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Piriformis Muscle Syndrome & Sciatica

PMS conjures up images and feelings in the minds of many.  Also called "the other PMS", it stands for Piriformis Muscle Syndrome, a condition often confused with sciatica.

Sciatica is a “catch all” phrase many people use to describe sensations that are felt in the buttocks, down the leg, and into the foot .  It usually affects only one leg and  is often self-diagnosed.  There can be several causes for such pain or numbing sensations in the body.  Often, pressure on the nerves giving rise to the sciatic nerve are involved or pressure on the sciatic nerve itself is the cause.

If there is a suspicion that a bone (such as a vertebra in the spine) or an intervertebral disk may be involved it should be checked out by a doctor or other licensed medical professional.


Many times there are muscular or connective tissue problems that are contributing to the symptoms you are experiencing.  The sciatic nerve passes through the muscles deep in the gluteal region and underneath the hamstring group in the back of the thigh.  As the nerve continues down the leg it gives off smaller branches passing behind the knee as they end up in the lower leg and feet.  That is why symptoms are often felt that far down the leg.




Massage approaches that have had success focus on relaxation of the hamstring muscles and release of tightness in the piriformis muscle.  The piriformis muscle is important in such pain patterns because the sciatic nerve runs underneath it in most people and through it in a small percentage (10 - 15%) of people.  Tightness in the piriformis will often put pressure on the sciatic nerve causing symptoms due to impairment of nerve function.  Nerves require intracellular fluid circulation to function at their best and disrupting this cellular flow can lead to poor nerve impulse conduction.  That means overactive nerves or “burned out” reflexes due to over stimulation.


Trigger point referrals in the piriformis and gluteus minimis muscles can also produce pain patterns that can be interpreted as sciatic pain.  The referrals from the piriformis muscle can extend down the back of the thigh (hamstring area) and into the bottom of the foot.  The gluteus minimis muscle has a referral pattern that involves the back of the thigh, too.  


Massage with fingertips, thumbs and forearms to the gluteal area can help.  The piriformis muscle is located deep to the gluteus maximus, the largest muscle in the body.  The piriformis connects the sacrum to the greater trochanter near the top of the thigh bone (femur) and to a thick ligament that connects the sacrum to the sit bones on the pelvis (sacrotuberous ligament).   {The greater trochanter is the prominent round bump you can feel on the outside of the hip area).


Since the gluteus maximus and hamstring muscles also connect to the sacrotuberous ligament, all of these muscles should be addressed to create balance in their tension levels.  


Spiral Synergy


Establishing balance in the pelvis is important when addressing sciatic issues.  The Spiral Synergy approach includes focus on the sacrum, pelvic balance, leg length balancing, psoas muscle and lumbar releases.  


Since the piriformis muscle attaches to the sacrum and the femur (thigh bone), restoring balanced movement to the bones and joints and releasing tension in the muscles and connective tissues can help bring relief.  



There are instructional DVDs available to learn the simple balancing methods for these body areas.  Learn more about them here.




Reflexology recognizes a reflex zone on the heel of the foot that correlates to the sciatic area of the body.  Fingertip or thumb crawling to this area can be helpful.