Piriformis Syndrome: Your Hamstring Might Not Be The Cause Of Your ‘Hamstring Pain’

There are several things that can contribute to pain in your hamstrings,  one of these is Piriformis Syndrome.


Piriformis syndrome can often masquerade as a hamstring strain or sciatica, with similar symptoms.

You might find that you have ongoing hamstring issues that just won’t get any better, even after completing all the hamstring stretching and strengthening programs in the world.

Maybe you have pain going from your bottom, down the back of your thigh and into you knee.

You might even have managed to get on top of it for a while, when suddenly its back!

If this sounds familiar, the source of your pain may actually be your piriformis muscle (a deep muscle in your buttock) and your sciatic nerve.

The piriformis is a muscle that works to help rotate the hip joint.

It originates from the sacrum (the triangle-shaped bone at the base of your spine) and extends across to insert at the top of the femur (thigh bone).


What is Piriformis Syndrome?

Piriformis Syndrome is a condition which involves the piriformis compressing or irritating the sciatic nerve.

The sciatic nerve starts in your lower back and passes through your buttock muscles and into the back of your thigh, where is supplies the hamstring.

If your piriformis muscle is tight, spasming or overloaded it can compress and irritate the sciatic nerve.

This can cause:

  • Pain
  • Tingling
  • Numbness in the buttock and into the back of the leg.

What Causes Piriformis Syndrome

You give your piriformis a workout every day when you walk, run, cross your legs and shift weight between your legs.

The muscle can be irritated from both long periods of inactivity and too much activity.

Common causes of piriformis syndrome can include:

  • Injury/trauma to the buttock area
  • Overuse from excessive exercise, stair climbing, running, long-distance walking
  • Prolonged sitting
  • Direct compression (i.e. sitting on a wallet in your back pocket)
  • Hip surgery
  • Altered biomechanics of the leg or back
  • More common in woman than men (6:1)

What are the Symptoms of Piriformis Syndrome

Symptoms may include:

  • dull ache in the buttock
  • pain may radiate to the hamstring, calf and foot
  • numbness/tingling in the buttock which may radiate down the back of the leg
  • tenderness in the buttock
  • increased pain with prolonged sitting or with activity

How To Treat Piriformis Pain

Rest and avoiding activities that worsen your symptoms are usually the first steps to take. But this is a short-term fix!

Your piriformis is becoming irritated because it can’t keep up with what you’re asking of it and we need to treat the underlying causes.


Physio can help with your Piriformis Syndrome and treatment may include:

  • Massage
  • Trigger point therapy
  • Joint mobilisations
  • Ultrasound
  • Dry needling/acupuncture
  • Stretching program to increase flexibility
  • Rehab program focusing on hip and core muscle strengthening

Supine pirifomis stretch

  1. Start lying down.
  2. Place the ankle of the side you are stretching onto your opposite knee.
  3. Lift this opposite leg and holding behind your thigh, gently pull forwards to feel stretch.
  4. Hold 30 seconds.


Self massage/trigger point release   

  1. Sitting on the ground, place the ankle of the affected side onto your opposite knee.
  2. Sit with the affected side on a spikey ball/golf ball/ tennis ball/foam roller/pocket physio.
  3. Slowly roll back and forth to find ‘tight spots’ or ‘trigger points’, sit on these points to feel a release.

Remember, there are other potential causes of pain in the buttock and thigh areas, so we recommend you consult your physiotherapist or healthcare professional for advice and treatment specific to you.

Looking to make an appointment or book a pilates class?

Booking online is the quickest, most convenient way to lock in the time, practitioner & class type you want.