Common spine & neck concerns we treat
- Pain that limits walking, lifting, or sleep
- Stiffness, swelling, or reduced range of motion
- Sports injuries: acute or overuse
- Arthritis or post-traumatic joint changes
- Conditions other doctors couldn't resolve
Piriformis Syndrome
Buttock pain from an irritated sciatic nerve
Piriformis syndrome is buttock and leg pain caused by the piriformis muscle irritating the sciatic nerve, often mistaken for true lumbar sciatica. Same-day or next-week evaluations across eight LA-area offices.
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Board-certified surgeons and podiatrists across eight Los Angeles area neighborhoods.
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What sets LAOSS apart
- Same- or next-day appointments at eight Los Angeles-area offices
- On-site imaging; PT coordinated with your in-network provider
- Conservative-first care, surgery only when needed
- Board-certified specialists, not generalists
Key takeaways
- Piriformis syndrome is one of many spine & neck conditions our specialists evaluate every day.
- Most patients improve with conservative care: stretching and strengthening in physical therapy, less prolonged sitting, and an image-guided piriformis injection when pain persists.
- When a procedure is the right call, we explain every option, recovery timeline, and return-to-activity milestone.
- On-site imaging at most offices and same-day appointments across eight Los Angeles-area locations.
What is piriformis syndrome?
Piriformis syndrome is buttock and leg pain caused by the piriformis muscle irritating the sciatic nerve, often mistaken for true lumbar sciatica. Symptoms can develop gradually or after a specific injury, so early evaluation matters when function starts to decline.
Most patients with piriformis syndrome improve with conservative care: physical therapy that stretches the piriformis and strengthens the hip and core, breaks from prolonged sitting, anti-inflammatory medication, and an image-guided injection into the muscle when pain persists. Because the symptoms overlap with sciatica that starts in the spine, part of the evaluation is ruling out a disc or other spinal cause. Surgery to release the muscle and free the nerve is rarely needed.
Below, we walk through the anatomy involved, the symptoms and causes we most often see, how we diagnose piriformis syndrome, and the full range of treatment options, from the simplest to the most involved.
Watch: Piriformis Syndrome
This is a pain and numbness you feel in your buttock and down the back of your leg. It involves the sciatic nerve. That's a large nerve that travels from your lower spine down to your foot.
Inside the spine & neck.
The spine has 33 vertebrae stacked in five regions: cervical, thoracic, lumbar, sacral, and coccygeal. Between each vertebra sits a disc that cushions and allows motion. The spinal cord and nerve roots run through the canal, so when a disc bulges, a joint enlarges, or a vertebra slips, pain can radiate into the arms or legs.
Symptoms and causes of piriformis syndrome
Common symptoms
- Deep buttock pain on one side
- Pain that radiates down the back of the leg
- Pain that worsens with sitting (drivers, cyclists)
- Tenderness when pressing on the buttock muscles
Common causes
- Prolonged sitting or driving
- Repetitive hip rotation (running, cycling)
- Anatomic variant where the sciatic nerve passes through the muscle
- Direct trauma to the buttock
How we diagnose piriformis syndrome
You want answers, fast, and we're built to give them. Most patients leave their first LAOSS visit with a clear diagnosis and a written plan, not another referral chain.
Here's what your initial visit for piriformis syndrome typically looks like:
- Detailed history: when it started, what makes it better or worse, what you've already tried
- Focused exam of the low back, hip, and buttock: range of motion, stability, strength, specific provocation tests
- On-site imaging at most offices: X-ray for bone, ultrasound or MRI when soft-tissue detail is needed
- A written plan with options ranging from conservative care to surgical procedures, in plain English
Schedule your evaluation at the LAOSS office nearest you.
How we treat piriformis syndrome at LAOSS
Once we've confirmed the diagnosis, the next step is matching the right treatment to your situation. We start with the least-invasive option that fits, and escalate only when it doesn't.
Conservative care
Step 1Conservative care first
Non-surgical options designed to relieve pain, restore movement, and avoid the OR when possible.
- Physical therapy: piriformis and hip stretching with hip and core strengthening
- Activity modification: breaks from prolonged sitting, driving, and cycling
- Anti-inflammatory medication and heat or ice for flare-ups
- Massage and soft-tissue therapy for the deep buttock muscles
- Image-guided injection of anesthetic and steroid into the piriformis muscle
Surgical care
When neededSurgery is rarely needed
Considered only after other causes of sciatica are ruled out and thorough non-surgical care has not helped.
- Piriformis release (cutting or lengthening the tight muscle or tendon)
- Sciatic nerve decompression (freeing the nerve where it is pinched)
- Endoscopic or open technique, chosen for your anatomy
- Physical therapy after surgery to restore hip strength and flexibility
Why experience matters.
