? physical therapy? Im taking motrin 800mg twice a day. I enjoyed reading through this site!

    any feedback would be appreciated

  77. Daryl

    So this pain will never go away? Thank you for this article. At least now I know what I’m dealing with. I was diagnosed with pre-osteoporosis on the left side. My pain is on the left side. I also work on concrete but had this pain long before that. Also wasn’t sure if it’s arthritis. I have osteo-arthritis iny right knee. I’m now experiencing same kind of pain I’m my left knee but thinking this pain is coming from the left side of the butt. Do you think it’s worth checking out by a doctor if it’s chronic pain?

  78. Lacinda

    I first noticed this pain 11 years ago while pregnant with twins and after that just off and on but it has gotten worse and this whole week it hasn’t let up any…its just a sharp pain deep within the lower buttock left hip area and it just hits me when standing, walking or sometimes just moving. I can lay down on the floor and cross my left leg over the right and i really can feel the stretch and the pain but its like it feels better….what else if anything can I do?

  79. Kim

    Hi, I am 47 year old female. I read through your article and feel I may have this Piriformis. I have bad feet, poor posture, work at a desk all day (ever since I can remember). I am in overall good health, had blood tests etc and a physical. I am maybe 20 pounds overweight and not a lot of exercise. I get headaches, more like neck aches very stiff. I have been having back pain for about a year in my lower back, more like the upper part of my butt with some weird ache in my upper legs down the front and sides. I was having low back pain on Friday at work, a little worse then usual, but tolerable. This pain lasted throughout the day and night, coming and going. Saturday when I woke up still the same pain, we took a drive about an hour and was still feeling bad. It seems when we got out of the care and I was walking around it went away or felt better. Few hours later when we drove home the drive was killing me, we had to stop so I could stand up for a minute and stretch. The stretching was painful as well, like very tight muscles when I would bend over, like when you exercise. When we finally got home If I stayed moving around the pain was not so bad. Then around 10pm when I sat down with in minutes the pain started, within a half hour I felt like I was in labor, very bad pain in the upper part of my butt as you describe at the top of my butt crack and going around my hips and into my legs a little. The pain was so bad it made me cry. I know something is wrong, but don’t want to be paranoid. I took 4 Advil and went to bed with heating pad. When I woke I could feel it coming back. The minute I sit I can feel it. It is hard to describe pain, just like labor and aching deep inside of my upper butt, below the belt line and into my legs. A little pain in my upper back when I cough too.

  80. Deven

    Hello. I have some kind of pain related to the piriformis (or there-abouts). I’m 27, male, healthy weight. I have a deep pain in my left glute that comes about only when I either lie on my left side (or sometimes my back) or when I shift my weight from one leg to the other while walking or twist in certain ways. If I walk slowly and don’t twist fast there isn’t much (if any) aggravation, but I work assembly in a manufacturing plant so that isn’t always possible.

    There’s no lasting pain (constant), only pain when I lie on my left or shift weight/twist sharply. The pain is a sharp twinge but goes away pretty quickly. Sitting doesn’t hurt, and driving my car doesn’t hurt. Nor sure if it’s in the sciatic nerve as I don’t have any pain shooting up or down my body. Just in the left glute (only left) and sometimes inner left hip. When I first got it I slept on my left side and it hurt so much I could barely walk. But moving around made the symptoms subside that morning/afternoon until it mostly went away (that day).

    Also, walking around more seemed to help alleviate the symptoms the first week, now not so much. Ibuprofen kills the pain entirely after about 1 hr of taking 400mg. I did some piriformis stretches the first week and all pain was completely gone with all motion. Then a couple days later it came back during work (felt like I stretched something too far and “jarred it loose”). Not sure if I should see someone or what. It’s not a pulled muscle (I don’t think) because moving around seems to help. At least it did.

    I’ve never had any kind of glute, hip, or back pain/problems before now.

    Thoughts?

  81. Bryan

    I’m a male, door to door sales person . lifting 60lbs regularly, driving for ten plus hours daily, in and out and up and down on this truck. Ben dealing with chronic butt pain just what u described in the article what can i do to find relief ?

  82. tiffany

    I don’t know if this is what i have but 4 weeks ago while i was sleeping i woke up in pain as if i pulled a muscle. and no it was not a leg spasm as i had those a lot growing up. but it comes and goes from my right butt to my knee. sometimes i cant bend my knee or walk for long periods of time. biofreeze doesn’t seem to be working nor ibuprofen. I’ve also been going to the chiropractor and the adjustments nor massages have helped… what should i do?

  83. Gilbert

    It is a very good article. I think it is the piriformis muscle is responsible for lower back problem that most police officers are encountering nowadays. The weight they carries on thier hips are enormous( belt- use of force gun etc) is the source of the piriformis syndrome. Is there any exercise that some can do to reduce this problem? Thank you.

