The following is a response I provided on a practitioner forum.
It’s important to differentiate between piriformis trigger point activity or knots and piriformis syndrome. The syndrome, as others have pointed out, involves compression of the sciatic nerve as it passes through or near the piriformis muscle and is associated with neurological symptoms.
Piriformis trigger points DO NOT cause neurological symptoms and give rise to referred pain over the sacroiliac joint region, hip or greater trochanter and possibly posterior thigh.
If you have neurological symptoms such as; numbness, tingling, shooting pain, burning, loss of sensation or weakness in the leg or foot then it could be piriformis syndrome, however, it is essential that your lumbar spine be eliminated as the cause! Not saying your GP is incorrect but piriformis syndrome is RARE.
Both piriformis trigger points and piriformis syndrome result from simple muscle spasm/trigger point activity and will both respond rapidly, 1 -3 treatments, to appropriate dry needling or acupuncture.
I’m very interested that you say “it gets bad towards the end of the day”. Would love to know what your day involves! If it’s sitting, you most probably need some advice on ergonomics as well as appropriate treatment.
Cred. McKenzie Method Practitioner
Doctor of Acupuncture