Piriformis Syndrome Treatment
Also known as: deep gluteal syndrome, extraspinal sciatica
Piriformis syndrome treatment aims to reduce buttock and leg pain while helping you return to comfortable movement and daily activity.
What is piriformis syndrome?
Piriformis syndrome is a neuromuscular disorder that occurs when the piriformis muscle, located in the buttock region near the hip joint, compresses or irritates the sciatic nerve. This irritation or compression leads to inflammation and causes symptoms such as buttock pain, tingling, numbness, or radiating leg pain similar to sciatica. The piriformis muscle plays a key role in lower body movement by stabilising the hip and assisting in rotating the leg outward. When this muscle spasms or becomes tight due to injury, overuse, or prolonged sitting, it can pinch the nearby sciatic nerve, resulting in persistent pain and discomfort. Piriformis syndrome is a clinical diagnosis and is often a diagnosis of exclusion, as its symptoms can overlap with other conditions.
What is the treatment for piriformis syndrome?
Treatment for piriformis syndrome focuses on relieving pain, reducing inflammation, and restoring hip and surrounding muscle mobility. Initial approaches usually involve conservative methods such as physical therapy, stretching exercises, and activity modification to avoid prolonged sitting, as well as muscle relaxants or anti-inflammatory medications to reduce muscle spasm and pain. Over-the-counter NSAIDs like ibuprofen can also help reduce pain and inflammation associated with the condition. Physical therapy often targets the piriformis muscle and surrounding gluteal muscles to improve flexibility and strength, which can help alleviate pressure on the sciatic nerve.
When symptoms persist or worsen despite conservative care, more invasive treatment modalities may be considered. These include ultrasound-guided piriformis muscle injections that deliver a combination of local anaesthetic and steroids directly into the piriformis muscle. These injections aim to provide short-term pain relief from the local anaesthetic and longer-term relief by reducing inflammation. For severe cases with sciatica-like pain, botulinum toxin injections may be used to temporarily relax the piriformis muscle, helping to relieve muscle spasm and nerve compression. Prolotherapy and platelet-rich plasma (PRP) injections are additional options, though their effectiveness is less established.
In rare cases where non-surgical treatments fail to provide adequate relief, surgical options such as sciatic nerve decompression or piriformis muscle release may be recommended. Endoscopic techniques are preferred over open surgery due to better outcomes, fewer complications, and faster recovery times. Surgery is typically reserved for severe cases with persistent pain affecting daily activities.
Hospital fee guide price: £1,820*
More about pricingBefore the injection
Before undergoing a piriformis muscle injection, you should inform your consultant about any allergies, current medications, or medical conditions to ensure safe administration. The clinician may perform a physical examination and use imaging techniques such as ultrasound or fluoroscopic guidance to accurately locate the piriformis muscle and surrounding structures. You may be advised to avoid anti-inflammatory medications or blood thinners before the procedure to reduce the risk of bleeding or bruising at the injection site.
During the injection
During the injection procedure, you will be positioned comfortably to allow access to the buttock region. Using ultrasound-guided injection techniques, the consultant inserts a needle precisely into the piriformis muscle, avoiding nearby nerves and blood vessels. A mixture of local anaesthetic and corticosteroid is then slowly injected to reduce inflammation and provide pain relief. The procedure is generally quick and minimally invasive, often completed within a few minutes. The duration of relief from corticosteroid injections can vary, lasting for weeks, months, and occasionally longer, depending on the individual.
After the injection
Following the injection, you may be briefly monitored for any immediate adverse events, such as allergic reactions or temporary numbness. Some soreness or mild pain at the injection site is common but usually resolves within a few days. You are typically advised to rest and avoid strenuous activities for a short period to allow the medication to take effect. A follow-up appointment may be scheduled to assess symptom improvement and determine if additional treatments are necessary. Physical therapy is often recommended after the injection to maintain mobility and prevent recurrence of symptoms.
Appointment and Treatment Plan
Assessment
Your clinician assesses your symptoms, movement patterns, and hip function to determine whether piriformis syndrome is contributing to sciatic nerve irritation.
Diagnosis
A clinical examination is performed to exclude spinal causes of sciatica and identify signs consistent with piriformis muscle involvement.
Conservative care
Most patients begin with non-surgical treatment, including physiotherapy, stretching, activity modification, and medication to reduce muscle spasm and inflammation.
Targeted injections
If symptoms persist, ultrasound-guided injections into the piriformis muscle may be offered to reduce inflammation, relax the muscle, and relieve nerve compression.
Further interventions (if required)
In selected cases, treatments such as botulinum toxin injections may be considered to address persistent muscle spasm.
Recovery and prevention
Rehabilitation focuses on restoring hip strength, flexibility, and movement control to reduce the risk of symptom recurrence.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
We offer 3 ways to pay for your treatment
We exist to take the stress out of private healthcare.
