patient-login Make a Referral
CALL US: 954-256-5301
Schedule A Consultation
pay-bill-icon
    patient-login Make a Referral
    CALL US: 954-256-5301
    Schedule A Consultation

    What Causes Piriformis Syndrome?

    Piriformis syndrome occurs when a small muscle deep in the buttock—the piriformis—compresses the nearby sciatic nerve. This irritation can mimic classic sciatica, causing sharp, radiating pain down your leg, especially while sitting, climbing stairs, or driving. While some cases stem from overuse, injury, or anatomy, the root issue isn’t in your spine—it’s soft tissue pressing directly on the nerve.

    If you've tried injections, physical therapy, or even back surgery with no success, piriformis syndrome may be the real source of your pain. In these cases, surgical nerve decompression can relieve the pressure and deliver lasting relief.

    Get Evaluated
    What Causes Piriformis Syndrome

    Check Your Symptoms: Are You Experiencing Any of the Following?

    • Deep, aching pain in one buttock
    • Sharp or burning pain that runs down the back of your leg
    • Discomfort that gets worse with sitting, driving, or climbing stairs
    • Tenderness in the gluteal area, especially when pressed
    • No findings on spine MRI—but the pain is still real
    • Little to no relief from physical therapy, injections, or spine treatments

    If you said yes to any of the above, you may be a candidate for nerve decompression surgery. 

    Book a Consultation

    What is Nerve Decompression Surgery for Piriformis Syndrome?

    Nerve decompression surgery targets the real source of pain: the sciatic nerve being pinched by the piriformis muscle deep in your hip. During surgery, our nerve experts make a small incision to gently release the piriformis muscle and free the sciatic nerve. In some cases, additional scar tissue around the nerve (called adhesions) is also removed—a process known as neurolysis. This reduces pressure, restores mobility, and helps prevent the pain from returning.

    The procedure is minimally invasive, typically outpatient, and designed to get you back to sitting, walking, and living without the constant burn or ache. In published studies, more than 80% of patients report significant relief after surgery—even after months or years of failed conservative care.

    Find Out If You’re Eligible for Nerve Decompression Surgery in Florida
    Schedule an Evaluation

    See How We’re Changing Lives,
One Patient at a Time

    Mike’s Story: Nerve Surgery Restored Mobility After Years of Chronic Pain
    piriformisvideo
    “I recommend him to anybody. He gave me back my quality of life.”

    Benefits of Surgery

    Piriformis Syndrome (T2) - icons_icon-film-reel
    Sit through a meal, meeting, or movie without burning pain
    Piriformis Syndrome (T2) - icons_icon-car
    Drive or commute comfortably again—without shifting constantly
    Piriformis Syndrome (T2) - icons_icon-person-hiking
    Get back to walking, working, or exercising on your own terms
    Piriformis Syndrome (T2) - icons_icon-moon-with-Zs
    Sleep through the night without leg pain waking you up

    Am I a Candidate for Surgery?

    If physical therapy, injections, or spine treatments haven’t eased your sciatic pain, piriformis syndrome surgery may be the answer. A comprehensive nerve evaluation can determine whether microsurgical decompression is right for you.

    You may be a candidate if you experience:

    • Deep buttock tenderness with radiating leg pain
    • Pain that worsens while sitting, driving, or climbing stairs
    • Normal spine MRI or failed back surgery without relief
    • Temporary relief from nerve blocks—but the pain keeps returning
    Get Qualified
    Am I a Candidate for Surgery-2
    Why is Piriformis Syndrome Often Misdiagnosed

    Why is Piriformis Syndrome Often Misdiagnosed?

    Piriformis syndrome is frequently overlooked because its symptoms closely mirror those of spinal conditions like disc herniations or sciatica. Yet unlike spinal issues, piriformis syndrome rarely shows up on standard imaging like MRIs, which often appear completely normal. Without a definitive diagnostic test, accurate diagnosis depends on a provider’s clinical expertise and ability to recognize the nuanced symptom patterns unique to peripheral nerve compression. Our focused training in peripheral nerve disorders allows us to identify cases that are commonly missed and provide highly targeted surgical solutions that address the true source of pain.

    Why is Piriformis Syndrome Often Misdiagnosed

    Considering Decompression Surgery for Piriformis Syndrome? What to Expect:

    Precision Diagnostics

    Diagnosing piriformis syndrome requires more than a standard MRI. We use advanced tools like nerve conduction studies, precision-guided diagnostic injections, and detailed clinical nerve mapping to identify the true source of sciatic-like pain. These technologies, rarely available in general practice, allow us to differentiate piriformis syndrome from spinal causes with a high degree of accuracy—ensuring that each patient receives a diagnosis based on evidence, not guesswork.

