Missing link in chronic hip and buttock pain

Chronic hip and buttock pain is common.  And there are a variety of causes including hip osteoarthritis, peripheral nerve entrapment, lumbar nerve root radiculopathy and sciatica.  I’ll be discussing a common cause of hip and buttock pain that is often overlooked and mismanaged in this month blog.  It is the so-called piriformis syndrome.

The piriformis is part of a deep buttock muscle group.  The piriformis gets more attention than other deep buttock muscles because the sciatic nerve pierces through it.  When the muscle becomes hypertrophied, it can squeeze and compress the sciatic nerve causing cramping or aching pain in the buttock and or hamstrings.  People often describe piriformis syndrome as deep, aching buttock pain.  Since the piriformis is part of a deep buttock muscle group, the piriformis syndrome should be called deep gluteal syndrome.

Piriformis hypertrophy occurs when the muscle gets tight, knotty and firm.  Chronic sacroiliac instability, core and gluteal muscle imbalance and weakness, excessive hip internal rotation and over pronation can cause the piriformis to become tight, knotty and firm.

Your hip and buttock pain may be coming from deep gluteal syndrome if:

  • Your buttock muscles have painful knots when press upon
  • Your sacroiliac pain relief by wearing sacroiliac belt
  • Hip flexion and external rotation, prolonged sitting and walking or getting in and out of the car exacerbate your hip and buttock pain
  • Your knees deviate outward during lunging or jumping exercises
  • You cannot fully internal rotate your hips
  • You have difficulty bringing your foot up to put on a sock while sitting

If your hip and buttock pain is cause by deep gluteal syndrome, stretching the piriformis muscle only provides temporary relief.  To properly treat hip and buttock pain associated with deep gluteal syndrome, you’ll need to activate and wake up the inhibited muscles to balance out the tight, overactive compensated muscles.  Thanks for reading.  🙂