    Gilbert

  84. Judy Weintraub

    I don’t believe i’ve had this before. I’m 64. it started 5 days ago after i had done some vacuuming and mopped the kitchen floor. I was a little sore in the right lower back during and after mopping, didn’t think anything of it at first, i hadn’t mopped in a long time. i vacuum often and it hasn’t caused any pain. The soreness steadily worsened and seemed to be in the right butt area and lower right back. Before long, it hurt so much that i thought of taking a Vicodin. The vicodin i have is from 2006 (prescription for my daughter) so you can see i don’t often think of taking Vicodin, that is just how bad this new pain was hurting. I never take NSAIDs or aspirin, i think they are harmful. I put a heating pad on the area but unlike when i get a muscle spasm in my lower back, the heating pad didn’t help. it felt good while it was on but no helpful improvement. The next day after sleep it was just as bad, terrible. I am fine as long as i lay still or sit. It only hurts when i walk and only on the right. I dread walking. One other thing, for many years i’ve been pretty sedentary, the only exercise i have gotten other than normal walking around and irregular chores, has been a short session of yoga stretching and breathing in the mornings before going to work. i’ve continued to do that gently since this pain started and it doesn’t seem to affect the pain one way or the other. About two months ago, i started going for daily half hour brisk walks in the mornings for exercise. I mostly walk on concrete sidewalks. I’ve enjoyed doing it. Since this pain started, i can’t walk, walking seems to make it worse and walking is the main thing that causes the pain, other than walking, i don’t feel it. I did a little more careful floor mopping (two small bathrooms) a couple of days after this pain started and that did not seem to aggravate it at all, but any walking hurts. On the third day i thought it seemed slightly better, but the fourth day, yesterday, it seemed no better and maybe worse. i dread walking from my couch to the kitchen to get a drink of water. When the pain first started, i thought of it as ‘lower right back.’ By yesterday, i mainly think of it as right buttock pain. Also, i noticed when i bent my right leg up to put it into a pants leg when getting dressed, it hurt to raise my leg, in the area where the leg meets the body in the front. I looked up sciatica on the internet a couple of days ago and learned it’s a symptom, not a diagnosis. Everything i read mentioned pain that goes down the leg. So far, mine does not do that. It seems concentrated in my right butt and low right back, and mainly only hurts when i walk. the left side seems fine, no pain. I have only read what is on this web page and will read the other links today. Related to other issues i’ve had over the years, i have almost no condidence in conventional medicine and i don’t tend to want to see doctors, expecting anything from no help to things being made worst. My experience has been that inflammation is very important to understand and to treat holistically, but after doing that nutritionally for years with unbelievably good health results (i think of it as general detoxification), due to some lifestyle and work related changes, i let a lot of things go holistically, and i believe i wouldn’t be having this problem if i were still living the way i did for over 10 years when all symptoms fell away, replaced by the best health i could ask for. i recently retired from my unhealthy job, but haven’t gotten back into the healthy lifestyle yet, haven’t felt up to the discipline, but know that it’s the best and only way to be really well. I also have a chronic pain in my neck on the left side that began about a year ago (Fall of 2012). I retired in January but the pain didn’t go away. Web searching led me to think it’s myofacial. my doctor referred me for physical therapy through my HMO but whatever they did worsened the pain so much, i only went to three sessions. I don’t get too much pain with it because it mainly hurts only if i turn my head to the left so i just avoid doing that, but i know that’s not the answer. I am preparing to get a line of credit on my house so i can afford things like myofascial release therapy paying out of pocket. i appreciate all the information here.

    • Whoa Judy; hold your horses.

      You likely do not need to take out a line of credit against your house to get this thing fixed. Just last week on my http://www.DoctorSchierling.com blog, I did articles titled HOW MANY VISITS FOR PIRIFORMIS SYNDROME and HOW MANY VISITS FOR CHRONIC NECK PAIN. Not sure a credit line is necessary. Get back on your healthy diet though.

      Dr. Russ

  85. A. Mobley

    I have no symptoms of the PCOS. However, I did do the stretches for piriformis syndrome and the two places I felt were my right hip and the center on the right side of my butt. It actually hurt to do the stretches. Should i feel pain while doing them? I have an appt tomorrow with a massage therapists.

  86. A. Mobley

    I have been having pain for over a year. The pain is deep on the right side of my butt and my right hip area. I also have sciatic pain that radiates down my leg all the way to my foot. I have started having numbness and tingling in my right foot also. I thought the pain was from ovulating on my right side or that I had a cyst. I have been to numerous doctors and they all want to take my uterus out. The last doctor I went to wants me to have an MRI because she is not convinced that a hysterctomy will solve it. She referred my to another doctor and he said I had weakness on my right side and ordered me to have two MRI’s. One of the lumbar area and the other of my pelvis area. I am really concerned because I really feel like Piriformis Syndrome is what I have and I am afraid of being misdiagnosed. It feels like someone has tied a knot in the muscle in my butt and it is connected to my hip area. Most of the time walking helps the pain, however, this last month has been horrible and lying down seems to make it feel better. i am very active and I exercise daily even with the pain that I have. Also, the pain started after having my husband pull a boot off. Any suggestions would greatly be appreciated.

  87. Cheryl

    I can’t tell you how happy I was to find your page as I feel like it’s the first thing that makes any sense of the excruciating pain I’ve been in for the past few months. Been bed ridden for 5 weeks only getting up for small walks around the house and other essential things. Which has been incredibly hard with three boys and a husband to take care of. Luckily I have a husband that is absolutely amazing.
    Only bad thing to finding your page is realizing you are so far away. I’m in Utah and a car ride to the dr or sitting for that matter is so painful I cry the entire way. I’ve researched this tissue remodeling and am hoping I can get some more info on this via email. I think I’ve found someone locally that does this but would like more info. Thanks!

    • Hello Cheryl,

      Last evening I had a call from my best friend who thinks he has developed Piriformis Syndrome. He said that he understood why people talked about ending it all. If you go to my other site (DOCTOR SCHIERLING) and look at our FAQ page for Tissue Work, you’ll find just about everything you could ask for.