Why experience matters
Spine & neck care is highly technique-dependent. Volume, training, and judgment together determine the outcome you actually feel six months later.
- Precise diagnosis from imaging and exam
- Conservative-first care that avoids unnecessary surgery
- Surgical technique refined over thousands of cases
- On-site imaging + coordinated PT through your in-network provider
The LAOSS approach
Our spine & neck specialists move stepwise: start with the least-invasive option that fits your situation, escalate only when it doesn't.
- Same-day imaging at most offices
- PT coordinated in your insurance network
- Board-certified surgeons performing the procedures themselves
- Direct access to your specialist between visits
Am I a candidate?
If most of these match your situation, an evaluation with a spine & neck specialist is the next step.
You may be a candidate if
These signs typically point toward an in-person evaluation with a spine & neck specialist.
- Pain or stiffness in the spine & neck that lasts more than a few days
- Swelling, instability, or noticeable change in function
- Symptoms that limit walking, lifting, sleep, or work
- Previous treatment that didn't fully resolve the problem
- Imaging or exam findings that suggest an underlying issue
What evaluation includes
Your first visit is built to give you an answer the same day, not just another referral.
- Detailed history: onset, mechanism, what makes it better or worse
- Hands-on exam focused on the affected joint or region
- On-site imaging at most offices (X-ray, ultrasound)
- Clear plan with options ranging from conservative to surgical
- Same-day or next-day scheduling for any follow-up tests
ImportantGo to the emergency room or call 911 for loss of bowel or bladder control, numbness in the groin or inner thighs, or weakness in the arms or legs that is getting worse quickly. Seek urgent evaluation for sudden severe pain, new numbness, or any sign of infection (fever, increasing redness or swelling).
Your spine & neck recovery roadmap.
Recovery is rarely a straight line, but a clear plan with measurable milestones makes the path predictable.
- Days 0 to 14
Right after care
In the first two weeks we focus on protecting the spine & neck, calming inflammation, and restoring basic motion.
- Activity modification with clear do/don't guidance
- Ice or heat and pain control as needed
- Gentle range-of-motion within safe limits
- Follow-up scheduled to track healing
- Weeks 2 to 8
Rehabilitation
Targeted physical therapy rebuilds strength, mobility, and confidence in the spine & neck.
- Progressive strengthening and neuromuscular work
- Manual therapy and soft-tissue treatment
- Sport- or job-specific movement re-training
- Coordinated PT through your in-network provider
- Months 2+
Long-term care
Once function is restored, the focus shifts to keeping you there, and catching any recurrence early.
- Return-to-activity plan with measured benchmarks
- Home program tailored to your sport or job
- Maintenance visits or imaging if symptoms change
- Direct line back to your specialist if needed
Risks & considerations
What to weigh before you decide.
We talk through the risks and benefits with every patient. Informed consent is a conversation, not a form.
General considerations
Every orthopedic intervention carries a small set of standard risks. We screen, prepare, and monitor for these on every patient.
- Infection (rare with modern technique and prophylaxis)
- Bleeding or bruising at the treatment site
- Reaction to anesthesia or medications
- Need for additional procedures in some cases
Spine and neck considerations
Some risks are tied to the structures we're treating in the spine & neck. We discuss these in detail at your visit so you can weigh them against the benefits.
- Temporary stiffness or weakness during recovery
- Incomplete pain relief in a small percentage of cases
- Nerve or vessel irritation near the treatment area
- Need for follow-up therapy to fully restore function
Meet our spine & neck doctors in the Greater Los Angeles area
At LAOSS, our spine & neck specialists are board-certified and treat these problems every day. From image-guided injections and minimally invasive spine procedures to spine surgery when it is needed, our physicians bring decades of experience to every case. We have cared for Los Angeles patients since 2007, with one goal for each: less pain, better movement, and a return to the activities you love.
Meet your spine & neck specialists.
Compare up to 34 providers
Accepting new patients
Jose Antonio Acosta, MD
Pain Management & Rehabilitation
Speaks English and Spanish
Habla español
- Glendale
- Encino
- Valencia
- +1 more
Care for piriformis syndrome starts here
Don't let piriformis syndrome be something you just power through. With same- or next-day appointments at multiple Los Angeles locations, you'll never wait weeks or months for answers. The same team handles your diagnosis, treatment, and recovery. Whether you need physical therapy, injections, or surgery, we plan it with you and coordinate each step.
Call or schedule online today to see a spine & neck specialist in Los Angeles.
Common piriformis syndrome questions
- We start with a focused orthopedic exam and detailed history. X-rays are usually done in-office; MRI or ultrasound is ordered when soft-tissue detail is needed. Most patients leave the first visit with a clear diagnosis and a written plan.
Don't wait on pain.
Book a visit with a spine & neck specialist at any of our eight Los Angeles-area offices.
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21 specialists · 8 offices
Greater Los Angeles
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