    Tailored Surgery

    Our surgical team performs piriformis decompression using refined microsurgical techniques and intraoperative nerve monitoring to safeguard the sciatic nerve and surrounding tissue. Under high-powered magnification, we release compression at the exact anatomical entrapment points—whether the nerve passes beneath, through, or beside the piriformis muscle. Every procedure is tailored to your individual anatomy, allowing for precise, durable relief and minimizing the risk of recurrence or complications.

    Rapid Recovery

    Piriformis decompression is typically performed as an outpatient procedure, allowing most patients to return home the same day. Light activity, such as walking, is often encouraged within 24 to 48 hours, with a gradual return to normal routines in the following weeks. Many patients experience meaningful relief within days of surgery, with continued improvement as inflammation resolves and nerve function is restored—making recovery both swift and sustainable.

    Why Trust The Institute of Florida?

    Why Trust The Institute of Florida-4

    One of the Few U.S. Centers Specializing in Surgical Treatment for Piriformis Syndrome

    We are a national referral destination for patients with sciatic pain caused by piriformis muscle entrapment. Our surgeons perform one of the highest volumes of piriformis decompression procedures in the country—delivering unmatched experience in both diagnostics and microsurgical treatment.

    Surgical Expertise That Begins With the Nerve

    Unlike general pain clinics or spine-focused providers, we treat the nerve itself. Our surgeons are trained in advanced peripheral nerve techniques and have performed hundreds of decompression procedures involving complex nerve anatomy—including piriformis syndrome. 

    Technology Designed for Precision Nerve Surgery

    We use high-magnification optics, real-time intraoperative nerve monitoring, and microsurgical instruments to isolate the problem with accuracy—preserving surrounding tissue and maximizing relief.

    More than 80% of Patients Report Lasting Relief

    We don’t just track procedures—we track outcomes. Across our surgical program, over 80% of patients with piriformis syndrome report long-term pain reduction, improved quality of life, and decreased reliance on medication.

    Meet Florida’s Top
    Nerve Surgery Experts

    dr-lakhiani-353w
    Chris Lakhiani, MD, FACS
    • 300 + Pelvic & Peripheral Nerve Reconstructions
    • National Lecturer On Pudendal Neuralgia
    Read Bio
    dr-nasser-353w
    Ahmed Nasser, MD
    • 150+ Occipital Nerve and Diaphragm Procedures
    • Specialist in Complex Nerve Compression Syndromes
    Read Bio
    dr-dayan-353w
    Joseph Dayan, MD, MBA
    • 250+ Flap Transfers
    • Pioneer In Lymphatic Surgery For Breast Cancer Survivors
    Read Bio
    dr-small-353w
    Tzvi Small, MD, FACS
    • 300+ Core and Pelvic Nerve Procedures
    • National Leader in Sports Hernia and Pudendal Neuralgia Surgery
    Read Bio

    Still in Pain? Let’s Fix That.

    If you’re living with unresolved sciatic pain—or treating a patient who is—our team is here to help. With advanced surgical expertise and proven results, we offer real hope for lasting relief.

    Now seeing patients in Ft. Lauderdale and Boynton Beach.

    Book a Consult

    Frequently Asked Questions

    Why does my leg pain keep coming back, even after spine treatment?
    If you've had back-focused treatments like epidurals or even spine surgery with little relief, your pain may be coming from the piriformis muscle compressing the sciatic nerve. This condition often mimics sciatica but requires a completely different approach.
    How serious is piriformis syndrome?

    While not life-threatening, piriformis syndrome can be extremely disruptive—limiting mobility, sleep, and quality of life. Left untreated, it may lead to chronic nerve irritation and worsening symptoms over time.

    How do you know if piriformis syndrome is the real issue?

    Standard imaging often misses piriformis syndrome. At The Institute of Florida, we use targeted physical exams, diagnostic injections, and nerve testing to confirm whether the sciatic nerve is being compressed at the muscle—not the spine.

    Is piriformis decompression surgery risky?

    When performed by a specialized nerve surgeon, this is a low-risk outpatient procedure. At The Institute of Florida, we use advanced microsurgical techniques and nerve monitoring to reduce complication rates and support faster recovery.

    What are the risks of piriformis surgery?

    Risks may include infection, bleeding, or temporary numbness. However, serious complications are rare. Our precision-focused techniques help minimize trauma and protect surrounding nerves and tissues.

    How long is the recovery after surgery?

    Most patients return home the same day and begin light activity within a week. Physical therapy may be recommended to support healing, and many patients report significant relief within the first few weeks.

    Will the pain come back after surgery?

    In most cases, no. Over 85% of our patients report lasting relief following piriformis decompression. While mild symptoms may return in rare cases, recurrence is uncommon when the nerve is fully decompressed.