      Sincerely,
      Dr. Russ

  88. Jessica

    Hello my name is Jessica,
    I have these same pains in my left butt cheek. It hurts when I sit for too long and then stand up. I have had 3 miscarriages. Is this because of the pain?

    • Hello Jessica,

      It is doubtful it is caused by the pain. The lower part of the spine is not only where the nerves that travel into the buttock and Piriformis region originate, it also happens to be where the nerves that control your female organs originate. While I think that this is an over-simplification of your whole problem, it could certainly be a contributing factor. Simple fact; irritate a nerve, and irritate anything along the pathway of said nerve. Just be aware that nerves do far more than provide sensory input. If I were you, I would do two things to start with. Even though this post is about misscarrying, you can read about them HERE.

      Dr. Russ

  89. michele

    I have similar pains – worse after sitting – when I get up I have to stretch and then the pain is less – what must I take ? Will exercise and losing weight help?

    • Hello Michele

      Stretching is usually a good thing, although not always (HERE). Unfortunately, “taking” something is rarely the answer for Piriformis Syndrome — or any health-related problem for that matter. As far as beneficial supplements, the first thing you must do is understand INFLAMMATION. Grasp the importance of Inflammation and all else follows.

      Dr. Russ

  90. carole

    I’ve been suffering from butt pain for almost 2 years now. Dr’s specialist have run all the tests in the book. they are now at the point of giving up on me as they do not know what else to do.

    I’m very excited to have found your site. wondering if this in fact could be my issue. i had a car accident and was for months sleeping in a lazy boy and couch due to severe pain in neck and torn shoulder capsule.
    i could feel pressure from my butt area but thought it was due to always lying down and sitting for very long periods of time.
    but the pain kept increasing till about 3 months later i started getting numbness in the legs and cramps in the feet that would twirl my toes right out. it came to a point were one morning i woke up to numbness in the lower leg and feet and my right leg started blocking sideways and has been ever since. I’ve done MRI’s Cat scans every tests in the book yet they still cannot find the cause of my issue to the point were they are making me feel its all in my head. well i know its not as i have been dealing with severe pain for almost 2 years now. i was a active mother of 2 before the accident and was living a normal healthy life until the accident.

    my question to you, could this also cause feet to discolor when sitting almost feeling like there is not enough circulation being done? and could this also cause a leg to remain sideways making it feel like every step something is pulling in the upper butt crack area? they have checked tail bone sacrum discs etc… nothing showed except a very small cyst along the lower spine left side.

    • Hello Carole,

      Anytime you irritate a nerve, you potentially irritate anything innervated or controlled by that nerve. This could certainly cause neurovascular issues such as discoloration, blanching, etc. This is seen all the time with neurovascular issues such as Raynaud’s Disease. Also, any time a muscle has tension or Scar Tissue, it will shorten. Shorten a muscle and you can certainly pull limbs or other body parts out of normal alignment.

      Dr. Russ

  91. Dap

    Hello I am 55 and approximately 7 years ago I was diagnosed with Chronic inflammatory demyelinating polyneuropathy (CIDP). I have been having infusions for this issue which at one point I was told it was in remission but still couldn’t walk without a tremendous amount of pain in my feet. I am on my second set of infusions which will last for 6 months this time rather than a full year and there doesn’t seem to be an end to this pain in site. Well the other day out of the blue my butt started hurting so badly that I can not only sit anymore which is the only thing I could do up to this point for a very long time but when I go to stand it just is such a sharp pain down my leg until I can get my leg situated to walk. I am now limping non stop which is making the CIDP in my feet hurt worse and I am just beside myself. Is there anything I can do to make this stop?? I cant sit I cant sleep I cant walk I just about at my wits end with all of this. This is just no way to live I hurt pretty much 99% of the time now. Any ideas at this point would be greatly appreciated. :) I could really use some insight.

    • Hello Dap,

      While Tissue Remodeling will not help with the CIDP, I know a couple of things that probably will. Firstly, since the name of the problem contains the word, INFLAMMATION, you have to understand what this really is. My experience tells me that very few people actually understand Inflammation, even though the word is bantered around constantly. Secondly, make sure to read THIS POST on the relationship between neurological problems, gluten and uncontrolled blood sugar.

      Sincerely,
      Dr. Russ

  92. Robert

    Is there any particular age group this affects? Or is it all from different walks and times in life? Can this be stress related? My wife is currently suffering from a lot of the similar symptoms you described. We are both overweight would this also have play a role? I have sciatic pain caused from a work injury on my L4 L5 but the way she describes it, it sounds very familiar to my own injury. Since she is overweight she has a hard time using the restroom and when she tries to clean herself she often presses or twists her back slightly to do so. Would appreciate anything you can tell me about this, I am concerned.

  93. Ana

    Can it happen simoultaineously on both hips, legs, front and back? Thank you.

    • Hello Ana,

      In a word, yes. I have written extensively that there are lots of different reasons people get Piriformis Syndrome. The Fascial Adhesions can occur at any number of places, but it is the Piriformis Muscle where the Sciatic Nerve actually gets ‘pinched’ or irritated.

  94. Jody Kenyon

    This is a reply for Tina. Strengthening what is weak will help, as piriformis is tight. This includes the adductor magnus, longus and brevis. A fantastic exercise I can recommend is Dr. Eric Goodman’s The Founder. This strengthens what is weak, and thus draws the femurs back and straight where they belong and this lessens the irritation of the sciatic nerve. I am a massage therapist and have had great results with trigger point therapy and clients doing the founder. You can google it; there is a youtube video.

