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Physical Therapy for Piriformis Syndrome – Information, Exercises, and More

You’re experiencing pain from piriformis syndrome — possibly severe pain

It could be affecting your life:

  • Socially
  • At home
  • At work

If you’re desperate for relief, you’re not alone. 

There are many forms of treatment for piriformis syndrome, including physical therapy.

In this article, we’ll share with you what’s causing your pain as well as methods of reli

ef to help you get back to living your best life.


What Is Piriformis Syndrome?

Piriformis syndrome is a neuromuscular disorder that develops due to irritation or compression of your sciatic nerve near your piriformis muscle

It’s a very painful condition for most patients and can greatly impact your daily life. It can cause pain in the buttocks, hip, lower back, the back of the leg, and even in your feet. 

Your piriformis muscle and your sciatic nerve work together to create this syndrome and cause your pain. 

Keep reading to learn more about this trouble-making team. 

What Causes Piriformis Syndrome?

Your piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. 

It connects the lowermost vertebrae with the upper part of the leg after traveling the “sciatic notch,” the opening in your pelvic bone that allows the sciatic nerve to travel into the leg. 

This muscle is important in your lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body, enabling you to walk, shift your weight from one foot to another, and maintain balance. 

It’s used in almost every motion of the hips and legs. 

The proximity of your piriformis muscle to the sciatic nerve is why issues can develop. 

When the sciatic nerve is irritated, pain and other symptoms occur. 

It’s estimated that about 5% of cases of sciatica are due to piriformis syndrome. 

Some common causes include:

  • Injury
  • Abnormal development or location of the piriformis muscle
  • Abnormal development or location of the sciatic nerve
  • Leg-length discrepancy 
  • Prior hip surgery 
  • Unusually vigorous exercise
  • Foot problems, including Morton’s Neuroma 

In many cases, the cause cannot be identified.

Who’s at Risk To Develop Piriformis Syndrome?

Anyone can develop piriformis syndrome, and it’s not based on age. 

However, it’s not known why, but females are more likely to be affected by this disorder than men by a ratio of 6:1. It could be due to anatomical differences. 

There are two groups of people who could be more likely to develop this condition based on their activities, or lack thereof:

  1. Athletes
  2. Those who sit for extended periods

Athletes, especially those who repeat the same motions over and over — such as lunging or running — are at higher risk of compressing the sciatic nerve. 

If you’re in this category, the best way to prevent this syndrome is to always practice correct form and complete proper warming up and cooling down exercises. 

On the other hand, those who live sedentary lifestyles or hold occupations that require sitting for a majority of the time are also at risk to develop piriformis syndrome. This can put undue pressure on the nerve. 

If this is you, it’s important to walk, stretch, and take adequate breaks from sitting in the same position. It’s also recommended to not sit for long periods with a wallet or something bulky in your back pocket. 

Piriformis Syndrome Symptoms

The first clue of piriformis syndrome is pain.

The pain is most commonly felt in your lower back or buttocks. It can radiate and travel down the back of the leg to the foot. 

Your pain can be intermittent and may come and go. You may describe your pain as sharp, severe, and radiating. 

Tingling and numbness are also common symptoms. 

One symptom that sets piriformis syndrome apart from sciatica is that piriformis syndrome usually has similar pain regarding both sides of the body, whereas sciatica typically affects one side more than the other. 

Your pain may be triggered while climbing stairs, running, or applying firm pressure directly over the piriformis muscle. Sitting for a long time can also trigger your pain. 

A person with piriformis syndrome typically has:

  • Difficulty sitting or putting weight on the buttock on one side
  • Muscle spasm of the piriformis muscle
  • Pain in the piriformis muscle during a rectal exam
  • Sciatic-type pain when the hip is moved and rotated outward against resistance 

Treatments For Piriformis Syndrome

Most patients begin with home remedies such as:

  • Ice packs
  • Heat
  • Rest 
  • Avoiding strenuous and repetitive activity

If you’ve tried treating your piriformis syndrome at home without relief, your doctor may recommend anti-inflammatory drugs such as aspirin, ibuprofen, or naproxen. Muscle relaxants are sometimes prescribed for your pain as well. 

Physical therapy is also recommended as a regular course of treatment, as well as osteopathic manipulative treatment

When all else fails, surgery is an option as a last resort. Surgery will adjust the piriformis muscle to take the pressure off the sciatic nerve. 

Does Physical Therapy Help Piriformis Syndrome?

Treating piriformis syndrome with physical therapy is a popular treatment form due to its natural, non-invasive nature. 

Typical piriformis syndrome physical therapy protocol begins with your physical therapist evaluating your condition and developing a treatment plan — including physical therapy exercises for piriformis syndrome.

Other techniques your physical therapist may use include:

  • Deep massage
  • Soft-tissue mobilization 
  • Stretching exercises
  • And more

You may also be given stretches and exercises you can perform at home with instructions to be gentle and avoid overdoing it. 

As you progress with your therapy, your therapist may begin to advance your treatment to include:

  • Posture training
  • Muscle strengthening
  • Strength conditioning 

Physical Therapy Exercises for Piriformis Syndrome

Physical therapy protocol for piriformis syndrome includes exercises that target the piriformis muscle, hamstrings, and hip extensors to help decrease sciatic pain and restore your normal range of motion in your hips.

It’s important to always follow the instruction of a Doctor of Physical Therapy and not attempt to perform exercises on your own without proper guidance.

Stretching and Range of Motion Exercises

Your physical therapist will first assess and record your current range of motion in your hip joints. Based on your condition, they will create a customized exercise program including stretching and range of motion exercises to decrease muscle spasms and gently improve your range of motion in your hip joints.

Massage Therapy

In addition to stretching and range of motion exercises, your physical therapist may also perform massage therapy techniques. Massage therapy can help decrease muscle tension that can cause painful spasms. It also helps promote circulation to the affected muscles to aid in healing.

How In Motion O.C. Can Help With Piriformis Syndrome

If you’re dealing with piriformis syndrome, physical therapy can help. At In Motion O.C., we have helped hundreds of patients recover from piriformis syndrome through high-quality physical therapy care. And we are the #1 rated physical therapy clinic on Google and Yelp.

It’s our passion to help people like you who are looking for relief from their pain so they can get back to enjoying their lives. 

If you’re looking for physical therapy for piriformis syndrome in Irvine, Fountain Valley, or Huntington Beach, contact us today to schedule an appointment at one of our clinics.

In Motion O.C.