Treating Piriformis Syndrome with Osteopathic Manipulative Treatment

Osteopathic Medicine Tampa
Dec 19, 2025
3 min read

Piriformis syndrome causes sharp pain and discomfort in the buttocks and can radiate down the leg, often mimicking sciatica. This condition arises when the piriformis muscle irritates or compresses the sciatic nerve. Many people with this syndrome struggle with persistent back pain and difficulty sitting or walking. Understanding the muscle attachments involved and the role of somatic dysfunction is key to effective treatment. Osteopathic Manipulative Treatment (OMT) offers a hands-on approach that targets the root causes of this syndrome, providing relief and improving function.

What Is Piriformis Syndrome?

The piriformis muscle is a small, flat muscle located deep in the buttock, running from the sacrum (the base of the spine) to the top of the femur (thigh bone). Its main function is to help rotate the hip and stabilize the pelvis during movement. When this muscle becomes tight, inflamed, or spasms, it can compress the nearby sciatic nerve, causing pain, numbness, or tingling sensations down the leg.

Symptoms often include:

Deep buttock pain that worsens with sitting
Pain radiating down the back of the thigh or calf
Difficulty walking or climbing stairs
Tenderness over the piriformis muscle

Because these symptoms overlap with other causes of back pain and sciatica, accurate diagnosis is essential.

The Importance of Muscle Attachments and Somatic Dysfunction

The piriformis muscle attaches to the anterior surface of the sacrum and inserts on the greater trochanter of the femur. This positioning means it interacts closely with the sacroiliac joint and the pelvis. Any dysfunction in these areas can affect the muscle’s length and tension.

Somatic dysfunction refers to impaired or altered function of the musculoskeletal system, including muscles, joints, and related tissues. In piriformis syndrome, somatic dysfunction may present as:

Restricted pelvic or sacral motion
Muscle tightness or spasm in the piriformis or surrounding muscles
Misalignment of the sacroiliac joint or lumbar spine

Identifying these dysfunctions is crucial because they contribute to the muscle’s abnormal tension and nerve irritation.

How Osteopathic Manipulative Treatment Helps

OMT uses skilled manual techniques to diagnose and treat somatic dysfunctions. For piriformis syndrome, OMT focuses on:

Releasing muscle tension in the piriformis and surrounding muscles
Restoring normal joint motion in the pelvis and lumbar spine
Improving blood flow and reducing inflammation around the sciatic nerve

Common OMT techniques for piriformis syndrome include:

Muscle energy techniques: The patient actively contracts muscles against resistance to relax tight muscles and improve joint mobility.
Myofascial release: Gentle pressure and stretching to release fascial restrictions around the piriformis.
Counterstrain: Positioning the body to reduce muscle spasm and pain.
Soft tissue mobilization: Hands-on massage and manipulation to improve tissue flexibility.

These treatments not only relieve pain but also address the underlying causes, reducing the chance of recurrence.

Benefits Beyond Piriformis Syndrome

OMT’s impact extends beyond treating the piriformis muscle. Because the musculoskeletal system is interconnected, improving pelvic and spinal function can also ease related issues such as: