How to Beat Piriformis Syndrome

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The piriformis muscle is a small, flat and triangular muscle located deep in the buttock. Piriformis syndrome is a neuromuscular condition that affects the sciatic nerve and causes hip and buttock pain. The cause of piriformis syndrome is not always clear, but it seems to happen as a result of irritation or injury. [1] To beat piriformis syndrome, you will need to take steps to deal with pain and discomfort, follow your doctor’s treatment recommendations, and do what you can to prevent further irritation of the piriformis muscle.

Method 1
Method 1 of 3:

Easing Pain and Discomfort

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  1. If you are having pain and discomfort from piriformis syndrome, then one of the best things you can do is rest your body. Piriformis syndrome may be the result of irritation or injury from exercise or other forms of strenuous activity. [2]
    • If you have a physical job or you like to exercise every day, then this advice may be a challenge for you. But it is important to rest to avoid further damage or irritation to the piriformis and to allow it to recover.
  2. Heat therapy is an effective way to help soothe pain and discomfort caused by piriformis syndrome. Heat therapy is also an effective way to warm up your muscles before stretching them. [3]
    • Try using a heating pad on the affected area or take a warm bath to cover more areas at once.
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  3. Certain stretches have been found to be effective at relieving some of the pain and discomfort associated with piriformis syndrome. For best results, you will need to perform the stretches three times per day. [4]
  4. 4
    Use a ball or roller to massage the muscle. Get a lacrosse ball or a foam roller and sit on it so it's right at the backside of your hip bone. Then, roll back and forth to apply deep pressure to your piriformis muscle. [7]
  5. After stretching, applying ice can be an effective way to reduce pain and swelling associated with piriformis syndrome. To use ice, wrap an ice pack or bag of frozen vegetables in a thin cloth or paper towel. Then place the ice pack on the most painful area. Leave the ice pack in place for about 20 minutes and then remove it. Wait for at least 2 hours to reapply. [9]
  6. Piriformis syndrome may be agitated by sitting or standing in certain positions, so you will need to make sure to avoid these positions. Do what you need to do to make yourself comfortable while sitting and standing. [10]
    • Try sitting on a cushion or comfortable chair if sitting feels painful to you. If you have trouble standing, consider using crutches or a cane to help support your weight while you stand.
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Method 2
Method 2 of 3:

Considering Medical Treatment Options

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  1. Get a diagnosis . Getting a diagnosis is the first step in treating any condition. There are no tests to confirm whether or not you have piriformis syndrome, so your doctor will perform a physical exam and ask you to explain all of your symptoms. Your doctor may also want you to have an MRI to rule out any other possible causes of your symptoms. [11]
  2. A physical therapist can design a program developed to meet your specific needs and guide you through exercises that will efficiently stretch your muscles and relieve pain. [12] Get started early with physical therapy to get the greatest benefit.
  3. Massage and trigger point therapy may offer relief for piriformis symptoms. In some cases, piriformis symptoms might actually be caused by trigger points, or muscle knots. These knots may be found in the piriformis or gluteal muscles, and the pressure they cause can lead to pain at the site of the knot or even elsewhere on the body. Locate a health professional who is trained in trigger point therapy (a doctor, massage therapist, physical therapist) and see if this is the source of your pain.
  4. Your doctor may recommend certain over-the-counter and prescription medications to help you deal with pain. For example, some doctors may prescribe a muscle relaxant to help ease the discomfort of your piriformis syndrome. [13]
    • Ask your doctor about taking ibuprofen or naproxen for occasional piriformis pain as well.
  5. Some injection treatments have been found to be helpful in cases of piriformis syndrome. Ask your doctor if an injection treatment might be useful in your situation. The two main injection treatments for piriformis syndrome include anesthetic injection and Botox injection.
    • Anesthetic injection. A pain relieving substance such as lidocaine or bupivacaine may be injected into the piriformis to help relieve pain. [14]
    • Botox injection. Botox injections have also been found to be effective in reducing pain and discomfort from piriformis syndrome. [15]
  6. Electrotherapy has been found to be effective in some cases of piriformis syndrome. Ask your doctor or physical therapist about the possibility of using Transcutaneous Electrical Nerve Stimulation (TENS) or Interferential Current Stimulator (IFC) to help treat your piriformis syndrome. [16] [17]
  7. Surgery has provided long-term pain relief for some sufferers of piriformis syndrome, but as with any surgery, there are some serious potential side effects to this treatment. It is best to exhaust all of your other treatment options before looking into surgery for piriformis syndrome. [18]
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Method 3
Method 3 of 3:

