FAQ: Piriformis Syndrome

Damien Ryan 09/04/25

Piriformis Syndrome: A Simple Guide

Fun fact: For 15% of people, the sciatic nerve passes THROUGH the piriformis muscle. This increases their susceptibility to suffer this condition. For approximate 80-85% of people, the sciatic nerve passes underneath the piriformis muscle.

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Where will I feel pain? You’ll typically feel pain in your buttock area, near the hip. The pain can also radiate down the back of your leg, mimicking sciatica.

What movements will I struggle to perform if I have this injury? You may struggle with sitting for long periods, walking, climbing stairs, or performing activities that involve rotating your hip (like crossing your legs or getting in and out of a car).

Will I feel pain in any other regions of my body? Yes, you might feel pain in the lower back, thighs, or even down to the foot due to nerve irritation. This is often referred to as “sciatica,” because of the close proximity in which the sciatic nerve runs/passes through.

How does it happen? It happens when the piriformis muscle (a small muscle in the buttock) becomes tight, overused or spasms, which puts pressure on the sciatic nerve. This can result from overuse of the piriformis muscle instead of using other gluteal muscles, poor posture, sitting for long periods, or even trauma like a fall.

What things should I try initially once I’ve hurt myself? Gentle stretching of the piriformis muscle can help. Trigger point release with a ball may help, but if this exacerbates your symptoms, then you should cease this. Avoid activities that trigger pain.

What things should I try to avoid in the initial stages of injury? Avoid sitting for long periods or any movement that aggravates the pain, like deep squats or lunges. Also, avoid high-impact exercises that strain the hip.

What type of exercises or movements do I need to be better at to rehab the injury? Strengthening the glutes, core, and hip muscles is key. Focus on exercises that improve your posture and mobility, such as:

Hip stretches (piriformis stretch)
Glute bridges
Core strengthening exercises like planks
Hip external rotation strengthening (resistance band exercises)

What other considerations contribute to the injury?

Posture: Poor posture can lead to muscle imbalances and strain on the piriformis.
Glute strength: Weak glutes can contribute to compensation by the piriformis.
Hip mobility: Tight hips can put pressure on the muscle.
Prolonged sitting: Sitting for too long can shorten the piriformis and lead to tightness.
Lumbar spine pathology: It’s important to rule out the potential of nerve compression occurring in the lumbar spine

What treatments can help relieve some pain or fast track my rehabilitation?

Physical therapy: A therapist can guide you through specific stretches and strengthening exercises as well as provide symptomatic relief with manual therapy techniques such as dry-needling, trigger point release or balancing any pelvic asymmetries.
Massage or Myofascial Release: This can help reduce tension in the piriformis muscle.

What are the expected timeframes of rehabilitation? The recovery time can vary, but most people start to feel better in a few weeks with proper rest, stretching, and strengthening. Full recovery can take 6 weeks to a few months, depending on the severity of the injury and how consistently you follow rehabilitation exercises.