July 15, 2025
Piriformis syndrome is a neuromuscular condition in which the piriformis muscle—located deep in the buttock—compresses or irritates the nearby sciatic nerve. This can cause pain, tingling, or numbness along the path of the sciatic nerve, which extends from the lower spine down the back of the leg.
The piriformis muscle plays a key role in stabilizing the hip and rotating the thigh outward. However, if the muscle becomes tight, inflamed, or spasms, it can aggravate the sciatic nerve underneath or alongside it.
While often confused with sciatica caused by spinal issues, piriformis syndrome is considered an extra-spinal cause of sciatic pain and requires a different treatment approach.
Symptoms typically develop gradually and are often one-sided. Common signs include:
The pain may worsen after prolonged sitting or physical activity, especially running or cycling. In some cases, people feel relief by lying flat or walking.
Piriformis syndrome can stem from a variety of causes:
Women are more likely to develop piriformis syndrome than men, possibly due to differences in pelvic anatomy and biomechanics [2].
There is no definitive test for piriformis syndrome, which makes diagnosis a challenge. Doctors often arrive at it by ruling out other causes of sciatica, such as herniated discs or spinal stenosis.
Tests may include:
Because symptoms overlap with other lumbar or nerve root issues, diagnosis often involves a process of elimination.
Treatment for piriformis syndrome typically begins with conservative (non-surgical) approaches. The goal is to reduce muscle tension, calm nerve irritation, and restore normal movement.
Massage is highly effective in treating piriformis syndrome. Techniques that target the glutes, hip rotators, and sacroiliac joint help:
Deep tissue massage, trigger point therapy, and myofascial release can all help. Massage should be done by a trained professional who understands sciatic nerve anatomy and can work gently but effectively in the region.
Study Note: One study found that patients with piriformis syndrome who received massage therapy reported significant improvements in pain and mobility [3].
Gentle piriformis and hip stretches can help release tension in the muscle. A physical therapist may also recommend exercises to:
Key stretches include the supine piriformis stretch, pigeon pose, and seated spinal twist.
Applying a heating pad to the gluteal area can ease muscle tightness, while ice packs may reduce inflammation after flare-ups.
NSAIDs (e.g., ibuprofen) can temporarily relieve pain and inflammation. Muscle relaxants may also be prescribed in more severe cases.
In some cases, corticosteroid or botulinum toxin injections are used to calm inflammation or reduce spasm in the piriformis muscle.
Surgical intervention is considered only when all other treatment options fail. Surgery involves cutting the piriformis muscle or relieving pressure on the sciatic nerve. This is extremely rare and usually a last resort.
Once symptoms improve, long-term management focuses on prevention. Consider the following:
If your pain persists beyond a week, or worsens despite rest and self-care, professional help is warranted. You should also seek medical evaluation if:
These signs could indicate other causes, such as disc herniation, that require different treatment.
While traditional reflexology focuses on pressure points in the feet, it can also be a complementary treatment for piriformis syndrome. Reflexology may help:
At massage spas that specialize in both reflexology and deep tissue massage, clients often benefit from a combined approach—starting with reflexology for general relaxation and progressing to targeted gluteal work.
Piriformis syndrome is a frustrating but manageable condition. With the right combination of massage, movement, and self-care, most people recover fully without invasive treatments. Early intervention is key—don’t wait until the pain becomes chronic.
If you're dealing with deep gluteal pain or sciatic symptoms, consult a qualified therapist who understands neuromuscular anatomy. Massage therapy, in particular, has proven to be one of the most effective, drug-free tools for resolving piriformis-related discomfort.
Reflexology Plus offers customized massage treatments for piriformis syndrome and other muscular conditions. Book your session today to start feeling relief where you need it most.
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