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 0ften 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 6-15 times more often, depending on whose studies you are looking at).  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 (Hint:  HERE is a simple test to help determine the difference).

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. 


Piriformis Syndrome

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


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 do not constitute “effective treatment” for most cases of Piriformis Syndrome (and surgery is such a crap-shoot….).  Never assume that a “Piriformis Release Surgery” will solve your problems!



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 — HERE).  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 you can oftentimes 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 (HERE).  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


If you found this page beneficial, please help us reach others by liking us or sharing on FACEBOOK.  Thank you, Dr. Russ Schierling.

1,101 responses to “PIRIFORMIS SYNDROME (PAIN in the BUTT)

  1. Cindy richard

    Dr. Russ my dad had tailbone injury 30 yrs ago. Since, he has had many surgeries, pain management, etc. 3 yrs ago doctors told him they could not pinpoint where the pain was coming from and his last option was a an. Implant box from Boston scientific. He had that surgery. For 3 years when he goes to have an “adjustment” for pain where they move the leads around to try and block his pain it only works for 3 or 4 days and the pain is back. I’m looking as usual for answers. This man has lived with this and tried to get help for 30 years. Any advise?

    • Hello Cindy, Electric pain blocks are wonderful — as long as the leads are situated perfectly; something that’s extremely difficult to do. I wish I had simple answers but after attending a 12 hour seminar 15 or so years ago on chronic tailbone pain (not to mention nearly 30 years of clinical experience) I can say that there are a cases of coccyx pain that are virtually impossible to figure out. Someone out there has the solution, I don’t and am not sure who that person would be.
      Sincerely, Dr. Russ

  2. Anna

    I fell 5 years ago from jumping up to hit a volley ball and landed on the side of my left foot. Bruising and swelling and sore for a short period. I have had many problems with my back, leg and foot pain, I have what feels like a constant current in my foot all day sometime shooting up my leg. I stand at my work all day. my back started bothering me along with hip pain. Started seeing an Ortho Dr. just getting steroid shots in the places I told them hurt. Shots worked for 2 weeks. I solved my back problem by removing the mats I stand on at work, I felt like the height of the mats were making me lean, and no more back pain. I have lost over 40 lbs in the past few months and sitting has become unbearable, I can not sit for even 10 minutes and I am almost in tears. My hip bone aches and the electric current in my let and foot increase. I get on the floor and get on my knees then my leg and foot become worse. I was told by my Chiropractor that I have Weavers Bottom. Reading this sounds like what I may have. Also reading this makes me feel I have no hope of getting better. I have a scheduled appointment for a steroid shot that is supposed to be done with a ultrasound to pin point where to place the injection. If this doesn’t work I don’t know what to do. I have tried all exercises and a cushion that has a gel to freeze. Nothing works. Any suggestions are appreciated.

  3. Joanne

    HI Dr Russell,
    I have just read your blog after another sleepless night in pain. I have had this for 4 years, which started with lower left back pain, was thought to be sacroiliac and after Cortisone in my sacroiliac joint 3 times which didn’t work, numerous MRIs my consultant said 2 years ago he thinks it is my piriformis. After some treatment at physio it settled but never went away. Came and went and saw Osteopaths as I thought it was my back more than piriformis. Anyway fast forward to now I have just had my ligaments replaced in my right knee, this was an old skiing injury which had been causing me lots of pain in recent years. It has always been painful but moreso of late. It turns out that my medial and acl were like bits of chewing gum. I am now back in the gym this week but still ‘sat’ more than I usually am as walking is still difficult. 2 months ago I couldn’t lay on my back and open my legs (like a gyny exam position) but the pain came and went, 3 weeks ago pain in my lower back flared up, I did some stretches for my glutes and piriformis early this week and YOWSA, I have been up all night with buttock and groin pain all week. Liftin up my leg for e.g. putting on socks. CAn you help? I am in the UK

  4. Diane

    Im just the opposite. I can sit for long periods without pain. Mine come early in the morning when getting out of bed. I lasts a couple hours until take a pain pill. During the day at work I am up and down with small children, not lifting but moving . After sitting, my legs tingle. It use to be just my left side tingling on the back of my leg but now my right side is affected. I don’t feel the need to see a doctor. The worse pain is in the morning and the rest of the day is tolerable. Im 68 but active. I also do the stretches and that helps for a short time.

  5. Victoria

    I was finding that I was having pains in my buttocks and lower hip area, mainly when I will wake up in the mornings or if I had to get up during the night to go to the bathroom. The pain is excruciating. At first I thought it was my mattress and I noticed that after I’m up for maybe an hour, moving around it goes away. Then I decided to look up “pain in the butt”. I am so glad I did. After reading your article completely I realized what my problem was. You hit the nail on the head. (Sounds painful), … Believe me, it is… Horrible.
    My doctor called me the very next day to give me my blood work results (everything was fine with that), but that gave me the opportunity to tell him about the pains that I was having in my butt when I wake up in the mornings (thinking it was because of my mattress). I’ll let him know what I read in your article, and I told him I basically understood what it meant and everything in the article as far as symptoms, I was having. I was just laid up for a couple of months because of nerve pain in my right leg from my ankle all the way up to my hip bone area. I was on Prednisone for a month. I told my doctor that I believed, from reading the article about “pain in the butt”, I realized I needed to start being more active and getting a for real exercise routine down. I asked my doctor’s opinion on what I thought about the article and if I was right considering my symptoms and the article, he agreed with me. He also told me to work on getting myself in a routine and doing more exercises and being more active and let him know how it was working for me.
    At least now I know why I was having all this pain mainly when I wake up from a real good sleep. Thank you so much. Now I have something to work with.

  6. Catherine Lindquist

    This was incredibly helpful.
    Thank you for all of youknowledge and skill I this
    Area. I believe that no radiologist nor physican would
    Be able to identify with anything close to these true results & findings. Too often things of importance are over looked.

  7. Faye

    I’m exhausted with trying to explain my circumstance. The two episodes of excruciating pain (pain that makes me pass out) have got me scared to death for when another could occur. I can’t see how I’ll cope. I was a happy runner 5 months ago. I don’t know what to do to get the drs to listen. Help😢

  8. Susan

    I have been suffering with what I now believe to be the condition you speak about. The pain in my left bum cheek and hip is awful when lying down and also the right as well. I have been to the docs and she thought I had bursitis and rest would help. Unfortunately it hasn’t gone away. It is worse at night lying down and have little sleep, the pain travels down my leg and my knee and top of my foot hurts. I started Pilates and I had to stop because of the pain in my hip when lying down doing exercises, walking sometimes is bad, plus the worse is when I carry shopping the pain it puts in my hip is awful. Iam at my wits end with it.The only relief is standing up ..Ive had sciatica before. So really fed up with sleep deprivation. Want my life back. HELP

  9. Susan

    Had laminectomy for L5-S1 herniated disc in 1999 when I was 33 years old. Then in 2002 had microdiscectomy (same level) in February. By October, same year, L3 – L4 had herniated. Diagnosis was obviously degenerative disc disease and I had to be fused at those levels. Since then I’ve had chronic pain that I’ve refused to allow to ruin/run my life. I’ve tried to stay active by exercising daily, (walking, yoga, Tai Chi, Tae Kwon Do) and gardening. However, a few days ago, I forgot/disregarded the fact that I’m a soon to be 52 year old woman with a surgically altered spine and pushed myself a little too far physically. I’m experiencing ,”paraformis syndrome” type pain that is accompanied with slight swelling, extreme tenderness that feels like a bruise, and, it feels as though I’m laying on a tennis ball when lying down. I can feel a knot on my butt. Has anyone else ever had these kind of symptoms? And if so, did it turn out to be hardware breakage? I’ve scheduled an appointment with my GP. But in the meantime I’m freaking out because I am terrified of the prospect of more surgery and all the crap that comes before and after.

  10. Lynda

    This is my symptoms exactly. Cannot sit for more than 5 minutes without pain in my buttocks and down my leg. Can lie on my back with no problems. Cannot drive without terrible pain. Pain down sides of my legs when bending. Had mri which showed bulging discs in L4 and 5 but this not really related. This all started 11 yrs ago when i had my twins. I walk every day as this is no problems. My only relief is to stand. Cannot go on in pain forever. HELP. Lynn

  11. Sarma Subramanya

    Very comprehensive information & explanatory. Thank u

  12. Tasha

    Yes this is it. Chiro isn’t working. It is an awful deep pain in my left buttocks and when pushed on fee like something is going to break. Just kills. How do I get this fixed? Bedtime sucks can lay on my left. Than laying on my right makes it hurt to if I don’t use pillows etc. Help what do I do about this???

  13. Jennifer

    Omg , I’ve been trying to figure this out for a long time. I think I just did ! I hope my Dr will listen because I’m miserable!!!

  14. Yolanda

    Too much pain in my left hip and both of my buttocks. I can not stand or walk for long periods of time. I had an MRI a week ago. My doctor told me that my MRI was normal. He is referring me to a pain management doctor, to see if they can help me.
    I’m tired of the pain the numerologist also said it could be my pelvis. I feel horrible as though I’m falling apart someone help me out with this please.

  15. Christel

    I am a 43 year old female. I went to an orthopedic doctor about 3 weeks ago. He gave me a steriod shot in both hips, which did NOT help at all. I set alot at work which is not good on my butt. My husband did the test above. He barely pressed on my left buttock and I came off the bed crying in pain. Please let me know what I can do to get relief from the pain. I take 800mg of ibuprofen twice a day.

  16. Gail

    This as explained more about my pain really good to read thank you.

  17. hali

    My name is hali, im 26 and i was diagnosed with PS a little over a month ago. I am active in working a in a pharmacy and chasing 2 kids under 3. I have had my pain for 3 months. 1 year ago I had a lumbar sprain while pregnant with my daughter, which such pain I went into labor and my daughter was born 6 weeks early. I have gone to physical therapy, lidocaine patches, naproxen/Tylenol therapy(which is killing my body), bath soaks, icy hot, and a 7 days steroid pack, but nothing seems to relieve this pain! I had an spinal scan 3 weeks ago and they found nothing wrong. What am I doing wrong and why am I not getting any relief. They gave me a pamphlet of PS workouts to do at home. I have not had a solid 3 hours of sleep in months. I think my body may be going into shock.

  18. Christina

    Hello Doctor, I am in dire need of help. My lower left buutock hurts a lot while sleeping and walking. Its worse when i move around too much. I fall down from a moving bike(accident) in January 2012 and till now i am experiencing the pain. I was diagnosed minor slipped disc and given Rejuneuron medicine. I cannot function daily without Ibuprofen.What could be the real cause of this pain and can it be healed permanently. I work as a waitress currently.

  19. Katie

    This is spot on accurate to my condition. I went to my chiropractor about 2 months ago and told him I felt like there was a Charlie horse right in the middle of my left buttock. Of course the adjustments left my back feeling nice and limber, but my problem has not been solved. This all started when I was trying to improve my running time and distance. Now I’m not running at all because I’m afraid of making things worse. I wish you did not live 5 hours away! It is impossible to sleep more than a couple of hours and driving is like straight torture.

  20. Amber

    I received a rocephin shot a little over 9 years ago. The pain was excruciating. Since then I have had MRIs and x rays. I have done physical therapy which helped a lot. The pain is worse when standing still too long. There was a point when I could not stand for more than 5 minutes without pain. I don’t think what I read above is the problem, but do you have any ideas of what it might be. No one believes me that it was from that shot, but they can’t tell me what it is either. Please help me.

    • Hello Amber,

      Although I see it with all kinds of antibiotics, the most common for this to happen are FLUROQINOLONES. Doctors are very aware that this is happening and choose to ignore peer-review and keep their heads in the sand — it’s easier that way than to have to explain that the treatment caused the problem.

      Dr. Russ

  21. Tahnya

    Thank you for this information. eIven though I’m discouraged, I believe I just figured out why and what I’ve been suffering for two years with NO ONE to be able to tell me. It all makes perfect sense.

    • HappyMom88

      I too am so happy!!! After driving for hours, I get butt cramp or pain in my right buttock due to foot being perched over gas pedal for hours. I hate driving now, but have to for travel baseball. I knew it was due to poor driving posture and couldn’t figure out how to solve it. Women suffer more than men for similar reasons that more women also drive with seat in 90 degree posture. I also sit most of the day at a computer, so I sometimes also have bad hip pain at night sleeping on side (although that is partially due to weight gain). I am hoping to try the new car seat position. I may even take my vehicle to an OT and see if they can help me position my car’s seat properly.

  22. monique

    hello doctor! im 32 years old and been on birth control for 5 years (depo) shot..i work in a office and i been having the glute pain that i also feel in my left leg hip area. what can i do to help the pain i feel so miserable and i anxiety hitting me now..im unconfortable most of the time sitting,laying down .and better when i stand please help me

  23. Lin

    Dr. Russ I had coccyx pain when sitting for several months. It cleared up for awhile and has been back for over a year now. I have burning in right buttock and it also can radiate to themy calf and foot when sitting and lying. Sitting is better on a hard surface. An xray only shows mild degenerative disc disease. I have had injections and internal physical therapy with no improvement. Can you please provide your thoughts?

  24. Karie

    This is a God send. I’ve dealt with these text book issues for years. They improve and then reappear. The symptoms are much worse at bed time after a leg/glute work out. I also find that when I’m not consistently in the gym, it’s worse as well. I’m familiar with myofascial release and the benefits there in. How can I be evaluated? Please help

    • Hello Karie,

      The fact that the gym makes it better and not worse means that it is almost surely a myofascial issue and not true PS. Anyone good at myofascial release should be able to help you.

      Dr. Russ

  25. Yvonne

    Just came accross your blog accidently.
    It wa like you were talking about me.
    Im 56yrs with Fibromyalgia and CRPS.
    I have had MRIs done, pulse therapy nothing helps. Then I read your article and boom all was clear. I have severe pain in both buttocks,with pain in left leg, trocanter region both sides and left groin and anterior pubic region.All tests NAD.
    Cant sit for more then 10mins. Standing also a problem and walking easiest thing to do.Pain increases going up an incline and declining.
    Sleeping also difficult especially on left side.
    On Zanaflex, Palexia and Ketamine all of which only dull the pain.
    What do you think?

  26. Jane

    Interesting. I was diagnosed with ankylosing spondylitis due to my sacrioiliac pain about 15 or so years ago as I have hlab27 gene, then undiagnosed by a rheumatologist because I didn’t have inflammatory markers nor did inflammation show on x ray. ( my son has AS with all the markers and the gene) Then diagnosed with depression. The pain was depressing. I tried all sorts of therapies and none worked. I continued to do yoga and to be active and just got on with it. The pain has alleviated somewhat post menopause and now I can do a lot more yoga. ( it was awful during my first pregnancy, disappeared after, no sign in second pregnancy, came back after with a vengeance)
    Tried running recently it got worse and then included heel pain which made it hard to do yoga so I stopped running and worked to get rid of the heel pain with yoga and exercises for plantar fasciitis which worked.
    I had never heard of piriformis but now realise this is what it must be. Pain first started about 18 years old and now I’m 54.
    It sounds like even if piriformis syndrome was known about all those years ago there would be the same problems treating it.
    I’m glad I understand it more now and if I’m kinder to myself ( have to listen to it) it is less cruel

    • Hello Jane,

      Answering this is sort of uncharted territory simply because even though I have treated a number of people with ANKYLOSING SPONDYLITIS, I have never treated someone with AS and Piriformis Syndrome. Make sure to look at the link as I have all sorts of info about AS and other Autoimmune Diseases.

      Dr. Russ

  27. Megan

    Hi I’m 20 years old and this is quite a new thing, don’t know what to do… I’ve got this dull ache in my buttocks, my bowel movements aren’t good it’s been two weeks please help.

  28. Dr. Herat Parmar

    Reading this article it seems it is beyond Orthopedic doctors to pin point exact diagnosis for Gluteal pain having “Various different diagnosis” When clinical and radiological diagnosis is a dilemma, how patient can be treated?

    • Hello Dr. Parmar,

      You are correct on all counts. However, both EMG and Diagnostic Ultrasound are getting better, and the MRN technology will probably someday be more readily available and covered by insurance. As far as treating PS non-surgically, I have found that many cases respond quite nicely to Tissue Remodeling or various other forms of bodywork.

      Dr. Russ

  29. Kevin

    I have been going to the chiropractor and a myofacial guy for lower back pain for over a year. It has recently turned into a constant piriformis/sciatic nerve area pain. Much worse when I sit or lay down then stand back up, but always there. Chiropractor mentioned injections, but what is the best option long term?

    • Very tough to say Kevin, but what I can tell you for sure is that I rarely see injections solve anything, although it might relieve you for awhile. The big problem is that the corticosteroid-based injections are massively degenerative.

      Dr. Russ

  30. mariaan

    Good morning I also suffer from this bum hip leg pain…it is only sore when I put pressure on it. I am a runner and I suffer a lot.
    I will go for physio….messages …. chiroptactor. Ijections….and then one day it will be gone….I will go for so many treatments that I don’ t know what helped..every year I waist mony on all things…..
    I don’t know how to deal with this anymore.

  31. Sherrie

    Hello Dr.
    I am a 52 year old overweight female with many health issues.I just had foot surgery, but what is pressing me at the moment is constant nagging dull aching pain right on and around my tailbone. I do have Degenerative disc disease, and I think a bulging disc in my lower back. I also am type 2 diabetic, have Fibromyalgia, Rheumatoid Arthritis, and Interstitial Cystitis. I also have Asthma, and Chronic obstructive pulmonary disease. When I am able to walk I felt better but didn’t lose more than 5 pounds. I eat well also.

  32. Carolyn

    Hi. I happened upon your blog by accident. I have been dealing with some hip/buttock pain over the last 9 months. I am a 56-year-old female runner. I continue to be active with walking and cycling, but I have been unable to run for months. I have researched the gamut of PS, tendonitis, bursitis, sciatica, etc. I began seeing a neurologist a few weeks ago and underwent an MRI. I was diagnosed with “Lumbar degenerative disc disease most pronounced at L4-L5. Severe narrowing of the central spinal canal at L4-L5. Moderate to severe narrowing of bilateral L2-L3, L3-L4, and L4-L5 neural foramina.” However, I have significant pain in the left hip/buttock that does not feel nerve-related; it feels muscular and I occasionally experience muscle spasms in my butt. My physician is performing an injection in a couple of weeks. I’m hopeful I will find some relief but have a sense it won’t work. My husband attempted your “test”, but neither triggered the pain. I’m trying to figure out if I have the correct diagnosis. Any feedback would be appreciated.

    • Hello Carolyn

      When you’ve got stenosis, it’s tough to say as it can cause all sorts of nerve irritation stuff. Inversion, when done correctly, or Spinal Decompression Therapy can often be effective for helping this problem. Make sure to read my post on the topic (HERE).

      Dr. Russ

  33. Krystina

    Ive had pelvic hip pains for years im 29. Ive had 4 c sections cut hip to hip because the first one was emergency. I recently had an mri after thinking i had impignment where arthritis was found on my spine. Mri showed soft tissue edema slight disc prominence and moderate facet arthropathy. I can hardly move after getting out of a chair. I now have burning tingling pain at the top of my but crack. I was also told i have trochanter bursitis. Could this be something i may have?

    • Hello Krystina,

      the hip-to-hip scar tissue could potentially pose a problem (make sure to read my stuff on post-surgical scar tissue). The MRI finding don’t seem pronounced enough to be causing the pain you are dealing with. You could have bursitis on your trochanter, but if so it would be very point tender. Best guess is that you have a fibrosis issue, probably in both the Thoracolumbar Fascia and the scar itself. All of this would put you in line for something called “Lower Crossed Syndrome”. I am getting ready to do a post on the topic so watch for it.

      Dr. Russ

      • Krystina

        I actually just had a abdominal hysterectomy and they removed some scar tissue. I had adenomyosis. Thank you! Its been miserable feeling drained and exhausted everyday. Although my hysterectomy made a huge difference with my engery unfortunately my pain in my hips/legs didnt go away. My back never bothered me until i had injections into my hip joint which on the second round he had an extremely hard time getting in my cartilage. Thank you for your response i will be looking!

  34. Mystery Girl

    I think I am suffering from this it is killing me. Could it be something else? It is taking away my quality of life to do anything. I am a 38 year old female, I had my spleen removed last year. Please help me.

    • Hello Mystery Girl,

      I have seen a lot of weird stuff (some of it severe) from the gas they pump you up with for these types of surgeries. It could be a disc problem. Realize that this could be a disc problem. Make sure to browse comments and see the test for determining the difference.

      Dr. Russ

  35. Hello Dr. Schierling. I’m an Irish dancer who has been having pain in my buttocks and upper hamstring when lifting my leg (high knee or straight), when sprinting/running, when flexing my buttocks (turning out my leg for dance) and when sitting. It’s a dull ache, but it really hurts my butt and my upper hamstring when I lift my leg and when I try to run. I have not been dancing or exercising and have been resting it, however it has not improved and quickly flares up when I try to do minor exercise. Physical therapy has helped, but the pain has remained consistent. The therapist was able to pin point the painful area by pushing on the right side of my buttocks, in the middle but rotated outward slightly. When pushed on it is extremely painful. I also visited a spine specialist to make sure it wasn’t a back issue, and lucky for me my spine is in great shape. Could this issue possibly be Piriformis Syndrome? I am really frustrated with the pain not going away and I’m having a hard time not being able to exercise.

    Any advice is helpful! Thank you for your time. 🙂

  36. Virginia Erickson

    Hi I am 71 and
    I have had this pain in my left butt cheek with tingling in butt cheek going around to my groin but no pain going down my leg. Gone to spin doctor had three CT scans showing arthritis, scoliosis with narrowing around the nerve at disc 1 and 2. And other disc’s bone on bone. I have had three injections in specific places of trouble and no relief. Now going to physical therapy to be evaluated. After reading your articles and the comments I am sure this is my pain. My question to you is can I have piriformis syndrome without the pain down my leg? It hurts exactly how you described it in sitting standing and bad when I’m sleeping.

    • Yes you can Virginia, even though it may not actually fill the official definition of the “syndrome” part. Make sure to check out our videos as I have at least six individuals who had PS over 25 years, gaining full or nearly so resolution of their problem.

      Dr. Russ

  37. Rose

    Im 24 years old and recently noticed a depression (which corresponds to the location of piriformis) on my right buttock, which is more prominent when I flex the hip. There is also some tightness experienced when i squat. So far there is no pain or tenderness over the area nor any radiating pain going down to leg.
    Could it be piriformis syndrome? And please guide me in how to treat this.
    Thank you

  38. Rayondra

    Hi I’m 22yrs old and I am in so much pain! Only my butt though ! The pain is so deep now I don’t know what will help anymore. I have an extremely flat butt and won’t grow lol but is there anything I can do? Anything that will make it ease up? Any meds? Anything?I’ve tired everything !!! Please help!!

  39. Melissa

    Hi I am a 37 active female and have been dealing with left mid buttock pain for 4 years. I use to run a lot and can’t do it anymore because it hurts so bad when I run. I have been to chiropractor and even had injections right into the buttock and spinal injections. None of it helped so had some deep tissue massages which did let some pressure off but still not 100% better. Over the last year I have been getting worse. Now hurts to walk, sit, and stretch. Kills me to sit on bleachers! I went back to Dr in fall with tremendous pain and sent me back to therapy. Been going for 3 months and still no relief and since therapy now having back issues along with back spasms that I never had before. Doing stretches and using a stimulator and they don’t seem to be doing anything. They started doing A stem and I am wanting them to do dry needling. I am a MR technologisit so I know my anatomy and it feels just like my priformis tendon is inflammed. I don’t know what else to do. I can’t live in pain like this for ever.

  40. Lesley

    This gave me a better understanding of what was causing my pain, after treatment on my disc in L 4/5, with epidural the discomfort/pain. In left buttock hip and going down my leg, due to heavy lifting at work, this treatment was amazing, how ever pain continued intermittently. It was good to hear others in the same predicament and it’s not in my head. Was interesting reading.

  41. Felicia

    This article explains everything that been going on with me for over two years and none of the doctors I have seen can explain what is going on with me. They all pretty much gave up on me and no I see others has actually gone through this. Especially women. I have scarred tissue and pain on my mid buttocks all the way down the back of my leg. First it was was my left leg and sometimes in both legs. It is very painful and alot of times I can’t walk at all. It is frustrating seeing several doctors and no one understands the pain. To know that what I am going throw may not show up on MRI’S or e-rays explains alot. I am not sure where to go from here but at least I know that someone can at le as the describe it

  42. Michelle

    I am 34, female, 4 kids and I just recently started getting tender pain in my right buttock (hip joint area) when I lean on that side when sitting or turning sides while laying. Coincidentally that is where I would have pain during my pregnancies. It was more of an annoying discomfort pain while this is tenderness. I hope it will suddenly go as it suddenly came.

  43. Amanda

    Finding this has shed some light on my current situation. Besides normal back pain due to c-sections and a torn muscle while playing baseball 2 years ago I haven’t experienced any injuries. For the past 2 months I’ve had an intense deep ache which is at times, unbearable. The pain runs from my tailbone area to my calf muscle and is constant. It feels as though my leg is in a consistent cramp though there is a lack of tightness as you’d normally have with a cramp. The pain I normally (normal to me over the past 17 years) have with my back due to my c-sections is gone, though I believe the pain in my backside and leg (right buttocks and leg) simply masks that pain.. I no longer notice it. My doctor first prescribed my Tylenol 3, ketorlac (sp – was a high dose ibuprofen/anti-inflammatory) and Baclofen. None of these helped with the pain at all. I’ve gone back in after massage and a cycle of these medications with no results to which I have now been appointed to have an x-ray. My doctor has also prescribed Oxycodone and Pregabalin. So far these medications have provided a small rest for the pain though not much. I take the Pregabalin before bed which allows me to sleep but I wake with pain and extreme stiffness. At this point I am desperate for any advice or questions I can bring back to my doctor. I am waiting for an MRI which takes time due to waiting lists. He is convinced it is Sciatica but I do not believe so as there is absolutely no back involvement at all. Calve muscle and buttock area are also sensitive to touch and becomes very painful with pressure as well.

