If you’re suffering from sciatic butt pain, especially if it’s accompanied by tingling or numbness, this is probably caused by the sciatic nerve getting compressed by the piriformis muscle.

When this happens it’s called piriformis syndrome and can sometimes extend its symptoms to the thigh and leg (usually the back of them), and even the foot.

• Can become chronic
• Can occur episodically
• Can occur just once following an injury

What is the piriformis muscle?

“Piriformis syndrome is an incredibly common condition that is predominately caused by excessive sitting,” says Eugene Charles, DC, Diplomate of applied kinesiology and author of “Journey to Healing: The Art and Science of Applied Kinesiology.”

“Sitting puts undue stress on the pelvis, and this, along with other reasons, led the famed Mayo Clinic to regard sitting as ‘the new smoking.’

“The strain on the sacroiliac joints in the pelvis cause the piriformis muscles to tighten in a vain attempt to stabilize the pelvis.

“This tightening can put pressure on the largest nerves in your body, the sciatic nerves, which lie directly under, and on some occasions through, the piriformis muscle.

“This tightening of the piriformis muscle can lead to sciatica — pain and tingling in the butt, hip and down the leg.”

When I was a personal trainer, the butt muscles I commonly talked about with my clients were the gluteus maximus and the gluteus minimus.

Fitness instructors often speak of the “glutes,” as these are the force production muscles that give our butts their shape (or lack thereof).

The piriformis muscle is also located in the butt, except that it’s close enough to the sciatic nerve that it can end up compressing it.

Back of the leg and butt. The piriformis muscle is indicated in red.

When something presses upon the sciatic nerve, it can cause pain, tingling or numbness at any point along this nerve’s path (hip to foot).

The sciatic nerve extends from the lower lumbar area to the foot; the longest nerve in the body.

Might you have piriformis syndrome?

• Pain or tenderness in the rump and sometimes hip area, especially if it’s on one side.

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• The pain radiates down the back of your leg (hamstrings).

• The pain may extend to the calf and even foot.

• Pain may be sharp or shooting.

• Tingling, numbness or an “electrical” feeling may be present between butt level and leg.

• Mode of onset is not indicative of diagnosis; piriformis syndrome can suddenly appear or come on gradually over several months.

• In addition to the sciatic nerve being pressed upon, the piriformis muscle can spasm, causing pain.

Other Causes of Piriformis Syndrome

• Injury

• Overuse in training or stretching

• Pregnancy weight gain and muscle tension

Evaluation of Sciatic Butt and Hip Pain

Though you may now be very sure that your butt and hip pain are being caused by sciatica aggravation via the piriformis muscle, you should still get an official diagnosis, as this will then lead to the right treatment.

The diagnosis may be based solely on your symptoms. The doctor may also have you perform certain joint motions.

Your doctor may recommend an MRI which can detect nerve inflammation.

There are various treatment and prevention approaches for sciatica related pain in the butt and hip.

Dr. Charles explains, “The most important treatments to remedy a piriformis syndrome is to have the 1, sacroiliac joints in your pelvis aligned with a chiropractic adjustment, 2, wear a sacroiliac belt for a month and 3, perform daily piriformis stretches.”

Here’s a complete description of treatments and prevention of piriformis syndrome.

Dr. Charles has helped thousands of patients and taught over 1,200 doctors during his 30+ years of practice. He has also created the Power Kinetics® Exercise Program and line of nutritional vitamins and performance supplements.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health. 
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Top image: Shutterstock/Red Moccasin