    • Thanks Jody,

      Another great piece of self-help advice! I am familiar with Dr Goodman’s work (need to read his book). I had forgotten about this exercise but am going to play with it some more. By the way, Jody is a Princeton-educated massage therapist practicing in the Ft Lauderdale area. Again, thanks Jody.

      Dr. Russ

  95. Hello,

    For years i have felt like i have been sitting on a golf ball with pain in my butt i recently have had arthroscopy hip surgery and the pain on my butt is much worse, making my piriformis go into spasms. But my dr thinks it is SI problems. I am tired of this pain!

  96. Diana

    Hello Dr Russ
    I was diagnosed with Severe Left sided stenosis about a year ago. I have had a series of 4 nerve blocks that have not been successful other than a lot of pain from the shots!! I have recently seen a spine doctor who sent me for yet another block and again no results. I went to see him today as my leg is so very painful!! I cannot sit for long periods of time nor stand for long periods of time. My leg burns yet it feels like tiny needles are sticking me. After walking a short time my foot starts to go numb and feels like it is flopping along. I have resorted to using a cane when I am out on long trips such as grocery shopping or walking the mall as I cannot stand the pain. However, today my doctor said seeing that the blocks are not working it has to be priiformis syndrome and he is not sending me off to another doctor to get a shot in the hip!! I am deathly afraid of going to yet another doctor who wants to pass me off to someone else! I have already had a total of 5 blocks completed in my spine and I am now looking at another one in my hip. I am confused on what to do next…please help!!!!

  97. Raymond

    Mine started with a hip [left] pain. I’ve had a stroke that mildly effects that side. Now there’s a nasty pain in my buttock dead center. This Sciatic type pain seems to be a result of reacting to the hip pain. I had a bone scan and C.A.T. scan which says I have very mild osteoarthritis of the hip joint but is much worse in my other hip which is pain free. A physio fellow wants me to sit on a tennis ball and for 2 minutes roll around on the “sore spot”
    I can barely walk. I need home care to help with all sorts of things. Stairs are not worth the agony to descend. 300 mg. doses of Tylenol help a little bit and my life is not worth living. My cat is my only family.

    • Hello Raymond,

      I feel for you. However, don’t give up hope. I had a Medicare-aged woman come see me last week for her chronic buttock pain — this after lots of chiro adjustments and therapy. She was 100% out of pain immediately. Make sure you check our the INFORMATION AND VIDEOS at my other site. BTW, do you live close to me?

      Sincerely,
      Dr. Russ

    • Andrea Carpenter

      Hang in there Raymond! I’m laying here right now in the same pain with my cat by my side:) I’ve been in so much pain that, I too am ready to give up. I seemed to have some relief after I took a muscle relaxer, so I’m going to keep reading here and hopefully it will give me some answers. Try to stay strong, your kitty needs you as much as you need it:)

  98. Asha Govender

    I have read up on piriformis syndrome that you have indicated on this site and would definitely want more information.Both my husband and I hav the same “butt pain” and I especially have been afraid to go to the dr and was wondering how can I describe someone kinda pushing a long sword into me,We would like to know our way forward to improve the pain,Its extremely excruciating

  99. Teresa

    I was doing a cartwheel and as I went over something pulled in my groin area and ever since, I have had pain in my right butt cheek, down the back of my thigh and sometimes my entire leg will ache. I was given anti-inflamatory and muscle relaxant drugs to help with the pain. Could this be Piriformis Syndrome?

  100. diyflunkie

    I have been diagnosed with piriformis syndrome. I injuried myself in a fall almost 2 years ago and started having pain in my right leg..which at the time was diagnosed as ITBand syndrome and SI joint dysfunction. My leg was full of knots shooting pain from my hip to my knee and knee to foot. After working on releasing the knots in my leg…my lower back was starting to hurt moreso. MRI was performed..showing 2 bulging disks and annular tear L4-S1.but no impingements which could of caused leg pain…although EMG showed mild neuropathy at S1. Here I am 2 years later after having bilaterial medial branch block and FLUOROSCOPICALLY GUIDED CONTRAST ENHANCED RIGHT S1TRANSFORAMINAL EPIDURAL STEROID INJECTION…hoping to eliminate the sharp stabbing pain that I was getting in my legs (both legs are affected now). Just recently my Dr. (being confused with the 2nd MRI showing no nerve impingement also) is thinking I have piriformis syndrome. I am really concerned about this diagnoses…as all of the research that I have done on piriformis syndrome shows that the pain runs down the back of the leg and is in the buttock area. My pain starts at my hip running down the side of the leg moving over the top of the lower thigh near the top of knee..side of knee down over the shin…down the side of the foot. I have a numb feeling the the side of my lower leg, Occasionally I will get these pains behind my knees…and different areas on the back of my legs…but not very often. I am wondering if piriformis syndrome can cause this pain or if it is strickly down the back of the leg. I am scheduled to have piriformis injections and because it is a W/C injury will have to go through with them. I am just tired of the pain I get in my legs especially after standing, walking and sitting for any length of time.

