• 27 Jun, 2026
• UnityPain
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Piriformis Trigger Point: Causes & Relief | UnityPain

When Deep Buttock Pain Won’t Let You Rest

If you have a deep, aching pain in your buttock that sometimes shoots down your leg, you are not alone. Many people deal with this kind of pain for months or even years before they get answers. It can make sitting at a desk, driving a car, or even sleeping feel like a challenge. One common but often overlooked cause of this pain is a trigger point in the piriformis muscle. Understanding what this muscle does and why it can become a source of pain may be the first step toward feeling better.

Chronic pain can be exhausting — not just physically, but emotionally too. If you have been brushed off or told everything “looks normal” on your imaging, please know that muscle-based pain is very real, even when it does not show up on an MRI or X-ray. You deserve care, and there are options that may help.

What Is the Piriformis Muscle?

The piriformis is a small, flat muscle located deep in your buttock. It starts at the lower spine, runs through the pelvis, and connects to the top of the thighbone. Its main job is to help you rotate your hip and keep your leg stable when you walk, climb stairs, or change directions. Even though it is small, it works very hard every day.

The sciatic nerve — the largest nerve in the body — runs very close to the piriformis, and in some people, it actually passes through the muscle. When the piriformis becomes tight, irritated, or develops what are called trigger points, it can press on or irritate the sciatic nerve. This is why piriformis problems can cause pain that travels down the back of the leg, sometimes all the way to the foot.

What Is a Trigger Point?

A trigger point is a tight, sensitive knot that forms inside a muscle. When you press on it, it may cause pain right at that spot or send pain to another area of the body. This is called referred pain. Trigger points can form when a muscle is overworked, strained, or held in one position for too long.

In the piriformis muscle, trigger points can develop after sitting for long periods, after a fall or injury to the hip or tailbone area, or from repetitive activities like running or cycling. Even stress and poor posture can play a role. Once a trigger point forms, the muscle may stay tight and painful even when you are resting, which makes it hard to find relief on your own.

Common Causes of Piriformis Trigger Points

Several everyday situations can lead to piriformis trigger points. Some of the most common causes include:

• Prolonged sitting: Sitting for long hours — especially on hard surfaces or with a wallet in your back pocket — puts steady pressure on the piriformis.
• Overuse from exercise: Running, hiking, climbing stairs, or playing sports that involve a lot of hip rotation can strain the muscle over time.
• Trauma or injury: A fall on the buttocks, a car accident, or a direct blow to the hip area can cause the muscle to tighten protectively.
• Leg length differences: When one leg is slightly shorter than the other, the hips shift, and the piriformis may have to work harder to compensate.
• Weakness in nearby muscles: When the glutes or hip muscles are weak, the piriformis is forced to take on extra work, leading to fatigue and trigger point formation.

Understanding the cause of your pain matters because it helps guide the right treatment. What works for someone who developed pain from running may be different from what helps someone whose pain started after a fall.

Symptoms to Watch For

Piriformis trigger point pain can feel different from person to person. Some people describe it as a deep, dull ache in one buttock. Others feel a sharp or burning pain that travels down the back of the thigh. Because the sciatic nerve can be involved, some people may also notice numbness or tingling in the leg or foot.

Common signs that the piriformis may be involved include:

• Pain that gets worse after sitting for 20 minutes or more
• Discomfort when climbing stairs or walking uphill
• Pain that eases slightly when you lie down and stretch your hip
• Tenderness when pressing deep into the middle of the buttock
• Pain with hip rotation, such as crossing your legs

It is important to have a healthcare provider evaluate your symptoms. Pain that travels down the leg can come from several different sources, including the spine, hip joint, or the piriformis itself. Getting the right diagnosis helps make sure you receive the right care.

Relief Options That May Help

The good news is that piriformis trigger point pain often responds well to treatment. Gentle stretching of the piriformis muscle is one of the most widely recommended starting points. A simple stretch involves lying on your back, crossing one ankle over the opposite knee, and gently pulling both legs toward your chest. Holding this stretch for 20 to 30 seconds several times a day may help release muscle tightness over time.

When stretching and rest are not enough, other options may include physical therapy, massage, heat or ice therapy, or anti-inflammatory medications. For more stubborn cases, a trigger point injection — where a small amount of medication is placed directly into the tight muscle knot — can help reduce pain and allow the muscle to relax. At Unity Pain Management in Modesto, CA, trigger point injections are one of the services offered for patients dealing with this type of muscle pain. A provider can evaluate your specific situation and discuss whether this approach might be right for you.

Taking the Next Step Toward Relief

Living with deep buttock and leg pain can be incredibly draining. It can affect your sleep, your work, your relationships, and your ability to enjoy the things you love. If you have been struggling and have not found lasting relief, please do not give up. There are pain specialists who understand muscle-based pain and take it seriously.

Reaching out to a qualified pain management provider is a meaningful step. Unity Pain Management is an insurance-friendly clinic serving the Modesto, CA area, offering in-person and telehealth visits. Whether you are just beginning to look for answers or have been managing pain for years, compassionate, individualized care is available. You do not have to keep living in pain.

References

• Travell, Janet G. and Simons, David G. Myofascial Pain and Dysfunction: The Trigger Point Manual. Williams & Wilkins. 1992.
• Hopayian, Kevork, et al. “The clinical features of the piriformis syndrome: a systematic review.” European Spine Journal. 2010.
• Fishman, Loren M., et al. “Piriformis syndrome: diagnosis, treatment, and outcome — a 10-year study.” Archives of Physical Medicine and Rehabilitation. 2002.
• National Institute of Neurological Disorders and Stroke. “Piriformis Syndrome Information Page.” National Institutes of Health. 2023.
• Shah, Jay P., et al. “Myofascial trigger points then and now: a historical and scientific perspective.” PM&R: The Journal of Injury, Function, and Rehabilitation. 2015.