  44. Linda

    Today I went to therapist in reference to back pain and she touch me that area where the piriformis muscle I am literally almost shot off the table because it’s so painful but for a long time. I have be in pain. I had total knee replacement on both knees and soon after knee replacement I start thinking that I need a hip replacement because the pain was so unbearable in the hip area at this moment I will be continuing to going to therapy but I think I have found an answer thank you so much for the information it has been very helpful to me.

  45. Chevonne

    Good day

    I am a 33 year old female and i think i suffer from what you explain. Doctors just give me pain killers. I have pain from my hip down into my feet. The pain is down my back into my bum cheek and then down my carves into my feet. Sometimes pain get so much that my whole area becomes so sensitive i cannot touch it and when i lay and stand up i cannot stretch my legs or trap on my feet. Please is there anything i can do to help my condition?

  46. Nafeesah

    Amazing! Found answer to my pain and the doctors never did. SMDH!!!

  47. Chris

    Hello Dr. Schierling,

    I got a problem through extensive cycling what I believed to be high hamstring tendonitis, because of the saddle digging in my thighs. I also get a dull pain, when sitting for longer times in soft chairs or car seats. Sitting on hard chairs is much better and triggers almost no pain.
    The problem with my theory is, that I am able to run a lot without this pain (recently a marathon). As web search showed, high hamstring tendonitis is also a problem for runners, so I am considering that it is not a high hamstring tendonitis.
    Can a piriformis syndrome only show when sitting and cycling but not when running?


  48. Elle

    I have this issue and have found the only thing that helps is myotherapy

  49. Tahnya

    Hi, I am a 39 yr old woman with previous spinal surgery fusing C-5, C-6, C-7 with a donor bone from my hip. I had recurrent pain about 3yrs later, had a rhysotomy (sp?) With great success for 4yrs now. I’m not super active, due to terrible fibromyalgia, but i do as much as i can. 4mos ago i began battling with some of the worst pain I’ve ever had, worse than my neck which I never thought possible. It came out of the blue really and starts in my very low back, my hip, the underside of my groin, runs down my legs into my heel. The pain and burning is pretty hard to describe really unless you’ve experienced it. occasionally I get a bit of relief that’s manageable, and I can function more which is why I can post this now. It was an ok day yesterday, and has lasted thru the night, but doesn’t typically last long and happens occasionally. I’m trying hard not to focus on it but it’s hard to focus on anything else. It’s affecting my life negatively at a fast rate. I had to quit my job, and I’ve pretty much lost the ability to care for my family. I can’t stand at The sink to do dishes, or even get in and out of the shower by myself. Its devastating.
    The symptom that concerns me the most is the hip, butt, groin pain and burning in the underside of my groin as well. I’ve had an MRI, and they found nothing…thats happened before and I’m just not convinced, there has to be a possible explanation. I’m not getting anywhere. Muscle relaxants don’t work, prednisone was a false hope. It worked well to take the edge off for a couple days so i could eat some, and sleep some as well. As soon as I went off of it, I got worse. I’m eating little and sleeping less. Im up for 2 days at a time. The pain is exhausting, but I still can’t sleep because it’s so bad and no sleep doesn’t exactly promote healing. PT made it worse so I stopped, I couldn’t handle it. Chiropractic methods also failed and make it worse. I’m at a loss and with no health insurance, it’s pretty hard to get the care you really need so, I need financially feasible options and maybe a suggestion on what it could be. I could really use some advice, and help. Thanks

    • Very tough to say what this might be Tahnya, however I would suggest you head over to my Doctor Schierling dot com site and learn everything you can about inflammation, fibrosis, central sensitization, and fibro — lots of great self-help sort of material.

      Dr. Russ

  50. Angie

    I am in my mid 40’s and am an avid weightlifter. Sadly I haven’t done any lifting for almost 2 months because of my butt pain. If I stand too long or go shopping (10 min or more) my mid butt hurts and my leg goes numb. I love to exercise…it makes me sane and I’m going crazy with this pain. I’ve gone to a chiropractor but it persists. Wondering if I should go to a different doctor and maybe get some sort of muscle relaxant? My symptoms do differ from others….It only hurts when I am standing to long or walking and it isn’t all the time but at least once a day and it’s bad when it comes on. Only thing to relieve it is to sit down. Can’t live my life on my butt. :0) Any advice would be great.

  51. Aline

    I have been in pain for 15 years now, after giving birth, I have been to different Dr and no one could tell me what I have. I have pain in butt but most of time by touching it and pain in the leg and sort of burning sessions. I tried everything I did echografie and radiography and nothing to see… I really don’t know what to do.

  52. Jess

    Wow! I wonder. I am 31 had hyperthyroid and with radiation treatment and now hypothyroid. I’ve been having bad often times excrutiating pain in my lower bac, hips and legs. I recently noticed a big dimple in my upper right rear cheek, min you I’m only 100lbs but because that’s where alot of times it seems the pain is radiating from, I noticed if any kind of pressure is applied there it send horrible deep sharp pain through my back and legs. Sitting in the car, restoom or anywhere becomes painful and I toss and turn at night it also affects things in the bedroom. I’ve had all kinds of tests done but will definitely be talking to my Dr. About this. I wonder if it is liked to autoimmune as well?

    • First Jess, make sure to read my stuff on both thyroid and autoimmunity in general as most thyroid issues, low or high, are autoimmune, and most autoimmunity can be addressed in the same general manner (HERE). Second, make sure to do the test I talk about in this post and mention in many responses.

      Dr. Russ

  53. wendy

    I’m in agony. Every night i get extreme pain in my hips, butt and legs. I can’t even turn over in bed. I had a spinal fusion two years ago – L4, L5, S1. MRIs are clear. However I have burning feet and I can feel two strips of fire down my legs during the day. Im on Pregabalin, Carbamezapine, Tramadol and Baclofen. The pain is so bad at night I just want to get out of bed and stand but I cant move. I also have intermittent pain in my left groin. Physio does not help. I’ve tried all the stretches given to me by physical therapists but no luck. Any idea what I can do? Please help.

    • Very doubtful Wendy that this is Piriformis Syndrome (rare bilaterally). Not sure what it is, but the most likely culprit if it is not a disc is some sort of inflammatory or autoimmune attack. Tons of info on my Dr Schierling site about dealing with this sort of thing.

      Dr. Russ

    • Brian

      Hey Wendy. I am having the same problem. I went from trying to sleep in my bed to sleeping in a recliner or an expensive computer chair that reclines. It helps soo much you don’t even know. I tried sleeping in bed but it left me in tears and I’m a Marine and consider myself to have a high tolerance to pain. I feel ya tho. I hope this helps. I know it sucks. I dream of sleeping in bed once they can figure out how to clear this up, but until then, at least I can get some sort of sleep. If you don’t mind me asking however, what do you take pregabalin and carbamezapine for? The doc has me on baclofen and pain meds and thats it. If the other two help with it let me know please!!! Lol

      Wish you well

  54. Jeffry S

    Valuable information. Lucky me I found your website by accident, and I am shocked why this accident didn’t happened earlier! I bookmarked it.

  55. Barrie

    I’ve had pain and been unable to run for 6 weeks now. Went doctor and he said Piriformis. I don’t have the shooting pain down my leg, I don’t have numbness nor do I have tingling. My buttocks hurt and felt tight in the center for about 4 days then that disappeared. Since then I’ve had pain at the very tip top of my hamstrings on the backside of my legs in further toward the inside of my legs. I’ve begun exercising, glute bridges, clam shells, front planks, one legged glute bridge. At what point will this pain cease and I can at least jog again?? Is this even Piriformis? I’m not certain the symptoms are indicative of that. Have another appt next week for 2nd opinion, but am curious as to your thoughts. Anxious to run. It’s been waaay too long.

  56. Willa Ward

    FYI had plantar fasciitis bilaterally. Dr. said I had to live with it. Started walking 6 miles a day and have not had a pain in 20+ years! I think if I do this again, I can resolve this the same way. Will let you know.

  57. Willa

    Thanks. I had already self Dx and this confirms it.

  58. Elizabeth

    I’ve been in so much pain and have had no answers from the doctors I’ve been going to I think they think I’m lying when i tell them I’ve had this for more then 6months but i have and outs pinky gotten worse. I googled my pain and that’s how i found out about Piriformis syndrome I’ve never heard about it before. They are sending me for an MRI which honestly I don’t want to go to because of the pain i will have to go threw just to lay on that bed and then to have to get up and to no they won’t even see anything if this is what i have. Thank you so much for posting this information now i have something to take to the orthopedic they’re sending me to in two weeks if i can last that long.

    Thank you ,


  59. Aleks

    Hello Dr. , this article seems like it’s about my current situation. I had this exact pain during my first pregnancy 7 years ago and nothing helped. I’m currently pregnant and the pain is too much to handle. What can I do to relive it? Thank you!

  60. Dana

    I didn’t stretch good back in Sept 2016. I did split it literally said “pop” it brought tears to my eyes…every since that muscle in that spot hurts, Is swollen, can’t rely extend leg, lift leg,or nothing without pain…seems to be getting worse as time goes on..I don’t know what to do about it… I feel like if they cut leg off from butt cheek down That it wound feel better

  61. Kelli

    To the young gal , I had a cortisone shot into myb” ” spot ” which had hurt me on and off for 2 years. 85 took the inflammation away , which is why I was having so much aggregation , including hip pain . /9 now I just guard that spot , I guard my back , in careful not to pull and cause any strain on my butt muscles . I’m also 45 so I have that going again St me but I’m a nurse assistant and that is why it happened .

  62. briel

    hi, I don’t know if this is related but anytime of the day, anywhere, I feel sudden pain simultaneously in my left side vagina(near the bone), buttocks, and my left ankle. It last around 1-2 seconds only. Can anybody advise or diagnose and what I am experiencing. I’ve been researching about this and still got no idea.

  63. Martin

    I have had chronic and constant pain in both buttocks for approximately 18 years. I’ve had physio, chiropractic treatment, massage, tried strengthening the muscles and been to my doctor and had X Rays yet still nothing seems to improve my condition. Have you any advice on what I can do? I’m in agony every single day, whether standing, lying down or sitting. As I’m only 35 I would like to ideally get rid of the pain, but I fear the best I can do is manage the pain. I would appreciate any advice at all.

    Thank you


  64. Chiara

    Around two months ago I started to get pain in my right butt cheek while sleeping – very painful when rolling over and excruciating when getting up. It started about a week after a holiday when I exercised with a sore back, went running and did HIIT barefoot and abs on a hard surface… Dr has given me anti-inflammatory tables and co-codamol for sleeping but it doesn’t help. I have seen a physio who found a very tight piriformis muscle and have had two sessions of acupuncture so far. The only result seems to be that I have developed a more typical sciatic nerve pain (down my leg, behind by kneee and my calves, sitting down is painful etc). I am also sore on the other side now although it feels more like an adjustment to my sleeping position than a tight muscle. Any advice? I need to sleep 😦

  65. sally

    I have had tingling in my left leg since February followed by numbness again just the left leg, i have had sciatica in the past too…. most recently i had a hysterectomy and 6 week post op i started get pains in my knees and hips and buttocks, traveling up from the knee up the thighs right round in a horseshoe shape, i can walk briskly with no pain but sitting, stairs, and laying down and sleeping are all sheer agony….. i have been referred to a Muscular skeletal doctor so he can see what it might be. pain killers do nothing so i don’t bother taking them. could i possibly have this too? also is there anything i can do to relieve the pain?

    • Because this problem is bilateral Sally, it’s almost certainly coming from your back. As long as there is not something like a tumor in there pressing on the nerve, some of the hints on my Solve Your Own Back Pain posts over at Doctor Schierling dot com could possibly prove helpful.

      Dr. Russ

  66. Aidan K

    I am a seventeen year old female who doesn’t get enough exercise and has high arches and foot pronation issues. I began to have pain in my left butt cheek five months ago. I haven’t been able to sleep on my right side, I can barely sleep on my back, and my right hip started hurting too in the past month or so so sleeping on my right side is also painful. I need to go to the doctor to figure out what is going on, but this is the closest thing I’ve found that matches my symptoms w/o any mention of swelling (as I do not have that). I just read this article and started crying cause I’m scared that I might be in pain for the rest of my life. Should I be scared of that or are there things doctors can do? And is it normal for this sort of pain to be happening in someone so young? Also, my pain initially started with sudden and acute pain in my lower back radiating up from my left buttock, and after it disappeared the pain in my left buttock started with the squeezing/sore/fullness feeling I have there now.

  67. Erik

    For years I had major sore calve muscles from doing nothing but normal day to day stuff. That went away when I started taking creatine supplements. Recently the soreness came back in one calf muscle and the other popped. Plus for years I would get tingling in my toes. Since the injury the tingling has been constant and only a little bit of soreness. I have also been experiencing a small buring sensation in both of my hamstrings. I got a eng test and it came back fine, no issues. Just started some physical therapy and done a few new stretches to add to my normal stretching I do for small amounts of running and Taekwondo. Today I got a major pain right in the buttock area, where the pforisis muscle may be and it hurts to move, sit, squat, stretch. Any ideas why it may be super sore? Thanks!

  68. Tai

    Wow this is so interesting and fits all my symptoms

  69. Sheryl

    Yes i think you hit the nail on the head.it seems to be getting worse,i cant seem to get it to stop.im going to the doctor in the morning. THANKYOU..

    • Penny

      Wow! I have been dealing with butt/hip/groin pain for years. I am a runner.
      I am a woman.
      My concern is that I have been running for years but cannot run anymore without pain in my hip/groin/butt. I have had injections, PT, acupuncture and now I am scheduled for hip surgery. I do have significant osteoarthritis in this hip.
      BUT – I do wonder if some of my pain is attributed to the piriformis. And, dang if I want to have surgery if its a performs issue.

  70. April

    Hi I have bursitis in my hips which I’ve had a huge flare-up for the first time that has not gone away. As a result I’m having cortisone injections in the hups. I’ve never had a problem. They take about 7 days to completely take away the pain and u can walk again. I’ve been getting them for a year and a half now usually by the same doctor. Recently I had a doctor do the injections who has hurt me before by taking too long to do them and pushing hard on the areas trying to find the worst area and I always ask for someone else because of this. I didn’t have a choice and he did them and I was fine except for the usual amount of aggravation from his poor technique when all of a sudden I got excruciating stabbing, radiating pain in the midle of my left butt cheek and down the outside and some of the front of my left thigh. It comes in waves. I’ve had it for 15 days now. Every time I think it’s getting better it starts again. He didn’t bother calling me back to let me know what he thought was going on. Could this be gapping because of the injections somehow? It’s not like my usual bursitis pain, it’s a sharper pain and comes and goes like lasting 10 min then stopping for an hour or 2 or 5. Does this sound like piriform? Nerve damage maybe? I don’t know what to do. I’ve been pretty much stuck in bed for 2 weeks. Scared to drive to the doctor. Ot hurts so bad I cry and yell so can’t go anywhere. Please help. Thank you

    • Hello April,

      First, you sound relatively young to me. Secondly, if you are having bilateral hip bursitis on a regular basis, this is a significant problem. Third, if you read the material I have on my doctor schierling dot com site on corticosteroid injections, you’ll see how dangerous and degenerative these really are (it sounds to me like your doctor is not following standards of care). Not sure if this is PS, but you really need to get to the bottom of this issue or you will soon have artificial hips.

      Dr. Russ

  71. Nawal

    So maybe I am gradually developing Piriformis Syndrome. I am over 73 yrs and quite healthy. I like to exercise and go for walking. In May I got cute pain, after X-ray and ultrasound which were ok, I diagnosed my self as having shin splint. I rested for about 7 weeks and wearing bandages etc. pain disappeared. Last week I started getting slight but tuck and thigh pain when I wake up or if I sit. When I move, it disappeared. Pain has increase and subsides at lower rate when I move. I feel at my best when I do my normal stretching exercises or after my 1hr walks.
    How can I help myself to reduce this pain? I am traveling tomorrow for 16 days

  72. Cindy

    In 2013 at 59 years, I experienced sharp right butt pain and was diagnosed sciatica. The next morning i was sitting in a chair and leaned over to pick my grandson up and felt incredible pain down my right leg. I went to lay down and only got up to eat. My daughter noticed my right leg was discolored. I had an extensive Blood clot from lower leg into abdomen. I recovered fairly well and wear custom comprehension stockings. The clot never completely dissolved and if I sit too long I get pain in right leg or groin and rarely butt. I am a psych provider so sit a lot but pain not usually an issue unless too many days in a row. I have had scans many times since and no new clot (old clot never completely dissolved). Recently I have been having right side butt pain and it is worse if I lay on my back. I am afraid of course it is a new clot but at the same time wonder if it could be nerve irritation or something else. I don’t stay on my back long but have a sensation with the pain of tightening. The pain does not immediately go away and I don’t push the issue testing things because don’t want to make things worse. There is a condition also found in women called May thurner syndrome and is a cause of the same type of dvt I had. I am going to see my doctor and get my pain in the butt looked at. I was misdiagnosed originally and understand no one including me considered a dvt until my leg was involved.

  73. Tammy

    I am a 53 year old active female. I am the perfect weight for my body build and very healthy in all areas other than my hip/butt. I fell in May of 2016 and hit on my right hip and didn’t think it hurt anything as I was able to get up and go about the day without pain. The next day my left butt muscles felt extremely sore like they had been overworked. The right side didn’t hurt at all. The following day I started experiencing pain in my hip and going into my left leg. It felt broken but the xray did not show a break. The doctor said I tore a muscle and triggered sciatica. He put me on muscle relaxers. They do help but the pain is still there and it gets worse the longer I am on my leg. Some days I can only be up a couple hours before it starts. My relief is when I sit or lay down. Standing and walking feels like my leg is trying to come off. I have all the normal sciatica issues in that leg
    also. Cramping numbness and tingling all the way down the back of my leg and into my foot. Any suggestions??? I do not want to stay on muscle relaxers.

    • Hello Tammy,

      Could be disc or even myofascial. Not PS though. Lots of self-help stuff on my blog.

      Dr. Russ

    • Shelby L.

      ….Tammy, I read your comment and I have also always been an active woman. I danced, skated, walked all the time , etc. I fell in 2012 , really hard, right on my behind, hitting the right side much harder. I am the kind of person that just sees if I’m ” OK” ,gets up and dusts myself off, rest a bit and go on. lol. I didnt start getting pain till a YEAR later. .; I had a childhood injury to the right side of entire body but had fully recovered from it, it took three and a half years…but I was fine. This fall aggravated that injury and I believe it tilted my hip EVER SO SLIGHTLY. Which is a big deal….and it was always this dull ache in my butt and noticed it would worsen with the weather turning bad. I could tell when it was going to rain, snow, etc, Crazy, lol. But them it started to go from there to my hip and I’ ve been battling it ever since. I have been using Baby Aspirin, Epsom salts baths and Tiger Balm. AND elevating my leg seems to help a great deal. I can skate and it is actually BETTER with doing this. I have no interest in meds, shots, etc, so I approached it from a standpoint of making sure I drink lots of water ( which I have always done anyway) , real food ( smoothies/ lots of veggies/ lean protein, and little carbs of the ” bad kind’. All veggies are carbs , but are the better carb, lol. ) Like you, I could only function a couple of hours at a time until I decided to not let this get the better of me. …and get myself back to a place of being active and getting on with life. I also had/ and sometimes still have the cramping, etc, as you described. I know that my Vitamin Supplements have helped, ( Take one magnesium tablet at night , with an Omega 3, it helps A LOT ) as well as eating avocados ( which I love ) , they have THREE times the potassium of a banana, can even be used in smoothies..
      I am 63 years young and I want to encourage you , that it CAN be better and I already have felt it improving some. ..and it is so much improved from even a year ago. I wish you blessings , may you find healing that works for you.

  74. Judy

    Ok….good article that makes a lot of sense….My question is what kinds of stretching exercises do you recommend…..I thought I was going to need a hip replacement, was so happy to hear otherwise however, I’m still in the dark as to what to do….
    I had one cortizone shot to relieve the pain , it helped tremendously, now what??

    • Be aware Judy that corticosteroids are massively degenerative and eat collagen-based tissue, which is basically everything in the joint. Using these drugs is essentially trading tomorrow for today. Tons of self help things, including stretches on my Doctor Schierling dot com site.

      Dr. Russ

      • Barb

        Interesting you should say that! First I’ve heard of this. I had two cortisone shots in my shoulder (which now feels better) but funny thing now I have problems in lower back (degenerative disks) and extreme pain in buttocks. Could the shots have cause the disk problem? I’m 63 and play sports three time a week.

      • The medical guidelines for using corticosteroids are rarely followed (HERE).

        Dr. Russ

  75. kim J

    Thanks for this page I was just diagnosed with Piriformis syndrome. I am so happy someone finally listen to me. my problem is my regular doctor keeps tell me to work out and stretch o and my favorite one loss weight, how I am in so much pain after I can’t move. any suggestion?

  76. Yvonne

    I have been in pain for many years complaining to my doctor about my butt sore to move certain positions to try and get comfortable and my legs.The pain is horrible ii had to stop doing aerobics and Pilates and even yoga cant get into positions any more stiff and so much pain
    Just found this sight 2 days ago and it describes my pain .one part i couldn’t walk at all .my doctor found a doctor who gave me cortisone in my butt to help me walk .which took 3 days .
    I cry with pain turning over in bed sitting still at times
    Walking getting in and out of my car

    My back is no good .but my.muscles hurt more than.my back i cant sleep for days which makes my pain more .

    I.am now in a different town.i will go to the doctor show him what i wrote down and try to get medication to help with pain and urgent help with sleeping

  77. Florence

    Thank you for this very informative article. I am suffering too much pain from this piriformis syndrome and I am already getting frustrated on how to ease the pain.I tried going to chiropractic treatment and did stretching every now and then,but to no avail.I am now having this small like ball lump in my butt cheek area which when pressed makes it painful and causes tingling in my left foot area.I am looking to your best medical advise to ease my pain.Thank you.

  78. Gargii

    This exactly what is happening to me. I had a ligament wear issue after which i experience this more as and when i use my left leg more ..or specifically while driving. I have consulted so many doctors and physiotherapists but they are not able to detect the actual cause and says it will heal with time. Can it be because of the knee ligament issue i had? Can it be healed? The pain sustains for 2/3days and subsides. Can you tell me some exercises?

  79. Sophie

    Hi there,
    This was really informative, and I definitely have this, but my question is what to do? I work with a PT, and things are pretty bad. It’s hard to sit and I have pain in the legs, butt, groin, hips. I had a cortisone shot in the muscles which I regretted, as it just irritated things and I got worse. I’ve been stretching and doing what I can, but I guess I’m wondering what course of action you would recommend. I am not currently seeing a chiropractor. I have a history of pelvic muscle problems, and I found it interesting that the piriformis is a pelvic muscle. Thank you so much!

  80. Marie


    I read your article and I am convinced that this is what I am experiencing. Also I’ve had the mesh inserted in me since 2001 in the vaginia. So I was thinking all this pain was from the anchors they inserted one dr even said he would remove them But I don’t want more surgery. what’s your opinionn on this?

  81. Charles

    Hello Dr Russ
    Fantastic article. It sums up my problems. I am male 72 years. I can’t sit or lay down without awful pain. I have been up all night with a throbbing stinging pain in my right ankle. Tried chiro. Was improving after 5 sessions and then he did something and I am back to where I started. Hoping for some relief soon. I need a sleep.

  82. Asif

    Hi Dr Russ.
    I am Asif from Pakistan ,I am 32 over all in good shape I have been struggling with low back pain since 2009
    I use to work as a loader in a factory heavy lifting was routine task after 3 years I developed a sore constant pain in my lower back near
    the dimple on lower back right side I believe it’s called SI joint gradually the pain got wore & I had to quit that job .
    but the pain never went away now I have a desk job but I can’t sit for more than 25 or 30 min . standing , going up stairs & driving makes pain worse

    I also feel a deep pain in the right glute & right hamstring also hurts pain also goes to my right foot sometimes & the entire leg feels week all the time
    My MRI showed L5 S1 Disk degeration / nerve root compression . SI joints didn’t show anything remarkable

    I have had 6 injections in my back with temporary relief , acupuncture & oral pain killers dnt really help me much .
    Prergablin reduces pain but it make me very dizzy & sleepy its also addictive

    I do some stretches for PS I saw on you tube but the next day pain gets worse , heating the area also make it bad

    There no qualified chiropractor available here .

    Please advise me .


    • Hello Asif,

      The problem with your situation is without a chiro (or DO or PT or someone similar) in the area, you are left with a drugs-only approach. Make sure to read my article called “CHRONIC LOW BACK PAIN AND THE THORACOLUMBAR FASCIA“.

      Dr. Russ

      • DAWN

        I am experiencing a great deal of pain. I was recently discharged from the hospital after a couple of days with an diagnosis which doesnt explain what is wrong with me. I had surgery last year the end of April, to remove 4 bone from my lower spine. I had narrowing of the lower spine which constricted the spinal cords, and cause my legs, hips and feet, swelling, pins and needles and sometimes numbness.
        I’m beginning to get the same pain and muscle cramps in my left hip, buttocks and leg. None of the medications they are giving me seem to relieve this pain entirely.
        I goggles my symptom’s and this Piriformis syndrome is exactly what I’m going through. Tired of taking medications and don’t know where to turn.

  83. Barbara

    Wow!! After reading your whole page/article, I was amazed with what I read. This whole article narrows it down to me and definitely all of the pain and discomfort that I feel and yes I am a female. The “Pain in the Butt” is not a good feeling at all & I don’t wish it on anyone!! Male or female!! The pain does radiate to both of my hips and legs and the back of my thighs. It hurts like you know what. It does hurt especially to sit. I do stand on my feet for long hours at a time at work. I do seek chiropractic care and it does not help. Thanks so much for this article. The information was very helpful. And yes….”Pain in the Butt” is a good name for it and yes it t truly is a Pain in the Butt!!!

