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Endoscopic Piriformis Release

The piriformis muscle is a small, pear-shaped muscle located in the buttocks. It attaches the pelvis to the upper part of the thighbone (femur). It is important for movements of the lower body and helps stabilize and rotate the hip and maintain balance.

Piriformis syndrome is a persistent pain syndrome that limits daily activity and work capacity. It occurs when the piriformis muscle becomes tight or spasms and irritates the sciatic nerve causing pain in the buttocks and sometimes shooting, burning, numbness and aching down the back of the leg. This syndrome is responsible for up to 6% of all cases of low back pain and/or sciatica. It typically affects middle aged women more often than men.

Symptoms include the inability to sit for prolonged periods of time on hard surfaces, pain getting out of bed, pain that worsens with hip movements and chronic hip/buttocks pain.

Piriformis syndrome is a clinical syndrome diagnosed by medical history and a focused physical exam of the hip which includes range of motion testing. The expert clinicians at LALL Orthopedics+ will likely order imaging such as X-Ray and MRI to rule out other common causes of sciatica including lumbar spine disease.

Piriformis syndrome is often caused by repetitive motions, such as those involved in twisting, running, or cycling. It can also be caused by an injury or overuse of the piriformis muscle causing enlargement; and by sitting for long periods of time on airplanes or at work, or with repetitive climbing and walking.

Treatment for piriformis syndrome typically involves an initial phase of conservative management including physical activity, stretching, massage, activity modification, short term rest as well as ice and heat therapy. In cases when conservative management fails to relieve pain, minimally invasive surgery may be necessary to release the piriformis muscle and relieve pressure on the sciatic nerve.

Endoscopic piriformis release is a minimally invasive surgical procedure used to treat piriformis syndrome. It is performed with the use of an endoscope, a small camera that is used to visualize the scarred tissue. The surgeons at LALL Orthopedics+ then use special tiny instruments to release the muscle from around the sciatic nerve, which relieves pressure on the nerve and helps to reduce pain and improve function.

Endoscopic release is a safe and effective treatment for piriformis syndrome. It is typically performed as an outpatient procedure which means that you go home the same day. There is usually little to no scarring and a very quick recovery time in a matter of few weeks.

If you are experiencing pain, numbness, or tingling in your legs or buttocks, schedule a consultation with LALL Orthopedics+. Their team of specially trained clinicians will determine if you have piriformis syndrome and discuss treatment options with you.

Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in hip arthroscopy and robotic hip replacement. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.

At a Glance

Ajay C. Lall, MD, MS, FAAOS

  • Board Certified – Orthopedic Surgery
  • Triple Fellowship Trained
  • Performs over 750 Surgeries Per Year
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