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Piriformis Syndrome Mechanisms
Piriformis syndrome gets its name by being the main cause of irritation of the sciatic nerve, the piriformis muscle. The piriformis muscle is a deep lateral rotator of the femur. Attachments of the piriformis are located at the anterior surface of the sacrotuberous ligament and the Greater Trochanter of the Femur shown in Figure 1.

The Sciatic Nerve
The affected nerve in piriformis syndrome is the sciatic nerve. Collectively the tibial and common fibular nerve makes up the general term sciatic nerve. Since the sciatic nerve is so close to the piriformis it is acknowledged that the muscle plays a role in irritating the nerve.

Symptoms
Symptoms are reported to be buttock pain that radiates into the ipsilateral thigh and leg. The symptoms seem to be aggravated by prolonged sitting, walking and walking up inclines. All these indications seem to imply that applying compressive loads on the nerve or performing the agonist motions of the piriformis muscle leads to more irritation to the sciatic nerve. The agonist motion of the piriformis muscle is to externally rotate the hip. Anything that involves rotating the hip like walking, mentioned earlier will only will cause the piriformis to irritate the sciatic nerve even more.