  84. Rusty

    Dr Russ,
    I am a 49 year old male and have had a pain in my right upper butt and I have pain that runs down my leg and ends at my ankle the top if my foot is numb. I can’t lay flat in bed and only lay about at a 45 degree angle. I did have a blown disk at the L4 L5 and had surgery to fix that. Still have the symptoms of piriformis syndrom. When I walk my feet room from the outside to the inside. I use shoes with rollbars to correct this. I have had this issue for about a year. Additionally I am a motorcycle rider and am retired from the military. I have been on gabapenten for about 6 months and do have some relief but am always in pain. Sitting increases pain walking and standing gives some relief but I can only stand or walk for short periods. Any thoughts. Thanks

  85. Kieran

    Dr i need your help!! Im 27 i have had this pain for 2 months and it is very very painful!! Ive payed out over 200 quid in the last few months on physio and its not going i feel like ill have this forever!! What is the solution!? Thankyou

    • Hello Kieran,

      About the best I can tell you, not knowing any more about the situation, is to pour over my blog and learn everything you can — not just about PS but about inflammation as well.

      Dr. Russ

      • Kieran

        ThankYou for your reply I have looked through this and have identified some possible solutions. I have impingement or femoro acetabular impingement (FAI) on my left leg due to playing so much sport so i thought this might be thw cause of this new pain on my left. I cant play anything anymore just cycling. Anyway thanks again.

  86. Bradley

    I’m a 40 year old male and every time I lay down for a period of time my buttocks hurts into my hip down my leg.It just happens on my right side! When I stand up it’s hard to start walking but once I get going it makes the pain go away? Do you think that I have PS please help I don’t get enough sleep at night!! Thanks Bradley

  87. sue

    hi, i suffer with 3 lower disc bulges at around L1. I suffer with pain in my back hip butt and leg. If its cold or i sit i get a bad paid in what seems deep in my butt and hip. I have to use a stick to walk.

  88. Marquita

    I love everything you said exactly right

  89. Ashley

    Hello Dr Russ,
    I have been having pain in the right outside part of my glute just behind the pelvic bone, this pain radiates down the back and outside of my right leg and stops at my knee. It feels like it’s jammed or needs to be popped. I try to stretch it out but that doesn’t seem to be working. I recently found out I am pregnant and I drive a truck so I am sitting for long periods at a time. I do walk, climb stairs and walk my dog throughout the day… Any suggestions?

  90. veonica wilkins

    Could domestic violence non cohabital cause this.A client went postal.He thru me around like a rag doll. Wrapped me around a pedestal table and legs wrapped around the pedestal..had a huge bruise in inside both thighs and right lung..They did an mri right then but it may been too soon.I can’t stretch with out spasming.Its my clutch foot I can’t use without spasming.People ask me to sit I say if you don’t mind I’ll stand.I can’t lay flat..my left leg will collapse on me. how can I know.?

  91. Greg

    I put my back out weight training some 7 yrs ago. I couldn’t move for a week button better and didn’t think about it, being young and all.
    Since then I’ve put my back out several times and started getting this pain which I think is p’s.

    I was diagnosed with a slipped disc and told to stretch and strengthen core. Currently off work as I got Intense p’s, no back issue as such just this pain along with really tight hamstring, left buttock and leg.

    Actually get depressed thinking will I ever solve this problem!!!

    • Hello Greg,

      I believe there’s a solution for every problem short of rigor mortis. It’s just a matter of finding the person with the solution. Usually it’s fairly simple and straight forward.

      Dr. Russ

  92. Yvonne

    It literally is a pain in the butt!!! Happy to know I’m not totally crazy but I wish I was alone. I am totally obsessed with that nagging pain…& constantly messaging that area… Folks will begin to talk if they haven’t already!!!

  93. Delise

    I am wondering If it is possible to aquire piriformis syndrome after spinal fusion on l4 l5? My back no longer hurts but my my butt, hip, and right leg are so bad I don’t know what to do. I’ve had a MRI and CTscan and they show the surgery hardware is in place.

  94. Mitchell

    Hit by a truck in ’98. Broke my hip and pelvis, it fused back together, just had second knee surgery and l5 s1 disc fusion, now am due for a hip surgery. Not one dr has mentioned the pf?? Kinda worried I have all the symptoms my left buttcheek kills and goes around to my hip. The Drs say it’s a ligament tear that needs to be fixed but I can feel some tendon or something in my buttcheek. What do you think? Thank you in advance.

  95. roykni

    I think have both, PS and disc issue. So an inversion table can help with my compressed disc but at the same time can make PS worse? PS mostly on left side, but occasionally on right side. Also frequnt SI dislocation on left. Years ago it was SI on right until I stopped carrying wallet in back right pocket.

  96. Abdullah

    Hello Dr. Russ,
    Many thanks for a great rich article.

    I’m 34 years old male, 190 cm tall and weight is 88 kg. I’m a right handed.
    I have maintained an active life style until 4 years ago when I got a bit lazy.

    18 months ago sometimes -and randomly- when I wake up I notice lite pain in the upper left side of my glute, nothing serious but it’s annoying, it fades away through out the day. I’ve noticed this is more likely to occur when I over sleep.

    4 months ago I got back to training including squatting -since 1 month ago I started high repetition bodyweight squatting-, rope jumping, and weight lifting. I’ve noticed the same pain comes back after cooling down of squatting repetitively.

    The pain is lite it’s more visible for a second when I bend forward and in other positions it comes for a second then goes away or fades.
    It always felt more reliefing to put the effected left leg over the right “left foot over right knee while laying on my back” the pain goes away.

    Some information that might help:
    Being right handed I’ve always felt that my squat form gets compromised specially in the last repetitions “I do alot of body weight squats, around 100 aday”, in which the right side does more work and the left is shaky.

    In general I’ve a weak lower body.

    I always blamed the bed thing on the mattresses specially that it I had to move alot at that time.

    Your help will be much appreciated.

    Thanks again,

  97. Leslie

    Help! I’m so desperate for any kind of release in my right hip and leg. I’ve been suffering with hip/leg pain for four years. I have always been a runner but 6 years ago I started to increase my mileage and started running marathons. I was always training with high mileage and also working 12 hour shifts on concrete floors. After two years of running marathons I noticed during my races my leg would feel fatigue especially running up hill. I went to the doctor and was diagnosed with bursitis and piriformitis and also my psoas is really tight. I also get clicking around my tailbone and my lower back feels tight. I was given an oral steroid to help with the inflammation which seemed to help but for only a short few months. I also started noticing a sharp pain running down my leg while I’d be standing at work for a long time. I knew from having been pregnant before that it was my sciatica. I began doing yoga and using a topical antiinflammatorie and seemed to help a little. Fast forward about a year I was running a race and I felt great but all of the sudden my right leg felt fatigue more than it ever has. I tried to run through it and my leg started to feel like I had bricks tied to it but my leg felt like jello. I almost fell so had to begin walking. If that makes sense. I didn’t know if I could finish. But after walk/ running for two miles I was able to continue but with a slower pace. It has been so frustrating to see how this has effected my running. I have not been enjoying it like I us to. Ever since that race I have experienced this, going on the fourth year. I became pregnant and took a long break from running thinking that this is good for my body to rest. Once I began running after I delivered my son three weeks later it was STILL there! My right leg froze up and it radiates all down my leg, from my hip down my butt, both my quad, hamstrings and calf. I have noticed the faster I try to run the harder it is to keep running and the worse my leg freezes up. So say I’m running a 5k, I will try and race it as fast as I can but I end up walking alot of it, but if I’m running a marathon I can keep running but my leg will feel fatigued. This all usually happens in the first few miles than it will subside until later in in the Marathon. I’ve tried massage therapy, cryotherapy, yoga, foam roller, foot zoning antiinflammatories and it will help a little but nothing will fix it. Any thoughts or suggestions? My next resort is an MRI but as a single mother that expense has kept me from getting one, but I think it’s about time.

    • Hello Leslie,

      Runners always hate to hear this, but were I you I would change sports. Try weightlifting, crossfit, whatever, but give your butt a break from the concrete and see what happens. I have seen way too many people who continue running until they are essentially debilitated.

      Dr. Russ

  98. Sharon

    I need HELP! This is exactly what I am going through for the last 4 years, I can’t sit for more than 30 minutes, can’t stand, and now I can’t sleep or lay on on my back, I can only sleep on my left side. I do get some relief working. I work 12 hour shifts but after 6-7 hours I start hurting, it also makes my knees hurt like a lot of pressure around both of them , the nerve pain gets so bad That I cant stand it. I have been to 3 doctors had 3 MRI and nothing shows up. Had a nerve branch block on my si joint and steroid injection on si joint and L4 L5
    Can someone please give me some advise on this.

    • Hello Sharon,

      A couple of things stick out to me in your comment. Firstly, while not impossible (I’ve seen it), bilateral PS is very rare —- especially bilateral PS that develops simultaneously on both sides. This tells me the problem is probably disc related. Also, if you are exercising the way you are, but are still overweight, I would guess there are issues with your diet. Important to understand that inflammation is driven mostly by diet, and is intimately related to disc problems as well a host of others.

      Dr. Russ

      • Sharon Stokes

        Hi , I want to clarify that I am not over weight I weigh 133, bmi is 24 , I had an injury 4 years ago and it all started then, I also have pain and pressue on my butt, when I start hurting it starts in my butt then my knees feel like they are gonna blow up and the burn on down to my feet, I worked 12 hours today and I had to immediately lay down on my Right side , I laid down around 8;15 and its 10:00 now and the pain is so bad , especially in my knees and feet , my feet feel like they’re on fire along with being cold.I take 2400 mg of neurotin, 750mg metrocarbinate x4, and 100 mg tramado x 2 a day. I dont know what to do or where to go , the doctors Ive seen says I have no problems with my spine.

      • Tough to say Sharon, but my best guess is that both sides problems have a common source. This tells me that it’s probably something in your spine or thereabouts. Wish I could do more for you.

        Dr. Russ

      • Barb

        Dr Russ,

        Thank you so much for the information! Knowing that diet can affect inflammation is empowering. I will have to look up more information on that and what foods to increase and what foods to avoid.

        In your last comment, are you saying that if the pain on touch is bilateral it likely is NOT piriformis? Sounds kind of sad to say, but I was hoping I would be able to finally put a label on my discomfort. Look forward to your reply.


      • Hello again Barb,

        That is exactly what I am saying. Not totally impossible as I have seen it. But quite rare. As for the inflammation / scar tissue connection, I have at least half a dozen blog posts on the topic (all filed under “inflammation” or found by doing a search on the word “Fibrosis”). It is a critical link that the medical community does not even mention to people.

        Dr. Russ

  99. Michelle

    Hello, I have just started getting burning sensation in both buttucks near the top of my legs, I admit I was sitting too long it started as a numb feeling then burning came after.
    It went when I sand up but after two weeks its still here and now find even sitting 25 mins can kick it off and also last night was first time it happened while in bed sleeping I awoke with the pain from a deep sleep
    Is this getting worse for me? Should I go tje doctors?
    Im over weight but I excercise everyday I swim 80 lengths front crawl of a 25 metre pool and walk 4 miles once a week. Help! Thank you

  100. Kelli

    Hi doctor , I’m a nursing assistant in a physical medicine rehab ( go figure ) and a few years ago I injured my ” butt “. It took me a long time to put it all together , but the pain went from my butt to my hip – and I feel they were connected . The butt pain was a like a nagging toothache and the only thing that ever brought or brings relief is when someone pushes on it with nearly all their weight. It hurts then but the pressure is then relieved. Sometimes that keeps me good for a few days . I also play softball and had been lifting heavier then I should of have been weights . The pain is now on my right butt and it does down my leg.
    Today I sat all day at work with a patient and I could barley stand it . My PT at work says it pirformis . What do you think ?

  101. Sachin

    Hi Dr.
    It all started a month ago I think. I used to keep my keys in my right back pocket.My right butt used to pain while driving, I knew that keeping anything in right back pocket is not good for sciatic nerve and would immeditaly remove that when it used to hurt.
    After a few days it would hurt without the key in the back pocket,I would then try to sit more erect and pain would subside. This went on for a month.

    And last week, I had tremendous mental stress because of my wife’s health issue. Next day, pain my butt increased badly and I could feel that while driving. My right leg would not feel happy and I had ache around my butt and mild ache down my leg.

    And since then I have not been able to sleep on my back. In 5 seconds, the pain starts.
    I cant even sleep right side way.

    If I have to sit on a chair or car, I have to keep something below my butts so there’s some sort of gap between the chair and area in my right butt that pains.

    Is this PS?

  102. michelle M

    my lower back always hurts, it’s been hurting for a few years. i went to a physical therapist and he said there was nothing wrong with me. Now fast forward 2 years later, I’m still having back pain and now I’m having sharp shooting pains in my right upper buttock area. it feels like i’m being electrocuted. I went to the ER and they said it was nerve pain/Siatica and said I may need to see a physical therapist or a neurologist. All they gave me was 800mg of motrin for pain and that’s not helping. so now I have to make an appointment with my primary doctor just to get a referral to see a physical therapist or the neurologist. Who should I see first? And in the meantime what can I do to ease this pain? Please help me.

  103. Cathy

    I have searched the net and can’t find anything that even resembles what I am experiencing. In looking at pictures of muscles and whatnot, that are in the area of my pain, I have found that the piriformis muscle, and the sciatic nerve are exactly where my pain is. However, my symptoms do not seem to match either. I’m always the odd duck like that.

    I do not have any pain at all, anywhere, unless I lie flat on my back, or lean too far back while resting in a chair/on a couch where my lower back is resting on the seat. After about 5 seconds, the pain starts. But when I try to get up, I have such severe pain from the top of my butt cheek, that runs over to my hip, that I seriously can not move. I can’t move my legs, I can’t raise my back up, I can’t roll over, and I can not sit up. I have a very high pain tolerance, and this pain makes me want to die. I gave birth without drugs and would rather do that again than try to get up.

    Unfortunately, I am a back sleeper. I keep 2 big pillows under my knees, and I have no pain that way. It only happens if I lie flat, or lean back too far. No pain during the day, never have any pain that runs down my leg, in my foot, or anywhere else. I asked my chiropractor about it, he didn’t have a real answer. This problem has been going on for many years. Never gets better, never gets worse. If I knew what the problem was, I could maybe do something to help it, but I have no idea what I’m dealing with. I try really hard to remember not to do things that make it hurt like that, but occasionally I forget, like last night when I slid down and leaned back on the couch, then wanted to scream and die. That’s what led me to your page. Do you have any idea what might be causing this issue?

    • Hello Cathy,

      In 25 years of practice, I have never seen anything quite like this. Definitely a nerve involvement. Not sure what’s firing it up — could be Scar Tissue but I have no real idea.

      Dr. Russ

    • Lilian

      Hi there…I had to reply
      I have exactly what you are describing. Any luck finding out what it is? Regards Lilian

      • Jacqui

        I have similar symptoms – haven’t been able to sit down for 6 years because of intense pain. I can’t lay on my back, and recently (last six months) both of my hips are really painful when I lay in bed on either side. The pain goes through the whole of my pelvis (front and back), but starts in the tailbone / buttock area. It is an absolute nightmare – the pain is very wearing, and can be excruciating. I don’t sit down. I have been diagnosed by several ‘specialists’ with coccydinia – but some said my symptoms aren’t ‘typical’. I am on here as no treatment, so far, has helped me. I am wondering if I have Piriformis syndrome. It yours isn’t PS, maybe it would be worth you looking up coccydinia? There is a really good website on this at coccyx dot org. Good luck to everybody reading – hopefully we will find relief one day.

  104. Kennedy

    The only time that I have pain in my right hip is when I am lying flat on my back, I get this intense pain in my “hip” area. Moving my right leg or torso is not a possibility at that point. The only way that I am able to relieve the pain is by using my left leg to roll myself over onto my right side. I have been going to the chiropractor for 3 years (ever since it started) and although he adjusts my hips every time the pain always comes back. It makes me very curious if it might be this, some areas on the right side of my sacrum are really quite sensitive to the touch and incredibly tight. This is a great article and very informative, I will definitely have to bring up this topic next time I see the chiropractor!

  105. Scott

    How’s it going just wondering can anyone help me I’m only 21 years of age and I’m a male I used to be a very active person I played every sport you could think of about 6 years ago out of no were I got a slight pain on my right leg by my buttocks and as the years went on they got worst I can’t really describe it but it was like I lost power in my leg because of the pain in my buttocks at first I thought it was a muscle but it wasn’t I was diagnosed with ankylosis rheumatoid arthritis about 3 years ago and then started taking acroxia tablets but to this day I still haven’t been able to play sport I do my exercise still to this day but for some reason I just do not think Its ankylosing. The pain is always there it’s feels like it’s a trap nerve but o paid so much money of physio and massages I just sick of it I would kindly appreciate if some body could please help or suggest help for me I would kindly appreciate it

    • Hello Scott,

      The real question here is whether or not they have your diagnosis right. If they do, you need to read my article on Doctor Schierling dot com called “Exit Strategy”. If not, you’ll have to figure out a way to solve the nerve issue with the Piriformis Muscle.

      Dr. Russ

  106. Casey

    Hi im Casey Im 14 and ive been researching buttock pain it hurts right in the middle of my upper but … But when i check it theres nothing there… I dont want to be disgusting or anything i touch it and i feel a bone right in the middle where it hurts i think thats whats causing it cause when i touch it it feels bruised and sore and yes i play sports and im a very athletic person please help!!

  107. Crecy

    I’ve Googled my symptoms and read different articles but yours is exactly what I’m feeling. The middle upper part of my butt hurts and across my lower back hurts hips ache when I stand to long and as I go to sit down I feel pain in my lower back and my knees ache on off through out the day. I could be laying in bed and everything hurts after awhile I also get sharp pains up and down my spine area they are so sharp at times I can’t move I’m only 38 and scared it’s going to get worse and I’m not going to be able to work. I’m a very active person I been nursing for 10 years I’m not over weight, I just changed my diet to vegan this year I know I need to see my doctor she knows I have back pain but all these other symptoms are getting worst I don’t want to seem like all I do is complain to her can you give me any suggestions.

  108. Lord Nite

    My spouse suffers from piriformis pain and diabetic neuropathy and was given Gabapenten to help. Is this Tissue Remodeling something that would help?

  109. Susan

    Dr. Schierling – Three weeks ago I packed up my condo, hired movers and drove to cross country with my brother. I sat in the passenger seat and found that I continued to have discomfort in my left lower buttock during the drive. I had no pain other than while sitting in the car. I tried sitting on a pillow but it didn’t help. Once I arrived at my destination I found that the pain returned while sitting but was worse when I laid down in bed. I am usually able to find a position to minimize or stop the pain but I don’t see anything changing.

    I am a 69 year old woman, in good health if you don’t count that about four months prior to my departure my physicians discovered that I had brain damage at the back of my brain due to shallow breathing while sleeping and a lack of air getting to the back of my brain. This effects layered thought and while it seems to be a minimal problem retired, it was the reason I retired from my position as a paralegal. The consequence/solution for this sleep deprivation diagnosis was a CPAP machine and a good nights sleep. I don’t believe the brain/CPAP issue is relative to the discomfort described above, but it seemed appropriate to add my most recent medical history. The truth is, other than this darn buttock discomfort, I feel healthy and younger than my age. I am not quite settled in my new location and have not yet found a physician. Any insights you may have would be greatly appreciated. Susan

  110. Taly

    Dr. may it be an inflammation in gluteus muscles ? It feels like all the muscles in the area got crazy and they jump and hurt but no test shows anything wrong. I am frustrated

  111. Taly

    Dr Schierling,
    It is been almost a year since i have pain and inflammation in the butt area. All my MRI’s and ultrasounds are great but i suffer a lot. I have pain in 2 buttocks and hips and it is hard for me to sit and to stand for a lot time. Terrible feeling. 4 months ago a doctor gave me steroids in pills and i really worked good. I took them for 1 month and everything got better for about 3 months and now the problem cane back and noone knows what it is. I make hot baths and Voltaren and Advil but it almost has no change. What would you recommend to try ?

  112. Wendy

    I have pain in my butt, lower back,and hip that ran down to my knees. Sometimes it feels like my whole leg is starting to go numb. This is both sides. I was diagnosed bursitis in my hips and giving cortisone in each hip one month apart, July and August 2015. I have just recently had a 2nd injection in my right hip and have another on left hip next week. They seem to stop the pain in my legs but not my butt. After sitting for awhile I find it quiet pain when I get up to walk. I am a bar tender and have been for 40 years. So always on my feet. The pain can quite often wake me at night. Living on Panadine Forte.

  113. Wendy

    Hello doctor. ….
    You are my new hero (and doctor Tent)! I admire your logical thinking though one thing I don’t hear anyone mention is the medications everyone is/ was on. For my father’s situation, I found that his ED Medication actually started his pain in his legs, buttocks, shoulders, wrists, etc….no doctor or test came up with this one. Luckily I ran into a similar website where people talked about their common side effects that were supposed to be so rare. ……people need to know to stop these medications and their mysterious pains in some cases could actually have a chance to get better as happened for my father. …..thank God for the Internet because doctors and safety inserts are inadequate.

  114. Rhonda

    I have been dealing with piriformis muscle, sciatic nerve pain and hip pain July will be a year now. I have been to a doctor which she took x-rays and didn’t see any broke bones because I have fell on stairs last year. She gave me a steroid shot which didn’t help. I have been to 2 different chiropractors. The last chiropractor I went to, took an xray and said one of my hips is turned out (this is the one where I have pain the most) and the other one is turned in. I never got relief from the chiropractors. I’m in pain all the time, every day. Is it possible that since my right hip is turned out it has my piriformis muscle tight and pinches or puts pressure on the sciatic nerve? What can be done to get my hip back to its normal position?

    • Hello Rhonda,

      The answer totally depends on what is causing your pelvis to torque. Often times, simply adjusting more is not the answer because if there is Scar Tissue present it will pull it back out.

      R. Russ

  115. Marilyn

    Thank u I have been suffering
    Badly. I have PN I pulled a groin muscle
    6 was ago still looking for relief. . Help. I’ve tried tape the whole nine yards no, relief. I’m 61 yrs old. It’s making very mean. Marilyn.

  116. Natalie

    HI Dr. Schierling,
    No I haven’t tried a chiropractor – but I will call around and look for one now. I almost hope that is what it is because this daily excruciating pain behind my left thigh and butt bone area cause almost my entire back to stiffen up now making it very difficult to walk and stand up straight. For now I have been taking Advil and Tylenol to relieve the pain and loosen things up. Thanks for taking the time to reply to my question.

  117. Linette

    Excellent,Thank u.

    • You are quite welcome Linette.

      Dr. Russ

    • Jeff

      I had very bad sciatica where I couldn’t sleep through the night for three months. I am now 99% better. My chiropractor and physio helped but key to my recovery was the use of the reformer in Pilates which allowed me to strengthen my core. It’s a lot of hard work but worth it.

  118. michael


    • Ellen

      Dr. Russ,
      I am happy to read your informative article. I have had piriformis syndrome for two years. A year ago I had a MRI and was told it was because I was a female and old at age 54. I was told to live with it. I had been a runner for 35 years. I started biking, stretching, walking and yoga, It felt some better for awhile, but now it’s very painful again. I have had ten acupuncture and adjustment sessions. I am slightly better. But if I walk too much or sit too much the pain is incredible. I have had to change my lifestyle and avoid many things. I can relate to the other sufferers. Now what do I do?

  119. Rose

    Are you familiar with the nerve (complications) damage associated with surgical pelvic mesh placement? *Such as obturator, pudendal, cluneal, etc…

    • Slightly Rose, but I don’t treat them.

      Dr. Russ

      • Natalie

        Dr. Schierling ,
        I was recently diagnosed with this and was given stretching exercises and meloxicam (to take daily for two weeks – and then as needed). I feel like nothing has changed and it is very difficult when I can’t even stand up straight in the morning to walk cause of the pain in the back of my thigh and buttocks AND I am scared to sneeze or cough because of the sharp pain it causes. Should I go back to the doctor? Should I request an x-ray or MRI?

      • Hello Natalie,

        I would guess that this is disc. Hopefully you have tried a chiropractor before going for advanced imaging.

        Dr. Russ

  120. Lacey

    Hi! I am a 24 yrs old and a week ago started having pain in my ankles, legs, bones by groin area and buttocks. Also feels sore. Most painful in the morning, and when I sit or lay down for any amount of time. Gets better when I stand or walk. I have high arches and do some Pilates. Can it be PS?
    Thank you for your time!

  121. Carmen

    I’m interested in have tissue remodeling. I was shot in the buttock 10 years ago and I have all the symptoms of piriformis. Can you refer anyone in my area??

  122. Sandra

    All that you’ve said here is the problems I am having. Are you sure that there is nothing that can be done to give me some relief. I work in a day care and I’m not use to not being able to move around like I need to. Please help!!:)

  123. laura

    Hi, I’ve been having constant stomach aches and diarrhea. My diarrhea smells like crazy bad, constant pain in my right Bum cheek like aching. Can’t get comfy and when pressing my bum cheek and there’s pain in a certain part. Tired all time out of breath feel sick add it all nearly five months stomachache worse when eating. Sometimes goes away a few days and sometimes sharp stabbing pain lower right side stomach thank u so much very worried.

  124. L

    Very informative….I think I have this painful syndrome..thanks to this article I am self diagnosing my self as not having actual hip/joint issues and will certainly tell the orthopedic doctor when I make appointment of this article. However I am unsure which is worse Piriformis syndrome or a hip issue…sounds like no cure/relief for the syndrome

  125. Jordan

    I would just like to say that I have had this for over 3 years now. I started feeling the pain after starting a desk job. I have always had jobs on my feet. I started with chiropractic treatment and was going about 3 times a week for 2 years! It would temporarily relieve the pain. I then decided to see a doctor who had an MRI ordered for me! Told her my hips hurt with shooting pain. She looked at the MRI of my back and told me there was nothing wrong and that I should work out? I was in tears! I decided to get a 2nd opinion and was told I had bursitis on my hip. So I did the injections! Made the pain way worse and now I have the pain on both hips! Went to a 3rd doctor and he sent me to physical therapy, which is where they told me about this piriformis muscle! The did some great things there. I went for about 3 months, 3 times per week with temporary pain relief. I am now done with PT for about 2 weeks and I am back at square one. The doctor decided to prescribe tramadol and Mobic. I took the Mobic with no relief and I feel like taking the tramadol will just end in addiction so I decided to wait on that. I have been referred to an orthopedic doctor but am waiting for an appointment! At my whits end with this! I have a hard time working and I miss a lot due to the pain. My current primary doctor does not fill out paperwork for short term disability so I am stuck with the pain until I see the orthopedic who is out on vacation right now. I don’t know what is next!!


