Piriformis syndrome is usually a neuromuscular situation if the piriformis muscle (a pear-formed muscle mass inside the buttocks) compresses the sciatic nerve (a nerve that extends through the lower backbone many of the way all the way down to the foot). This results in pain from the buttocks and hips. https://www.theorthopaedicandpainpractice.com/lower-back-and-buttock-pain/