Pain deep in the buttocks that won't go away?
Do you feel pain deep in one of your buttocks? Does the pain get worse when you sit, drive, or climb stairs? Does it sometimes spread to the back of your thigh and even down to your calf?
Many people automatically assume that the cause is a herniated disc. The truth is that such symptoms can also be related to another condition— piriformis syndrome.
At the Center for Physical Therapy and Rehabilitation OFFICE THERAPY We often see patients who have been treating their „lower back“ for months, when in fact the main source of the problem turns out to be in the buttocks. That is precisely why a proper assessment is the first and most important step toward a successful recovery.
What is piriformis syndrome?
The piriformis is a small but extremely important muscle located deep within the gluteal region.
Its main function is to:
- stabilizes the hip joint;
- assists with external rotation of the hip;
- It is involved in walking, running, and changing direction.
The sciatic nerve (n. ischiadicus)—the largest nerve in the human body—runs right next to it.
When the piriformis muscle becomes tense, inflamed, or enlarged, it may begin to press on or irritate this nerve. This is precisely the condition we call piriformis syndrome.
What are the symptoms?
Most often, patients describe:
- pain deep in the buttocks;
- pain on only one side;
- discomfort from prolonged sitting;
- pain when getting up from a chair;
- pain when climbing stairs;
- pain after prolonged walking;
- radiating to the back of the thigh;
- occasional numbness or tingling;
- a sensation of „pulling“ in the leg.
Many people notice that sitting for more than 20–30 minutes significantly worsens their symptoms.
Why does it happen?
The most common reasons include:
Prolonged sitting
This is especially true for people who work at a desk or spend long hours behind the wheel.
Overuse Injuries in Sports
It is commonly seen in:
- runners;
- soccer players;
- tennis players;
- cyclists;
- people who start intense workouts after a period of inactivity.
Impaired motor function
When other muscles around the pelvis aren't functioning optimally, the piriformis muscle begins to compensate.
Previous injuries
After a fall onto the buttocks or following an injury to the pelvic area.
Pyriformis syndrome or a herniated disc?
This is one of the most frequently asked questions.
Both conditions can cause similar symptoms, but their treatment is not always the same.
With a herniated disc, the main problem lies in the spine.
In piriformis syndrome, the source of the problem is in the gluteal muscle region.
Therefore, a definitive diagnosis cannot be made based on symptoms alone.
How do we make the diagnosis?
At OFFICE THERAPY, we begin with a detailed functional assessment.
It includes:
- a discussion of the symptoms;
- analysis of gait;
- hip joint examination;
- examination of the lumbar spine;
- specific functional tests;
- assessment of muscle balance;
- an assessment of whether the symptoms may originate in the lower back.
Our goal is not simply to identify the problem, but to discover the real cause of it.
How is it treated?
In most cases, conservative treatment yields very good results.
Depending on the condition, it may include:
Kinesitherapy
Selected exercises for:
- relaxation of tense structures;
- improving pelvic mobility;
- engagement of the gluteal muscles;
- stabilization of the pelvis;
- Restoration of the correct movement pattern.
Manual therapy
If necessary, techniques can be used to improve the mobility of soft tissues and joints.
Apparatus Physiotherapy
For certain patients, methods such as high-energy laser therapy, TECAR therapy, or other physical therapy procedures may be appropriate when indicated following a clinical evaluation.
A Gradual Return to Exercise
The goal is not only to reduce pain, but also to help the patient safely return to daily life, sports, and their favorite activities.
What Should You Avoid Doing?
A common mistake is prolonged stretching „without guidance.“.
If the symptoms are actually caused by a herniated disc, certain exercises may even make the condition worse.
We also do not recommend:
- self-medication without a diagnosis;
- massages without determining the cause;
- ignoring the symptoms for months;
- continuing to train intensely despite severe pain.
How long does the recovery last?
Duration depends on:
- the reason;
- How long has the problem existed?;
- physical activity;
- the presence of other medical conditions;
- adherence to the treatment program.
When rehabilitation begins early, many patients notice a gradual improvement within the first few weeks, but the exact timeframe varies from person to person.
When is it a good idea to see a specialist?
It is recommended that you get checked if:
- the pain lasts for more than two weeks;
- you can't sit still;
- the pain begins to spread down the leg;
- the symptoms recur;
- Your sports activities or work are limited.
Why is an accurate diagnosis so important?
Pain in the buttocks does not always mean piriformis syndrome.
Similar symptoms may also be caused by:
- herniated disc;
- a problem in the sacroiliac joint;
- tendon inflammation;
- hip pathology;
- other neurological conditions.
Therefore, treatment should be tailored to the specific cause, not just the symptoms.
How can we help at OFFICE THERAPY?
At the Center for Physical Therapy and Rehabilitation OFFICE THERAPY We believe that a successful recovery begins with a careful assessment, not with a one-size-fits-all treatment plan.
Following a thorough evaluation, we develop a personalized plan that may include a combination of kinesiotherapy, manual therapy, physical therapy using equipment, and a gradual return to daily activities and sports.
Our goal is not merely to provide temporary pain relief, but to identify the root cause of the problem and guide you through the entire recovery process.
If you’re experiencing pain in your buttocks that doesn’t go away or starts to spread down your leg, make an appointment for a consultation. A timely evaluation often helps avoid prolonged treatment and ensures the most appropriate approach is chosen right from the start.
В Center for Physical Therapy and Rehabilitation – OFFICETHERAPY We'll help you through the entire process—from managing pain and inflammation to safely returning to your favorite activities and sports.
Phone: 0898 636 762
📍Address: gr. Sofia, Lozenets, Str. Flower Garden 77-79
You can easily book an appointment online or yes Describe the problem Please contact us using the contact form below, and our team will get in touch with you and guide you toward the most suitable recovery plan.