    • Hello Jordan,

      Either way you slice it, you have been though a lot of treatment. The problem is, this is the norm for huge numbers of people.

      Dr. Russ

      • Jordan

        Just got a call back from the orthopedic specialist… He doesn’t handle back problems and will not see me for this! Great! I didn’t realize this was a back problem? I had an MRI done that shows I have a very healthy spine!

      • Hello Jordan,

        Because PS in its variations is usually a soft tissue problem, it does not image will with standard tests and technology. Very frustrating for those suffering.

        Dr. Russ

    • Tam

      I have had piriformis syndrome for over ten years now, I had one piriformis muscle bigger than the other detected on an MRI scan of the pelvic area. Spinal scan will not detect it.
      I’m in agony everyday and I have it bilaterally, I’ve had one muscle released, the sciatic nerve branched off through the muscle and was squashed completely and it stings inside loads at present, I think I have scar tissue forming, I’m so uncomfortable 8 mths on. the other is still squashing the nerve. I’m in so much pain in awful. I find sleeping very hard, it’s agonising.
      Sadly mine was ignored by Dr’s when it first started, no one listened me, if they had at the beginning I would not be like this now. Physio may of helped me during early days. I’m angry as it’s ruined my life. Luckily now I have the best GP who is doing all he can for me.

  126. Cindie

    Dr Shierling
    I have been dealing with pain in my left buttock going down my leg for 2 1/2 months now I’ve seen the chiropractor five times he couldn’t help get rid of the pain and recommended a neurologist who tested my leg with the nerve test and found it to be normal he sent me to a pain management I have had two epidural injections which have done nothing anti-inflammatories work but have upset my stomach I have lost 15 pounds in two months is there a few stretches that I should be doing the can help stretch this muscle I am starting physical therapy next week. I’ve had two MRIs the one in the back shows no herniated disc just a slight bulge and two small posterior tears the MRI in the pelvic area done with dye was normal I don’t know what to do anymore. When this all started I also started vaginal spotting I’m a 63-year-old female went to the OB she performed a D&C for Polyps that came back normal but said that I have fibroids do you think that could be related to the pain nobody else think so. I’m was an active in shape person, now I feel like I’m withering away.

    • Hello Cindie,

      Doubtful the two are related. Make sure to read my posts on this subject over at my Doctor Schierling dot com site.

      Dr. Russ

    • Rebecca

      Candy I read your story and omg it was me , I can not believe the facts that you have put to paper. I have been to ,gynos,neuro’s, gastro’ s. Even rheumatoid specialists still no answer. If I find one I will surely pass it on
      Best wishes Bec xoxo
      Ps hopefully we find relief sooner than later xo

    • JA

      I came across another thread from a different site in which women who received steriod injections had fluctuations in their menstrual cycle, even post menopausal women. It’s a side effect of steriod injections.

      • Corticosteroids have a side effect profile as deep and wide as the Mississippi River. Lots of info on my DoctorSchierling dot com site pertaining to Corticosteroids.

        Dr. Russ

  127. Hege

    Dear Dr. Schierling.

    I’ve been a registered nurse for 8 years. 6 out of these years i’ve struggled with left hip pain. I’ve seen several GPs and physios and they all say it is muscular. It is a constant dull pain, becomes unabareble with repetitive movements such as cycling or work out on a rowing machine. I then immediately have to stretch, and any stretch at any time is painful and only give a short window of relief.

    How do you diagnose Piriformis syndrome and considering my symptoms is it likely that this is what I suffer from? What is the best treatment?

    Thank you in advanced.

    Kind regards,


    • Hello Hege,

      Diagnosing true PS is tough, as there are all sorts of myofasical issues that can mimic. The biggest difference is probably that true PS will have Sciatica, and the myofascial stuff probably won’t. But don’t kid yourself — the myofascial problems and Fascial Adhesions have the potential to be miserable.

      Dr. Russ

  128. Dominique

    Hello Dr. Russ,

    I lived with chronic pain in my right “hip” for a couple of years, putting it down to the hard building/ landscaping work I was doing; but when that stopped and the pain didn’t go away I started looking for other causes, and more importantly, solutions. I eventually hit gold last December with a physiotherapist who identified ‘piriformis syndrome’, gave me stretches to do and massages. Life got a lot better: i can go for hours without pain. I can sleep! BUT if I skip a day of “self-care”, the pain comes back. Which brought me to your web site this morning and perhaps the missing part of my ‘treatment’.
    I have strong/high arches; I walk at least one hour a day, often more, wearing Salomon walking shoes which i replace regularly… but you say:
    “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)”
    Could you please, please expand/ explain? What should I be looking for in a walking shoe? How can I tell if they are ‘stability’ or ‘dual-density’? The shoes I have say “EVA midsoles” and “OrthoLite advanced formula insoles” which may be just proprietary jargon… but should it be avoided?
    I am determined to live without pain – and I thank you for all the information on your website that aims for the same goal. THANK YOU so much.

    • Hello Dominique,

      I don’t claim to be any sort of expert on feet. I can tell you what I’ve learned from having high arches with both foot issues and hip / buttock problems (not constant and nothing like it used to be). If you have high arches, you cannot buy a shoe that has a high enough arch to compensate for your high, rigid, foot. You will get the best information on the shoe you want by reading about it online. If you are in or near CO, go see Shawn at Xtreme Footwerks in Idaho Springs — he’s the guru.

      Dr. Russ

  129. Kari

    Hi, Dr. Schierling…I, too, was so grateful to find your page. Six weeks ago, I had a terrible sinus infection and received two antibiotic injections–one in each hip (but administered by different people on different days). Both hurt a lot and were sore for a couple of days. But three weeks after receiving them, I was at the gym and attempted a single squat with very light weights. I felt searing pain in both injection sites and immediately stopped. For a few days, I couldn’t bend or lift my legs enough to tie my shoes (though I could walk OK). It’s now been three weeks, and one side in particular keeps getting worse. I have pain from the injection site down the back of my left butt cheek. Can’t cross my legs while sitting or do several other very ordinary things (not to mention yoga, Zumba, and PiYo, which I love). Could injections in those locations cause PS? And on both sides? And it is strange that the worst of the pain came several weeks after the injections were given? Trying to figure out what’s going on with me–and what to do about it. Thank you for any insight you can provide!

    • Hello Karri,

      Let me first say that according to current peer-review, antibiotics are mostly not considered the standard of care for sinus infections any longer because the huge majority of all URI are known to be viral. Besides that, they set you up for future problems. As for your symptoms as related to antibiotics, I have a slew of articles on my blog filed under the category “Antibiotics”. Many, including a recent one, are about the degenerative nature of certain of this class of drug. Skim the titles and you will see how often antibiotics are related to chronic pain. The worst offenders, by far, are antibiotics from the Fluoroquinolone family (cipro, levo, etc).

      Dr. Russ

  130. Bonnie

    Love this site!!! You got the piriformis scar tissue pain problem right on the mark. I need you to go with me to the many doctors I have seen am still going to. LOL

  131. Himanshu D

    Hello Dr. Russ
    Firstly i really would like to thank you for writing this article.
    Secondly i’d like to ask you what might my problem be. When I first started MMA training back in august ’15 my trainer used to make us stretch our legs 180°. Which indeed was a painful thing to do. But one day he came behind me and suddenly pressed my glutes downwards in order to spread my legs more. I felt a lightning pain and heard a sound. But the pain doesn’t followed after that. But after a couple minutes while doing chest level jumps I felt the intense pain in my lower back. For almost a month I felt the pain in my lower back. Although it wasn’t that much severe back than. I felt like I could recover. But than after 3-4 months it vanished completely. And started again a couple weeks later. In January ’16 I joined the Gym. And it was after that I realised that my pain was getting down to my left buttock. I thought it might vanish in a month or so. I did leg press abductor/addctor leg curls and extensions etc. And within a week i felt that the pain was increasing. So whenever i used to walk it used to get a lot worse. It made it impossible for me to walk. Then after 1.5 months some tingling in my feet started. It was then that i consulted a physiotherapist. He used some IFT machine to provide some electrical impulses to my left buttock. It reduced my buttock’s pain by 50% as he was also engaging me into stretching. But the pain didn’t go away even after a month of therapy. And even worse. The tingling which was very little in the beginning started to radiate upto my knee. Please help me identify this problem and let me know if there is any way to cure it. The symptoms are the following :
    1. Unbearable pain in left buttock while walking.(although 20-25% while not walking)
    2. Tingling / Numbness in the area under the knee.(which started from the feet and travelled upto the knee. Also the Numbness is mostly felt in the left-back side of my left leg and all 4 fingers of the feet except the big toe. It only gets numb when I get’s up from bed or sitting position.)
    3. In the beginning pain felt while walking was only in buttock than it radiated to the right and now to the back side of the knee.
    4. Pain gets better if I stops walking and do some stretching or rests for a while.
    5. I cannot jump, run, jog, cycle. Or it gets unbearable for me.
    6. I cannot lift my leg while standing without bending the knee.
    7. Numbness started when the pain finally radiated to the knee.
    Please help me sir. I would be forever grateful for your help. Please do help me. My life has became hell due to this pain.

    • Hello Himanshu,

      Your trainer needs to be beat for his stupidity. Not sure where the tear might be. If you were in my office, I would start working and see what I could do with this, but the problem might be too deep to access. Hard to say. I would pay to have this pain relieved for you if I could do so. It’s just too hard to say exactly what is going on.

      Dr. Russ

      PS; please let me know if you find a solution to this.

  132. Kathryn

    I found this helpful. I started with knee pain in the back of my knee then pain and tightness in my hamstrings. I had physio and massage and deep heat treatment on my thigh. But all my symptoms are back im fed up. I will go to dr and tell him this us what I think it is. Will massage help over the area to release adhesions. I am very sensitive n tense in my mid buttock area and hip pain

  133. Ruben

    it’s possible in guys as well correct?

    im embarrassed if its only a lady thing. but im feeling those kinda things also

    • You are correct Ruben,

      It is certainly possible in males. It’s just that it is much more common in females.

      Dr. Russ

      • Ruben

        how can i figure out for sure if it is this or something else?? everyone i talk to thinks it might be early signs of diabetes or nerve damage. how do i narrow it down and eliminate false suspects?

        i feel it around the knees, from my right knee up to the hip, shins, calves, bottom and tops of feet, hamstrings – my lower half basically sucks right now. and because of that – every single day sucks because i dont feel normal. like you said in your description sitting is what affects it the most – in fact sitting for too long is probably what caused it i think. along with years of poor posture, lack of exercise, like traditional exercise (i always thought going to work and working hard was exercise enough) now i cant even go to work.

        any help you could provide would be very much appreciated – i thank you for your time

      • The whole Diabetes / Inflammation thing is why I am such a stickler for Paleo. Have you seen a doctor to be evaluated for Peripheral Neuropathy? I just put up an article on it on my blog last week or the week before. Also make sure to look at the “test” I link to numerous times on this page (it is also in the body of the article).

        Dr. Russ

  134. Antoinette

    So how do I treat piriformis syndrome now?

  135. Danielle

    Thank you so much for the amazing article! For almost a year this pain is driving me crazy no metter what I do. It gets way worse when I lay down. You described my symptoms and it feels good to finally find out what is bothering me since my doctor and chiropractor could not help. I’ll do more researches to find out what could i do to get better. Thank you!!!

  136. Lora

    Is there anything I can do to help it. I only have the problem if on a long trip in car or sit to long on couch. I do streching it helps. Get up and walk helps. Just tired of it it’s been 2 years.

  137. Naomi

    Have had constant hip and back pain issues for years on my outer right hip and tailbone area of back. Had an mri done of spine 12 years ago and had a hymangioma and swelling at l4/l5. Have had my ribs dislocate at c2/c3 with no obvious cause. Have had pelvic/pubic separation during last pregnancy making walking nearly impossible. I also have Instertitial Cystitis with severe detrusors every 3 minutes or so and Pelvic Floor Dysfunction. Now my sacroilliac joint keeps popping out of place on my right side. I have had bad bouts of sciatica in the past as well. I now have small fiber neuropathy for which I take gabapentin. I have bouts of cramps in my feet that nearly cripple me as it shoots up from the arch into my pelvis area. Now my left side butt cheek has a deep aching pressure that hurts worse if I lean forward or sit. I also get extremely bad cramps in my calve hip and pubic area that radiate down my leg to my knee. My right knee locks and pops. I also get symptoms of raynauds when exposed to cold and by cold I mean anything below 80 degrees causes my hands feet face and butt to go ice cold and white and then when I warm back up they get bright red and flushed like I was playing in the snow. something as simple as walking in the refrigerated isle at grocery store induces this. I am starting to worry that there is something really wrong.Is this all related to a pinched sciatia?

    • The fact that you have at least two Autoimmune Diseases (Raynaud’s & Interstitial Cystitis) not to mention the PN (a hallmark of both Fibromyalgia and blood sugar dysregulation) tells me that you have Inflammation running rampant in your body. This is the first thing you need to deal with. Fortunately for you, today’s blog post is on Peripheral Neuropathy. Take a look at it because I will show you some tricks to help you potentially deal with all of these problems.

      Dr. Russ

  138. Anita Grace

    Thank you so very much, I can’t believe that this hits the nail on the head perfectly this is exactly what is wrong with me and I had no idea I thought I had bone cancer or something! Thank you very much!

  139. Christine

    I’m a 57yr. old female with no children. My job involves labor as I am a product merchandiser. This pain started about 3months ago and doesn’t usually bother me at work. Yes, concrete floors. Right side, stops at knee from the right butt cheek. Hard to walk at times at home. Some creams help….thought it was arthritis or old hamstring pull from 30yrs. back. Try diabetic shoes?

    • No idea where you live, but if I saw you in my clinic with this, I would automatically think of Scar Tissue / Fibrosis in the buttock / hamstring area. I would treat you, and probably not even make a follow up appointment. Best guess, it would dramatically improve almost instantly.

      Dr. Russ

  140. Brenda

    hi dr. Russ,
    back in january i fell directly on my buttocks onto a stoop stool. Could this have triggered the pain in my piriformis? i have never had this pain before. My masseuse told me it is possible. Can this be true?

    Thank you

  141. Marie

    I have previously had a slipped disc removed on left side .for the last week I have pain on right side buttock area that goes to my hip and groin area worse when walking or sitting .thebpajn is constant I feel like when I am walking I’m walking strange as if my body is pushing to one side .please help

  142. Breyana

    I have been having this problem for about a year and it is getting worst. I haven’t seen a doctor and I don’t know what it is that’s giving me unbearable pain. You actually described every problem my leg hurts my upper but area and my hip. It’s so hard for me to work let alone drive I am only 21 is this common for younger females?

  143. Kim

    I have been having a battle with this for over 25 years now. Sometimes does cause sciatica pain down my leg but most the time DOES NOT! I had a pain specialist tell me that the chance of it being in that tiny muscle was so rare…well, he laughed at me! Sometimes, the pain is to the point my leg gives out and I’m down in an instant. I’ve had problems with my back for years. Two years ago I had a steel rod put in my cervical neck and I do have some bulging discs in lumbar and sacral sprine. Have lots of arthritis in lower back too which dr. tells me is causing all the pain and not to worry but I’m sick of this!

  144. Derek

    I am a 27 year old male. My back issue comes and goes. Have been good for 2 years but the last 3 months it’s been back and as bad as ever. I am told I have a pinched nerve in my lower spine. My pain initially was right in my tail bone. I have been doing physio twice a week, being put on a traction table. Feel like that pain has gotten better but now have sever pain from my butt to the back of my knee. What can I do to fix this?

  145. Christina

    On January 17th, I developed a sore back from taking down decorations (this is nothing new and I thought very little of it) On the 20th, I experienced extreme pain, tingling, and weakness in both legs. Within an hour, I was incapable of walking and my husband and to carry me just to get me into a wheelchair. MRI was done ASAP to r/o Cauda Equina. I had also developed difficulty voiding. MRI shows some degeneration at L4-5, DJD, and mild to moderate cord compression, lumbar stenosis. I was treated with anti-inflammatories and sent home with a walker. When I was discharged I was unable to bear any weight on my right foot and minimally on my left foot. I strained with all my might to void because straight cath was something I was desperately trying to avoid. I remained out of work until the 23rd, use a cane, and still go to PT 2/wk. I’ve gained back much of feeling in my right foot. However numbness and tingling persist across the buttocks and I have pressure at the bottom of my spine. I have strained to pee SO much, I feel as though my urethra opening has stretched as well. I’ve been told nerve damage can take a very long time to heal, but i am getting frustrated and do hope and pray that the “tennis ball” I feel I’m sitting on goes away sooner rather than later. I’m still uncertain as to whether or not to use ice and/or heat. ANY advice would be so appreciated.

    • Hello Christina,

      I have actually had a case of Cauda Equina Syndrome in my clinic that the ER had sent home with Tylenol (we sent him to a different ER with a hand-written note explaining what his problem was). This would have definitely been at the top of my list concerning you. However, cord compression can do very similar things. This is not PS. I have a post on my Doctor Schierling site called CHRONIC LOW BACK PAIN AND THE THORACOLUMBAR FASCIA that has a ‘Top Ten’ list of DIY for your back. I would probably at least talk to someone in your area about Spinal Decompression Therapy. “Moderate Cord Compression” will sooner rather than later lead to some sort of surgery.

      I wish you well,
      Dr. Russ

  146. Willette

    So what does a person do to release the fascia? I have had butt pain and lower back pain for about 5 months. Lately I find the most relief from the tightness by massaging with a lacrosse ball. It seems when my butt hurts then it causes my lower back to hurt.

  147. Taly

    Hello Dr. ! I am 33 years old , mom of 2 kids. I am suffering from buttocks pain two sided already 6 months. All my MRI’s are ok. I feel a preassure pain when lying on sides. When sitting i feel like sit bones pain. My pain was worse and i also had hips pain and feeling of instability. Anti inflammation drugs didnt help and my doc gave me the prednisone for a month. The pain got better in hips but buttocks pain is still there and another strange thing is jumping of muscles in buttocks and hamstring and feeling tightness in hamstrings. I had no injuries . I have seen a lot of doctors and noone can tell me what it can be. Some doctors tell that may be PS . Is there any test i can do to make sure the problem is PS ? Ultrasound maybe ?

    • Although the newest diagnostic ultrasounds are far better than they used to be, I still don’t believe they do a good job of imaging PS. There are very special sorts of EMG’s that can sometimes tell you something. Be sure to read my article called “Imaging the Piriformis” over at Doctor Schierling dot com.

      Dr. Russ

  148. Solange

    The content of the article reveal of what happening to my son. I would love to discuss more.This feel like a huge relief for him. Hopefully he will be diagnosed properly

  149. Jeanette

    So you have educated me on the differences of PS and Herniated Disc. I believe I have PS any treatments available

  150. Gloria

    Help!!!! I have had 6 back surgeries. Lumbar spine almost all fused. I am 63. Osteoporosis and numerous autoimmune dx. T10 compression fracture and vertebroplasty and recently RF. Told I have bursitis, bilateral SI joint issues and petiformis… Tried PT numerous times. No relief. 4’10” was 5′. Pain is all the time ! Walking or lying in bed. It awakens me. Is there ANY hope for help? I can hardly stand it!!! I Cannot sleep on my back because of surgeries and can only lie on right side which is my worst side. I NEVER can sleep for more than an hour or two before I have to sit up for awhile. I am DESPERATE!!!! And in tears often. I try to keep active but am told because of back surgeries and the way I walk it compounds the sciatica, bursitis and PI. I cannot have injections or take steroids becsuse of side affects and have numerous medication allergies and side affects. Is there ANY HOPE left for me? Doctors keep saying more back surgety and I refuse!!! No more !!!! Please help me!!! Now I have pain in feet, and lots of chsrlie horse type of spasms all over my body, buttocks, hips, stomach, legs, feet, hands. I have numerous (hundreds) of small and medium size lumps all over my body that are very tender. They come and go. Fibromyalgia? I have that too ! Ct scans shoe numetous calcifications all over my body is this related to my pain?

    • Hello Gloria,

      It certainly sounds bad. And while I do not have an “Easy Button” like they do on TV, if you go to my Doctor Schierling dot com site and type the words “Exit Strategy” into the search bar, there’s something that may help you.

      Dr. Russ

  151. Raymond

    I have a swollen L4L5 that my physician tells me it is cracked and is leaking fluid on my L5 root nerve. Have had 1 sac injection and 2 epidurals in my swollen disc. With not much relief. I only get relief by laying flat. It hurts to walk and to rise from sitting. Most of my pain is in my butt cheeks. But have some in my lower back area. Have been this way since having knee surgery. One leg is an inch longer then the other and one foot stick out 10 degrees to the outside than the other. Exercise doesn’t help. Stretching very little comfort when I sit butt and groin numb up. Any suggestions.

    • Make sure to read my post on Doctor Schierling dot com called “Chronic Low Back Pain and the Thoracolumbar Fascia”. I do not believe your problem is Fascia-related from what you are telling me, but I have a “Top Ten” list for healing your own back.

      Best wishes,
      Dr. Russ

  152. Sharon

    This pain is unbareable it is so bad that it wakes me up My pain medication is not helping me at all just wanting to know what else I can do to sibsize my pain in having other obtions

  153. Marc

    I believe i have periformis syndrome. Is physical therapy a good way to go for getting rid of it? I have had it now for about five weeks. Stretching seems to help the most. The most constant thing is not having full sensation on the outer bottom of the affected leg, as well as the out part of the calf on the same side.

  154. Mikayla

    For about 5 and a half years i have had terrible pain in my upper glut area. It definitely feels like a deep charlie horse in my muscle like it is always tensing and won’t relax. I get spasms in glut muscles and done my leg and my low back. I think it through me out of alignment so I have really bad tightness in my shoulder with the same numbness down my arm. In the last two months I’ve had numbness with no pain on my face. All on the left side of my body. Right side feels fine, normal. This pain is constant and I feel that I’ve tried everything. I stretch and stretch and do yoga. I tried muscle relaxers for a short time, no relief what so ever. I’ve tried electro pulse therapy. I use a heating pad. I was visiting a chiropractor regularly. Massages seem to make it worse. I just started a doctoral program for oriental medicine and I receive acupuncture regularly. It seems like nothing truly brings relief. I have had either no insurance or state insurance, so it’s been hard to get help. No MRI, don’t know if I should. The pain reaches a ten often and sometimes I wonder if I should go to the emergency room. Is there any hope? Can the muscle or nerves die if the pain continues for years? I just turned 24, I had no injury to cause this. Tall and thin, no kids. Always been very active in sports, outdoor stuff, yoga. Desperate for help.
    Thank you, Mikayla

    • Hello Mikayla,

      Not completely sure what this could be. Doubtful MRI will show anything. The fact that massages make it worse is interesting. I have several articles about Central Sensitization, but it is impossible for me to even speculate on something like this.

      Dr. Russ

  155. I have been suffering night spasms in my legs for years never really knowing what it was. Always around the time I get a bad bout of sciatica. I wake with both legs in spasms and can hardly stand. I have to struggle out of bed leaning my hands on the wall in front and try to get my feet down as they are contorted. My lower legs then crack and it leaves my legs pulsating…I can never seem to get answers from doctors or osteopaths that I have seen in the past. I have been told I could have surgery to try and help but it is not recommended due to the risks involved.Is this being caused by the piriformis muscle and how can I get a diagnosis

  156. Sandy

    I have most of the symptoms you described, but no butt pain. My pain ranges from my hip to my knee to my lower leg to my feet. It started out worse in my hip area and is now worse in my knee area. I have had slight back pain a few times. My pain is at its worst when I sit very long or when I sleep. It is better when I am active. I have lupus and my doctor brushes it off as arthritis. This pain is different though and only when I’m not active. Any thoughts?

    • Almost impossible to say Sandy. Make sure you take a look at the Autoimmunity Protocols over at DoctorSchierling dot com.

      Dr. Russ

    • Not the Dr.

      That sounds like my sciatica pain. Don’t look at auto immunity info. See if your doctor can check you out for sciatica.

      • Hello ND,

        The problem with a physician “diagnosing” sciatica is that sciatica is a symptom, not a diagnosis. If, in fact, the doc happened to puncture both Sciatic Nerves with the injections, they will hopefully get better on their own as there is no treatment for this sort of thing that I am aware of. However, if you take a look at my blog, it is replete with letters from people who have had terrible reactions (mostly various forms of autoimmune) to antibiotic injections (mostly but not limited to fluoroquinalones such as Cipro). The web itself is full of sites dedicated to this very thing.

        Dr Russ

  157. Tatenda

    Hi. I have this big lump for the past 5 days. It is on my right butt and very painful. It’s getting bigger than it was the first day. First day it had a small portion with puss and I squeezed it out. I’m 35 weeks pregnant and I can’t even lay facing upwards because of the pain on butt. If I touch the lump, its temperature is hot compared to rest of my body. It’s about 4-5cm wide. Now the lump is just hard and no sign of puss. What could it be?

    • Hello Tatenda,

      This is about as far out of my league as something can be. Could be a pilonidal cyst depending on where it is (or even MRSA). Not sure, but whatever it is, you need to see a doctor ASAP as this is not even remotely related to Piriformis Syndrome.

      Dr. Russ

  158. Jim

    Wow!!! I’ve been dealing with this unbelievable pain!!! AND I MEAN PAIN!!! I USED TO BE A PERSONAL TRAINER, I totally understand the importance of having a strong core, and continued to work for 10 yrs. Trying to keep my muscles strong around my back to keep to support my spine. Until, I am no longer able to do so, I continue to move,move ,move!!! As painful as it is,, but I’m afraid I’m only doing more damage at this point

    • Hello Jim,

      I would have to have more information to give you my opinion on your last sentence.

