11 Ways to Heal Piriformis Syndrome Quickly

The largest nerve in the human body is the sciatic nerve. This super long nerve twists and turns around different bones and dips and dives through all sorts of muscles. It stretches all the way from your low back to your feet, splitting into two nerves (the common peroneal nerve and the tibial nerve) usually near the back of your knee. 

Along the way, there are many spots for the sciatic nerve to get pushed on, compressed, and trapped. And when this happens, it can cause all sorts of sciatica-like symptoms, including burning or aching pain that radiates down your leg from your butt and even numbness and tingling.

While a bulging disc is often to blame for the symptoms of sciatica, your piriformis muscle is another very common cause. Luckily, exercises that focus on calming tightness in the muscles, and releasing tension on the sciatic nerve can help to calm symptoms and improve your mobility. Keep reading for 11 ways to heal piriformis syndrome quickly.

Understanding piriformis syndrome

Piriformis syndrome happens when your piriformis muscle — a small but mighty muscle that sits deep in your buttocks — compresses, irritates, or entraps your sciatic nerve. This can cause symptoms that usually include:

• Pain in the glute area (back of the hips) that may "shoot," burn, or ache down the back of the leg (sciatica-like pain)
• Numbness in the buttocks
• Tingling sensations along the distribution of the sciatic nerve

The piriformis muscle rotates and stabilizes the hip, playing a key role in walking. In most people, the sciatic nerve runs underneath the piriformis muscle, but in some, the nerve passes through or over the muscle, increasing the risk of compression. When the muscle becomes tight or inflamed, it can trap the nerve, leading to discomfort and mobility issues.

How to heal piriformis syndrome quickly with exercise

When it comes to treating piriformis syndrome, physical therapy is often recommended as a first-line treatment. Through specific exercises, stretches, and manual therapy, physical therapy can effectively reduce muscle tension and alleviating pressure on your sciatic nerve. 

Here are 5 common exercises for piriformis muscle syndrome. It’s important to note that these exercises should be tailored to individual needs and performed under professional guidance.

1. Seated piriformis stretch

Reduce tightness in the piriformis muscle by stretching it directly. Try this seated piriformis stretch (also known as the figure-4 stretch).

• Sit on a chair with both feet flat on the ground. 
• Cross one ankle over to your opposite knee, making a figure-4 with your legs. 
• Sit up straight to feel a slight stretch in the back of your hips. 
• Hinge at your hips, and bring your chest toward your knee as far as you comfortably can (keep your back straight) .
• Hold for 30-60 seconds, then release.

2. Nerve Glides

Healthy nerves should be able to move and stretch without pain. If your piriformis muscle is pressing on your sciatic nerve, nerve glides can be helpful in restoring this pain-free movement. These exercises may also help calm pain signals in your spinal cord.

• Lie on your back with legs straight. Lift the affected leg slightly, keeping your knee straight, until you feel a gentle stretch.
• Slowly flex your foot towards your shin, then point your toes away. 
• At the same time, tilt your head back when you flex your foot, and forward when you point your toes.
• Repeat this coordinated foot-head movement 10-15 times, keeping a range of motion that is pain-free.

3. Trigger point release with tennis ball

Trigger point release in the piriformis muscle and the tissues surrounding it may be able to release tension on your sciatic nerve and ease pain.

• Stand with your back facing a wall and place a tennis ball between your gluteal muscles and the wall. 
• Position the ball on a tight and tender spot within the muscles of your glutes and/or piriformis muscle.
• Lean into the wall to increase pressure from the ball.

4. Lying piriformis stretch

Try this stretch to target multiple hip muscles, including the piriformis.

• Lie on your back with knees bent and feet flat on the floor.
• Cross one ankle over to your opposite knee, making a figure-4 with your legs.
• Gently pull your knee across your body, toward your opposite shoulder until you feel a stretch in the back of your hip.
• Keep your hips grounded and avoid rolling
•  to the side as your stretch.
• Hold for 30 seconds, easing deeper into the stretch as the muscle relaxes.

5. Foam rolling

A foam roller may be able to help release tension in the piriformis muscle and surrounding tissues.

• Sit on a foam roller with it positioned under your buttocks. 
• Cross the affected leg over your other leg. 
• Slowly roll back and forth over the piriformis muscle and surrounding tissues, pausing on any tender spots.

Other piriformis syndrome treatment options

While exercises (like the ones above) are key to treating piriformis syndrome treatment, there are other treatment options that may be able to compliment your recovery:

• Manual therapy: A physical therapist can perform hands-on techniques to release tension in the piriformis muscle and surrounding tissues. This may include massage, trigger point release, muscle energy techniques or others.
• Heat therapy: Warming up your muscle with a heat pack, or even treatments like ultrasound can be helpful by increasing blood flow and encouraging relaxation in a tight muscle — especially right before exercise!
• Lifestyle adjustments: This might include things like improving your posture, taking breaks from sitting, using proper body mechanics during daily activities, and addressing any underlying biomechanical issues that might be contributing to your symptoms.
• Acupuncture and dry needling: These techniques can help reduce muscle tension and pain.
• Injections: In some cases, lidocaine, steroid, or botox injections may be recommended to reduce inflammation and muscle spasms.
• Surgery: In rare cases where conservative treatments fail, surgery to release the piriformis muscle or decompress the sciatic nerve may be considered.

Where to get help when symptoms aren’t improving

Piriformis syndrome can be painful and frustrating, but the right exercises and treatments can help ease discomfort and restore mobility. Since symptoms can mimic other conditions, getting a proper diagnosis is key to ensuring effective treatment. A physical therapist can assess your symptoms, guide you through targeted exercises, and provide hands-on techniques to help you heal. Schedule an appointment with one of the physical therapists at Origin Physical Therapy today to start your personalized recovery plan and get back to moving comfortably.