  101. sally

    Helo name is Sally, I am 49 amd over the years i have suffered with back pain to the point of not being able to move. However in the last week from nowhere my buttocks ache bad specially of a night i cant lie in a position for very long it starts to hurt really bad i am in constant discomfort. Also when sitting i have to keep moving position. Also i have pain in my right leg which is very sharp an seems deep as if it is in my chin bone. I wasnt sure if i should visit my GP do you think i should go. Many Thanks Sally

  102. Laura

    I have had either Scatica or piriformis syndrome since February. It started as foot pain and I thought I had a neuroma. I would have pain at my desk job everyday by 3:00 or if I drove 45 minutes or longer. Pain is in right butt cheek, down back of led to the knee. I also feel a sharp pain on the side of my hip and it is very tender. I would wake up with numb toes and it hurt to walk. I have tried the chiropractor and a massage therapist. The only thing that took the pain away was a week of Methylprednisolone. This means inflammation was the problem. I have switched to an anti inflammatory diet but still have the pain. Thinking of trying a doctor next but will not do shots.

    • Hello Laura,

      A few thoughts. Although the ANTI-INFLAMMATORY DIET will not ‘cure’ many of these specific problems, it will help you with your overall health. Continue this. The decision to forgo the SHOTS is also smart. They are very degenerative and rarely help over the long haul. As far as the whole “is it Piriformis Syndrome or Sciatica?” argument, you need to read THIS.

      Sincerely,
      Dr. Russ

  103. Emily

    I have the worst pain (mainly on the right side but left has started as well) in this exact area of the butt. It also travels down the muscle on the side of my leg down into my knee. I’ve had many chiropractic adjustments to correct several areas in my neck, back, and hips. However, the chiro apts have not helped this area, even with weekly massages (which are always only focused on this area). I’ve tried incorporating a foam roller, stretches, leg and butt exercises as well as daily vitamins and fish oil. Nothing has helped! Driving, sleeping, sitting, walking have all come excruciatingly painful. I’m not sure what to do but these pains have been constant for 14 months. I am 29 years old and do not have children.

  104. Anne

    This has been my experience as well. I have Spondylolisthesis, fibromyalgia, and after researching the pains in my butt, suspect Piriformis Syndrome also. I feel these are all connected. Tried meds, had injections into the lower spine, went on anti-depressants, etc, but felt no better. After Googling Dr. Schierling’s fibromyalgia webpage, I realized that there needed to be some changes in my lifestyle. The changes I found most helpful were swimming, doing stretches, and jogging in the pool. Don’t overdo the stretches and start off easy and build it up. I hope this helps you like it did me.

    • Right you are Anne. Everything is connected on some level. I strongly suggest that people exhaust all self-help options before trying anything more invasive (yes, the drugs are invasive). Glad it worked for you — great advice.

      Dr. Russ

  105. B.C.

    Does taking calcium supplements like Calicfood help with Piriformis Syndrome?

  106. Jody Kenyon

    Trigger points in piriformis, glutes, TFL, can all cause extreme pain in the butt as well. There is a great book available called “The Trigger Point Therapy Workbook” by Claire Davies. This book teaches the reader about trigger points and shows the best ways to treat them yourself. I am an LMT and I have learned much from the book that is helpful for treating my clients with TPs. This therapy is an important tool for getting well and being pain free.

    • Thanks for the comment Jody,

      I have seen this book as well as many others which are similar. Although I see many people who have trigger points, the majority of those I treat; trigger points are not their major problem. Many people dealing with chronic Fascial Adhesions do not have severe primary trigger points —- they have Scarred Fascia. Most of the people who make trips to see me have tried just about every self-help technique (not to mention all sorts of other things, some of which are very invasive) trying to find some relief.

      Sincerely,
      Dr. Russ

  107. Dannielle

    I was diagnosed with piriformis syndrome 10 months after having my daughter and months of tests. I was on a high mg of gabapentin. 4x a day. After I became pregnant again and tried pt for the third time since being diagnosed I was put on pain medication. It has been 7 months since I had my second child and the pain is almost unbearable. The pain went from increasing intensity every few months to now I notice it weekly. Percocets do little help and my doctor pretty much told me to deal with it after cutting off all my medication. I have no idea what to try now since I’ve done everything short of surgery. I’m only 25 and can barley take care of my 2 year old and 7 month old. Any suggestion would be greatly appreciated.

    • I believe you Dannielle,

      You wrote to me at 1:00 am. My question to you is this; what tests did they use to arrive at the diagnosis?

      Dr. Russ

      • Dannielle

        After xrays,MRI, ultrasounds,and a nerve test they finally did a range of motion and pressure test they diagnosed me. My last physical therapist told me I definitely have piriformis but she thought there is some other issue as well, but unfortunately I can’t afford to have more tests done at the moment.

  108. Joe

    Unfortunately, no. I am near Nashville, TN. I happened across the website while digging for information. I’ve had low back pain in the past (2010) and an MRI showed a bulging disc. Surgeon recommended PT only and that worked well. This pain is somewhat similar, although I didn’t have any pain in my foot before and the pain in my back was more centralized. What I have now feels more to me like a strain, but I’m aware that sciatic nerve pain can be very deceiving so I’m not sure. Could the pain that started presenting in the heel only at the begining have been sciatiaca? I need to get in to the MD, but with medical costs (even with ins.) so high, I hate the prospect of chasing down the cause, much less the treatment. I had success using the McKenzie method before but with this, it only seems to work at the time I’m doing it. Walking is supposed to help, as I recall, but in my case it hurts.

  109. Joe

    It began about 4 weeks ago, acute pain in my right heal when I walked. Worse in the morning, but not much better throughout the day. Although I’ve never experienced it before, DIY research seemed to point toward plantar fasciitis. I started performing some suggested stretches, heal inserts, night splint, etc… Within a week my heal pain became much less, BUT…I now have SEVERE pain in my low back/hip area. I can sometimes get comfortable lying on my stomach or even sitting, but it comes back with a vengeance within a few steps when walking/standing. I have been performing back extension (McKenzie Method) stretches for 3 weeks with no results. More or less pain free until I get up and start walking. The pain comes rushing back. Very discouraging.