      Dr. Russ

      • Jim

        Hi, about 10 yrs ago. I had to hold down a consumer, or better known as a Handycapped Adult. 2 xs. In doing so, I herniated and bulged 7 discs, I used my left leg to hold his core down. I was literally holding him down with every Oz of strenght I had.
        It has never gotten better. I’ve had 1 lazer surgery, over the yrs.on my lower back, I’ve also, ripped my pec. (Another surgery) after the pec tear, at a ER they injected me in my left butt, with morfion, hit my siadica! Almost, couldn’t walk.had the pec surgery also, fell on my butt 2 xs at another job. In doing so. Fell on my right hand 2x causeing on going nerve damage. In my right hand. However, my main concern is, the question,,,, did I rip that muscle??? Holding down that consumer 10 yrs ago???? I’ve never been the same since. I exercise, at least try 2. My hip, groin pain, siadica, and left leg giving out without warning. Is too much! I stretch every morning, very lightly exercise, and keep moving, In doing so,, costently fall!! Help,,_plz!

      • Sounds like you are asking me a legal question. All I have is the information on my site.

        Russ S

      • Jim

        Plz… No I am not asking you a legal question, plz is all,,, I want to know is could I possibly have ripped that muscle? Back 10 yrs. Ago? I have worked , continueusly…….. In doing so ………stretching ,, and very light exercise, but trying to keep moving……… Pretty much non stop. The pain is the same, feels like hipps are broken, unbaleavabile groin pain and ofcorse, Siadica down the back of my left leg. It won’t ease up, I can’t drive 4 any distance,, and quite often my leg has no feeling, and I go down unexpectedly,, just value youre opinion.
        Again thanks for any input
        J Herbert

      • Hello again Jim,

        You certainly could have ripped the muscle. Bear in mind that most of the time, what people refer to as “torn” or “ripped” muscles (or for that matter, “pulled” muscles) are actually injured Fascia, which will not show up with standard advanced imaging.

        Dr. Russ

      • Jim

        Thanks soooo much,, words can not express my gratitude. And yed, I’ve found out after many yrs. Modern imaging doesn’t pick up my problem. It has been a very miserable to say the least 10 yrs. For myself. My symptoms have not changed, and have exepted the fact, I have to live with this. I’ve tried everything from operations, acupuncture, injections, P.T. and the list goes on. I had continued to work,, threw out the yrs. Only to find, I reinjure my back, again and again. Ppl.watch my left leg give out. And I fall literally on my face! Last dpring, my left leg, touched a hot motorcycle pipe, never even noticed it till 4 days later. At which time it had turned into a spider infection.
        My leg goes numb and I never felt it. But the hip, butt, groin, and constant siadica I do notice!!! I can’t begin to express my gratitude for ure help.. I do stretch, everymorning and continue to try and exercise. Adprin, Aleive, and everything gover the counter doesn’t touch the pain!! The only releive I get comes from my pain management Doctor, I ice, I heat, in stsfting to learn self psin control.Our Brains r very powerful !! I’m trying to teach myself, mind over matter. And pray to God for some releif. Stay as stress free as possibile. And keep my mind active.. If u don’t mind, it dont matter. ( Kinda )
        God bless

      • Jim

        Good morning,
        In reference to our past conversation, I HONESTLY. Beleive. This is my main issue. And with that being said, I am stretching, very light exercise, I move nostop beause of the pain. I woud not allow another surgery! I used to be personal trainer. I know my body better than anyone ! I know what it takes to change my body, no matter what age I am, (54) however, nothinghelps. It feels as though, its hopeless. No one believes me. I’m a Christan and I don’t lie. I take it 1 day @ a time. It excuse the expressionbut it SUCKS. To say the least. Ppl watch my leg give out. I m constently falling hitting myhead, urning my leg, as it is numb most 80% of the time. Pain medicine works, but only 4 a small period of time. I do not, allow myself to become addicted to any medicine. So I purge my self off all medicines before I require a stroger dose. You are a godsent, this form is very helpful ! My heart goes out 2 all, that have 2 deal with this nasty Symdrone. I think I screwed my self in thinking I was invinsabile! ? No 1 person is invinsabile!! We r what we eat, r bodys r like machine, take care of ure body and it will take care of u! Abuse it,,,,,,, and we’ll….. Hear we r. Trying to figure out what’s wrong.. Any feedback is greatly appreciated.
        Sincerely Appreciated

  159. sophia

    Hi, I think I may be a victim of Piriformis Syndrome. I am crushed. I have always live a very active lifestyle. I am now 40 years old and have been in and out of the gym for 23 years. In the past, I would consider myself an athlete and even have had people asked me in the gym, if I am an athlete. I use to Hit the gym 5 days a week. About 2 years ago, I probably took my workout a little too far. I was trying to really focus on my butt and I began to dedicate 2 days per week on legs and glutes. My butt used to be my best asset and now it is a pain in my A** (no pun intended. ok maybe). Seriously. I had no clue. about a year and a half in and I started to feel burning pain on my gluteus muscles, but I ignored it. I then started to notice my butt began to sag. I thought maybe I needed to up my protein and increase my weights. Fast forward, by the time I realized something was wrong, I was too late. I first tried cutting my leg days to 1 day per week, then quit working legs all together for a couple of months. Nothing worked. Now, when I sit down, I feel my butt burning. I am so sad. I don’t know what to do… All of my muscles are gone. Now my butt is flat with no shape to them what so ever. I wished I had done more research earlier when I noticed the pain, I wonder if I could have prevented it. If there is anything I can do to alleviate the pain, please let me know. Thanks so much !

    • Hello Sophia,

      If you start looking at the blog posts on PS on my other site (doctor schierling dot com) you will see I have tons of self-help information. Beyond that, have you tried any sort of body work?

      Dr. Russ

      • jim

        Hi ,, Not exactly sure what u are reffering to by body work? However if You mean Exercise? Yes,, I have exercised most of my life. Since age 18, I have always been active. Diet and exercise have been apart of my life since my wife past 18 yrs ago. However when I was at a job, 10 yrs. ago and was asked to restrain a consumer whom, belonged behind bars, instead of in a home for the slow, or other mental disorders. I herniated and bulged 7 discs. The male weighed in at about 350lbs was 6’3″ and I was 160 lbs, but fit. He Head bucked me, Smashed my head with a fire extinguisher. I performed my job and had to hold him on the ground for 20 min. twice. In doing so, I held both his arms down and used my left leg to hold the rest of his body down. I was honestly fighting for my life!! I had to do so without hurting him. Not easy! Trust me, when someone like this is, told they cant do something they had in the past they get crazy STRONG!! After…. I have had crazy Crazy! Pain. I have had ! laser spine surgery, ( No Relief ) my leg goes numb, ( the leg I used to hold him down,) it feels as if Ive been kicked in the groin, the only way i can explain it is, it feels as if my Hips are broken…Ive gotten out of my truck before to have my leg numb, ( nothing there ) grab a tree to keep from hitting the ground and ripped my pec. from my bicep. While at another job, I was checking the parking lots to see if they needed to be salted, and slipped and had my hand with my clipboard crunched by my rear to brake my fall. which left me with nerve damage in my hand. At any rate have I tried exirecise? Yes ! stretching, massage. injections, aqupuncture. I wonder if while at the ER, for my pec tear, a P.A. shot me in the syadica with some kinda pain killer would do damage, I wasnt able to use that leg for 45 min.?

      • By “bodywork” I mean any of the myriad of massage-like techniques used to break up adhesed tissue.

        Dr. Russ

    • Lori

      Dr. Russ,
      I unfortunately did have the Release surgery that promised to cure the pain I’d been having for 20+ years. I was told by the Surgeon that my Sciatic Nerve was wrapped around my Piriformis muscle from birth… Needless to say, I was heart broken when my pain is the same on good days and worse most days. This was after 20 years of tests, Specialists, being called a hypochondriac and a “Pill Seeker”. When they gave my Piriformis Syndrome a name I was so relieved to know I wasn’t crazy! I put all my hope in the surgery being “the answer” and was assured it was. After 5 years and still in pain, the Surgeon tells me that it’s how it’s going to be and I knew that the Surgery had risks. He refuses to see me. SO… I am back to square one… Any thoughts, ideas, or encouraging words? 😉
      Lori in Minnesota

  160. Anna

    I can’t find anything on what is causing my pain only when I stand up after bending over or squatting down. When I am about to be upright I get these horrible pains in my back upper thigh where my leg and butt meet and what I think is pain in both hips but it all feels like its in the back (not my back) . I don’t have any radiating to my leg pains . It started yesterday out of nowhere when I stood up after bending over. Do you have any idea to what this is?

  161. Tresia

    You are correct, no relief lying down or sitting. The pain initially midway my buttocks and horizontal pain it radiates my back thighs down to the knee. Extreme pain! It wakes me every night Have to get out of bed to walk my heated car seat appears to offer some relief. I fell in a clients home in May 2015., my doctor has ignored my reporting of pain. I stepped into client’s family room one step uncarpet floor.. Fell flat in buttocks! Still in much pain!

  162. Matt

    Good morning,

    I’m 33, and I’ve had what I believe to be Piriformis Syndrome for 12 years now. Some days it’s worse than others. Lately it’s been worse than usual.

    I’ve seen countless doctors, chiropractors, acupuncturists, massage therapists (including ones that do Active Release Therapy), etc. I’ve done months of physical therapy 3 different times. I’ve tried stretching programs, exercising, not exercising, have had MRIs, trigger point injections, dropped thousands of dollars on a nice new bed, new chairs, foam pads, etc and the list goes on. Nothing has been able to give me consistent, long-term relief. I just manage the symptoms day to day the best I can, and try to move forward.

    I’m intrigued by your website and the idea that you can make this go away. However, given all of the different things I’ve already tried that have failed, and the distance / cost it would take to fly from New England to Missouri, I’m skeptical that it will just be another addition to my list.

    Do you think you can you help me?

    Thank you.

    • Hello Matt,

      No idea with a case history like yours as to whether or not I can help (HERE). Wish I could do better than that, but I never really know beforehand. If you ever decide to vacation in the area or are traveling through, be sure to stop by.

      Dr. Russ

  163. Diana

    Thanks for the info..helped me understand better..I’m going to look into it more..I’m in so much pain and doing pt at the moment but have had it for years..nothing work’s. .I’m hoping to find out more about this when I go to my dr. Appt on thursday. …thanks,again

  164. Denise

    Hello Dr. Russ,

    I have had piriformis syndrome for over a year and a half and it has significantly reduced my quality of life at only age 31. I have undergone 3 rounds of PT, had acupuncture, massage, saw two different chiropractors (one who did active release on my piriformis twice per week for months), and had two lidocaine/steroid injections into my piriformis, which did absolutely nothing. I have also had injections in my SI joint, s1 nerve root, and hip joint, all which did nothing as well. All of my MRIs have been clear, and I’ve had 5 (hip and low back). It seems that everything that is supposed to help PS has made it worse. Massage activates the pain for days, I experience no relief. The pain also goes to my lateral hip, and sometimes the front of my hip and low back. Out of desperation, I finally allowed a hip surgeon to go in and take a look. He found a labral tear and repaired it, but said my sciatic nerve looked good. He said I did have a small band near the nerve that he cut (it was very small) just in case it was pressing on the nerve. Needless to say, my hip and butt pain have been even worse after surgery. I’m very interested to research the technique you discuss here regarding the fascist adhesions, I just can’t help but be nervous that it would aggravate my pain in the same way massage and active release did. I can handle a lot of pain, but both of those things caused increased pain for days, and then a return to my normal pain level, never an improvement. Should I still look into the technique? Are there practitioners in various areas that practice it? I’m very committed to feeling better but fear that I will be on prescription pain killers for the rest of my life. Any advice/guidance is appreciated.

    • Hello Denise,

      Not surprised the MRI’s have been clear as it does not show up on this test. As to whether or not what I do would aggravate it, it’s tough to say. If you start reading through my blog posts on PS over at Doctor Schierling dot com, you’ll notice that a couple of patients have stirred their problem by overstretching post-treatment. I have helped lots of people with this problem — some who have had it for as long as 40+ years (see our testimonials). I have also had people who did not respond at all. I’ve even had several people who responded beautifully for a week or so; then their problem came back. The only promise I make people is that you will know in one treatment if it is going to work. Believe me when I say that I wish I could promise better. Unfortunately, I have not yet determined a way to know beforehand.

      Dr. Russ

  165. Stephanie

    I have a pain it’s almost like a fatigued muscle pain right UNDER my butt check, right where your leg bends. Right now the left side has been hurting for the last week. It switched from side to side, but isn’t usually on both sides at the same time. I think it’s weak muscle. How do I isolate which muscle it is to try to work on it. I can’t do any kind of lunges they make my knees HURT!!!

    • Hello Stephanie,

      This is not PS. Have you been adjusted? Being out of adjustment subtly affects nerves without necessarily causing full blown sciatica. I will say that anytime someone starts talking about problems like this that are switching sides and moving around, the potential for autoimmunity enters my mind. Most of the time, isolating muscles is the last thing you want to do, as it is better to work on complex movements that involve lots of muscles. One more thing, I am a fan of lunges but if not done exactly right, they can cause knee problems (you were probably already aware of this).

      Dr. Russ

  166. paula martin

    Can the pain travel upwards causing a feeling of severe angina?

  167. paula martin

    Can the effects of piriformis syndrome travel upwards in the body causing a pain in the chest (heart) that seems to be angina?

  168. Tina

    How do I fix it? Every night arround 9ish I am in pain!! I fell on my porch steps last winter and ever since then I am in so much pain…. I don’t know what to do..

    • There are any number of things you can do — most are over on my Doctor Schierling dot com site.

      Dr. Russ

    • linda

      Out of curiosity, have you had the pain since your fall or were you pain free for awhile? I fell 18 months ago but have only been in pain for 9 months or so. I thought everything was fine for awhile now I’m in pain everyday.

  169. Bobbie

    Dear Dr. Russ,
    I was told eight years ago by Pain management Dr that there wasn’t too much he could do for my pain, yet I was able to get a referral for a spinal cord implant. That didn’t cover my pain. He did give me two shots in upper buttox that kept me pain free for a month. Also was told if I continue to be so persistent I would get myself fixed. I’ve had a fusion done and been told I need one more surgery. Yet I moved out of state and can’t find any surgeon that agrees.I’m confused. Is it really hopeless?

  170. prosperoussite

    I have had left buttock pain for the past year not been able to sleep on left side at all. Sustained an injury while sitting in a chair something stuck me in my left buttocks went to ER and csplinters were removed, what is my issue?

  171. Patricia

    Thank you so much Dr. Russ for this informative article. I sustained an injury on my job in 2002; 2005 became permanently disabled (L3-S2) herniated, bulging disc among other things and for 3 years I’ve been given epidural with some relief. However, for the pass two years I have endured this nagging rt. hip pain and the butt pain that’s often not quite sciatica. I also have a severe left foot valgus, which I wear a knee high brace which is somewhat helpful but still often painful. So your article certainly helped put things in perspective for this nurse of 40 years now disabled. Thank- you. There IS power in being informed.

  172. Catherine

    Dear Dr Russ,

    I know I have a herniated disc at L5/S1 from an MRI scan that appears in contact with my sciatic nerve. However, I am not convinced that it is the cause of my pain, I have had two spinal injections which have not helped at all.

    I have not been able to sit down for 12 weeks. If I don’t sit my pain is minimal or gone, except when I lie on my right side in bed which can also be uncomfortable.

    When sitting if I slide my buttocks to the very edge of my chair and lean right back I can sit for an extended period – maybe one hour. However, if I sit in a normal upright position after 5-10 minutes I am in great pain in the right hip region and back of thigh and have to stand, and then the pain eventually eases.

    Do you think I could have PS? I have been doing pilates and find that this relieves my symptoms temporarily. I have also been doing some piriformis stretching just recently when I read your site, which feels good.

    Osteopathy has not helped.

    Any suggestions would be gratefully received. I can’t sit at work, I can’t travel in the car – it’s very disabling.

    Many thanks and regards

  173. Staci

    Hi Dr.Schierling.
    I am a 46 yo woman, w/several autoimmune diseases, who has been living in chronic pain hell for the past 4 yrs. I had a myomectomy in Jan if 2012 & since maybe 4mos after, I have developed chronic, debilitating pain. I hv been diagnosed w/ Hashimoto’s thyroiditis, Hypothyroidism, IBS, Raynaud’s, UC, and RA. And most recently, my pain management dr want me to be tested for Adrenal disease.
    And I have sciatica pain EVERY time I walk or stand for more than afew minutes. I try to push thru it but my hips freeze up first , then my legs, and it feels as though I can’t take another step. I am on opioid pain meds, muscle relaxers for spasms (which feel like a spinning, flat sawblade in my low back/butt cheek). I can’t work, I can’t do much of anything, my life has become just trying to remember to take meds, and dealing with the different levels of pain. My life has been robbed from me, I used to go to the gym in the early evening for 2 hours at a shot, 6 days a week and pilates 5 days a week in the am. I was fit and pain free, then suddenly all the above happened. I want my life back….do you have any suggestions on wht doctors to see, tests to ask for, anything?
    I thank you in advance for any help or guidance you can provide.

  174. Nick

    Hi Doctor

    Great article. I have been experience pain in left buttock which travels down to my calf muscles. The Pain is worsen in the mornings and while sitting and standing as I am unable to put any pressure on my butt muscles. It’s seems to go away once I have been in a sitting position for good time i.e. driving. I do do a lot of running. Could you please advise what steps I need to take for the pain to go away and for me to exercise again. I am 27 and fairly fit. Is this piriformis and do I need to concerned about my lower back?
    Thanks again 🙂

  175. Penny Vann

    I have been to so many doctors….then when I decide to Google why my back and bottom still hurts…..these are answers! I am going to your blog/page to read more! Doctors don’t take the time to care. Thank you for taking that time to help.
    We need more doctors like you.


    Penny Vann

  176. Michele

    I’ve had 2 failed fusions L5-S1 then L4-S1. I get what can only be described as a hot ice pick in the area where my right sacroilliac joint is with nerve pain down my but to my calf….or so I’ve been told by 3 specialists. Could this be piriformis misdiagnosed???

  177. Jenn

    Dr. Russ,

    I’m a 23 year old female and have been experiencing sharp constant pain in the inner of my right buttock going down to my knee for the past month. I am a long distance runner and have been training for a 50k over the past 6 months (thus increasing my normal distance training) I’ve now reached the point that the standing, sitting, and even laying down the pain will still exist. It has gotten so bad that I’m having trouble sleeping at night and get constantly woken up from it. The only time I have some relief is after I’ve done some stretching and muscle massaging. Before any of my runs I do a short warm up jog and lightly stretch. After that I do my long run followed up with 20 minutes of stretching. I also notice that my hips/lower back pops/grinds whenever I do any kind of leg lifts. Is PS a possibility? And should I see a specialist and what kind of doctor? I afraid if I go in, they’ll just prescribe me pain killers and muscle relaxers instead of really treating the problem. Running is my passion and I would hate for this injury to stop me from doing that. Any advice would be great. Thanks!

    • Hello Jenn,

      Not sure I have any earth-shattering solutions for you, but I would suggest that you get this figured out before you continue to train so hard. You could potentially end up causing yourself irreversible damage. Don’t ask me how I know about this (the story can be found on my blog).

      Dr. Russ

  178. Amy

    Hi Dr. Russell,

    I have been experiencing occasional pain in my lower back and right buttock and i was having difficulty picking things up and even looking down without it hurting. My doctor believes it is sciatica and she gave e flexiril, which has helped. I haven’t taken it often because, as I said, it’s intermittent.

    This week, the pain has worsened immensely. I don’t know if it’s even a related issue or the same one, but I have been having pain when walking in my buttock. It sometimes causes discomfort on my hip and my thigh. Sometimes, it feels “dead” or numb. Other times, it actually hurts and i find myself limping and overcompensating for the painful side (right) without realizing it.

    Just this weekend, the pain hit a 10. It was horrendous and I found myself in tears and on my knees unable to move because any movement only caused more pain. The pain seems to cover the entire right buttock area (middle part up to the top) and it feels like my muscle is locking up or cramping up. i can’t tell. I just know i can’t make a small move with causing it to hurt and feeling like I can’t move because I’d make it worse. Hoping you can please help.

    • Hello Amy,

      Firstly, Because there are so many different causes, sciatica is not so much a diagnosis as a symptom. So ‘diagnosing’ you with Sciatica is really not a diagnosis at all. Secondly, I would suggest that you go to my Doctor Schierling site and look up the “Piriformis Test,” which will help you differentiate between two very forms of sciatica — from a disc or from Piriformis Syndrome.

      Dr. Russ

  179. Linda

    I had a laminectomy at L5S1 in the mid 80’s. Several months after that surgery I developed agonizing pain and was forced to walk with a very bad limp and totally “lop-sided” due to scar tissue formation. I went into a chronic pain clinic at a local hospital for 8 weeks and several types of treatment were tried until I was able to loosen things up so that I could walk correctly again. In the intervening years I have had some troubles with my lower back and more than one doctor has done tests and told me that I have other disks that are narrowing.

    Last March I flew from Florida to Illinois for a program for one of my grandchildren. Before I left I experienced this pain in my bottom and by the time I navigated through the airport, flew for 2.5 hours I was in so much pain I couldn’t do anything but cry. My chiropractor was able to help me get through the weekend and attend the program by using electrical stimulation and deep massage. When I returned to Florida I was fine for several months.

    In August I experienced the same thing and when my Ortho Doctor did some tests and examined me he said it was bursitis and gave me a steroid shot. The shot hurt like 60 but it seemed to take care of the issue. He did inform me that it was not a cure and the condition could indeed come back.

    Last week on Wednesday the situation came back with a vengeance. I again went to my chiropractor this time because I had the wedding of a very close family member on Saturday and was willing to try whatever might get me the best and quickest results. She used the same techniques but as we spoke and she did her examination, she said she thought I could have PS, which I had never heard of. I did make it to the wedding but only by taking pain meds.

    So on Wednesday when I had had no sleep to speak of for 2 nights, I contacted my ortho and he is doing an MRI on Monday and then I will see the specialist in the practice who deals with backs. He said it sounded much more like I was experiencing disk issues again.

    I’m still not convinced it is not PS and I plan to ask this new doctor about it when I see him after the MRI on Tuesday. I have been managing these last few days only by staying filled up with pain meds and steroids and I hate feeling so out of it on these drugs.

    Any advice on how to address this to get the best conclusion would be greatly appreciated.


  180. Stephanie

    I had a pretty traumatic fall about 3 years ago, the pain was excruciating…… Anytime I moved it felt like my right back and leg was being shocked, at one point I passed out from pain. An MRI showed 2 herniated discs. I quit working out for about 3 months and returned as normal with minimal pain. Over the past year the pain has gradually grown, and is bothering me on a daily basis. It hurts when I use the restroom, it hurts when I sit in the bath, it hurt when I drive, it throbs sometimes for no reason. I’ve noticed my left leg is also slightly longer than my right, which is the side my pain is on. I’m wondering if maybe my hip is broke, fractured??? It is starting to affect my daily life. Just standing still will hurt me. The main form of exercise I do is running….when I run it doesn’t hurt. Recently I’ve began feeling the pain in the front side of my hip as well, actually it’s slightly above my hip, but in the front. What would you think this sounds like? Thank you so much for the informative article.

  181. Cheryl

    Dr. Russ,

    I’m 52 and have been at a desk job for 22 years. Several months ago, I began to have deep left buttocks pain ONLY when sitting at work. Sitting anywhere else caused no pain, and the pain was immediately relieved by standing. I tried different chairs and using various types of cushions. (Also, I have had left hip pain, back pain, and radiating leg pain for many years – don’t know if there is a correlation.) Recently, the pain in my buttock (still just the one side) happens no matter where I sit, and is still immediately relieved by standing. Do you think this is PS?

    Thank you!

  182. Steve

    Can the irritation cause twitching of the muscle in your experience? I have had ongoing twitching for a week or so. But had the pain first. I do a mixture of a lot of sitting and then very hard cycling!

  183. Leah


    I am 24 years old and 15 weeks pregnant. I’ve had chronic lower back pain for roughly 10 years now, however, over this past 2-3 weeks, now and again, when I wake up I can barely sit up and standing is worse! My whole lower back area and both sides of my bum are in excruciating pain. I stand up to stretch it out and it is relieved maybe 5-10 minutes after. I can barely walk in that space of time. I’ve never felt anything like it. Do you think it could be Piriformis Syndrome?

    Kind regards,

  184. Mary

    Hi. I got my right knee injected with kenolog and lidocaine s/p meniscus repair. I developed by his right buttock tingling and pain. If I have weight on my right leg it catches. Painful. I walk and it is better. I can lie down on the right side and it feels better with pressure on it. Sounds crazy huh? It does run down my leg but the pain is butt cheek and calf mostly. Is this PS. Do all chiropractors know how to remodel?? Thanks

    • Hello Mary,

      I have seen occasions where injections fire off PS-like symptoms. However, not sure if I have ever seen a knee injection cause this in the pelvis area. As to the remodeling, some do and some don’t. You’ll just have to ask.

      Dr. Russ

  185. Kelly

    Hi Dr. Shierling~

    Wow! Great article. After reading it, I too am convinced this is what has been driving me batty for about 26 years. I remember when it started. While I was pregnant with my first child laying on my back an annoying aching pain in my lower back, deep in my hip came on me and ever since then I have had this pain that radiates into my buttocks left side and only a few times has that radiated down in my leg so I don’t believe it’s actually sciatica I do however believe it is the Piriformis syndrome.

    There is one thing though that I’ve noticed that wasn’t mentioned. For me, I have a very strange way of relieving the pressure temporarily and it has become a habit if you will. The pain is in my left hip and butt muscle. Deep in there, so I lean over bearing weight on my left leg. I raise my right leg as high as I can and then POP goes that whatever it is. It feels like my hip is popping back into alignment, but I could be wrong. Maybe you can comment on that. Like I said it seems to relieve things for a while. I have to perform this weird ritual at least 5 times a day.

    Feels like there might be arthritis in my hips too. I also am AMAZED at the stiffness in the muscle. It’s seems as though deep stretching would be just what the dr ordered but no. The muscle refuses to give. Not sure what that is about. Ex ballet, gymnastics, dance so stretching is huge and now that I am older (45) it is no longer relieving to stretch.

    But, I was recently diagnosed with Fibromialgia which has been a living nightmare in itself so stretching my muscles creates more intense pain.

    It would be wonderful to have some relief. Thank you for your research and sharing your knowledge with us.



