Piriformis Syndrome Is A Pain in the Butt!

My “Unofficial” Diagnosis

A pain in the butt? Yes, I do have a pain in my butt—literally. Really it’s more of a dull ache that makes sitting uncomfortable.

Specifically, I feel this achy pain primarily in my right butt cheek. On the bright side, this discomfort gets me out of my chair and on my feet to alleviate the discomfort.

After spending some time Googling potential reasons for said pain, I self-diagnosed piriformis syndrome—a diagnosis of which I’m fairly confident.

What Is Piriformis Syndrome?

Contractions or spasms of the piriformis muscle can compress or irritate the sciatic nerve and cause pain. The piriformis muscle is in each buttock and attaches the sacrum to the top of the thigh bone.

When your piriformis is tight, it can irritate your sciatic nerve and cause piriformis syndrome. Your sciatic nerve is a large nerve that travels from your low back, under your piriformis, to your legs. The main symptoms of piriformis syndrome are a dull ache, numbness, and/or pain in your buttocks that radiates down the back of your leg on one or both sides.

Piriformis syndrome is most common in people who sit for long periods. But athletes who spend a lot of time in the weight room and cyclists can also experience this condition.

How to Treat It

Stretches and exercises are the go-to treatments for piriformis syndrome. A consistent regimen of stretching and exercise can improve symptoms. The goal is to relax the piriformis so it’s not irritating the sciatic nerve.

You may be tempted to sit down or stop moving, but rest isn’t the answer. Often rest—or specifically sitting—is what caused the problem in the first place.

Stretches and Exercises for Piriformis Syndrome

Stretching helps loosen tight muscles by creating length and flexibility. Exercises improve the strength and mobility of the piriformis and surrounding hip muscles. Together, they can help alleviate the symptoms of piriformis syndrome.

Even if you don’t have piriformis syndrome, these stretches and exercises can be used to prevent it—which is something I wholeheartedly recommend.

If you’d like a video, here are a couple that safely demonstrate several of these stretches. Here’s a third very short 30ish-second video that offers a nice stretch not described below.

1. Knee-to-shoulder stretch

• Lie flat on your back with your legs straight.

• Lift your leg and bend your knee. With your opposite hand, pull your knee toward your opposite shoulder.

• Hold for 30 seconds.

• Do this on each side three times, twice a day.

2. Figure Four stretch

• Lie flat on your back with both knees bent.

• Cross your ankle over your opposite knee.

• Grab the back of your thigh area behind your opposite knee.

• Gently pull your thigh straight toward your chest.

• Hold for 30 seconds.

• Do this on each side three times, twice a day.

You can also do this stretch seated in a chair.

• Sit in a chair with both feet on the floor.

• Cross your ankle over your opposite knee.

• Let your knee fall downward, keeping your ankle in place.

• Push your knee down gently or lean forward to feel the stretch in your buttocks.

• Hold for 30 seconds.

• Do this on each side three times, twice a day.

3. Bridge

• Lie flat on your back with both knees bent.

• Contract your core and lift your hips off the floor.

• Slowly lower your hips back to the floor.

• Repeat 10 times per set.

• Do three sets, once or twice a day.

4. Side leg lifts

• Lie on your side with your ankles stacked on top of one another. You can rest your head on a pillow or your arm.

• Lift your leg slowly, keeping it straight.

• Slowly lower your leg to the original position.

• Repeat 10 times on both sides per set.

• Do three sets, once or twice a day.

5. Clamshell

• Lie on your side with your ankles stacked and your knees bent in an “L” shape.

• Keeping your heels together, lift your top knee as if you were opening a clamshell.

• Slowly lower your knee to the original position.

• Repeat 10 times on both sides per set.

• Do three sets, once or twice a day.

6. Facedown leg raises

• Lie on your stomach with your legs extended. It may be more comfortable to place a blanket or small pillow under your hips.

• Lift one leg off the floor, keeping your leg straight.

• Slowly lower your leg to the original position.

• Repeat 10 times on both sides per set.

• Do three sets, once or twice a day.

7. Standing small range squat

• Stand straight with your heels shoulder-width apart.

• Hinge your hips and push your buttocks back, squatting as low as comfortable.

• Slowly return to a standing position.

• Repeat 10 times per set.

• Do three sets, once or twice a day.

Other Exercises and Options for Piriformis Syndrome

• Cardio exercises: Aerobic exercise is important for your hip muscles and overall health. The best cardio exercise for piriformis syndrome is walking or using an elliptical machine.

• Core exercises: A strong core can help support your piriformis. Examples include crunches, leg lifts, and planks.

• Foam roller: Some people use a foam roller or tennis ball to help with piriformis syndrome. A foam roller or ball can find a trigger point in your piriformis muscle and release it.

• Yoga and Pilates: You’ll find many stretches and exercises in yoga and Pilates classes that can relieve piriformis syndrome.

As I can state from experience, piriformis syndrome can be a source of significant discomfort. I’m in the early stages, but I hope by using the stretches and exercises and sitting less, I will alleviate my symptoms and prevent future flare-ups.

Before undertaking these, or any other exercises, you should consult with a healthcare professional. This is especially the case if you're experiencing severe or persistent symptoms.