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Piriformis syndrome — deep buttock pain with sciatic nerve irritation — is frequently confused with disc sciatica. At Pura Vida, we identify and treat the piriformis muscle and the pelvic imbalance that drives it into spasm.
The piriformis is a small muscle deep in the buttock that externally rotates the hip. The sciatic nerve passes either beneath, through, or above the piriformis muscle (anatomic variation exists). When the piriformis is tight or in spasm — from pelvic imbalance, SI joint dysfunction, or prolonged sitting — it compresses or irritates the sciatic nerve, producing buttock pain and sciatic symptoms that mimic lumbar disc radiculopathy. Piriformis syndrome is frequently present concurrently with or as a consequence of SI joint dysfunction and lumbar subluxation. Effective treatment addresses both the muscle and the upstream spinal drivers of its spasm.
Dr. Foss addresses piriformis syndrome at both the muscular and pelvic levels. SOT SI joint corrections remove the sacroiliac dysfunction that causes the piriformis to remain in protective spasm. Deep soft-tissue release directly to the piriformis — through the gluteal tissue — releases the muscle's grip on the sciatic nerve. Hip joint adjustments normalize external rotator mechanics. Once the pelvic foundation is corrected and the muscle is released, sciatic symptoms typically resolve without the need for cortisone injections or surgery.
At Pura Vida Chiropractic, Dr. Foss uses Sacro-Occipital Technique (SOT) — a gentle, category-based system that addresses the spine, pelvis, and craniosacral rhythm as one integrated unit. SOT restores proper biomechanics, reduces nerve interference, and creates the neurological environment your body needs to heal itself.
For many patients, combining spinal correction with regenerative therapies produces faster and more lasting results. Depending on your condition, Dr. Foss may incorporate one or more of the following:
Patented unfocused shock waves spread over a broad treatment area to reduce inflammation, increase blood flow, and activate stem cells — promoting cellular regeneration and long-term pain relief.
Photobiomodulation with a 10–15W Class IV laser delivers therapeutic light energy deep into tissue, reducing inflammation, blocking pain signals, and speeding healing at the cellular level.
Pura Vida Chiropractic is a family-friendly, bilingual (English/Spanish) clinic serving San Antonio, TX. Dr. Dan Foss is trained in Sacro-Occipital Technique (SOT), a comprehensive chiropractic system that addresses the whole body — not just the area of pain. We combine hands-on spinal correction with the latest regenerative technology to help patients resolve the root cause of their condition rather than masking symptoms.
We are insurance friendly. Bring your insurance card and ID to the office to verify how your insurance can contribute to your care. New patient appointments are available promptly.
Comparing options? See how to choose a chiropractor near me in San Antonio or read our guide on how to choose the best chiropractor in San Antonio.
Piriformis syndrome occurs when the piriformis muscle in the deep buttock becomes hypertonic and compresses the sciatic nerve, which passes through or beneath it. Drivers include prolonged sitting, sacral torsion, leg-length asymmetry, sports activity, and prior pelvic injury. The pattern produces buttock pain with sciatica-like radiation down the leg.
Dr. Foss addresses the underlying sacral and pelvic dysfunction driving the piriformis hypertonicity. SOT corrects the pelvic pattern, soft-tissue work releases the piriformis muscle directly, and Class IV laser reduces deep inflammation. Most piriformis patients see meaningful relief within several visits.
Most patients see relief within 6–10 visits over 4–6 weeks. Chronic cases may require 12–16 visits with concurrent stretching and core work. Recurrence is uncommon when the underlying sacral pattern is corrected.
Yes. SOT uses gentle pelvic-blocking techniques. Dr. Foss differentiates piriformis syndrome from true sciatic radiculopathy before treatment and screens for lumbar disc pathology when symptoms include true neurological signs.
Schedule your new patient appointment with Dr. Foss at Pura Vida Chiropractic in San Antonio, TX. We'll identify the root cause and build a personalized care plan.
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