    • Hello Kelly,

      Thank you for the kind words. Best guess is that this is not actually PS, but some sort of Fascial Adhesion causing a bony restriction and subsequent crepitus that is relieved by you “popping” it. Figure out where that adhesion is, and you’ve gone a long way toward solving your problem. By the way, make sure you check out my posts on FIBROMYALGIA as well.

      Dr. Russ

  186. asherrozil

    Hi Doctor,
    I have a 18year old sister who experience a pain in her waist,and it extends to her leg and sometimes vertebrae column.It started 9years ago when she was given an injection on her buttock.
    Later on,she fell down and the pain has been excruciating anytime she feels it.
    Visit to several doctors indicate there is nothing wrong with her.
    Please can i know what is wrong and some remedies?

    • Hello Asherrozil,

      Tough to say exactly what is going on, but I have seen similar problems before. This is not PS, but likely some sort of nerve injury from hitting the sciatic nerve. As to whether or not Tissue Remodeling or anything else for that matter would help her, I really don’t know.

      Dr. Russ

  187. Joseph

    Dr Schierling,
    I’m in my Junior year of college and I’ve been dealing with pelvic problems since the summer after senior year football. I was working out and I dont remember ever getting injured, but I slowly got this nagging pain in my left glute and it got worse and worse until I saw a doctor. He sent me to a chiropractor who said i had sciatica and who I went to several times for adjustments and electrical stimulation, and I would leave feeling slightly better but the pain would come back soon after. This was about a year or two ago, now I dont have as much consistent pain, but anytime I bend over or try to stretch I get this terrible pain in my glute and cant stretch. I have essentially no flexibility now in my left side only because of this, and when I squat or try to stretch my hips tilt really badly to accommodate that side. Do you think it’s piriformis syndrome? I try to roll on it with a lacrosse ball sometimes and it helps a little but stretching just seems like a lost cause because I’ve tried a lot and I can’t really do it and it doesnt help when I try. Is there anything I can do?

    • Hello Joseph,

      When simple stretching and exercises don’t work, I usually suggest trying Tissue Remodeling — something that sounds like it might help you. I do have tons of self-help stuff on my DoctorSchierling site.

      Dr. Russ

    • Dwayne

      Great Article!
      My life has been taken away (I will get it back) by a literal pain in the but. I had ongoing pain in my back for the last 5yrs. In the beginning I would only experience pain every so often. This pain would last for a week and than it would be gone. Over time (a few accidents, being sedentary in office environments) the issue has developed into a serious problem that has effected almost every facet of my life.

      For the past year I am experiencing pain in my piriformis (have you noticed spell check doesn’t even recognize the word) that causes sciatica like conditions down my leg into my foot. When I awake in the morning I look like the Leaning Tower of Pisa. My entire body is slanted and I have to adjust most of my weight to the “good side” of my body in order to make it to the bathroom. Once there everything is done in a slanted position. It is hard to walk and very painful. I force myself to get up and make it downstairs to the kitchen. I eat, take some anti inflammatory medication and try to walk around as best as possible. After a few hours I start to come around. The periformis stays painful but somewhat bearable (funny how you get used to pain and treat it like normal) but I am not as much on a slant. I can not sit down for long periods of time. Driving in the car is a whole new experience and usually takes me some time to get moving after getting out of the car which is a task in itself. I am in some kind of pain all the time.

      I have been scheduled for an MRI and I hope this will show more. No one has been able to tell me what is wrong and its bad to say but I feel that due to the lack of knowledge in these areas it is easy to give a person the run around. I just want to know what is wrong so I can work to heal it. It is essential that I find a solution. I am 36 years old and have a family to take care of. Why is it so hard to find out what is wrong with you? Can you offer a better strategy to determine the root of this problem?


      • Thanks for the kudos Dwayne,

        Sounds like it is PS. Make sure to check out my article on Doctor Schierling dot com about “Imaging the Pirifomris”. If that is in fact what this is, MRI will prove worthless. I have about 20-25 articles on PS over on that site.

        Dr. Russ

    • Francisca

      Dr. Schierling, I have been dealing with a radiating pain that starts at the left side of my lower back and radiates through my left buttocks and thigh. It started out as something that would flare up every so often. It is now something that happens whenever I sit down for more than 10 min. I will literally get up from a sitting position and be limping. I cannot sleep at all at night because my left side will radiate with pain no matter what side or position I try to get in. Pain relief medicine does absolutely nothing for it now. It takes about a good hour of moving around in the morning before the pain finally subsides. I am a makeup artist so I am on my feet all day. Oddly it is the only time I am not feeling the pain. Suggestions????

  188. Olene

    My buttock aches also going around top of leg feels achy burning foot aches so does knee at times what is this dr says hip joint xray showed cartilage worn down i’m tired of aching

  189. tanya

    Good Evening
    Interested to see this article . 15 years ago shortly after giving birth to my daughter i was laying down when i started getting pain that would radiate from my mid lower back into my buttock and down my leg only while lying or sitting for long periods of time. Im still suffering to this day. Everytime i lay down ,without fail, i get radiating pain that goes from my buttock/hip area down my leg and draws my leg up every 30-40 seconds and leaves me without sleep. The nerves in my hip and leg are so sensative that ( if i am not taking medication) i can get something as simple as a itch on my arm ( or anywhere) and it sends that nerve/muscle into drawing up and reacting. I’ve recently also started getting a hot tingling burning feeling deep in my hip area (where the leg joint connects to the hip) on both sides..worse in the right. If pressed it burns and radiates pain in that area as well as the upper part of my leg and upper butt area..my right hip is always sore. Also it tends to be more irratated when im ovulating or on my menstral cycle.

  190. Diane

    Dr. Schierling…
    I was so thrilled to find your webpage…. I am a 65 year old female and have been having lower back problems for several years putting me on disability. I have seen several doctors with diagnoses such as sciatica, sacrolilliac, bulging disks, disk degeneration, etc. and have undergone pain management, physical therapy, cortisone / epidural injections, and RFA’s for nerve burnings. I’ve had 2 MRI’s (the last one being 2 yrs ago) and they both showed the things mentioned above plus more.
    My LATEST problem is a scale of 10 for “butt pain”… It’s intense and I ice it about 5-6 times a day which gives me a little relief but not long lasting… I just went through another 6 weeksof Phys. Ther. and the PT said she didn’t know what else she could do…I take plavix (due to a stroke a few yrs back) so I can’t take anti-inflammatory drugs… i am at my wit’s end. I haven’t slept in the bed but probably 4 times in 2 months. Most nights consist of 2 hrs sleep…pain & up for hours… then maybe another 2 hrs sleep (if I’m lucky).
    The dr. is ordering something called a tens unit to see if that helps. He has also suggested pain management again….
    I noticed in an above post that ayoung lady said her pain travelled from one side of her butt and then would hurt on the other side (but never at the same time). That’s exactly what I’m going through. I have to sit completely straight (and not for a long period)…am having trouble walking and last night I fell down…
    Can you offer ANYTHING to get me going in a direction where I can have a decent life? Surgery was suggested a few years back…but it scares me since I’ve had so many “different” diagnoses ….they don’t really know what they are treating… One dr wanted to place some kind of pain control unit inside my body where I can control the pain (He never even went over any of my history …just spent 7 minutes with me and determined I needed this “implant”… needless to say.. I didn’t go back to him.
    HELP ME…. Please…. Once again it is 2 am and I am still up….

  191. Genny

    Dear Dr. Schierling,
    I am 27 yrs old and have been experiencing these painful electric sting in the upper part of my right butt for almost 3 yrs. The pain does not radiate anywhere. It usually comes with prolonged bending or if I lift or work with heavy things for longtime(more than 20 min). Then I cant sit, walk or sleep in certain positions coz it triggers the sting which is extremely painful to bear and I can feel the muscles sore at that area. It usually used to diminish on application of hot water bag on my back but it doesn’t seem to work these days.
    I would like to make a point that in other days I am extremely fine and long hours of walking, sitting and standing does NOT trigger the pain. it only comes back when I do bending or lifting jobs for more than 20min.
    Do u think it could be PS? would it get any worse?

    • It could certainly be a piriformis issue (myofascial) but sounds like there is no sciatic nerve issues — at least not yet. Have you been to a competent chiro yet? That is one thing I would consider trying first, along with the piriformis and gluteal stretches.

      Dr. Russ

  192. Dana

    I was recently told I have a slipped disc, L5, S1 and could barely move the pain was so bad. Some lower back but more the entire length of my left leg. I have been going for acupuncture for a week and a half and my acupuncturist told me my piriformis was pressing down on my static nerve causing the pain in my leg. Acupuncture has greatly increased my mobility in just a week and a half and would recommend it to anyone with a similar problem. It will take several visits and they will be painful but you’ll heal quicker then doing nothing in my opinion. Best if luck.

  193. sara

    I’m a 35 year old female carrying my second child. Just got the pain in the butt that is so sharp and awkward, I can’t stand on that leg or put pressure on it. Unfortunately I also struggle with Pubic Symphisis, both issues I developed with my first pregnancy. The public symphysis never went away 16 months post partum and I’ve seen many people and done many exercises and nothing helped. I am wondering if the two could be related? I use to be a runner and much more active before these issues arose and I would do anything to get there again. Will massage help the sciatic issue in the butt?

  194. Heather

    In April, I discussed my aching glute muscle with a yoga instructor as she also does deep tissue massage. I thought, perhaps, that would help with my problem.

    After probing the area, she felt it was my Piriformis muscle. She mentioned to me how she could feel a “void” in the area and suggested I do strengthening exercises.

    Since then, my pain has progressed. I now have, and what I assume to be, symptoms of sciatica. There is tingling in my left leg all the way to my toes. I also get a burning sensations and a feeling of creepy crawlies in my shin. Plus, the pain in my glute still exists. I am miserable.

    As I am an avid yogi (hot vinyasa), and a very active person, this has put a real damper on things I love in my life. Day to day living is painful. I currently take 12 Advil daily, and alternate between ice and heat.

    I am considering acupuncture.

    What I’m wondering is whether or not it’s Piriformis or related to Sciatica? Perhaps a disc issue? It’s hard for me to do the “test” as I always have pain in the areas, with the exception of my back. I really do not have any pain in my back. Just a little tightness when I wake up.

    Four years ago, I suffered from a herniated disc in my neck – between C5/C6. I was the worst pain imaginable. I was in PT for a large portion of the summer. Looking back, what I can say I learned from that experience was it just takes time to heal. Maybe the same applies to this injury.

    Any advice you can give would be greatly appreciated.

  195. Valareé

    Dr. Schierling,
    You do not know how excited I was to find your website!! I have been researching for awhile now why I am having the pain I am having! I am an OT by profession so I had some idea of what was going on and had narrowed it down to something going on with my L5-S1 (sciatic) but just could not pinpoint the problem ! After reading this info on Piriformis Syndrome I am convinced that is exactly what is going on with me! I got so excited reading this but then it just ended……… You stated get rid of fascia adhesions and you get rid of chronic pain but didn’t say how to do this : (. Where can I find out how to heal myself ? How do I get rid of these fascial adhesions? Thank you for a reply.

  196. Angela

    Dear Dr. Russell Schierling,
    I am in desperate need of answers and or help. I am now 18 years old and have been experienceing the same excruciating pain on the very top of my buttox, for the past three years of my life. I was forced to quit volleyball my sophomore year of highschool because I could physically not do the exercises, let alone walk to practice without an obvious limp. The pain starts in the top of my buttox and shoots all the way down my entire leg, causing me to struggle greatly when walking. Over the course of these three years I have tried working out in a gym five times and was forced to stop each time because the pain was almost unbearable. When sitting for extended periods of time, I can almost not walk at all once I get up, and more times than not my leg has actually given out. I am in fairly good shape, and only weigh 135 pounds and am 5’8. Before I had to quit volleyball I was one of the fittest on the team. I have gone to over 7 appointments with doctors, physical therapists and even a chiropractor once. I have gotten two Mri’s of my back and they didn’t show anything. I did physical therapy for about 3 months the first year that I was feeling pain and they diagnosed it as sciatica. I would do stretches that seemed to help for a little over an hour and the pain would come right back. Frustrated, I gave up and tried to deal with the pain. However, it proved to be too difficult and I went back to physical therapy about 6 months later and tried once more, but again, nothing was resolved. Some nights the pain is so bad that I cry myself to sleep because it is the most painful thing to lay down flat. At this point I am desperate, and frustrated beyond belief. I am 18 years old and all I want is to be able to go for a morning jog without having to drop out after 5 minutes and limp home because I cannot take the pain. Something also weird is that over the course of these three years the pain (exact same) has moved from my right to my left side and back again. It’s been on both sides at different times but never at the same time. I stretch every morning, and it does barely anything. Please help me, or at least guide me in the right direction because I am desperate beyond belief. Thank you.

    • Hello Angela,

      I hate what you are going through. Other than the fact that her problem started with a severe injury, ‘JANE’S STORY‘ reminds me of you. The first thing you need to do is to see if Tissue Remodeling is going to work for you (any Fascial Adhesions need to be addressed). If that does not work, I would consider seeing a Carrick-trained Functional Neurologist. The part of your history that is somewhat perplexing is the fact that, “over the course of these three years the pain (exact same) has moved from my right to my left side and back again.” Although I have see this a few times over the years, it’s an odd finding that sends up a red flag. A pinching in the right buttock should not cause pain on the left, and visa versa.

      Please keep me in the loop and let me know what you find out.
      Dr. Russ

  197. Trina

    I’m only 15 and I have pain in my butt and it’s traveling up to my lower back. I play a lot of sports and I lift a lot of heavy things which might be the cause of my problem. I just want to know what can I do to make the pain go away faster? Could I ever get this pain again?

  198. lANCE

    I have the aching pain in my glutes and sometimes in the front hip area. I also get a numbness somewhat aching pain in the side of my thighs. I have worked a desk job for years and have not seriously worked out besides walking occasionally. Now I am trying to get into shape after all these years but when running I get a pain in each of knees on the outside. Just wondering what you thought that might be?

  199. Carmen

    Hello Dr Schierling, I’m a 59 year old female and I had 2 discs replaced in my neck in 2011. When I awoke from surgery, my whole body was jerking violently. I have RLS and believe that it may have been a reaction to the anesthesia. I was very active before the surgery. To make a long story a bit shorter, I believe the violent jerking of my body could have caused my problems. I have been in so much pain. Lower back, buttocks ( sometimes it feels like I’m sitting on a rock). The pain travels all the way down to the bottom of my foot. Pain, burning, numbness. The pain is relentless. I have been on every med you can name and have had so many tests run, I can’t list them all. I tried PT 3 times. It left me in so much pain I couldn’t walk. I’ve tried Chiro, acupuncture, you name it I’ve tried it. I had a laminectomy/formanectomy 6 months after cervical surgery. Dr thought that would be the answer to my pain. I got no relief. I’m at my wits end. It’s been over 4 years, this changed my life, I had to retire as I can’t sit, walk or stand but a few minutes. The pain causes intense fatigue and keeps me unable to do very much in a day. I try hard and push myself but pay for it in the end. No dr has ever mentioned PS to me. After 4 years will I ever get any relief?

  200. Abe

    Hi, I’ve been in pain for about 2 yrs now…I’m a 39 yr old male that is normally in good shape. I’ve had a low back and right hip pain for about 2 yrs but in the past yr it has really seemed to ground me. The pain in consistently in low back and sacrum area. When I bend over I have no sharp pain in my low back, glutes, and thighs. It’s a constant dull nag that never goes away. The pain also wraps around to the front of my hip on my right side and sometimes on my left near the greater trocanter area. I also have a terrible internal snapping hip on my right side. I’ve been to at least 10 chiros, two doctors, a rolfer, and I am currently doing a M.A.T. program but nothing seems to be helping the actual pain. 3 of the chiros have told me I have arthritis in my low back ( l5 l4 s1 facet) and this has been seen on xray. I have a mild curve in my spine and a small pelvic tilt. I know this a lot but if I can’t get past the pain I feel I will never get better. I’ve been wanting to use an inversion table but I am not sure how wise it will be considering the arthrosis. Any thoughts on any of this? It really has destroyed my life. I have had a very hard time finding a good therapist that can really analyze my situation accurately.

    • Hello Abe,

      I am a huge fan of Inversion. Before doing it, make sure you read my blog post on how to do it correctly over at my DoctorSchierling.com site. Doubtful that the degeneration is the cause of your pain. Arthritis or DJD is a common scapegoat because it is one of the few things which can actually be seen with imaging. Are the rolfers being intense — i.e bruising you or making you feel like you are going to cry?

      Dr. Russ

  201. Stella

    Hi Dr. Russell
    early last month I sat at e edge of a motorcycle for a short trip on reaching my destination my butt started aching me seriously that I had to take a pain reliever, this persisted for some weeks, I later noticed any time I sit in a vehicle for more than 30mins my butt aches, just 2days ago I travelled in a bus for 4 hrs and on getting home I had very extreme pain in my butt, am scared is it a condition in which may medication is required, i am quite chubby, I hardly exercise could that also be the cause?

    • This certainly sounds like it’s possible you caused some (hopefully minor) PS. As far as the chubby, sedentary part; take the bull by the horns and do something about this. By exercising wisely and eating healthy foods, you can largely control the amount of Systemic Inflammation in your body.

      Dr. Russ

  202. danielle

    Hi. I’ve been having some trouble in 2013 I was in a bad car accident. I was the driver. I seen it coming and braced really hard. I was told it was a torn tendon and would heal itself. I never had pain before the accident. I believe this to be foot trauma but I’m uncertain. I will now describe were the pain originates from. The last two toes on my right foot. Where it looks like it forms a y shape there is severe pain in that area it runs up my leg on the side up into my hip butt area. I am now pregnant and my legs/feet are swelling causing pain to the area in my toes. Its gotten really bad to were if I walk any amount of time it causes severe discomfort. All the way from my foot to my butt

  203. Irene

    I use to have thick tissue on my buttocks and now I notice my butt has gotten flatter and I can feel the bones it’s like the muscle has gotten thinner or something on my buttocks, I’m also having a lot of pain on my left cheek on my buttock that is makes uncomfortable to sit or lay down. I had sciatica nerve problems before but they went away now I have this problem. What can this be?

  204. Chad

    Hi Dr. Shierling,
    I was deadlifting 2 months ago and awkwardly put the weight down. Now I have a sharp pain just above my glutes. This happens if I go down stairs or pick something off the ground. I was told I have glute amnesia as well if that means anything.

    Thanks and much appreciated

    • Hello Chad,

      Even though I used to be a relatively serious powerlifter, I had not idea what “Glute Amnesia” was, so I looked it up. For those who are like me and have never heard of this, it is basically a deconditioning due to too much sitting. Interestingly enough, there are studies that have come out very recently claiming you cannot overcome a lifestyle of sitting — no matter how much exercise you do. Make sure to watch my blog as I am going to address this issue and others with a post on the multitudes of problems associated with sitting.

      Dr. Russ

  205. Kelly

    Hi, I run XC and track so basically I’m running all year round. Recently I’ve had pain when walking/running in my hip and when I put pressure on my butt when I roll it out, there’s a sore spot right in the middle of my cheek. I can still run but after practice today, it was extremely hard to even walk normally because that butt/hip area hurts so much. I tried icing and doing a few stretches I found online which helped for a while but it came back. It especially hurts when I go from practice to my job (I’m a hostess at a local restaurant) and I have to speed walk around for 5+ hours. Does this sound like the injury described in this article, something else, or just soreness from 1000 meter repeats I did yesterday on a gravel trail?

    • Hello Kelly,

      I would not be too worried after just one day. If the problem persists, lay off because believe me when I tell you that you do not want to aggravate this problem if that is what it is.

      Dr. Russ

  206. Francisco

    Dear Dr Schierling,
    My name is Francisco and I am a 21 year old male who is experiencing symptoms such as these. 2 years ago I was on the treadmill , and I did the mistake of not warming up and just pushing through fast paced intensity on it when I felt like a snap in my buttock/leg and felt a cold rush of blood. Keep in mind that this was 2 years ago and wet since I have limited mobility on this leg. I’m extremely active always working out or running/biking. I haven’t had any complications until recently this summer in which the pain has become excrutiating especially when I wake up. It is a hassle to get out of bed and the only brief comfort I get is by sitting down, biking or running. I just don’t know what to do, as it is becoming an irritating problem and a painful one to say the least. I can’t stand for too long because my glute/leg starts to hurt and bending down is extremely hard to perform. I still exercise my legs , regularly squatting and can push through the pain but after my workout is complete an a good hour passes by the pain comes back. If you could please advice me any exercises or stretches to perform it would be greatly appreciated.

  207. Deb

    I came off my horse November last year and have been experiencing the pain across my butt crack and tingling in both my legs ever since. Sitting for long periods of time (1hr) is a nightmare of pain. The doctor put me on nerve blockers but I took myself of them as I didn’t like the way they affected my head. Thanks for the article and thank heavens I stumbled across it, as it describes my pain and areas of pain exactly. I’m going to book mark this page and show it to my chiropractor. Do you have any advice on what I can do to help myself heal or relieve some of the pain. I have a fairly high pain tolerance but there are days when it gets a bit much. Thanks you Deb

    • Hello Deb,

      Although not unheard of, bilateral PS is not very common. I would try some inversion and see what that does. Usually Inversion (done per instructions on my Doctor Schierling dot com site) is quite beneficial for disc issues. However, it tends to aggravate PS. Try just a little bit and see what happens.

      Dr. Russ

  208. Kevin Buttner

    Dear Dr Schierling,

    After a second L4L5 disc operation, I suffered from a nerve inflammation in my right shoulder. It took my quite a while to get back into some sort of shape, but I got there. Then I made the mistake of overdoing my workout on my hometrainer – I put the resistance too high and trained far too often. The result is a tight and overworked Piriformis muscle.

    I’ve worked hard with the physical therapist for five months now. I’m quite strong and have a lot of control over the muscles. However, the tightness remains. I have faith I’ll get there. There’s one question that keeps popping up in my head, though. Perhaps you could answer it? Sitting for a while increases the tightness a bit. But does sitting for like an hour actually aggravate the condition? Does it make it worse? Or does it just feel worse? I’m curious, because I have to do some sitting for my job and wonder whether this hampers my progress.

    • Hello Kevin,

      I am not really sure. What I am sure about is that prolonged sitting is being tied to virtually every health problem you can name. I also know that an inability to sit is probably the most classic sign of PS. I would guess that it aggravates it. Thanks for your question.

      Dr. Russ

  209. The Freckled Runner

    I started to get the pain earlier in the year. I was training for a few marathons and upping my mileage. Once it got to a bad point, I didn’t run much for a week and it seemed lessen greatly and eventually go away. I’m training for another marathon now and this pain came back on Sunday. It starts at the top of my left butt, goes into the middle of my butt, down the back of my leg, and to the outside of my left calf. I haven’t ran since Sunday because it’s hurting so bad! I work an office job so I sit a majority of the day and can tell it’s aggravated by that. Also, when driving I will get shooting pains. Help!!!! My marathon is in 10 weeks and I’m very scared a PT will tell me to stop running. What do you think?

    • As an athlete myself, I’m no different than you. The thought of giving up, changing, or ratcheting back on my training regimen is not an appealing thought (although I have had to do it several times). However, whatever this is, you risk making it permanent by continuing to train on the same schedule. Try something else, like training in the water for a week. Or maybe do some upper body resistance training. I see lots of people whose lives are destroyed by this stuff — it’s not something to mess around with.

      Dr. Russ

  210. KM

    Hello Dr. Schierling,
    Approximately 14 years ago I was diagnosed with permanent sciatic nerve damage from being in a car accident. A lady “T-Boned” me. It was tolerable for the last years, but as of lately, I have continual, constant pain in my hip that on occasion, wraps around to the front of my thigh and travels down my leg. I picked up something heavy recently and the hip pain ceased but now I have been experiencing deep “butt” pain. It hurts to stand, walk, or to try to change positions in the bed. Sitting isn’t too terrible. I have been sitting a a desk that isn’t really a desk for awhile now (months), because I am a novelist (or rather, aspiring novelist). There is no way for me to put my legs under the desk, as there is a shelf there. Oftentimes I find myself resting one or both feet on the shelf so I can get closer to the desk. So, my question is – is this pain due to the way I am sitting? Or is it what you’ve spoken of here? I am to the point that I just cannot take it anymore.

    All the best,

  211. Trish

    I started with left groin, buttock and thigh pain back in April after doing yard work. I was doing a lot of bending and squatting for several hours. The next day I woke up with this pain. I have not been able to sit or lie flat on my back due to the pain. I have done PT for 3 months, saws chiropractor once and just started Active Release. I have also alternated between ice and heat. I had 3 steroid injections: left hip, ligament in buttocks and pirformis each about 2 weeks apart. Post pirformis injection seemed to increase my pain. Any other suggestions or do you know of anyone physician wise who can help me in my area. I live outside of Philadelphia,PA. I am a Nurse Practioner, former ER nurse for 10 years and started running in 5 TV grade long distance competitively all through grade school, high school and college. Stopped running after that and I also played soccer in grade school and high school. This is worst pain of my life. Please help.

    • Hello Trish,

      Wish I had something to offer you beyond what’s on my sites. Do you have the sciatica with it?

      Dr. Russ

      • Trish

        EMG normal today with no signs of nerve damage. I cannot sit or lie flat on my buttocks as I get intense pain. I have seen so many specialists and still no answers on cause of pain or how to fix it. I have been walking twice a day, active release twice a week and PT twice a week. Not sure if any of these aggravate condition. Need answers. I still think it is pirformis, but no one will confirm for sure. Any suggestions would be appreciated.

      • No great answers for you. Just be aware that it takes a certain kind of EMG to see PS, and it does not image will with most tests. Take a look at my post called “Imaging the Piriformis”. It’s over at my http://www.DoctorSchierling site

        Dr. Russ

  212. stoney

    I have been having pains every day that I wake up in pain my butt area and the back of my thighs…I don’t Work out…and I thought it was from me sleeping on my Couch..but even in my bed I’m having the same problem!!!.. it hurts threw out the day..this has been going on for months…what can I do? I also been having leg cramps in my calf’s from time to time…in my sleep I wake up crying!! Please help me..I’m 30 yrs old

  213. Melissa

    I have had this for so long. It has taken years to get answers. I’ve been diagnosed with different issues but when I realized I had joint hypermobility and chronic saccro illiac joint pain I realized I also had piriformis syndrome as well. My ortho briefly mentioned it but then he changed the subject. I believe most Doctors dont like to tell you they really can’t fix your problem. I have tried physical therapy, injection and they never worked. I have a small TENS unit at home that does help briefly, not long term. My pain is constant and has changed my life drastically. In your article I noticed you mentioned the Ozarks and I am from Arkansas. Any information or help/advice would be greatly appreciated.

