Actress Andie MacDowell recently got candid about her health, revealing key symptoms that led to her diagnosis of piriformis syndrome, on The Drew Barrymore Show. Piriformis syndrome is a little-known, painful condition that can significantly impact mobility and daily activities. To better understand the condition, what causes it, and how to prevent or manage it, we spoke with healthcare professionals who help break down key takeaways.
Andie MacDowell’s piriformis syndrome symptoms
During her interview with Drew Barrymore, MacDowell, 66, spoke of experiencing pain in her leg. This led her to believe she might need hip replacement surgery. However, doctors ultimately diagnosed her with piriformis syndrome.
“It’s a muscle that kind of clamps down on my sciatic nerve, and it was shooting down my leg,” MacDowell explained. “I thought I was going to have to have [a] hip replacement, thank God, my hips are fine.”
Rather than undergoing surgery, MacDowell turned to targeted exercises to strengthen her hips and glutes to alleviate the pain. “I have to work [my] bottom and work my hip. I just do it every day,” she said, noting that her dedication to movement has made her pain disappear. “It doesn’t hurt anymore—it’s a miracle.”
What is piriformis syndrome?
“Piriformis syndrome is a painful condition that develops when the sciatic nerve is irritated or compressed near the piriformis muscle,” explains Sheetal DeCaria, MD, Physician and Owner of Revitalize Medical Center. This small muscle, located deep in the buttocks, becomes tight, leading to a compressed nerve. “It sometimes causes just a deep, dull ache in the gluteal/buttock area, but it can also cause shooting pain or ‘sciatica’ into the leg,” adds Dr. DeCaria.
Piriformis syndrome often gets confused with other causes of sciatica, such as a herniated disc. But uniquely, it stems from muscle tightness rather than spinal issues. “Many people mistake pain around the piriformis, or buttock pain, for piriformis syndrome, and the condition is often over-diagnosed as a result,” adds David Spinner, DO, Director of Pain Management at White Plains Hospital.
“Piriformis syndrome is relatively rare,” Dr. Spinner adds. “Should you feel like you are starting to have symptoms, you should see a pain management or physiatry specialist for an evaluation.”
Common symptoms of piriformis syndrome
According to Dr. DeCaria, the first signs of piriformis syndrome include “an ache or tenderness in your buttock along with shooting pain down your leg when sitting.” Other symptoms include numbness or a tingling feeling that may get worse when sitting for long periods, walking or climbing stairs.
As mentioned, these sciatica symptoms can also have other causes. “If you do notice any of these symptoms, be sure to see your doctor. If it is not a disc herniation (and even if it is), I highly recommend a physical therapy evaluation to rule out any physical causes for the piriformis symptoms,” advises Dr. DeCaria.
What causes piriformis syndrome?
Piriformis syndrome can develop due to various factors.
“Causes include direct trauma to the muscle from sitting on a wallet overlying the piriformis muscle, prolonged sitting, hip issues or hip surgery and anything that leads to an abnormal walk or an imbalance in the pelvis.” — Dr. DeCaria.
MacDowell admitted that her previous exercise routine may have contributed to her symptoms. “I had been riding my indoor bike like a crazy person,” she shared. “It’s not appropriate for my body, and I ended up with bad knees and a bad hip… I thought I was literally falling apart.”
However, it’s important to remember that no single activity puts someone at risk of developing this painful condition. “If all or part of the sciatic nerve becomes taut as it passes through or next to the piriformis muscle, someone could develop piriformis syndrome,” reminds Dr. Spinner.
How piriformis syndrome is treated
Treatment for piriformis syndrome focuses on relieving muscle tightness and reducing nerve compression. This includes “a good physical therapy program with a focus on piriformis stretching,” says Dr. Spinner. “Non-surgical options include injections into the piriformis muscle, including steroids or Botox.”
Dr. DeCaria adds physical therapy primarily involves targeted strengthening exercises, similar to MacDowell’s routine. She also mentions “stretching to relieve tight muscles, applying heat, using a myofascial release tool and dry needling.” In most cases, surgery is not necessary.
Reducing your risk of piriformis syndrome
Although not always avoidable, there are steps you can take to reduce your risk of developing piriformis syndrome. The best tip Dr. DeCaria shares? Movement. “Strengthening gluteal muscles and hip abductors is key!” she says. “Think clam shell exercises and bridges.”
When possible, avoid prolonged sitting (especially on hard surfaces) or carrying a wallet in your back pocket. If you sit for the majority of the day, she recommends a seat cushion designed to offset pressure, such as this one. “If you do any repetitive activity sport that seems to aggravate it, take a break and work with a physical therapist before returning to it,” adds Dr. DeCaria.
Andie MacDowell’s holistic approach to health
Beyond addressing her piriformis syndrome, MacDowell is a strong advocate for healthy aging. She encourages others to embrace movement and strength training as they get older, something that both improved her piriformis syndrome symptoms and overall well-being. “I think as you age, lift weights, work with a [personal trainer] PT person to build your muscles,” she advised during her interview.
“I’m happier now than I have been in a long time,” she shared. “I’m taking good care of myself. It took me forever.”
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