Preventing Piriformis Syndrome

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  1. Taking five minutes to warm up your muscles can help to prevent injury and it is also a good way to prevent piriformis syndrome. Make sure that you allow your body some time to warm up before you do anything too strenuous. [19]
    • To warm up, just do a lighter version of the type of exercise you are about to perform. For example, if you are about to go for a run, spend five minutes walking briskly.
  2. Uneven surfaces can cause you to strain your muscles more than flat surfaces do. To avoid this potential risk factor, choose flat surfaces to exercise on. For example, if you live in a hilly area, go to a track to walk or run. [20]
  3. Muscles tighten up when we exercise, so it is necessary to stretch after a workout to loosen them up again. After you finish exercising, take a few minutes to stretch all of your major muscle groups. Stretch your neck, arms, legs, and back. [21]
  4. Poor posture may also lead to the development of piriformis syndrome, especially during exercise. Take extra care to stand up straight and tall when you are walking or running. Pay attention to your posture all other times as well. [22]
  5. Overdoing it may lead to the development of piriformis syndrome, so it is important to know your limits. If you begin to feel pain and/or discomfort during your workout, then stop and take a break. If the pain continues after you resume, then do not do any more exercise. Rest and wait for the pain to subside. If it does not subside, then call your doctor. [23]
  6. 6
    Avoid sitting so you're rotating one hip more than the other. If you tend to shift to one side while you're sitting, a lot of times your piriformis muscle will get tight. That puts tension on your sciatic nerve and sends pain signals down your leg. [24]
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      Tips

      • Make sure that you follow your doctor’s instructions for treating your piriformis syndrome. Do not stop a treatment or medication without consulting your doctor first.
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      • If you keep your wallet or phone in your back pocket, try storing them elsewhere. Sitting on these items can aggravate and press on the piriformis muscle.
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      Warnings

      • Piriformis syndrome may continue to cause pain and discomfort without proper treatment. See your doctor right away if you notice that your symptoms have not improved or if they seem to be getting worse.
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      References

      1. ↑ http://www.spine-health.com/conditions/sciatica/what-piriformis-syndrome
      2. ↑ http://emedicine.medscape.com/article/87545-treatment
      3. ↑ http://emedicine.medscape.com/article/87545-treatment
      4. ↑ http://www.spine-health.com/conditions/sciatica/piriformis-muscle-stretch-and-physical-therapy
      5. ↑ Joshua Grahlman, PT, DPT, FAFS. Physical Therapist & Entrepreneur. Expert Interview. 8 September 2020.
      6. ↑ Joshua Grahlman, PT, DPT, FAFS. Physical Therapist & Entrepreneur. Expert Interview. 8 September 2020.
      7. ↑ Joshua Grahlman, PT, DPT, FAFS. Physical Therapist & Entrepreneur. Expert Interview. 8 September 2020.
      8. ↑ Joshua Grahlman, PT, DPT, FAFS. Physical Therapist & Entrepreneur. Expert Interview. 8 September 2020.
      9. ↑ http://www.spine-health.com/conditions/sciatica/piriformis-syndrome-treatment
      1. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments?page=2
      2. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments
      3. ↑ http://www.spine-health.com/conditions/sciatica/piriformis-muscle-stretch-and-physical-therapy
      4. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments?page=2
      5. ↑ http://emedicine.medscape.com/article/87545-treatment
      6. ↑ http://www.ncbi.nlm.nih.gov/pubmed/12447093
      7. ↑ http://emedicine.medscape.com/article/87545-treatment
      8. ↑ http://www.spine-health.com/conditions/sciatica/piriformis-syndrome-treatment
      9. ↑ http://www.ncbi.nlm.nih.gov/pubmed/16425055
      10. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments?page=2
      11. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments?page=2
      12. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments?page=2
      13. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments?page=2
      14. ↑ http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments?page=2
      15. ↑ Joshua Grahlman, PT, DPT, FAFS. Physical Therapist & Entrepreneur. Expert Interview. 8 September 2020.
      16. ↑ Joshua Grahlman, PT, DPT, FAFS. Physical Therapist & Entrepreneur. Expert Interview. 8 September 2020.

      About This Article

      Article Summary X

      If you’re struggling with piriformis syndrome, take frequent rest breaks to minimize pain and give your piriformis muscles time to heal. You can also soothe pain and improve your circulation by taking a warm bath or putting a heating pad over your hips and buttocks. To help limber up your aching muscles and relieve discomfort, do piriformis stretches 3 times a day. After you stretch, apply ice to the affected area for 20 minutes to prevent pain and swelling. Finally, avoid sitting or standing in positions that aggravate your pain as much as possible. Scroll down for more advice from our Chiropractic co-author, including how to get medical treatments for piriformis syndrome.

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