    • Hello Melissa,

      Go over to my Doctor Schierling dot com site and take a look around. Much more information than this site. BTW, I am in a county that borders Arkansas (I am north of Mountain Home, close to West Plains). Not sure where you are, but as close as you are, it might be worth a trip.

      Dr. Russ

  214. myecco glover

    This really describes what i feel it feels like a permanent charlie horse or a muscule that cant stretch im a 27 yr old male i thought it was due to my broken toe but im not sure what it is but its the worst pain ever im 6’6 and it brings me to my knees

  215. Kathryn

    Thank you for this, as an active person it is disheartening to get to the point where your body doesn’t cooperate anymore. Sitting all day makes me want to stand but then standing for awhile hurts too. I just finished a PT of 2 mos and I feel like I’m back to square 1. I cannot go to the doctor twice a week forever. Diagnosed with bulging disk and hip that is ‘sticky’ but trying to get fit again and it is hard, so sore today after a measly workout last night. I used to be an avid road cyclist too and the long rides (70 miles) are what put me over the edge with this. And, previous doctors had treated me solely for the hip as this article mentions. An anti inflammatory diet helps a little but not 100%.

    • Hello Kathryn,

      Your timing is amazing as I responded to Jay’s post this morning (it may be just above or below this one) about their progressively worsening buttock / leg pain. This person started training for a 100 mile bike ride back in February. They are two weeks out and my guess is they will go ahead with this race. Chronic Pain is simply not worth it. Thank you for your post.

      Dr. Russ

  216. shine

    Hello Doc! I’m female 28 yrs old. Last month when my monthly period ends I felt something warm and like throbbing tightening feeling in my left pelvis area just above my left thigh. The nextday I felt numbness, very warm tingling pain on my hips down to my buttocks and sometimes down to my left legs. But there is no problem on my walking the next week I’m feeling better but the numbness and discomfort feeling still there. I decided to see a doctor and he said I had sprain in ligaments and gave me mefenamic. The pain was gone not until I finished my meds. It came back but now the pain is more on my left hips lower back,thighs and below the belt line ,down to my buttocks and sometimes the back of my left thigh and legs felt like something is vibrating but will gone soon. There’s no problem on my walking or setting but the discomfort feeling won’t go away. As if it felt like something is gripping tightly on left side of my hips,pelvis thighs and occasionally pain at my buttocks area. I’m so confused now if its just this or there’s something else.

  217. Jay

    Started training for a century bike ride in Feb. (This is my first time riding road bikes) My ride is in 2 weeks. Two days ago started with pain in the right ankle and back of thigh. It’s very sore in my right buttocks and I am fine once I’m up and about walking, it’s the sitting that is very painful. Applying any slight pressure along the back of the leg hurts too. I find that 600mg of Ibuprofen does nothing. I have a history of rheumatoid arthritis and a few years ago had a MRI on my spine that found nothing significant. Does this sound like Piriformis Syndrome? Stretching the muscles feels great, and I almost don’t notice any problems one I am walking. I have a 50-mi commute (one way) so it’s especially worse when I get out the car. I don’t think I’ll be able to get into the doctors before the ride. Just wondering what I can do to improve my situation but I don’t want to try something if it’s not piriformis.

    • Hello Jay,

      Sounds like it certainly could be PS. Bikers are prone to PS, Pudendal Nerve Entrapment, and other similar problems. Not sure I would advise you to go through with your bike ride — particularly due to the fact that you’ll be doing 100 miles.

      Dr. Russ

  218. mike

    This is really helpful and educating and even more precise to other diagnostic comments being posted. I actually have difficulty standing upright and walking properly due to a very painful feeling in my butt and hips. I can’t even sit properly after I use the toilet and I feel so weak and tired after I use the toilet. And after I use the toilet, I get painful swelling around my anus I believe is hemorrhoid but just can’t tell the cause of all this pain and its making my life miserable and its like it wants to cripple my life and activities. Bt with this, info on piriformis, I believe its exactly what is wrong with me because I try to stretch to feel good and the stretching is just around my hips and to exercise my leg to align my body.

  219. Kathleen

    Hi – I am getting to be a bit depressed about my condition. I have been running since I was 10 years old and am now 45. I ran competitively and my last half marathon was a 1:40. Have never had any severe injuries, ever. In July 2014 I went running one day and had no problems. They next day I tried to go and couldn’t pick up my right leg with a severe pain and lack of strength in the hamstring area. I did not run for several months hoping it would go away, but I sit here a year later with the same pain and inability to run. The pain seemed to move to my buttock and now I think it is piriformus syndrome. I have had acupuncture treatment and massage but no relief. Any suggestions?

  220. Christine

    Dr. Russ,

    I really need your help. My fiance already had 2 pinched nerves from accidents. He had 9 mm disc bulge before, got laser surgery, which went down to 7 mm, got into another accident and ended up with 2 pinched nerves. He was living with 2 pinched nerves for 3 years but was able to walk, do normal daily activities. One day, (by the way, he is in the roofing business) he was lifting something heavy and he said he felt something pop. He said his back was hurting so we took him to an acupuncture. After acupuncture right when he got off the table while i was trying to help him out of the office his legs looked like they were shaking and jello-like and he was in so much more pain than before the acupuncture treatment. His leg wasn’t hurting before the acupuncture treatment but was in excruciating pain right when he got off the acupuncture table. The acupuncturist said sometimes it takes more pain to get better, but it’s been a month since his last acupuncture visit and his pain centralized to his back and his leg was feeling better a week ago. Suddenly this week his leg AND his back is hurting and it’s like he just took 2 steps backwards and I don’t know what to do. This Friday will be the 4th week. He just felt a whole new type of pain few days ago when he got up too fast from sitting down which scared him. He thought he was getting better but after he got up too fast now he’s not so sure. We are both very scared. He’s been trying to walk around but he’s in pain when he walks so he lays down but when he’s laying down he feels like it hurts more so he sits up, but I told him sitting up isn’t good for him either so, we’re both stuck not knowing what to do and not sure how to handle this. He doesn’t have health insurance.

    Can you help? What’s going on?? I cry everyday. I don’t know what to do I just cry and cry every day while im driving, in the shower. I’m about to lose my job because I’m so nervous and scared.

  221. suzi

    Hi…I am 24 years old and for the past one year i have had severe pain on my right side. Pain feels like it coming from the inside of my bone it’s that deep. I find it hard to get up when I’m sitting or lying down. Pain gets worse when I’m on my feet for a long time. I find it hard to turn around from one side to the other when I’m sleeping. The next day pain is usually less but I can’t walk as fast as I used to. What could it be?

  222. Dylan Johnson

    im an 18 year old male, and about a week ago i was moving some furniture around and the next morning my right butt hurt really bad. the pain then went to my thigh, now its hurting my lower leg and foot. its been a week and the pain seems to be going away, idk though. what could be wrong and how do i treat it?

    • Firstly, it is highly doubtuful that this was the start of PS for you. The fact that it is getting better in a week tells me it’s probably not a full-blown disc herniation either. Head over to my DoctorSchiering.com site and check out the post called “THE TOP TEN WAYS TO LICK CHRONIC LOW BACK PAIN”. I would also consider seeing a local chiro as well.

      Dr. Russ

  223. Marcin

    Hi Russ,

    In some weird coincidence things started looking up soon after I commented here 11 days ago. My nerve issues seem to be slowly going away, first time in months. I was even able to do light squats and deadlifts with correct form yesterday. Your website helped me understand a lot of the things that were happening to me so I wanted to give back and share a few thoughts.

    I think the bottom line is that I had inactive glutes from sitting which eventually caused not only piriformis syndrome but now I see it also must have been the primary reason for sprained ankles in the past. I’m 193cm so I have very long legs. Now that my glutes are much stronger I can feel how unstable my gait had been. The thing with muscles is that you don’t know they are weak until they become strong. I can’t believe I actually used to squat 110kg with these weak glutes. My piriformis must have taken a lot of beating over the years. Actually, both of them.

    For all those people who think they are losing this battle, keep at it! Everybody says to foam roll and stretch but don’t forget to strengthen that ass. If you have a stubborn case like me it’s also absolutely essential to slowly integrate these glutes into the patterns of walking and squatting once they are woken up. Lunges are the best. This will not only prevent your injuries from reoccurring but strong glutes will actually enable you to stretch your piriformis better. Also, stretching muscles is 10x easier when they are warm and tired.

    I also mentioned before that I sometimes experienced an unpleasant nerve “snap” when I sat in lotus position. I now realize it was actually my piriformis letting go of the sciatic nerve. It was unpleasant so I intuitively tried to avoid it, not knowing that I’m actually defeating the point of stretching. As soon as I realized it’s something I should be seeking out, I started seeing effects.

    I’m really looking forward to the next few weeks and the progress I’m going to make in the gym. As much as I hate injuries they helped me understand a lot about my body – but this wouldn’t happen without people like Russ. If only more doctors looked at things holistically… perhaps I wouldn’t have wasted months thinking I have a bulging disc.

    Thanks Doc!


    • Hello Marcin,

      I would love to tell you that my supernatural powers solved your problem halfway around the world, but we both know that’s BS. I love stories like yours. I think that everyone can take something away from this post. Just be aware that not everyone is going to be able to “work through” their problem like you have. There are any number of PS sufferers would would die doing what you are doing. However, I do agree that on at least some level, at least at first, gently, wisely trying to work through a problem can be beneficial.

      Thanks for the comment.
      Dr. Russ

  224. Kay

    Hi Dr. Russ,

    I was doing exercises, leg lifts – lifting my leg to the left only about a few inches high while standing 20 reps. two days later it started with a twitching in my butt muscle (really don’t laugh 😉 ) when I was sitting and then it changed to pain deep in the butt muscle. it alternates starts with twitching and then turns into pain.The pain sometimes goes into my foot and leg and butt, or like today just in my butt on the bone part. sitting is terrible (work is really difficult) and lying on my back not so good either (so sleeping is difficult). I feel better when I stand up though it is sometimes in my foot. Is this PS? No idea what to do. Cant take ibuprofen because it hurts my stomach and its been 3 weeks of pain every day now… 😦 Help.


    • Hello Kay,

      Something in there (probably the Piriformis Muscle) has been facilitated (turned on). Be aware that there are any number of reasons this can happen. As always, follow standard protocols. You can try to gently work through it like Marcin just commented about. You can do the PS stretches. You can get some sort of massage or Tissue Remodeling. And lastly, never neglect your diet. What you eat is either driving Inflammation or squelching Inflammation. I wish you well.

      Dr. Russ

      • Marcin

        Hello Russ,

        Yes, I am aware of that – but if there is even one person inspired by my post it’s worth it. It’s very easy to fall into victim mentality when piriformis syndrome is ruining your life and nothing seems to help so success stories are important.
        If I have been able to fly over to you for a therapy, I would have done that in a heartbeat, and considering how knowledgeable you are, I would recommend that to anyone with PS. But if somebody is unable to do that, there might be a light at the end of the tunnel if they go about it the right way and they are willing to be consistent about it for months, or perhaps years.

        I’m not lying to myself that it’s over either. I’ve had breakthroughs before but I used to be foolish enough to immediately jump back to heavy training and eventually make the issue worse. It’s much better now but I can still feel sort of a “pulling” to the left in my hip when I walk or squat, even though it’s not painful. To me it’s evidence that I still have too much neural activity in my piriformis so I’m using very light weights and working on my form.

        Anyway, now I understand how difficult it is to unlearn a faulty motor pattern – so eventually sensibility is something I acquired. That’s why I said I learned a lot about my body. Now that my glutes are stronger I have the confidence that if I keep at it, don’t force it and continue with stretches, I may be able to restore the balance in most activities and later be able to reinforce the correct patterns so that I don’t get injured in the future. Being mindful about this little muscle in every step that I make is daunting but it’s doable and comes easier with time.

        Best wishes to anyone reading this.

        Kind regards,

  225. Nicole

    Hi Dr. Russ,
    I have suffered 3 years with intense pain that shoots down my right leg. When I wake up in the morning there is a tightness in my right buttock and the pain is intense, sometimes I can’t even walk. I’ve had an MRI which shows I have a buldging disc on my L4 or 5. I’ve been to massage therapist, chiropractor and I’ve had a one series of three cortisone shot, an epidural and I’m currently taking a mild muscle relaxer because I do not like prescription drugs plus 3-4 ibuprofen a day. I get some relief after a hot shower then a cold shower then taking the motrin. Now that the epidural is wearing off I’ve been told to come back in for another one. The pain in my right buttock it is more severe and now my ankles are hurting mostly in my right ankle, and I have a burning sensation that comes and goes in my lower calf. When I walk for too long my right leg goes numb. I do have a little bit of lower back pain. I’m just not sure what to do anymore. I am overweight, I’m 38 years old and I am a female. I use to exercise but am limited. I’ve begun to eat healthier but exercise is very difficult in this pain. I’m doing stretches that my physical therapist has told me to do but it does only relieve a little. I do pool exercises and chair exercises at this point. What would you recommend?

    • The very first thing I would do is try an intense Scar Tissue Remodeling Treatment on the affected area. If that does not make a difference, try some of the advice on my Doctor Schierling site (“Chronic Low Back Pain and the Thoracolumbar Fascia”).

      Dr. Russ

  226. Ruby

    I started having hip pain,and now I have ,well if I sit let’s say 15to 30min. Or more,to move or get up it will hurt as if I wore broken in between my buttocks the middle bone, I weigh 180pnds. I used to be 145,155pnds,is it because I’m now over weight ,what do I need to do ?

    • While disc problems are often related to weight issues, I don’t find that to be the case with most PS. However, overweight, disc, and some cases of PS are all considered to be “Inflammatory” problems. Visit my Doctor Schierling site for dozens of articles on the best ways to squelch Inflammation.

      Dr. Russ

  227. Marcin

    Hi Dr Russell,

    First of all thank you for your awesome website. Probably the most resourceful place on the net.

    I’ve had sciatica in my left leg for almost a year now (just turned 25, male). MRI showed a minor bulge at S1 but months of conservative treatment went by and the symptoms are still there – and constantly evolving. At first I used to have pains but these days all I have is paresthesias in my heel and the back of my leg, electric shocks in my feet when walking, and an area in my buttocks (near the femur) is numb. Also I started having wet/warm feeling in my calf recently. So all sorts of weird sciatic nerve symptoms.

    I’ve been aware that it might be piriformis for a long time and I’ve done all the stretches, flossing, avoided sitting, foam rolled, strengthened my glutes, worked on fixing my duck-foot gait. Sometimes it feels like I’m making progress and sometimes it feels like delaying something which is getting worse.

    When I sat in a lotus position or something similar, I often felt a “snap” in my butt with an electric shock going down my leg. Piriformis stretches have GREATLY reduced that which tells me it must be related.

    I have nasty trigger points in the butt/where the femur attaches to the thigh (exactly where my butt is numb). Not sure if it’s from the piriformis or hamstring or both but I had a bruise one time after foam rolling – it might be how I tumbled upon your website. It felt like something has separated or “unstuck”. There are other trigger points there which are much deeper and they’re difficult to release even though they’re immensely painful.

    Oh and when I flex my glute in a third world squat position I get a weird sensation going down my leg, almost like something is limiting the range of motion. It’s hard to describe but something is definitely “off” on that side. Could it be fascia?

    Sorry for the wall of text. Just to summarize – I feel like what I have done so far has helped me in restoring some range of motion. I remember I felt like I’m not recruiting a lot of the muscles on my left side when I squatted – they’re firing much better now. So muscle-wise it’s going good but I’m really confused and worried about the new nerve symptoms, especially the “wet/warm” feeling on my calf. I know healing takes time but sometimes I’m losing faith. What do you think?

    Kind regards,

    • Hello Marcin,

      Definitely some sort of nerve irritation. Because diagnostic imaging is so unfruitful for these types of problems, it is difficult to guess what might be causing this. I could narrow it down to the usual suspects as seen / discussed on my site, but telling you which specific one is the culprit, how severe it is, and how long it will take to heal, are virtually impossible via a history. Wishing you the best.

      Dr. Russ

  228. Beatriz

    Dear Dr. Russ.

    I’m a 18 year old female, and I have been dealing with a deep pain since I was 16. It started by only hurting at night, whenever I slept on my side. If I laid on my right, I would wake up because of the extreme pain that has settled on the area around my right upper tight and buttock. The exactly same would happen to the left side.

    My first conclusion was that I must have a deflated and bad matress, but that proved to not be the issue since the pain would happen no matter the surface I slept in. It was a soreness strong enough to make me wake more than 5 times per night, and at the end I’d be so sore that even changing sides wouldn’t help.

    It’s been 2 years and I still have the exact same pain, only it has become worse. Now I can feel it if I run and sometimes when I walk. It’s a very deep pain and it makes my sleep miserable.

    If you have any imput, I’d love to hear it.


    • Hello Beatriz,

      It’s tough to say what this is, but when I see a problem occurring bilaterally, I have to believe it’s coming from the spine — or maybe even systemic. Doubtful it is PS. What does your doctor say about it?

      Dr. Russ

      • Beatriz

        Hi Dr. Russ,

        Thank you very much for your reply. I’ve yet to see a doctor, because I’ve been trying to figure this out for myself, but now it’s come to a point that I know that I simply can’t do it alone. I tried yoga/streching/exercising, but nothing worked for the pain. The more effective method was to take anti-inflammatorys, but even that didn’t help 100%.

        If we can go by soreness, I’d also guess my spine is the issue, since I indeed have lower back pain that doesn’t ease with massages or any sort of muscle therapy.

        I’ll probably see a doctor soon, and in case you’re curious, I can pass by here once again to inform you of the results.

        In any case, thank you again!


      • Am always interested in what you find out, as are my readers.

        Dr. Russ

  229. Jogesh

    I’m 25 years old male.
    I’ve been suffering from stabbing pain in right hip(mostly) for about 10 weeks now. Along with that i also experience episodes of tingling sensation in groin and scrotum area accompanied by weak erections.
    No drug(lyrica) seems to work. Active release therapy(kind of chiropractic adjustment) provide relief but that too lasts only for few hours. After that my hips start getting sore.
    I’ve booked appointment with an neurologist and hope that he might provide me with some solution.

    • Not sure (and not surprised that drugs don’t work), but anytime someone has loss of sexual function or any bowel or bladder issue that don’t respond very quickly to treatment (make sure there is no “Saddle Paresthesia” like that seen in Cauda Equina Syndrome — see my Doctor Schierling site for more info), I would strongly consider a neurological consult — especially after ten weeks. Please do me a favor and let me know what you are told at your visit with the Neurologist.

      Dr. Russ

      • Jogesh

        My neurologist sent me to get MRI focusing on Pudendal nerve. Report showed a lipoma 2.5 cm in size on anteroinferior margin of left piriformis muscle over which pudendal nerve is draped. Then he sent me for nerve root injection targeting pudendal nerve to conclude whether it was lipoma around pudendal nerve causing problem , which I underwent.First two days, symptoms would flare up, but on third day my tingling and pain decreased considerably and i was able achieve erections. this continued for about 5 days and now all symptoms are coming back.
        Whats your take on all of this.

      • Hello Jogesh,

        I am no expert, but you have a fatty tumor that is approximately 1 inch around, and it sounds like it could be causing much of your problem. I would talk to your doctors and maybe even get another opinion.

        Dr. Russ

  230. carol

    I have been diagnosed with ishieal bursitis. I’m wondering if this could be fro. Pirformus syndrome. I do have this issue and USUALLY massage therapy relieve the hip pain and SI pain but the sitting is still issue.

  231. Dan Orcherton

    I have a pain in the lower part, to the right of the anus. It hurts when I sit for a bout an hour or so. It is fine when I get up and walk a little. Not sure what to do. Can you offer a solution. I had a right kneww miniscus tear about 5 months ago, and I am taking Ntures Way (Joint restore) (Glucosamine+Chondroitin and MSM. WHat do I need to do? THanks Dan

    • Not likely a supplement is going to solve this problem. My first thought is Weaver’s Bottom or Ischial Bursitis, which you can read about on my Doctor Schierling dot com site. I also have an article called What are the Most Common Causes of Butt Pain?“.

      Dr. Russ

  232. Joy

    Hi i had sharp pains come and go in my but while sitting. Leg would often hurt along with my hips. While standing on my feet would hurt also. My toes started getting numb. Then later felt like i was walking on a ball. Had pains in my legs until now they have given out where im not walking. I can move them and stand on them but too stiff to walk. Almost be two years no knows whats wrong with me.

  233. Adi

    hi im getting pain in the butt when i drive more than an hour, driving a bike not a car, i dont experience much pain driving car. I live in india, so we are dependent on bikes rather than cars. I don’t kno if this is associated with piriformis-syn., but its miserable to have that pain. No i haven’t showed this to any doctor/consulted a doctor., it usually occurs while driving back home, rather than going to college. My college is around 25kms from my place. please help!

    • Hello Adi,

      Doubtful this is PS. Look at the test I have talked about numerous times in this thread. I would spend some time foam rolling or using a tennis or similar ball to roll around on. Also, try doing the PS stretches for your glutes and TL Fascia and see if this helps.

      Dr. Russ

  234. emily

    I am a 21 year old female personal trainer and hence do a bit of resistence training and run quite a bit. Earlier this year i began getting a very deep pain in my right buttock and hip area. I thought it was my hip flexor but a sports therapist said i had extremely tight piraformis. Whenever I would pick something heavy up I would get a sudden pain in my buttock. Its getting worse but the thing is that it never hurts while I train or run only after even if i stretch. When it is massaged I get a numbness down the side of my leg into my tibialis anterior and outer ankle.
    Do you know what this is?? And how do I make this pain go away?

    • Hello Emily,

      I have left several links to the “Test” I use in the office. Although there is no sure-fire way to know whether or not this is PS, disc, or something else, use your search feature to look for the word ‘test’ then do it.

      Dr. Russ

  235. Kim

    Hello Dr Russ,
    When you say “faulty spinal mechanics”
    would a spinal fusion (L2-L5) be included in that description?
    I have painful adhesions after a discectomy just below the fusion.
    I have additional (different) pain that wraps around my hips and is also deep into my buttocks. Pretty sure this different pain is from something other than the adhesions.
    I greatly appreciate that you explain things in layman’s terms, as I’m not a medical professional.
    Any thoughts or ideas would. Be greatly appreciated.

    Thanks, Kim C.

    • Hello Kim,

      Sorry I was not clearer about that, but yes, a four-level spinal fusion would count as, “faulty spinal mechanics”. According to the latest medical research, it’s extremely difficult (many would say impossible) to tell what pain is coming from what tissue in a normal spine. Once you’ve fused those segments, all bets are off. Bear in mind that this does not mean there is no hope for you. It just means you have to attack these things from any number of angles (Biomechanical, Anti-inflammatory Diet, Gut Health, etc, etc, etc). I wish you the best and if there is any way I can help you out, please don’t hesitate to ask.

      Dr. Russ

  236. Kimberly W.

    Hi Dr. Russ,

    I am writing today to get your opinion on what might be the cause of constant pain in my right hip. It started off in February of this year with just a minimal uncomfortable pain when I laid down at night. It eventually got to the point that I could not sleep due to the pain going all the way down my right leg and causing a numbness and sharp shooting pains on my right hip/buttocks area. I went skiing the beginning of March of this year and after that trip and during it, the pain intensified. I tried a chiro and he did EMS on me but told me that I was too tight to even work on and referred me to a Sports Medicine doctor. I went to see the Dr. and he did a minimal exam and touched what he said was my bursa sac and identified that what I was experiencing was Bursitis. He suggested an injection in to the Bursa Sac and I agreed as I thought he would know best. The pain from the injection of the bursa sac was excruciating. He told me that I would feel better within 4-5 days. The pain went away for a couple of days (not for at least 7 days later) and then came back. My workout is being affected and I am wondering if the workout could also be the issue. I do Barre, Flywheel (used to do this but it hurts too bad now), and TRX training and I play tennis. The pain isn’t going away and my friend suggested your site as it seems I might be experiencing PS. Does this sound like PS instead of Bursitis to you? Should I be limiting my exercise or increasing my stretching more? Thanks ahead of time for your response.

    My best,

    • Hello Kimberly,

      I have never seen a case of Hip Bursitis causing Sciatica. Too tight to work on? Go over to my DoctorSchierling.com site and read my post called “Chronic Low Back Pain and the Thoracolumbar Fascia“. I recently wrote about these injections and their guidelines, and the fact that they are not very effective (and are very degenerative). This could certainly be PS but it is so hard to say without more info.

