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Most people who have piriformis syndrome get better with treatment and lifestyle changes. Failure to treat this condition can lead to permanent nerve damage, so be sure to follow your doctorâs instructions.
Causes of Piriformis Syndrome. The exact causes of piriformis syndrome are unknown. Suspected causes include: 1  Muscle spasm in the piriformis muscle, either because of irritation in the piriformis muscle itself, or irritation of a nearby structure such as the sacroiliac joint or hip.2  Tightening of the muscle, in response to injury or spasm. 3  Swelling of the piriformis muscle, due to injury or spasm.auses of Piriformis Syndrome. The exact causes of piriformis syndrome are unknown. Suspected causes include: 1  Muscle spasm in the piriformis muscle, either because of irritation in the piriformis muscle itself, or irritation of a nearby structure such as the sacroiliac joint or hip.