Our payment options are designed to offer you easy access to our treatments and services. You can choose to pay on the day, spread the cost, or use your private medical insurance.
Our patient services team will guide you through the process, providing clear costs and support throughout your course of treatment so you can focus on the thing that matters most – your health.
Whether you pay in advance, spread the cost, or use your private medical insurance, rest assured you will be receiving exceptional care 365 days a year.
Pay in Advance
Even if you do not have medical insurance, you can still get quick and comprehensive access to private medical care.
We provide transparent pricing from your initial consultation to the completion of your treatment so you know where you stand, every step of the way.
We accept all major debit and credit cards, as well as Apple Pay for UK residents. Please note that we do not accept cash or cheques.
Spread the cost monthly
Paying for your treatment at One Stop Healthcare can be spread monthly from 12 to 60 months, rather than paying in one go.
With an upfront 10% deposit paid, via our Financial partner Chrysalis Finance, we offer various flexible terms to enable you to spread the cost, including 12-months at 0% APR. Click here to find out more.
Monthly payments need to be linked to a One Stop Healthcare treatment over £385 and is subject to a 14-day ‘cooling-off’ period before any treatment can start.
Your on-going payments will be made directly between Chrysalis and yourself. It’s that simple.
Pay using PMI
We are recognised by all major health insurance companies and with our extensive range of services, there are lots of benefits to using your insurance with us. Our patient services team is here to answer any questions you may have about using your private health insurance with us.
Please bring along your policy details including your scheme details, membership or policy number, expiry date and confirmation of eligibility to claim (i.e. your authorisation number). If you do not have these details with you, we will require payment from you on the day. Patients are liable for any amounts not settled by their insurer.
Pricing
Hospital fee guide price: £1,820
Procedure price subject to bespoke quotation.
Additional consultant fee not included.
FAQs
Yes, piriformis syndrome can go away, especially with proper treatment and management. Many patients experience significant relief through conservative treatments such as physical therapy, stretching exercises, activity modification, and anti-inflammatory medications. Early intervention is key to preventing the condition from becoming chronic. In some cases, symptoms may resolve spontaneously, but persistent or severe cases might require injections or, rarely, surgical intervention.
Sneezing can sometimes exacerbate piriformis syndrome symptoms by increasing intra-abdominal and spinal pressure, which can irritate the sciatic nerve or surrounding tissues. This may result in sharp or shooting pain in the buttocks or down the leg. However, the severity of pain triggered by sneezing varies among individuals and depends on the extent of nerve compression and inflammation.
Yes, piriformis syndrome can cause numbness in the toes. Since the sciatic nerve runs from the lower spine through the buttock and down the leg to the foot, compression or irritation of this nerve by the piriformis muscle can lead to numbness, tingling, or weakness along its pathway, including the toes. This symptom is often accompanied by buttock pain and radiating leg pain.
When managing piriformis syndrome, it is important to avoid exercises that increase pressure on the piriformis muscle or aggravate the sciatic nerve. Activities such as prolonged sitting, running on uneven surfaces, deep squats, heavy lifting, or exercises that significantly worsen symptoms, particularly those involving prolonged hip loading or extreme rotational positions, may worsen symptoms. High-impact activities that involve repetitive motions of the lower spine and hip joint should be limited until pain subsides. Instead, focus on gentle stretching and strengthening exercises guided by a physical therapist. Traditional stretching recommendations for piriformis syndrome include external rotation and hip flexion exercises.
Yes, an injection can help piriformis syndrome, especially when conservative treatments have not provided sufficient relief. Ultrasound-guided corticosteroid injections into the piriformis muscle deliver a combination of local anaesthetic and steroids to reduce inflammation, muscle spasm, and pain. These injections can provide immediate pain relief and improve mobility, allowing patients to participate more fully in physical therapy. Botulinum toxin injections may also be used to relax the piriformis muscle in cases of severe muscle spasm.
The success rate of piriformis injections varies with the severity of the condition and the individual’s response to treatment. Studies have shown that many patients experience noticeable improvements in pain and function following ultrasound-guided corticosteroid injections. Relief can last from several weeks to months, although symptoms may eventually wear off, necessitating repeat injections. Overall, injections are considered an effective pain management tool as part of a comprehensive treatment plan.
Piriformis syndrome can occur during pregnancy due to changes in posture, weight gain, and hormonal effects that cause ligament laxity and muscle imbalances. These factors can increase the risk of piriformis muscle spasm or irritation of the sciatic nerve, leading to buttock pain and leg symptoms. Although not extremely common, pregnant women experiencing persistent buttock or leg pain should be evaluated for piriformis syndrome as part of the differential diagnosis.
The duration of relief from a piriformis injection varies widely among patients. Typically, the local anaesthetic provides immediate but short-term pain relief, while the corticosteroid reduces inflammation over the following days to weeks. Pain relief can last from a few weeks to several months, depending on the individual’s condition and response to treatment. Repeat injections may be necessary if symptoms recur.