The Piriformis Problem

Piriformis syndrome, explained properly.

A guide to deep buttock and leg pain, written by a research scientist who lived with it for [X] years. It sets out what the evidence supports, what it doesn't, and the step-by-step plan that finally got him better.

Buy the ebook for £15 Read the first chapter free
Length
[000] pages
Sources
[000] studies
Format
PDF and EPUB
Refund window
30 days
Back view of the right hip A schematic drawing of the pelvis and top of the thigh bone seen from behind. The piriformis muscle runs from the sacrum to the greater trochanter of the femur, and the sciatic nerve passes beneath it and down the back of the leg. Piriformis Greater trochanter Sciatic nerve Sacrum Sit bone (ischial tuberosity)
Fig. 1 The right hip from behind. The sciatic nerve leaves the pelvis just beneath the piriformis, which is one reason pain from this area is so easily mistaken for a back problem.

Does this sound familiar?

  • A deep ache in one buttock that gets worse the longer you sit.
  • Pain, tingling or numbness down the back of the thigh.
  • Scans that show nothing, or show something nobody thinks explains it.
  • Stretches, massage and rest that help for a day and then stop helping.

Piriformis syndrome is a real but contested diagnosis. It overlaps with problems in the lower back, the hamstring tendons and the hip, and there is no single test that confirms it. That is a large part of why so many people get stuck, passed between appointments with advice that contradicts itself.

This book does not promise a cure. It gives you a clear account of what is known, a way to make sense of your own symptoms, and a structured plan for building back up, with honest notes on how strong the evidence is at each step.

Written for you if

  • your buttock or leg pain has lasted weeks or months
  • a clinician has mentioned piriformis, or you suspect it
  • you want to understand the evidence before spending more on treatments

Not the right book if

  • you have any of the urgent symptoms listed below
  • you want one stretch that fixes everything overnight
  • you are hoping to skip being examined by a professional

What's in the book

Nine chapters, written to be read in order the first time and dipped into afterwards. The first half explains the condition. The second half is the plan.

Read chapter 1 free
  1. 1What piriformis syndrome is, and what it isn't1
  2. 2Why it's so often missed15
  3. 3The conditions that look like it27
  4. 4What the research says about treatment41
  5. 5Settling things down: the first few weeks63
  6. 6Sitting, sleeping and working77
  7. 7Building strength and tolerance89
  8. 8When progress stalls111
  9. 9Staying well123
  10. AExercise library, with photographs131
  11. BQuestions to take to your GP or physio149
  12. CHow to read a medical study153

How the research was done

Every claim is referenced

The book draws on [000] published studies, from anatomy and imaging work to clinical trials. Full references sit at the end of each chapter, so you can check anything that matters to you.

The strength of the evidence is stated

Where advice rests on a single small study, or on clinical experience alone, the text says so. Where good trials disagree, you get both sides.

Personal experience is kept separate

What helped me is clearly marked as my experience. It sits alongside the research, never in place of it.

Chapter 2. Why it's so often missed

There is no single test that confirms piriformis syndrome. Most clinicians reach the diagnosis by first ruling out more common causes of buttock and leg pain, such as a disc problem in the lower back.4

This matters for you in a practical way. A scan that comes back clear does not mean nothing is wrong. It means one of the likelier explanations has been looked for and not found.5

Strength of evidence Moderate. Consistent across several reviews, though most of the underlying studies are small.

  1. [Author A, et al. Title of review. Journal. Year;Vol:pages.]
  2. [Author B, et al. Title of study. Journal. Year;Vol:pages.]

17

A page from chapter 2, showing how references and evidence notes appear in the book.

Why I wrote this

For [X] years I had pain deep in my [left] buttock that ran down my leg whenever I sat for long. I saw [GPs, physiotherapists, a sports doctor] and tried most of the usual advice. Some of it helped for a while. Most of it didn't.

I'm a research scientist by training, with a PhD and more than ten years spent editing medical and scientific papers. So eventually I did what I know how to do. I read the research, a lot of it, and wrote down what held up and what didn't.

This book is the result. It is the guide I wish someone had handed me in the first month. I'm not a doctor or a physiotherapist, and the book doesn't pretend otherwise. It is written to help you understand your situation and work well with the professionals who can examine you.

[Your name], PhD

  • PhD, [University]
  • [10+] years as a scientific and medical editor
  • [00] peer-reviewed publications
  • Clinical review by [name, role, e.g. chartered physiotherapist]

Read the first chapter before you buy

Chapter 1 is free to download. No email address needed. If the way it's written suits you, the rest of the book will too.

Download chapter 1 (PDF)

Get the book

£15

One payment. No subscription, no upsells.

  • The full book as PDF and EPUB, to read on any device or print at home
  • Printable exercise plan and symptom diary
  • Free updated editions when new research changes the advice
  • A full refund within 30 days if it isn't useful to you
Buy the ebook

Payment is handled by Payhip, who email your download link straight away. You don't need to create an account, and your card details are never shared with me.

When to get urgent help instead

Go to A&E or call 999 if you have leg pain or sciatica with any of the following:

  • symptoms in both legs
  • weakness or numbness in both legs that is severe or getting worse
  • numbness around or under your genitals, or around your bottom
  • difficulty controlling when you pee or poo, or not noticing when you need to go

These can be signs of a serious problem that needs treating in hospital straight away. The NHS page on sciatica has more detail.

Questions

How do I know piriformis syndrome is what I have?

The book can't tell you that, and nobody online can. It explains how the diagnosis is made, which conditions look similar, and the questions worth taking to your GP or physiotherapist so that you get a proper assessment.

Is this medical advice?

No. It is general information based on published research and one person's experience of recovery. It is not a substitute for being examined by a qualified clinician, and you should check any new exercise programme with one if you have other health conditions. See the medical disclaimer.

Do I need any equipment?

Not much. The plan uses your body weight, a chair and a resistance band. [Confirm or adjust once the exercise chapter is final.]

What format is it in?

You get both a PDF, for reading on a computer or printing, and an EPUB, which works on Kindle, Apple Books, Kobo and most other e-readers.

What if it doesn't help?

Email me within 30 days of buying and I'll refund you in full. You don't need to give a reason.

Will the book be updated?

Yes. When new research changes the advice, I'll update the book, and everyone who has bought it can download the new edition at no cost.

Who handles my payment?

Payhip, an established UK platform for selling digital products. They process the payment, deal with VAT and email your download link. I receive your name and email address so I can send updates, and never see your card details. See the privacy notice.

Can I ask you a question?

Yes, email hello@[your-domain]. I read everything, though I can't give individual medical advice.