Hip Pain & Piriformis Syndrome

Hip pain is a common complaint with many potential causes, including bursitis, tendinopathy, labral dysfunction, osteoarthritis, and referred pain from the lumbar spine. Piriformis syndrome is a specific condition where the piriformis muscle — a deep rotator in the buttock — compresses or irritates the sciatic nerve, causing pain in the buttock that can radiate down the leg.

Greater trochanteric pain syndrome (formerly called hip bursitis) is another common cause of lateral hip pain, involving the gluteal tendons and trochanteric bursa. These conditions frequently overlap and require thorough evaluation to identify the correct diagnosis and treatment approach.

At NeoLife Physical Therapy, we perform a detailed examination to differentiate between the many causes of hip and buttock pain. Accurate diagnosis is essential because the treatment for piriformis syndrome differs significantly from the treatment for hip bursitis, labral pathology, or lumbar-referred pain.

Your NeoLife therapist will conduct a comprehensive hip examination including range of motion testing, strength assessment, special tests for labral and bursitis pathology, piriformis provocation tests, lumbar spine screening, and gait analysis to pinpoint the source of your symptoms.

Treatment is tailored to your specific diagnosis and may include deep tissue manual therapy and hip joint mobilization, functional dry needling of the piriformis, gluteals, and hip rotators, progressive hip and core strengthening (critical for long-term resolution), gait retraining and movement pattern correction, activity modification and load management, and education on sleeping positions and daily habits that affect recovery.

Dry needling is particularly effective for piriformis syndrome — it directly targets the deep piriformis muscle to release tension and reduce sciatic nerve compression. Combined with hip strengthening, this approach resolves most cases of piriformis syndrome within 4–8 weeks.