Can piriformis syndrome send pain all the way down to the heal? and pain in the achilles area?

Piriformis syndrome: Piriformis syndrome pain usually stops at about the knee. If it goes lower, you may want to have your sciatic nerves looked at.

Yes. : It's known as " pain in the butt" caused by a muscle located deep in the gluteal region. Initiated by running or walking due to muscleskeletal issues , sciatic and herniated disc. Piriforms syndrome causes pain in the buttock that radiates down the leg into the foot. The sciatic nerve is impinged by the piriformis muscle.

Piriformis syndrome: Because the piriformis muscle can compress the sciatic nerve, the symptoms of pain, tingling or numbness can trace down to the length of the sciatic nerve. Although the sciatic nerve branches to smaller nerves around the knee, the symptoms are most noticable above the knee. Indirectly, you may be adjusting the way you walk due to piriformis syndrome and this could contribute to achilles pain.

Rare: In 25 years I have seen this once and it was from a nerve entrapment at the level of the knee.