Piriformis Syndrome Physiotherapy in Clapham

The piriformis is a small muscle deep in your buttock, and the sciatic nerve runs close to it. Piriformis syndrome is when this area irritates or squeezes the nerve, causing buttock pain and sometimes sciatica-like symptoms.

The Royal National Orthopaedic Hospital describes it as part of deep gluteal syndrome, where the sciatic nerve is irritated as it travels through the buttock rather than at the spine.

• Deep pain in one buttock
• Pain that spreads down the back of your thigh
• Tingling or numbness down the leg
• Pain that’s worse when sitting, especially driving
• Pain getting up from sitting or climbing stairs

Both can cause pain down the back of the leg. Sciatica usually starts from the lower back, for example from a slipped disc, while piriformis syndrome comes from the buttock. Pain from the sacroiliac joint or hip tendons can feel similar too. Olivia will assess you carefully to find the source.

The Royal National Orthopaedic Hospital explains that it can follow a fall or develop from repetitive movements, postural habits, muscle tightness or movement patterns that reduce the space for the nerve. Long periods of sitting often make it worse.

The Royal National Orthopaedic Hospital recommends education, exercise and changes to activities as the first treatment. Depending on your assessment, physiotherapy may include:

• Advice on sitting, driving and activities to ease pressure on the nerve
• Strengthening for your buttock, hip and core muscles
• Gentle stretches and nerve mobility exercises
• Hands-on treatment to ease muscle tension
• A step-by-step return to running, exercise or sport

Sitting for long periods is a common trigger. It can help to:

• Take regular breaks to stand and move
• Avoid sitting on a wallet or phone in your back pocket
• Use a cushion that takes pressure off the painful side
• Adjust your car seat so your hips are slightly higher than your knees

The piriformis stretch is one of the most searched-for exercises, but stretching alone often isn’t enough, and some stretches can irritate the nerve further. A combination of strengthening, movement and the right stretches usually works best. Olivia will show you what suits you.

Your first appointment lasts 60 minutes and takes place in a private room at our Clapham clinic. Olivia will:

• Talk through your symptoms, what makes them worse and your goals
• Assess your back, pelvis and hips, your strength and how you move
• Explain what she has found and agree a treatment plan with you
• Give you exercises and practical advice to start at home