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Piriformis Syndrome


According to Doctors Janet Travell and David Simons in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual, myofascial trigger points (tiny contraction knots) in overworked gluteus minimus and piriformis muscles in the buttocks are a frequent cause of sciatica and all the other distressing symptoms listed above.

trigger points

Symptoms of sciatica include aching pain, numbness, tingling, burning, and hypersensitivity in your low back, buttocks, hips, and down your legs into your ankles and feet.

The drawings show gluteus minimus trigger point and its referred sciatic pain. Simple aching pain in these areas is usually referred from gluteus minimus trigger points.

Piriformis Syndrome

Piriformis trigger points, by keeping the muscles tight and rock hard, can cause actual sciatic nerve compression. Pain from piriformis trigger points is harsher and more electric than pain from gluteus minimus trigger points and is felt in the back of the thigh, the calf, and the sole of the foot. There may also be other abnormal sensations, such as numbness, tingling, burning, or hypersensitivity, in any of these areas.

piriformis points

The drawings show a piriformis trigger point and its referred buttocks pain.

A piriformis muscle that is shortened and swollen by trigger points can also compress numerous other nerves and blood vessels coming out of the pelvis.

This can result in a sense of swelling in the buttocks, leg, calf, and foot.

In addition, a tight piriformis muscle can impinge upon the pudendal nerve, causing impotence in males and pain in the groin, genitals, or rectal area of either gender.

Piriformis muscles that compress gluteal nerves and blood vessels are also believed to be responsible for gluteal muscle atrophy, wherein one or both buttocks waste away.

For decades, the medical profession has known this particular group of sciatic symptoms as “piriformis syndrome,” although the cause of the piriformis enlargement was never really understood.

Surgical release of the piriformis muscle for the treatment of sciatica was once a common treatment. Amazingly, this unnecessary operation is still performed by surgeons who are ignorant of the effects of myofascial trigger points.


In the medical world, the symptoms of sciatica are routinely assumed to be caused by pressure on the sciatic nerve as a result of a compressed disk or other spinal abnormality.

Surgery on the spine in a search for the cause of presumed sciatic nerve impingement is very common, even though it regularly fails to erase sciatic symptoms. Sometimes, of course, spinal surgery is needed for relieving a true herniated disk, and good results are often attained. Unfortunately, surgical successes tend to confirm the surgeon’s belief that the operation is always the correct thing to do.

Doctors Travell and Simons believe that trigger points should be at the top of the list during any examination for pain, numbness, and other abnormal sensations in the low back, hips, and legs. Wider recognition of the myofascial causes of sciatica could eliminate many unnecessary surgical operations.


You don’t have to wait for the medical community to abandon antiquated methods and catch up with trigger point science. You can take care of your own trigger points.

trigger points workbook

In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies simplifies Travell and Simons' extensive research into myofascial pain and makes it accessible to the layman. His innovative methods of self-applied trigger point massage will get rid of the numbness, tingling, and aching pain of sciatica and piriformis syndrome when trigger points are the cause.

To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.

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