      Dr. Russ

  237. Laverta

    I hope someone can supply me with some answers. I am a 47 year old female who was diagnosed with Sciatica about 4 months ago. I had started having unreal tightness and spasms in my buttocks and the back of my legs. I have Googled several topics in regards to this and was practicing multiple stretches at home to try and get some relief. The muscle relaxants they had me taking where not providing much if any relief and seem to be causing a exacerbation of my chronic migraines. The pain and spasms have now advanced to my outer foot. Actually both feet are being affected. I am have unbearable pain and cramps in the outer portion of my feet opposite side of my arch. Nothing I do seems to relieve the pain. Now to make matters worse the other day I was taking my very large dog outside and was heading over the back deck steps. My dog saw something and shot after it before I realized what he was doing . So I immediately became airborne off the the steps and while in midair I hear and feel a loud pop up under my right butt cheek. Then I landed on the ground. At first I was afraid to try and move I first thought was I had broke a bone somewhere because of the loud pop/snap sound I had heard as well as the pain that I felt with it. Then I did attempt to get up and immedately could tell my back right leg muscle and butt muscle was not as tight but instead now I am experiencing increased pain up under my right butt cheek especially when I sit down. It is now painful to touch. I’m afraid to try and stretch those muscles now. I don’t know if a muscle or tendon tore or ripped or if there is a bone up under there that broke. I carry a chronic low vitamin D level and have broke just about every toe on my feet just by knocking my feet into something. So it seems as though I’m predispose to brittle bones or osteoporosis although I have never been medically diagnosed with osteoporosis. I sure hope someone has some answers for me. The pain and cramps in my feet is really becoming unbearable and now this pain/injury under my right buttock really hurts and has me worried. I’ll end by adding I’m still having muscles spasms in the back of my thighs it just isn’t as tight or as bad as it was before I heard the loud pop when I went flying off the steps. Thanks in advance for any input. Laverta

  238. O

    Hi Dr Russ. I have been having pain deep in the left side of my buttocks for some time now. However I can’t say if it started before or after I had my baby one year ago. I’ve always had lower back pains on my left side (before pregnancy as I had sprained my back some two years prior) but this sharp pain only became painfully noticeable recently when I lie on my back for an extended period. Attempting to move afterward always feel like I’m trying to bend or stretch something too taunt or stiff to move. (I should also say that my hips are 56ins and so I have a deep arch when lying on my back – don’t know if that’s improtant). However, I’ve had six ultrasound treatment sessions but the pain is still there… Is this piriformis syndrome and what other treatments can I utilise? Will it ever go away? I love the gym but I am afraid to workout now thinking that I might aggravate the inflamed area…. But this inactive lifestyle is also seeing me packing on the weight slowly and am sure that can’t be good either……

    • Hello O,

      My opinion based on 25 years in the field is that ultrasound rarely provides great results — particularly for severe problems. You need to try some form of hardcore tissue remodeling as seen on my Doctor Schierling dot com site.

      Dr. Russ

  239. Brian

    Hi there. Would love to have your opinion. Among other things I suffer from L5 spondylolisthesis over S1, with local pain and nerve pain in the legs/feet.

    I have a long story but I will just focus on one bit – about 2 months ago pain in my rear hip, side hip, and butt area (which has been there for years in various mild forms) rapidly increased over the period of about a week. There is no additional/different nerve pain that came along with this. In the past I could relieve my butt pain by going for a good walk. Now, with the pain much worse, nothing helps other than laying down – even better if I lay down on my back. Heat helps but not much, as does working into my butt with a Body Back Buddy tool. These two things give me more transient relief that lasting relief. I have pills for my back and chronic headaches but they don’t much help my butt pain. My pain management doc thinks it’s referred spondylolisthesis pain but my experience is that every different doctor will have a different opinion about something that isn’t totally clear cut… appreciate your thoughts

    • Brian

      I personally think that my SI joints might be involved. My hips/legs are uneven even with a lift in one shoe, and I had an xray once that showed possible signs of arthritic SI changes. A lot of this pain I describe is very close to the sacrum, especially later in the day, which I suspect is why my pain doc is so quick to blame the spondylolosthesis. I am a 25yo male by the way. Thanks

      • Hello Brian,

        Firstly, what grade is the spondylo? Butt pain often times arises from SI issue (I have a couple articles about this on my Doctor Schierlilng dot com site), but your doc could be correct about the spondylo. Also, have you tried the piriformis stretches?

        Dr. Russ

  240. M

    Hi, I’m a teenage endurance athlete and I think may have this however I don’t match a lot of the symptoms. I’ve recently got back into running after an injury to my iliac crest due to what we assumed, was growing and overworking however after developing another pain in my hamstring/hip/buttocks I am beginning to doubt this explanation and wondering if it may be this or something biomechanically at fault. It aches slightly however I don’t pay attention to this, I get a sharp pain with weight bearing on my hip and it feels like I can’t move it as freely when weight bearing in contrast to the other side, and it hurts to bend down with my legs not bent. I went to physio and found everything was fine except having tight hamstrings due to growing and an slightly flat arch- which could a reason for my pain however it feels deep inside my buttocks near my hip. It hurts to walk sometimes when I’m thinking about how I am walking, so I don’t know if it hurts to walk normally and I’m almost as if limping. I’m also getting intermittent pains in my knees I’ve tried ice, rest, stretching and it hasn’t seemed to ease off! I’m so sick of being injured! Do you have any idea to what it could be if not piriformis syndrome and have you seen any similar cases? I know I’ve probably totally misdiagnosed myself and will have only irritated a muscle however it’s hard not to come up with possible explanations and going to the doctors never really seems to prove that helpful.Thanks for your time and I’m so glad I came across this page/article?


    • Doubtful this is PS. However, it is almost certainly some sort of myofascial issue. Depending on where in the illiac crest your pain is, this could be pointing at a muscle imbalance issue, particularly in a hip flexor, IT Band, or one of the abdominals.

      Dr. Russ

  241. Leta pritchard

    i fell on left leg then rolled onto left hip then i fell over on my coffee cup landed on ribs broke 3. Now horrible pain down left leg and on butt more towards rectum can’t sit. My left leg is numb on the outside all the way down from hip to little toe can’t stands for sheets to touch that part of my leg cant get answers

  242. Jeff a

    I have been having severe buttock pain on my right side. When I lay down at night it goes away. I took three days off from running. When I went back to it, I tried to run 6 easy miles at a 7:23 pace. By the third mile I had to stop the pain in my buttock was debilitating. someone please help

  243. balaji

    i am 21 years old. I have pain down my right leg for the past 3 months. back of my thigh and region between right low back and upper buttock hurts while sitting. i feel pain in all parts of the right leg sometimes especially the outside hip. can u predict what could be cause of this pain, herniated disc or piriformis syndrome?

    thanks in advance

  244. Keeandra

    Hi I’m 23 years old and for the past 5 years I’ve experienced pain in my right half of my butt and recently the pain has been more excruciating maybe because I drive a lot but the pain starts from leg and goes all the way up to my butt only a really deep stretch helps the pain nothing else. I’m just wondering what it is? Would you recommend deep tissue massages? If not what else would you recommend?

  245. Nona

    41 yr old female, not overweight, physically active (fitness instructor) and started having low back (si joint) issues about 10 yrs ago. This was right after I had my 1st born. Pain seemed to come off and on, back would go out about once every year. Very doable right? This past year, my back has gone out a lot more and now have non-stop butt /hip and SI joint pain. Stabbing and sharp pain only on the right side.
    Doctor said its piriformis syndrome irritating the sciatic nerve. I am going to a chiropractor regularly and it seems to help a bit even though it is still there and I have good and bad days.
    I also think I have hemmorhoids, in and external. Could that contribute to this? Not sure, just wondering. I’m doing everything I’m supposed to do. I eat right, I’m active, I stretch, meditate and sleep well. Anything else you can recommend I should do? Getting hopeless at this point!

  246. Vanessa

    This type of pain started during my last pregnancy. It was so bad some days I could not get up to walk with out feeling the worst pain ever imaginable. After delivery it miraculously disappeared. Its been a year and a half and it’s returned. And getting a little bit more painful every day. my dr sent me for an mri and of course found nothing. I’m not sure what to do moving forward.

    • Hello Vanessa,

      All I can tell you is that women get PS at a much greater rate than men. Whether knowingly or unknowingly, much of this starts with childbearing. As far as moving forward, keep your eyes on my Doctor Schierling dot com site because I am going to do a PS “self-help” post in the very near future.

      Dr. Russ

      Dr. Russ

  247. Rebecca

    46 year old female. I have lower back trouble for many years and it was mostly due to having 5 children and carrying them around on my hip. However, a few months ago, I began to feel a deep ache in my right buttock. I could feel it when I walked or stretched a certain way. The pain is worse at night, so bad that I resorted to trying to sleep sitting up, and then just dreaded night time. I just didn’t want to feel the pain and the fear that happens when you can’t roll over, or move, and when you finally can, it is so painful. I’ve tried to describe the pain to my oldest daughters, and it is so difficult to describe. It’s like a Charlie horse, dull ache, “stowed up”, unbelievable sort of pain. I finally broke down and went to a Chiropractor here in town and I’m praying his treatment will relieve me of the pain and let me sleep again. What I’ve read on this site, seems to be exactly what I’m feeling. I want my Chiropractor to read this site!!! I can’t afford the care I need, (single mom to all those angel babies!) is there anything you can tell me to do that is the most important that I can do on my own? I see all the stretches and I’m already doing some, although a couple hit the spot exactly and it really hurts. Also, I’ve a had a rash on my shins for over two years. it comes and goes. Mostly my right leg. One day a few months ago, I woke up with a huge indention in my shin, right next to the rash.(went to the ER, they said take Benedryl) My ankle looked swollen. Can this Piriformis muscle be causing this slight swelling and maybe even the rash?

    • Hello Rebecca,

      Firstly, bear in mind that there is a distinct possibility that this buttock pain could be the result of a disc issue. Secondly, any time you irritate a nerve, there is irritation along the path of that nerve. This can manifest in nothing tangible, symptoms such as pain / numbness / tingling / etc, or it can sometimes exhibit visible or non musculoskeletal symptoms (sometimes these might seem unrelated — HERE). As far as relief is concerned, look back at the link I gave on Thoracolumbar Fascia (it has a number of self-help items). You could also try sitting on a ball or foam roller. Sometimes stretching is counterproductive if the adhesed tissue is not broken up first.

      Dr. Russ

  248. Mike A

    60 year old male…terrible ache in right buttock area. A PT says its Piriformis Syndrome.. His services did absolutely no good. Walking for a 1/4 mile starts the pain…within a 1/2 miles pain go to a 8 or 9… If i start running the psin goes away instantly… When i stop running the pain comes right back… I bicycled 120 miles recently and had absolutely no pain. When i unicycle i get pain…tylenol, ibuprophen does not help…i have been running, swimming, bicycling for 43 years. The pain started about 3 years ago.

  249. sandra

    I have had si joint injection they worked for 3 weeks. Pain is back.which includes pirifmoris pain. It’s been over 11 yrs now of pain. How can I know if my si joint or pirifmoris is causing my chronic sciatica? What tests do u recommend as mri was clear?

    • Hello Sandra,

      There are some simple orthopedic tests that can help, which every chiropractor is familiar with. As far as imaging, these sorts of problems — especially when there is a substantial fascial or muscular component — don’t image well.

      Dr. Russ

  250. Katherine

    My name is Kat, I am 27 years old and recently gave birth to my first child. I knew I would be sore but my butt is STILL sore and it has been about 9 weeks! The doctors and nurses told me it would subside after about 6 weeks, and to expect tenderness since my knees were literally AT my ears while delivering. I hurt after resting or sitting for more than ten minutes or so, getting up helps a little bit, but I am always hurting. Is it possible that during labor/delivery I stretched my glute muscles so far that now I have scar tissue in the Fascia? Is this the beginning of Piriformis? What can I do to relieve the pain, are there specific stretches that help?
    Any help you can offer would be appreciated! Thanks!

  251. Natalie

    I’ve had a really low ache/pain in my lower back for 4 weeks, came on overnight, feels sore when sitting or bending forward, fine standing/walking/running.
    I do weightlifting but cannot recall a ‘bad lift’ or twinning my lower back.
    It’s really low near my butt crack and feels really deep, cannot foam roll it away.
    My sports therapist thinks it is SI joint dysfunction, what do you think?

  252. Tori

    Hello Doc,

    I am 21 years old and I just had a baby 6 months ago. I had a normal pregnancy and a vaginal delivery with an epidural. I developed some really debilitating sciatic pain shooting down my left leg a couple of days after I came home from the hospital. I don’t think the epi had anything to do with it. At first I thought I had a slipped disc but then I realized the pain is more localized deep in my lower buttock next to my hip. I take ibuprofen at least twice a day and I’ve noticed that when I’m up and active at my job I notice the pain less than when I have been sitting down for a while. I feel like an 80 year old woman when I get out of bed in the mornings and sometimes the pain keeps me up at night if I haven’t taken ibuprofen. It’s like a constant stabbing pain in my hip and it jolts all the way down to my pinky toe. I went to a couple chiropractor sessions to get adjusted and some pressure relief but it didn’t seem to help. I’m not as active as I used to be because it hurts so bad I want to scream. What can I do to make this pain go away?

  253. Katherine Palmer

    I am 27 yrs old and gave birth to my first child about 9 weeks ago. My buttocks has been super sore ever since; the doctor/nurses said it would be for about six weeks but I hasn’t got much better. It’s it possible that I stretched out my muscles (my knees were literally AT my ears during delivery!) and am now suffering due to scar tissue in the fascia?
    I don’t suffer from sciatica, but I do get Plantar Fasciitis and it has been flaring up the last couple of weeks. Is this ache going to subside or am I likely to hurt for the rest of my life!?

  254. Denise

    So you just live with the pain? I have been in pain for going on 5 years now. No doctor can find anything wrong according to my Bloodwork.
    My pain is so severe that I wake up every 45min to a hour of sleep.
    The pain is in my butt.. more in the hip and pelvis area leading down to the bottom of my feet. I can not walk in the mornings for the first 15 to 20 min
    Is there a specific blood test for this?
    Any information would be great.

  255. Monina

    Thank you very much for the information. I just would like to ask how many in your practice had the piriformis syndrome as a complication of a total hip replacement? I had bilateral hip replacement and my left was affected that I developed a “foot drop”. The pain is so severe and I’m wondering what I can do as not to let the same thing happen to my right. What to do for my left that has already been damaged I think. Hope you could help me. Thanks. …. Monina

    • Hello Monina,

      I have seen some people with messed up Fascia after having a total hip replacement. Did see a gentleman once who, due to an array of complications, ended up with four different replacements in a couple year period. He had a scar that looked more like a trench at the area of his trochanter. Was able to help him about 60% over three treatments. He had lots of symptoms of PS, but I’m not sure it that’s what you would call it.

      Dr. Russ

  256. Kimberly

    Hi Doc. I am 52, 140, 5’7 female. Recently underwent 3 EPI for DDD(s1,L4-5) and it has helped significantly. However, I believe 2 things are going on and have told my doctor this. RS pain in the hip/upper buttock pain that feels like a spike in the bone has not benefited from the EPI(which I hope never to do again, neck headaches now, getting better each day tho). Hip pain comes on at night after a few hrs of sleep and WOW it wakes me and I have to stand and walk around. Ive been an active woman until this last year. I am the primary driver and have height arches(wore a lot of heals in the day). Any advice would be appreciated as I must convey to my Doc some idea of its source. As you have said ” its not his pain in the butt”. Last two nights have been worse, -6 in Michigan right now, just mentioning as some days I feel like a human barameter. MRI showed some arthritis but nothing worth medicating. Have pain meds for the really bad nights, Thanks for this sight!

    • Hello Kimberly,

      It can sometimes be nearly impossible to tell the difference between a lumbar disc issue and Piriformis Syndrome. As far as the injections go, while I am a huge fan of avoiding surgery if at all possible, you have to understand that STEROID INJECTIONS present some unique problems (i.e. side effects) of their own. The very first thing I would suggest that you do would be to declare war on INFLAMMATION (without the drugs). Click on the link and start reading the posts for more information. Glad you enjoy the site.

      Dr. Russ

  257. Patricia

    Hello, I am 12 years old. This has been happening to me for a long time. I work out, I have a job, and I frequently move truck loads of stuff in and out of a form of storage space. It hurts to walk. It hurts to sit. It hurts to sleep. I commonly find an aching pain in middle part of my butt. Some days I have trouble walking because my leg( any part from the thigh to the feet) hurts. I don’t know what to do. I am so discomforted, I don’t even want to sit down, or really walk anywhere. Can you tell me what’s wrong? Also, every time I sit down, my feet become numb.

    • Hello Patricia,

      There are a couple of clues in this history. Firstly, I am impressed that a 12 year old has a solid job and works out (maybe you’re 21 and transposed the numbers?). An inability to sit is characteristic of PS, but is also a common characteristic of disc problems as well. Because both of your feet go numb, I have doubts about PS. It almost makes me wonder if you have a Grade III (or even IV) Spondylolisthesis. Tough for me to say, but at your age I would have this at least looked at and evaluated by someone who knows what they are doing.

      Dr. Russ

  258. Emily


    Thank you for your informative articles! I’m 21 years old and in mid/late Oct. of 2014 I began to get an aching pain/tight feeling in my lower butt and hip area. I thought maybe it was due to the cold weather approaching, but now I’m becoming more concerned it’s something else. The pain is only in the right side, no tingling or discomfort in other areas of the body aside from lower back pain, but my current job cleaning houses could be the culprit of that (also, some intense lower back pain when my period starts is normal for me)
    Going up any kind of stairs or even doing some gentle yoga where leg raises are involved, I can hear something not quite like a popping or grinding but something in my hip area does make an audible sound. It is more uncomfortable than anything and happens in both hips, although the right side is more prone to pain afterwards.
    There are some days where I wake up and have a kind of limp because of the discomfort. sitting for long periods of time and especially sleeping is difficult. I try to have a pillow between my legs or to sleep on one side to help (lying face up with legs straight gives me a cramped feeling in the afflicted area, making it worse) right now I’m only occasionally taking Aleve or Advil for this.
    I used to regularly see a chiropractor around the time I was in high school for frequent tightness/tension in my back/neck (which still troubles me to this day but I cannot afford to return) during the examination I was told I have flat feet but there was never any mention at the time of potential hip problems?
    a few weeks ago I went cross country skiiing and fell a couple of times on my butt—could this have done something significant to worsen the pain? It’s much more regular since this incident.
    Thank you in advance for any advice you can give

  259. Chelsea

    HI Doc, I’ve been dealing with some sort of piriformis syndrome for 3 years. It comes and goes and then comes back with a vengeance, leave me in terrible pain, not being able to sleep at night and making it painful to sit at my desk, drive, etc. My leg will go numb and tingle at times, sometimes the pain will shoot down the back side of my thigh. Stretching temporarily relieves the pain as well as having someone dig their elbow into it (under my pelvis)… I’ve been referred to physical therapy so I hope it works, but my general doctor did not take me very seriously at all because I wasn’t in pain when I saw him about it. It’s right where a wallet would sit on my butt… it’s a deep pain that feels like it’s under a bunch of muscles. It’s certainly the most annoying thing I’ve dealt with and I can’t live the rest of my life like this. I’m only 27… Pointing me in the direction of a few options to cure this would be helpful. Thank you.

    • Sounds like Piriformis Syndrome. Be at least somewhat cautious with the elbow. I recently treated a woman who was living a normal pain-free and active life until someone put an elbow in her buttock. She developed PS from this that has turned her life upside down. As far as where to find information, I would say that by BLOG POSTS on the subject are a good place to start.

      Dr. Russ

  260. Michelle

    I hope you can help me to figure out what’s going on… Approximately 10 months ago, after a yoga class I attended regularly, I was walking through a grocery store and experienced severe “cramping” in my left hip area. This went on for months, sometimes episodes worse than others. A sports med doctor, after an mri that showed nothing wrong, diagnosed piriformis. I’ve also spent hours in physical therapy, cortisine injections, tens sessions and it still hasn’t gone away. However, my pain doesn’t come when lying down or sitting, its when I walk or stand and aggravated by running or hiking. The pain is excruciating and it’s completely changed my very active lifestyle. I can get the pain to subside with reduced exercise, but it always returns when I resume normal workouts. Help please….

  261. Keith

    Doc, I am confused whether I might have PS, hamstring syndrome, or possibly something else. It all started with carrying a heavy load and a quick unbalanced position that caused shooting pain up my back(pins and needles). At first I figured I pulled a muscle in my lower back, left side. My back was very stiff and painful for several weeks, but it gradually subsided. Now I am back to running, lifting, yoga, etc., however, my hamstrings (specifically where they attach in my buttocks) are extremely tight and I have lower back stiffness/tightness. At one point I had tingling down my left leg for several weeks; although, that is virtually nonexistent now. Using a massage roller or rolling on a hard ball I can feel pain around the outside of the boney part of my buttocks and lower part of my back. Nothing seems to bother me when exercising; afterwards though I can feel my hamstrings tighting/knotting which eventually refers into my lower back. This is more pronounced with any exercise involving the hamstrings. If I massage my hamstrings when they tighten it seems to release the pressure, but only for a little while before things tighten up again.

    Any ideas? Thanks..

    • Hello Keith,

      This could be any number of things. Bear in mind that part of the hamstring muscle actually attaches to the sacrotuberous ligament. This is why problems in this area can be cause by hamstrings, piriformis, thoracolumbar fascia, or all three (HERE).

      Dr. Russ

  262. Tim raleigh

    my right butt cheek pain meets a lot of the criteria, but is relieved by sitting. it’s more of a very strong stabbing pain if I activate the muscle in the wrong position. I have also had the same pain but in the groin, which seems like it might be the same problem but on the opposite side; it’s never been on both sides at the same time. the butt cheek pain seems to be triggered by pressure on the tail bone (SIJ I think), eg lying down flat on a flat floor will trigger it straight away. the groin side pain seems to be triggered by sleeping on my side without a pillow between my legs. any thoughts? thanks greatly

  263. blackwell1117

    Dr.Russ my left buttock started aching at night a couple of days ago then today while sitting at my desk working i began to experience sharp shooting pains intermittently in the outside of my hip. The pain comes and goes sometimes strong some mild. Mostly when I’m sitting or lying down occasionally when walking but it never stays long. No problem walking or standing or dancing. A lol tenderness on my hip bone when I press on it. I also had some.numbness when ever I laid on it but after massaging it it was fine. could this ps?

  264. luv2teachu

    I am almost positive I have PS. Deep buttock pain that is “hard to find” when being massaged, began when I was a runner, pain and numbness down my leg. However, my leg pain is on my OUTSIDE thigh, instead of the back. Have you seen this? Thank you!

  265. Debra Nelson

    Hello,, I’m not sure if I’m doing this right and if it will show up here, but here goes. About 7 weeks ago during Bikram hot yoga I was doing a floor pose called sitting head to knee. I was sitting with my left leg out at an angle, my right leg bent and my right foot pressed against my inner left thigh. We are to then have our arms stretched up above our heads, clasp our hands, turn our body to the left and bend down and grasp our feet 2″ below our toes and then curl and bend down to touch our head to our knees. I’ve been doing this hot yoga for 4 years but during that class 7 weeks ago I lost concentration and I turned my body, bent over and then ‘adjusted’ my left leg by walking my buttock a little forward all at the same time and I felt something….can’t really describe it, it didn’t hurt, it just felt odd, wrong. I was able to finish my practice without a problem. Later than evening I started to experience pain in my upper left thigh, at the very upper part, and I’ve had it since then. I cannot touch my toes from a standing position anymore without experiencing extreme pain in my upper left thigh, it almost feels like the pain wraps around my upper left thing. The only other time I feel pain is when I try to take a running step, then I feel pain in the front top of my left thigh. I have been to a physio therapist who said I have torn my gluteus medius, a licensed massage therapist who says I have tight (erector?) muscles in my back and a D.O. who says it’s my piriformis. When I research all of these suggestions I don’t feel like I fit any of them because my pain does not worsen with sitting or lying down. I can do any movements, including all yoga poses except the ones when I am standing with straight legs and bending forward at the waist or just running/taking quick steps. I can also put all of my weight on the left leg without any issues as well. Can you please help? Thank-you for your time.

    • This is almost certainly not PS — at least not yet. It is, however, some sort of myofascial issue — probably a Fascial Tear tear (microscopic) of some sort.

      Dr. Russ

      • Debra Nelson

        Thank-you so much! I did some research just now and yes, I seem to have more of those symptoms than the other diagnosis that I have received. Would you suggest I do some stretches of that area and in the meantime avoid hot yoga until my pain has gone? or could I continue with hot yoga and just avoid doing any of the poses that would cause pain?

  266. Lyle

    In advance, I want to say really appreciate any insight. I am a 29 year old male, former competitive athlete now suffering from intense pain in my right upper leg/butt cheek while sitting. I pulled/tore a hamstring 11 months ago sprinting in a kickball game (stupid, I know). I rehabbed my hamstring back to 100% over a five month period. I have since tweaked this muscle twice. The first time I was back to 100% in a couple months, the the second time has been a different story. What felt like a minor aggravation has turned into an almost unbearable pain while sitting. I have been told it is a hamstring issue by a PT, but the pain is much different than what I previously felt. In addition to rehab-centric stretching, strengthening exercises and an Aleve regimen, I have had Graston techniques, dry needling, stem and ultrasound performed on me – nothing is working. In fact, I’d say it’s getting worse. I also have a history of neck, pec and back issues, although these never previously translated into leg issues. What are your thoughts? I have an appointment with an Ortho/sports medicine physician this Friday. Will an MRI reveal what my issue is (and hopefully shed light on a treatment)? Should I get a Cortisone shot?

    Thank you

  267. gsrinteriordesign

    After trying to really pinpoint a cause of my discomfort I honed on a possible piriformis injury and your site. Two years ago I over-extended doing a standing bow pose and heard a ‘pop’ and experienced significant pain (in the standing leg). I immediately worked with an excellent therapist who, with some great stretching sessions, greatly alleviated my issues walking and with stairs, but I have lingering pain deep in my left buttock and have ever since. It is definitely exacerbated by sitting for extended periods of time and I’ve never fully regained flexibility on that side. That said, unless I’m doing something strenuous it’s much more like a very restless discomfort (eg during long flights or extended running). Given the activity that is the source of the injury and the remaining symptoms do you feel that it is indeed damage to the piriformis muscle?

    • You definitely “popped” some tissue somewhere. Whether it’s the piroformis or not; who knows? It certainly could be. Honestly, the first thing I would do at this point is to sit on a tennis ball and “waller” around on it in the area of pain (you might need something harder like a baseball). Or you could have your husband stick his elbow in the area and work it out. You have to be careful because one of the worst cases of all out debilitating Piriformis Syndrome I ever saw was the result of a massage therapist getting over-aggressive with an elbow in a 60 year old woman’s glute. She had moderate discomfort until that point. Although I admire her toughness, she is virtually incapacitated at this point.

      Dr. Russ

      • gsrinteriordesign

        Thank you for the thoughts!

      • CORTICOSTEROID INJECTIONS are always a roll of the dice. Part of the hamstring is attatched to the Sacrotuberous Ligament, which is itself intimately related to the Piriformis Muscle. Search my DoctorSchierling.com site, as I wrote an article on this (it may be at Spinal Decompression Missouri). Bottom line, if you have scar tissue in that hammy you run the risk of repeatedly “tweaking” it.

        Dr. Russ

  268. laritaraine

    I have been complaining of right “hip