  110. Tracy

    In addition to the pain in my butt that you have described I also have started getting pains high up on the back of my leg that feel like someone has put a tazer gun on my leg,, lasts for a few seconds than goes away. Could this all be from the Piriformis muscle? Will stretching help?

    • Absolutely your sciatic-like sensations could be from Piriformis Syndrome. Yes, try stretching. But be warned that if severe enough Fascial Adhesions are present, you can actually make things worse — sort of like pulling on the ends of a rope that has a loose knot in the center, and hoping it is going to free it up.

      Sincerely,
      Dr. Russ

      • Tracy

        I have read your info on Fascial Adhesions and have been diagnosed with Plantar Fasciatis on the same side of my body,,, Is this all related? What do I do?

        Thank You

      • Tracy,

        I have a page on Plantar Fasciitis. Be sure to check it out. It could very well be related. If not, you will have to get some sort of orthotic device. Do you have high arches. High arches tend to run together with Piriformis Syndrome and Plantar Fasciitis.

        Dr. Russ

    • Lucas

      Hi. Yes I felt the exact way you felt except mine was said differently.On the left buttocks than ran down the backside of my leg, the inside felt as if I was packaged meat cooking on a hot stove. The pain was intense and after physical therapy sessions I felt much better and stayed off work and took my meds. Though the pain has gone away, it is limited and minor pains only come after bad posture I noticed.

  111. Kristin

    I went to new chiropractor and he diagnosed this as my piriformis muscle. He gave me some stretches to do but since I am very flexible, they didn’t help. I did find that yoga helps a great deal. In fact, I haven’t had any pain for 6 months now.

    • It is all about movement. Not just the fact that people need to be active, but the fact that every single cell and tissue in your body must move properly in relationship to the cells and tissues around them. Yoga stretches promotes movement and will help will all sorts of physical problems, including many cases of Piriformis Syndrome. Be aware though that this approach will not work for everyone — particularly those who are dealing with major Scar Tissue / Fascial Adhesions. Thanks for your input Kristin.

      Dr. Russ

  112. Alice

    I have also been fighting pain in the butt that feels like someone is jamming an icepick in my right butt cheek. Sometimes I can barely sit which is bad as I am a Customer Service Rep and sit most of the day. Doctor says it is a muscle in my back that is causing the butt/hip pain. He doesn’t seem interested in it.

  113. Carolyn Edel

    I did that same scenario almost 7 years ago. I did not nor ever will go for shots as they are temporary. I did, however, learn that the glut muscles were weak as well as the leg that the piriformis was in was extremely weak. I do not have any more issues since I have strengthed the glut muscles and the actual leg…Shots are only temporary!

    • You are correct Carolyn; muscle weaknesses or misfiring muscles can be a huge problem. Be aware that for many people, this approach is impossible due to either scar tissue, neurological issues, or other considerations. If simple strengthening exercises fixed your problems, count your blessings. For most hardcore Piriformis Syndrome sufferers, trying to solve the problem simply by strengthening muscles will end up making them worse.

      Sincerely,
      Dr. Russ

  114. teresa

    This was diagnosed from my doctor as my pain would not go away. I had fallen down the stairs and suffered heavy deep bruises and thought that was it, I would heal in a month or two. After a month I was not getting better my doctor sent me to physical therapy and massage therapist then a chiropractor. That’s when I was diagnosed. Now waiting for shots in that muscle so I can get some relief.

  115. Mary-Iris Taylor

    Dr. Russ, I have just begun experiencing incredible pain deep in both my butt cheeks (however one is worse than the other). I initially thought it was our mattress (which we’ve had for a year but this pain started this week) because it is especially bad in the morning when I get out of bed. I can hardly walk — and lying flat on my back when sleeping seems to make it worse. If I sleep on my stomach or side it lessens the pain. My back and thighs don’t seem to be involved — at least not yet. Stretching and walking seem to help. I thought the sudden onset was really odd. Does this sound like piriformis syndrome to you?

  116. Trina

    This information was so helpful. I have been researching my pain since it began on 7/18/2011. My pain started very sudden and very severe from head to toe and progressively worsened as the months passed. But it also changed. The pain became centralized in my lower pelvic area, hips, thighs and buttocks. Now its mostly in my right thigh to the tip of my knee & buttocks. The pain is excruciating!
    I have had many MRI’s, nerve tests, CAT scan, xrays. All normal. I’ve basically been diagnosed with Chronic pain. I take gabapentin and morphine every 8hours and for breakthrough pain I take oxycodone. I believe that I may have what you describe in your article as piriformis syndrome.
    I will share this information with my doctor next week. Thank you

    • Hello Trina,

      You could be correct, but you may very well have some sort of systemic inflammatory autoimmune issue as well. Make sure you read my blog post (DoctorSchierling.com) on Systemic Tendinosis. Great information for you.

      Let me know what your doctor thinks.
      Sincerely, Dr. Russ

      • Trina

        Hi Dr. Russ I initially blogged you around 8/19/13. After reading your article on piriformis syndrome I spoke with my doctor about it she printed out some exercises that I could do to strengthen that muscle. But I haven’t tried it yet because as I continued to read your article along with other blogs, if the muscle is seriously scarred or there are fascial adhesions present, those exercises can actually make the pain worse. My question to you is how can piriformis syndrome be diagnosed? Are there any tests to determine this? And what is ultimately the cure to rid me of this horrible pain? I don’t want surgery nor do I want to be on strong narcotics for the rest of my life.

