The Back Pain & Injury PodcastThe Back Pain & Injury Podcast

Piriformis Syndrome

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Exactly what is piriformis, how is it diagnosed and what you can do about it if you think you have it?

All these questions and more are answered by Dr Alison Grimaldi, specialist hip and pelvic pain physiotherapist in this episode that focuses entirely on what piriformis is and how it can be treated.

There is lots of confusion about piriformis and the best forms of treatment so this is a great opportunity to understand more about what it is and is not and the best ways to identify the right treatment.



  • Piriformis is an irritation of the sciatic nerve which usually stems from compression of the nerve as it runs through the buttocks.
  • Piriformis syndrome can be a result of anatomical setup or hypertrophy when the piriformis muscle becomes enlarged through working particularly hard.
  • Signs that you have piriformis syndrome is pain in the mid-buttock area with the pain extending downwards through the leg.
  • Changes in sensory awareness can be an indication of the syndrome
  • Training efficient behaviour of the muscles combined gentle exercise to move the nerve, education and taking away some of the things that are irritating are part of an effective rehabilitation program.
  • Different buttock muscles are affected in different ways by inactivity.
  • A lack of loading on other muscles can change the behaviour of muscles resulting in overactivity by the piriformis muscle.
  • If you are having a cortisol injection combine it with good rehabilitation to make the most of the pain relief and to ensure you have effective strategies in place.
  • Surgery is a last resort option and surgical intervention is releasing the tendon where it joins into the back of the hip so the muscle retracts away from the bone
  • Botox is increasingly being used for piriformis  syndrome
  • For most people, it’s around 3 to 6 months for recovery and there will usually be flare-ups along the way.
  • It’s about re-education of muscle patterns and behaviours.
  • Get a clear diagnosis and pair any injections with good rehabilitation.



‘Piriformis  syndrome is often diagnosed for any sort of buttock pain’

‘Cortisol injections can be used as a treatment to give relief although this is usually short term’

‘Sometimes stretches can be part of the problem, not the solution’



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Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at if you have any questions for him.



Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
























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