Piriformis Syndrome

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.

What Is Piriformis Syndrome?

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.

Common Symptoms

Deep, aching pain in the buttock
Sciatica-like pain, tingling, or numbness down the back of the leg
Pain worsening with prolonged sitting, especially on hard surfaces
Tenderness deep in the buttock, especially with compression
Pain with hip external rotation (crossing the leg)
Buttock pain worsening with climbing stairs or hills

Common Causes & Contributing Factors

Sacroiliac joint dysfunction creating piriformis protective spasm
Pelvic imbalance overloading one piriformis
Prolonged sitting (especially with hip externally rotated)
Trauma to the buttock from a fall or motor vehicle accident
Anatomic variant with sciatic nerve piercing the piriformis
Overuse in runners and cyclists

The Pura Vida Protocol: Chiropractic Care for Piriformis Syndrome

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.

Advanced Therapies We Combine With Chiropractic

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:

SoftWave Therapy

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.

Class IV Laser Therapy

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.

Why Choose Pura Vida Chiropractic in San Antonio?

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 with most insurance plans including Blue Cross Blue Shield of Texas, UnitedHealthcare, Humana, Aetna, Ambetter, Oscar Health, Community First, and Molina Healthcare. New patient appointments are available promptly.

Ready to Get Relief from Piriformis Syndrome?

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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