Is Piriformis Syndrome Even Real? Here’s Why Your Butt Pain Might Not Be What You Think

Let’s cut to the chase: if you’ve ever had deep butt pain that shoots down your leg and someone told you “it’s your piriformis,” there’s a good chance you’ve been chasing that diagnosis for months—or even years. And honestly? You’re not alone. I can’t tell you how many patients walk into our clinic saying they’ve been stretching their piriformis every day, foam rolling, getting massages, injections, or trying every YouTube stretch under the sun… and the pain is still there. Here’s the problem: piriformis syndrome is one of the most overused and oversimplified explanations for sciatic-like pain. The theory is that a small muscle deep in the hip gets tight or spasms and irritates the sciatic nerve, causing pain, numbness, or tingling down your butt and leg. It’s a clean little explanation—just one muscle to blame. But the truth is, research shows that true piriformis syndrome is extremely rare, likely less than 6% of cases, and many experts argue that it’s not even really a valid diagnosis in most situations. What’s actually happening for most people is something different—either a movement pattern problem, a spine or nerve irritation issue upstream, a stability issue that’s never been addressed, or a combo of several things. So when you’ve been stretching and smashing the same muscle every day for months with no change, it’s not because you’re “not doing enough”—it’s because you’re not actually treating the root cause. And that’s what we see every week. People get stuck in the stretch-chase-repeat cycle, thinking their piriformis is the villain, when the real problem is how they move, load their body, or stabilize their hips and core. Once we actually assess how someone moves, figure out what’s driving the irritation, and teach them how to build strength and control in the areas that matter, the results are dramatic—because we’re treating the problem, not the symptom. So if you’ve been stretching your piriformis for months or years and still dealing with pain, it’s time to stop blaming that one little muscle and get a real plan. If you're ready to stop stretching or rolling your piriformis and actually learn why you’re having pain, schedule a Free Discovery Visit with the link at the top of the page.