How the Piriformis Causes Sciatic Pain

Written By Isaiah Young

Sciatic pain stinks. A lot. Why does it hurt so badly? Why does it run down my leg? What can be done to help it?

Today we’re going to talk about the Sciatic Nerve; The largest nerve in human body, as well as the piriformis and how they relate with each other

The piriformis is a small but powerful muscle deep in the buttock. Its job is to rotate the hip and stabilize the pelvis. The sciatic nerve—your body’s largest nerve—runs either under, over, or in some people through the piriformis.

The sciatic nerve is one of the biggest nerves. I was surprised when I first saw one. It seemed to be just about as thick as my pinkie! After I saw it, it made perfect sense to me that it could hurt so much when it gets squeezed or impinged. The pain runs down that back of the leg because that is where the rest of the sciatic nerve pathway continues to go.

If the piriformis becomes:

  • Tight

  • Inflamed

  • Spasming

  • Overworked from posture or movement patterns

…it can press on or irritate the sciatic nerve. This is known as piriformis syndrome, and it can mimic classic sciatica

How can we help this?

One way of treating the piriformis and sciatic pain is Neuromuscular therapy

What NMT does for the piriformis


1. Releases trigger points The piriformis often develops these tight knots that refer pain down the leg. NMT applies sustained, precise pressure to deactivate these points.

2. Reduces muscle tension and spasm By softening the piriformis, NMT decreases the mechanical pressure on the sciatic nerve.

3. Improves blood flow Better circulation helps reduce inflammation and speeds healing in the deep gluteal muscles.

4. Corrects neuromuscular imbalances NMT practitioners assess posture, gait, and muscle firing patterns. Often, the piriformis is overworking because other hip stabilizers are underworking. Addressing these patterns reduces recurrence.

5. Restores healthy movement By releasing the piriformis and surrounding tissues (gluteus medius, deep rotators, hamstrings), NMT helps the hip move freely again, reducing nerve irritation.

Why it works so well

Sciatic pain from the piriformis is fundamentally a mechanical compression problem. NMT directly addresses the root cause by:

  • Softening the muscle

  • Releasing nerve entrapment

  • Rebalancing the surrounding structures

It’s not just relaxing—it’s corrective.

Isaiah Young
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NMT and Chronic Pain