      • Hello Trina,

        Piriformis Syndrome is extremely difficult to actually ‘diagnose’. In fact, most cases are made simply via clinical findings because it will not show up on standard tests such as MRI. There is new technology MRN (which is MRI of the nerves overlayed over a MRI) and special new kinds of EMG (standard EMG will not do it). Some people run into problems with their insurance paying for brand new technology.

  117. Tammy

    i have been suffering with this since 1997. I am currently seeing a neuromuscular doctor that is great. We believe that my problems started when I got an injection in my right buttock and I do not believe that the nurse knew what she was doing. I have already had an MRI of the lumbar spine and pelvis (to include the butt cheek) and will have a follow-up with contrast. They really believe that it is piriformis syndrome and I believe it is too.

  118. Kathleen Pierman

    Thank you for your explanation of the exact pain you have indicated. I have been down the route as many and have been misdiagnosed. However, with today’s technology, I cannot believe there is not something that can be done.

  119. Cheryl Keefer

    I am so glad to have found this info!! After having this exact described pain for approx 7 months, I haven’t found anything to alleviate the pain. And my doctor is starting me on some testing that I fear will be to no avail. Definitely gonna show him this article!! Can’t thank you enough!’n

  120. michelle

    After reading this I know exactly what I’m suffering from. No Dr will listen I have just had a complete hip replacement because they swore that was the problem and 6 weeks After surgery I’m still in just as much if not more pain then I was .It’s going on 7 yrs I can’t get treatment for it. Pain of course because nothing is showing on the hundreds of tests ran already. And because half the nation abuses them so we who need can’t have. I need your help so bad as to what to so to help the pain. This has finally broke me I don’t enjoy life anymore and I should I have everything to be happy for except this. I feel like I’m losing my mind looking for relief. hope to hear from you.

  121. cassey

    This was very informative. I have been trying to explain this pain I am feeling for 7 years and all the doctors have done is take Xrays that come back normal. I have another appointment and I will be taking a copy of this article with me. Thanks a million

  122. Joan Nishite

    Piriformis syndrome, I have never heard of it before, but I have had these symptoms for most of my life. Thank you for the information. Great job!

  123. Ljay

    Funny I’ve read this post probably 5-10 times and I think that each time something will jump out and magically fix me. I’ve suffered from excruciatingly chronic pain for 13 years. Had two hip ops, 15 injections and pretty much broke from all the weekly treatments I have in an attempt to keep me sain. Like others it has sucked the life out of me, I’ve quite my job and suffering from depression. If there is ANY advice you can offer I’d appreciate it. Apparently my piriformis looked ok under the knife but my nerve was severely swollen and irritated- my question, well something caused that so why didn’t ou wok that out while ou had a 12cm incision in my butt open!!!?? I am basically begging for help- ain meds and Pilates don’t help :(

    • vinod

      there are medicines in homeopathy for this chronic pains and its effective. But the MD doctors dont suggest you that becuase they dont know how the homeopathy works. BUt it works. god bless u :-)

      • Hello Vinod,

        Right you are about homeopathy working for many cases of Chronic Pain. And it should come as no surprise that the medical community does not embrace homeopathy or other forms of natural healing. As we all know, the Pharmaceutical Industry rules the day when it comes to the practice of medicine. Just be aware that if someone has Piriformis Syndrome due to Scar Tissue or Nerve Entrapment, homeopathic remedies are probably not going to be much help. The beautiful thing is that they are inexpensive, with no downside (side effects). Try them and see? Absolutely! The truth is, most people I see for Piriformis Syndrome have tried just about everything under the sun.

        Dr. Russ

  124. Shalene Harriss

    THANK YOU!! I am going to take this article with me to my doctor who says nothibg is wrong with me! I am so glad i came across this!!!!!!

  125. Lynn L.

    This is very interesting. I’ve been experiencing pain in the exact areas as described for several years now. I’ve attributed my pain to my scoliosis, thinking it’s something I have to “live with.” Now that the pain has gotten progressively worse, I’ve been trying to get a diagnosis for over six months. First doc said it was a pinched nerve. Second doc said it was SI Joint dysfunction. I’ve had MRI’s, CT scans, x-rays and ultrasounds, and just found out yesterday I have “tendenosis” in my gluteus medius tendon (aka dead butt syndrome?). I can’t help but think I also have piriformis problems, along with “snapping hip syndrome.” I’ve tried PT, pain killers, ice packs, warm packs, hot tubs, acupuncture and SI joint injections – and I have no relief for any of this. I’m desperate to know what I can do to relieve the pain, both short term and long term. I can’t sit for very long and standing/walking for more than about 5 minutes is wildly painful. I also find my right leg (below the knee cap) and right foot start to perspire when my piriformus/dead butt syndrome is acting up. I’m going to a teaching hospital tomorrow to meet with a “top doc” intervention radiologist. Hopefully, he can do something to help me. This chronic, intractable pain is excrutiating and is sucking my will to live. Thanks for this post. It’s very helpful. :-)

