Piriformis Syndrome
Deep, cranky ache in one buttock. Worse with sitting — especially on a wallet or a long drive — sometimes trailing sciatic-style tingles down the leg. Piriformis syndrome is sciati…
Medically reviewed by Dr. Alan S. Bader, DC — Chiropractic Physician, Nevada License B-567 · Dr. Bader · Dr. Doyle · Last reviewed: July 2026
Deep, cranky ache in one buttock. Worse with sitting — especially on a wallet or a long drive — sometimes trailing sciatic-style tingles down the leg. Piriformis syndrome is sciatica's most convincing impostor, and telling them apart changes the entire care plan.
What’s actually going on
The piriformis is a deep hip rotator that lies directly over (in some anatomies, around) the sciatic nerve. When it's tight, irritated or overworked — often covering for lazy gluteal muscles — it can compress the nerve and mimic disc-type sciatica without any spine problem at all.
Common causes we see
- Prolonged sitting — the modern piriformis diet
- Wallet-in-back-pocket compression (genuinely)
- Overuse in runners and hikers, especially on cambered trails
- Gluteal weakness making the piriformis moonlight as a stabilizer
- A fall onto the buttock
How we evaluate it
Piriformis stretch and contraction tests, hip examination, and — essential — lumbar and nerve-root screening, because the treatment for a disc problem and a muscle problem differ completely. When the spine tests clean and the piriformis reproduces your pain, the impostor is unmasked.
How chiropractic care may help
Piriformis patterns respond gratifyingly to specific care: deep soft-tissue work to the muscle itself, hip and SI joint adjustments to fix the mechanics it's compensating for, stretching that targets it correctly (most people stretch it wrong — we'll show you), and gluteal strengthening so it can retire from its second job. Many cases improve substantially within a few weeks; sitting habits decide whether it stays gone.
What to expect
Expect direct work on a tender muscle (worth it), homework, and a conversation about your driving and desk setup.
⚠ When to seek medical care instead
Same nerve rules apply: progressive leg weakness, saddle numbness, or bladder/bowel changes are not piriformis — emergency or urgent referral. True nerve deficits point back to the spine and get worked up accordingly.
Differentiation basis: negative lumbar/nerve-root findings with positive piriformis provocation (FAIR-type testing) per orthopedic practice.
This page is education, not medical advice for your specific situation — an examination is how care decisions get made. If you may be experiencing an emergency, call 911. Full medical disclaimer.
In pain right now? Acute patients get priority scheduling. Call and tell us what’s going on — same-week appointments are usually available.
☎ (775) 829-7575Piriformis Syndrome — FAQs
Piriformis or a disc — how can you tell?
Discs usually announce themselves with spine findings and nerve-tension signs; piriformis reproduces symptoms with muscle-specific tests while the spine tests clean. Occasionally both contribute — the exam sorts the percentages.
Why does sitting make it so much worse?
You're literally sitting on the culprit. Pressure plus shortened position plus time equals an irritated muscle pressing a nerve. Standing breaks and seat tweaks are part of the prescription.
Will stretching alone fix it?
Sometimes — if the stretch is right and the cause was simple. When weakness or joint mechanics started the compensation, stretching without strengthening is mowing a weed.
What patients say
Reno Patients, In Their Own Words
“First time here… Friendly and efficient receptionist, she explained everything in detail. I saw Dr. Bader. Listened to my areas of pain, explained many things and my first adjustment was great. He is also friendly, has good “bedside” manners. They are a hometown health provider.”
“I’ve been seeing Dr. Bader for the last 15 years. He is extremely knowledgeable and has a great bedside manor. The office is very well run… Most insurance is accepted and if it’s not, the cash plan is very reasonable. Walk in’s are acceptable and same day appointments are most likely.”
“Dr Bader is a Super Chiropractor! Palmer educated.”
“They actually work on fixing your issues with adjustments and therapy and get you in and out of the office in a timely manner.”
Real patient reviews from Google and Yelp, quoted word-for-word (ellipses mark trims — nothing else is changed). Individual experiences vary — care decisions always follow an examination. Read them all — unfiltered — at the sources.
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