What Causes Piriformis Syndrome and Hip Pain

What Causes Piriformis Syndrome and Hip Pain

Piriformis syndrome, and a large percentage of ongoing hip pain, is caused by the piriformis muscle pressing on or into the sciatic nerve. Understanding the causes that lead to this, is key to managing it in the future.

Piriformis syndrome causes fall into one of two main categories; overload and biomechanical inefficiencies.

Overload simply means the muscles were worked either too hard or too long without adequate rest and recovery.

While playing a round of golf is great fun, doing it after spending a few months on the couch and not working up to the full round can cause piriformis syndrome. Trotting onto a tennis court for a match with little to no preparation, outside of grabbing a racquet, is another way overload can cause piriformis syndrome.

Additionally, trying to increase exercise intensity or duration too quickly, or simply not scheduling adequate rest periods in your training program can also lead to piriformis syndrome.

Another common, although often ignored, cause of piriformis syndrome is sitting for long periods of time. Whether it’s at a desk, behind a steering wheel, or even on the couch, sitting causes the piriformis muscle to shorten, which in turn places pressure on the sciatic nerve.

The second way piriformis syndrome manifests itself is from biomechanical inefficiencies. Biomechanical inefficiencies relate to such things as muscle imbalance (whether strength or flexibility), faulty foot and body mechanics, gait disturbances and poor posture. Essentially, how your body moves.

Other causes can include spinal problems, tight, stiff muscles in the lower back, hips and buttocks, and running or walking with your toes pointed too far in or too far out.

While there are other factors that can cause piriformis syndrome, the two main causes listed above are the umbrella for almost any reason for the syndrome. To learn more about piriformis syndrome causes and hip pain, visit our comprehensive piriformis syndrome article for additional information.

Until next time, stay healthy, keep stretching and God bless.

Kind regards,
Brad Walker
The Stretch Coach


P.S. If you enjoyed this blog post, please help spread the word by sharing, liking and tweeting, or leave a comment below.


    Some of the recommended exercises that exert alot of pressure on the knees, are definitely not advisable for people in the older age group.

    As this can cause more harm/damage/more wear and tear than good.

  2. forgot mention – you’ve got great exercise in your stretching book to conteract computer or couch potato sitting – the Standing Abductor Stretch – can be done anywhere – like in a library – brilliant – must do it now !

  3. amazing email to get as that’s exactly what I’m going through (advanced age group, osteporisis, collapsed L4/L5 – thank you so much – everything written there is perfect info. thanks a bunch – think get foot (walking) movement (tread) checked by videod treadmill at sports shop essential.

  4. I don’t really like to comment in any blog, for things are as they are! But
    all hip related lesions, are a mechanical disbalance, I have been treating
    chronic patients and athletes for the last 30 years………., fix the misbalance and
    everything falls into place. Every other medical term to operate hip mechanical
    misbalances, are just that a sad ploy that traumatizes all internal organs and
    structural tissue. Good day to all, Ricky Rehab.

  5. sounds like a logical commonsensical solution to a pain many people have. I for one tend not to stretch sufficiently before or after and tend to exercise or play tennis for too long.

    • Thanks James, I appreciate your comments and I hope the article was helpful.

  6. i think this article misses 2 things. first, a common underlying cause of weak/unbalanced gluteus medius, quadratus lumborum and transverse abdominis muscles (primarily) .and second, a simply remedy. low intensity, one legged squats (properly done) from just the height of a stair has been very successful with my clients to help alleviate sciatica, lower back, hip and knee problems. these all have the same basis – lack of stability caused by underlying hip stabilizer muscle weakness/inbalances.

    • Thanks Ed, I really appreciate your contribution. Any form of weakness or imbalance (whether strength or flexibility) falls under the “Biomechanical Inefficiency” heading. I’ve added it above. And I’ll cover the topic of treatment / remedy in another article. Thanks again.

    • Ed, i could not have said it better myself, right to the point, of what really happens, with ALL weak/ disbalance structural lesions! fix the stability problem and even miofascial lesions fix themselves naturally! good day Ed.

  7. sory but i want to ask you ab my mother’s case, she feel pain at hip when she stands up or sits down and feels uncomfortable when she walks what’re the problems able to be? thanks so much

    • Hi Minh, thanks for your inquiry but without being able to physically consult with your mother I can’t give you a definite answer. Take a look at the articles in our “Hips, Groin & Thigh” section to see if any of the symptoms in there match what your mother is experiencing… http://stretchcoach.com/articles/

      • thanks so much , have a good day Brad :)

  8. This is super relevant to my ongoing situation. I have two BHR hips (2009 & 2011), my posture improvements/corrections really helped. At 67, as I continue to surf & snowboard, staying hydrated seems to be the biggest aid in my pain management.

    • Thanks Ben, I appreciate your comments and I’m glad it was helpful.


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