Hip – Simply Move Chiropractic

Understanding and Treating Piriformis Syndrome in Charlotte, NC

Dr. Natalie Otoya — Thu, 22 Jan 2026 13:20:10 +0000

If you’ve been struggling with deep buttock pain, tingling down your leg, or a stubborn ache that just won’t go away, piriformis syndrome might be the cause — and you’re not alone. As a chiropractor in Charlotte, NC, I see many patients who have been misdiagnosed or have suffered for months thinking their pain was “just sciatica” or low back strain. In reality, when the piriformis muscle irritates the sciatic nerve, a very specific pattern of discomfort emerges — and thankfully, there are effective, evidence-based treatments available right here at Simply Move Chiropractic.

What Is Piriformis Syndrome?

The piriformis muscle is a small muscle deep in the buttocks that helps rotate the hip and stabilize the hip joint. In some people, the piriformis can become tight, inflamed, or develop trigger points (knots), which compress or irritate the sciatic nerve as it runs underneath or through the muscle. This irritation results in symptoms that can mimic sciatica — from buttock pain to pain radiating down the back of the thigh, sometimes with numbness or tingling. Unlike true sciatica from a herniated disc, piriformis syndrome is a muscle and soft-tissue problem, so the treatment approach must address the muscle itself.

Common Symptoms I See in My Charlotte Practice

Deep ache or sharp pain in the buttock
Pain when sitting, especially for prolonged periods
Pain that may radiate down the back of the leg
Tingling or numbness in the thigh or calf
Discomfort with certain movements like climbing stairs or crossing the legs

These symptoms often overlap with other conditions, which is why a thorough exam and assessment — including orthopedic tests and muscle evaluation — is important in making the right diagnosis.

How I Diagnose Piriformis Syndrome

There’s no single definitive test for piriformis syndrome, but I use a combination of:

Detailed history and symptom patterns
Physical examination (assessing hip motion, muscle tightness, trigger points)
Provocative tests that stretch or compress the piriformis
Neurological checks to rule out true nerve root compression

Red flags that signal a need for more advanced medical evaluation include significant weakness, loss of bowel/bladder control, or progressive neurological deficit — in those cases, I’ll work with or refer to appropriate specialists.

My Approach to Treatment — What Works and Why

At Simply Move Chiropractic in Charlotte, I combine manual therapies, functional exercises, and advanced modalities to address piriformis syndrome at its root — muscle dysfunction and sciatic nerve irritation.

1. Functional and Therapeutic Exercises

Exercise is the foundation of long-term recovery. I prescribe tailored exercises that:

Strengthen the glutes, hips, and core to reduce strain on the piriformis
Improve hip mobility and neuromuscular control
Reduce muscle imbalances

Examples include glute bridges, clamshells, hip rotations with resistance bands, and targeted stretching routines focusing on the piriformis and surrounding hip muscles. These help promote proper movement patterns and decrease nerve irritation.

Piriformis syndrome looks different from person to person, so I always start with a custom movement assessment and design an individualized exercise program to support long-term relief and prevention.

2. Active Release Technique (ART)

Active Release Technique (ART) is a hands-on soft tissue treatment that breaks up tightness and adhesions in muscles and fascia. For piriformis syndrome, I use ART to release the piriformis and surrounding gluteal muscles. This helps:

Reduce muscle tension
Restore normal muscle length and function
Improve circulation and nerve mobility

ART works particularly well because it targets the actual tissue dysfunction rather than just masking symptoms.

3. Dry Needle Therapy

One of the most effective treatments I offer is dry needling, especially for tight or trigger-point-laden piriformis muscles. Dry needling involves inserting very thin, sterile filiform needles into muscle trigger points to release tension and reset muscle tone.

Clinical research supports dry needling for piriformis syndrome: a randomized trial found that ultrasound-guided dry needling significantly reduced pain intensity compared with no intervention after one week. Another study comparing dry needling to exercise programs found both to be beneficial at reducing pain and disability.

I typically combine dry needling with corrective exercises to maximize outcomes.

4. Shockwave Therapy

Shockwave Therapy (Extracorporeal Shockwave Therapy or ESWT) is another advanced option I use for patients who need extra help. Shockwave delivers acoustic waves that stimulate tissue healing, improve blood flow, and reduce chronic muscle and tendon pain. Studies have shown radial shockwave to be effective for reducing pain and stiffness in piriformis syndrome, improving function compared to baseline therapy alone.

Shockwave is non-invasive, quick and typically quite effective for piriformis syndrome.

Bringing It All Together — Your Recovery Plan in Charlotte, NC

At my office, I combine these treatments into a personalized plan based on your presentation and goals. Most patients experience significant reduction in pain and improved function within a few weeks, with continued improvement as we rebuild strength, mobility, and muscle balance.

If you’re tired of living with buttock pain, burning sensations, or nerve-like symptoms that just won’t quit, don’t wait any longer. Piriformis syndrome is highly treatable, especially when addressed early and with a comprehensive approach.

Come see me in Charlotte.

