Knee Pain and Piriformis Syndrome

I'm a runner, and lately I've been experiencing pain radiating down the back of my leg. It hurts worse when I sit or climb stairs. What is causing this?

Dr. Frank M. Phillips:

It sounds as though you're experiencing pain from irritation of your sciatic nerve, quite possibly caused by Piriformis Syndrome. The condition is, quite literally, a pain in the backside. That's because the Piriformis, the muscle which runs from your sacrum (mid-line base of spine) to the outer hipbone, is heavily used by runners when rotating their hips and legs.

Piriformis Syndrome is one of the leading causes of sciatica in runners and other athletes. It occurs when the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and radiating pain along the course of the sciatic nerve. This radiating pain, called "sciatica," often goes down the back of the thigh and/or into the lower back. Patients generally complain of pain deep in the buttocks, which is made worse by sitting, climbing stairs, or performing squats.

Treatment Options:

Since Piriformis Syndrome is essentially an "overuse" injury, it's important that you cease the activity that is causing inflammation. Icing the area periodically for 15-20 minutes at a time can be beneficial, along with therapeutic massage.

If you don't notice significant short-term improvement through conservative treatment options, make sure that you see an orthopaedic physician for an evaluation. Your physician may notice factors that are contributing to your condition including faulty foot and spine mechanics, gait disturbances, and poor posture or sitting habits. Orthotics or special exercises are often prescribed to improve the condition of the muscle.

It's also important to see an orthopaedic surgeon to rule out the possibility of a herniated spinal disc, which is also a common—and more serious cause of sciatica.

For more information about Dr. Phillips and the Sports Medicine physicians of Midwest Orthopaedics at Rush, call 877 MD BONES or contact us through this Web site.

This information is not intended as a substitute for the professional advice of your physician, nor to be a complete description of every aspect of a condition, nor a complete list of possible side effects of any medication. Decisions concerning your treatment should be based on your own health care provider's evaluation of your personal health history and current condition. Consult your physician before following any of the suggestions on this Web site. All articles on this Web site represent the personal opinions of the individual authors and should not be construed as official policy of Midwest Orthopaedics at Rush.