  126. Laura

    Thank you so much for this great article. I was misdiagnosed with fibromyalgia yesterday and I had to laugh when I read what the symptoms are. I haven’t had chronic pain for more than 3 months, it is acute and happens when I bend or twist, then that piriformis muscle goes crazy spasming and I can’t get it to unlock. It then squeezes my piformis so hard that I can’t sit, drive a car, or stand for long periods of time. My own mother, a registered nurse, did not buy that I had FM either. I have suffered from low back pain and shoulder pain on my right side since I was a child. The earliest children are usually diagnosed with FM is in their teens. The doctor also did not do a tender points test. I had to laugh when he gave me 4 bottles of Cymbalta for free. I guess he had his MO. Make me wait an hour to see him, then slap me with some blanket chronic pain diagnosis rather than take a full medical history. Well I have flat feet, and my right leg is slightly shorter than the other, which causes all the problems and sciatica like symptoms on my right side. When I saw a podiatrist for orthotics in 2009, he informed me that the flat feet would cause my lower back pain if I didn’t wear the orthotics every day with a quality shoe. My chiropractor said it was a muscle in my back that was shorter in women than in men, but she didn’t tell me what muscle it was. This article helped me to put all the pieces together. Thank you so much for writing this article, I only wish more doctors were as knowledgable so I didn’t have to waste my time.

  127. Anna

    Dear Dr. Russ-
    I am a 20 year old female and occasionally (2x a month maybe..) have a very deep pain in my left butt cheek (very rarely in my right). It’s not to the point where I can’t function but it is a pain that is noticeable. If I press down on my buttcheek, it feels tender and sore, like I’ve fallen on it but that’s never the case, it’s just a pain that comes and goes for no real reason. What you’ve written above sounds like it could be what my problem is but I’m just wondering if women my age get this? Am I too young to have this? I have had a child and understand this could’ve controbuted to my issue… Will it continue to get worse? Thanks for reading and for writing this interesting and informative article!

  128. Pauline Atkin, Chester England

    At last…..a diagnosis!!! I cannot begin to tell you how much peace of mind I feel having read your ‘Pain in the Butt’ website.
    Since 2008 I have attended different clinics within our local hospital to no avail. I have spinal stenosis, apparently my lumbar facet joints are ‘rubbish’, & all forms of treatment thus far have failed, i.e. spinal & root nerve injections, medications etc.. Despite all my hip area pain, no osteo arthritis manifests itself. Now I know why!!
    I feel I can cope now I know what is causing the pain.
    THANK YOU SO MUCH DR RUSS!

  129. Val2081

    Thank you for such an in depth and interesting article on butt pain. The pics could be exactly where my pain is. I feel I now know what I am up against and understand better how I can cope with it.

  130. Thank you for the your remarkable comments and opinions on Piriformis Syndrome. My closest relative, my Uncle Donald (we are both English) he’s now retired and close to 80 years, (but as mentally sharp and physically active as ever) like myself, I’m still chasing news, he spent most of his life as a War War Correspondent. In 1971 after suffering a concussion after a land mine explosion in Vietnam, he had a Laminectomy performed in Tokyo where fusion lower lumbar fusion was used.He appeared to fully recover and was left with his ‘left leg’ shorter than the other. It never stopped him from playing sports and being very active and pursuing his career until retirement.

    As his eyesight is failing (Glucoma) he had a few falls,nothing dramatic, but in the last year. Result seems to have been all the symptoms of sciatica in his right hip radiating down the front of his leg.

    Unlike many cases of Piriformis Syndrome, his symptoms occur when lying down – in any position – walking or sitting upright in a chair removes the pain.

    Xrays and MRI show little but the slight lower lumbar deterioration – an area he has had minor aches in. for 20 years.

    Apropos treatment, strong pain killers bring little or no relief. Many Physiotherapists along with countless doctors seem stumped. Cortisone injections failed. All Surgeons talk surgical exploration. into the Piriformis muscle. An old friend of his a former MASH surgeon advises him against it at his age. Biggest problem he has is he can’t lie down to get sleep. Obviously he can’t sit up all night or walk to removed the pain.

    I worry about this dilemma as every specialist has had a different opinion?

  131. Przedłużanie Rzęs Warszawa

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  132. Margie Achman

    After 14 years of wildland firefighting, working in and running a commercial greenhouse’s for many years, volunteering, becoming an employee with the Red Cross, and being a very busy Mom, Wife and person in general, I started having a pain in my butt. We moved to Missouri over a year ago from Alaska where I had a great Chiropractor, Heather — hard shoes to fill. I asked around and found Dr. Schierling – heard he was the best! My large family in Missouri all go to him and even family outside the state when they come visit. Anyway he had been doing adjustments and I, as usual, complained to him about my pain in the butt. The pain was so bad I could not sit, stand or lay on my side. Driving would make me cry! We set up an appointment for the Tissue Remodeling Treatment. Trust me the first 3 minutes were not fun, but immediately it stopped hurting. The bruising wasn’t pretty, but boy I would walk, sit, stand and yes, drive! Best thing I ever did. Haven’t had the pain back since and that was 8 months ago – Thanks Dr. Schierling!

  133. I had a pain in my butt that ran down to my knees. It got so bad I was taking pain meds every day and sitting or standing was painful. Even though I had been to going to Dr. Schierling for adjustments and had him do the remodeling for my neck, I did not realize that he could do anything about the sciatic nerve that was causing me so much pain. After just one soft tissue treatment I was pain free and did not need a second treatment. I am now going back to see if Dr. Schierling can relieve the pain in my heel from my fallen arches. I am so thankful our family has Dr. Schierling in our lives!

  134. Elysieum

    Thanks Doc. What advice would give in reducing the pain around my lower back (the chief source of associated buttock pain). Your advice is greatly appreciated.

    Thank you

  135. I would strongly suggest that you read THIS POST in its entirety — including watching the videos.

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