PMS ultrasound explained

Overview

PMS stands for Piriformis Muscle Syndrome. This is a condition where a small muscle deep in your buttock — called the piriformis muscle — becomes tight or spasms. This can irritate the sciatic nerve, causing pain, tingling, or numbness in your buttock and down the back of your leg. An ultrasound scan uses sound waves to create live images of this muscle, helping doctors see if it looks abnormal and guide treatments if needed.

Piriformis muscle syndrome is a fairly common cause of buttock and leg pain, though exact numbers are unknown. Many cases are mild and get better with simple care.

It can affect anyone, but you may be more likely to develop it if you sit for long hours, run, or have had an injury to your buttock or hip.

Symptoms

Common symptoms

• Pain or aching in one buttock
• Pain that travels down the back of the leg
• Tingling or numbness in the buttock or leg
• Pain that gets worse when sitting for a long time

Causes

Main causes

• Overuse of the muscle from activities like running or climbing stairs
• Prolonged sitting, especially with a wallet or object in a back pocket
• Injury to the buttock or pelvic area
• Changes in muscles due to poor posture

Risk factors

• Long-distance runners
• People who sit for long periods, such as drivers or office workers
• Previous hip or buttock surgery
• An abnormal walking pattern or leg length difference

When to see a doctor

See a doctor urgently if:

• If you have sudden loss of bladder or bowel control, or severe weakness in your legs, call emergency services immediately.
• If you have severe pain after an injury, or leg pain with swelling and fever, seek same-day medical care.

Book a routine appointment if:

• If buttock or leg pain lasts more than a few weeks
• If the pain is affecting your daily activities or sleep
• If you have tingling or numbness that is not going away

Diagnosis

A healthcare professional will first ask about your symptoms and examine you. They may press on specific spots to see if the piriformis muscle is tender. If needed, they can arrange an ultrasound scan to look at the muscle directly and rule out other causes.

Tests that may be done

• An ultrasound scan of the buttock and pelvic area
• Sometimes an MRI scan for a more detailed view
• Nerve tests to check how well the sciatic nerve is working

What to expect at your appointment

For an ultrasound, you will lie on your stomach or side. A gel is applied to your skin, and a small handheld probe is moved over the buttock area. It usually takes about 15 to 30 minutes and causes no pain. No special preparation is needed.

Treatment

Treatment typically starts with simple, non-invasive measures. Most people improve with physical therapy and home exercises. Ultrasound can be used to guide targeted injections to the muscle if initial treatments are not enough.

Self-care at home

• Gently stretch your buttock and leg muscles daily
• Apply a warm pack to the area to relax the muscle
• Avoid sitting for long periods — stand up and walk every 30 minutes
• Try sleeping on your side with a pillow between your knees if it worsens at night

Medical treatments

Your healthcare provider may suggest physical therapy, manual therapy, or in some cases, a guided injection into the piriformis muscle using ultrasound. The injection typically contains a local anesthetic or a corticosteroid – but your doctor will explain the options and decide what is most appropriate for you. Surgery is rarely needed.

When is surgery considered?

Surgery is only considered if symptoms remain severe after many months of treatment and all other options have been tried. This is very uncommon.

Living with this condition

Many people manage well with a few simple adjustments. Listen to your body, take breaks from sitting, and try not to push through sharp pain.

Lifestyle tips

• Incorporate gentle stretching into your daily routine
• Adjust your chair or standing desk to improve your posture
• Avoid keeping bulky items like wallets in your back pocket
• Stay physically active with low-impact activities like walking or swimming

Diet and exercise

A healthy diet and regular exercise support overall muscle health. Focus on strengthening your core, hips, and buttock muscles with gentle resistance exercises, and always warm up before more intense activities.

Mental health and emotional wellbeing

Living with chronic pain can be stressful and exhausting. It is normal to feel frustrated, anxious, or down at times. Talk to your doctor if these feelings persist – support is available.

Prevention

It may not always be possible to prevent piriformis muscle syndrome, but you can reduce your risk by staying active, using good posture, and taking regular breaks from sitting.

Complications

If left untreated

• The pain may become chronic and harder to treat
• You may develop altered walking habits that strain other parts of your body
• The sciatic nerve may become more irritated, leading to persistent numbness or weakness

Long-term outlook

The outlook is generally positive. With proper care, most people see significant improvement within a few weeks to months. Ultrasound can help your doctor deliver more precise treatments, and a full recovery is very possible.

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