Sacroiliac Joint Dysfunction Treatment in Charlotte, NC

Dr. Natalie Otoya — Tue, 26 Aug 2025 14:55:28 +0000

Understanding Sacroiliac Joint Dysfunction

The sacroiliac (SI) joints are small but powerful joints located where your spine meets your pelvis. Each person has two SI joints, connecting the sacrum (the triangular bone at the base of the spine) to the iliac bones of the pelvis. These joints play an essential role in stabilizing the spine and transferring weight from the upper body into the lower extremities. Unlike the freely mobile joints in your arms and legs, the SI joints allow only limited motion—mostly a slight tilting and gliding—to provide both stability and shock absorption during walking, running, and lifting.

When the SI joint becomes irritated, inflamed, or unstable, the result is sacroiliac joint dysfunction. This condition is a common cause of low back pain, often mistaken for a lumbar disc problem or hip issue.

Causes of SI Joint Dysfunction

There are multiple reasons why the sacroiliac joints can become painful:

Trauma or injury – Falls, accidents, or lifting something heavy improperly can strain the joint.
Pregnancy – Hormonal changes increase ligament laxity, which can lead to instability.
Leg length discrepancy – Unequal loading across the pelvis puts stress on one joint.
Repetitive stress – Running, twisting, or prolonged sitting can irritate the joint.
Arthritis and degeneration – Over time, wear and tear can inflame the SI joint surfaces.

Symptoms of SI Joint Dysfunction

The hallmark symptom is pain in the lower back or buttock region, which may radiate into the hip, groin, or even the thigh. Many patients describe it as sharp, stabbing, or aching. The pain often worsens when standing up from a seated position, climbing stairs, or bearing more weight on one leg.

Other common signs include:

Tenderness directly over the SI joint
Pain aggravated by long periods of standing or sitting
Stiffness in the lower back and hips
Difficulty performing functional activities such as walking or running

Diagnosing

Diagnosing SI joint dysfunction can be challenging because its symptoms overlap with lumbar disc herniation, hip pathology, or even sciatica. Chiropractors and medical providers use a combination of:

Patient history and physical exam – Special orthopedic tests, like the FABER or Gaenslen’s test, can help reproduce pain specific to the SI joint.
Diagnostic imaging – X-rays, CT scans, or MRI may be ordered to rule out other causes.
Diagnostic injections – In some cases, a physician may inject anesthetic into the joint to confirm it as the pain source.

Conventional Treatment Options

Traditional approaches to managing sacroiliac joint dysfunction include:

Anti-inflammatory medications to reduce pain and swelling
Steroid injections into the SI joint for short-term relief
Physical therapy focused on stabilization and strengthening
Radiofrequency ablation (in severe cases) to reduce pain signals
Surgical fusion (rare and only considered when all else fails)

Treatment at Simply Move Chiropractic

At Simply Move Chiropractic, I take a non-invasive, movement-based approach to treating sacroiliac joint dysfunction. Instead of just masking the pain, my goal is to restore proper joint mechanics, muscle balance, and stability.

Functional Movement Exercises

Strengthening the core, glutes, and hips is critical to long-term success. I provide individualized exercise programs that stabilize the pelvis and retrain healthy movement patterns.

Active Release Technique (ART)

This hands-on therapy releases tight or overworked muscles around the SI joint, including the gluteal muscles, piriformis, and hip flexors. By improving soft tissue function, we reduce strain on the joint.

Shockwave Therapy

Radial shockwave stimulates healing and reduces chronic inflammation in the ligaments and tendons supporting the SI joint. Studies suggest it is effective for musculoskeletal pain and improving function.

KinesioTape

Applied strategically across the low back and pelvis, kinesiotape provides gentle support to the sacroiliac joint while still allowing normal movement. It helps reduce pain, improve proprioception, and stabilize the area during daily activities

Dry Needle Therapy

y targeting trigger points in the glutes, piriformis, and lumbar stabilizers, dry needling decreases muscle tension that contributes to SI joint dysfunction.

Chiropractic Adjustments

Depending on your biomechanics, I may suggest temporary heel lifts, custom orthotics, or footwear changes to reduce tendon strain during recovery.

Research Supporting Conservative Care

A clinical study published in the Journal of Bodywork and Movement Therapies found that manual therapy combined with exercise significantly improved pain and function in patients with SI joint dysfunction (Al-Subahi et al., 2017). Another study in the Journal of Orthopaedic & Sports Physical Therapy reported that dry needling provided measurable pain relief and improved movement in patients with low back and pelvic pain related to SI dysfunction (Llamas-Ramos et al., 2014). Further research has shown kinesiotaping can decrease pain and improve function in patients with SI joint dysfunction (pubmed.ncbi.nlm.nih.gov).

Finding Relief in Charlotte

If you’re struggling with sacroiliac joint dysfunction, you don’t have to live with chronic low back or hip pain. At Simply Move Chiropractic in Charlotte, I use a combination of hands-on therapies, advanced technology, and functional movement strategies to help patients get lasting relief and return to the activities they love.