How is piriformis syndrome treated?

The piriformis is a deep muscle in the buttock near the sciatic nerve. Irritation in this area can cause buttock pain or symptoms that travel down the leg. A clinician first considers whether the pattern fits piriformis syndrome or another cause, such as sciatica from the lower back. Sitting for long periods, uphill walking, running, or repeated hip rotation may need temporary adjustment. The examination may include hip movement, strength, sensation, reflexes, and back assessment.

Physiotherapy can combine gentle hip and lower-back mobility with progressive strengthening of the gluteal and trunk muscles. Your therapist may alter sitting position, lifting technique, running volume, or recovery breaks. Stretching should be controlled rather than forced into sharp buttock or leg pain. Dry needling may be discussed as an adjunct for muscle tenderness, and a cortisone injection may be considered when targeted inflammation or pain remains limiting. These options require an examination and do not replace a rehabilitation plan.

Arrange a medical assessment for persistent buttock pain, radiating leg pain, numbness, or weakness. Seek urgent care for new loss of bladder or bowel control, numbness around the groin, rapidly worsening leg weakness, or severe symptoms after significant trauma. A hot, red, swollen area or fever also needs prompt review.

Ask how your symptoms differ from sciatica, which positions are safe, and which exercises should be paused. Discuss whether imaging, an injection, or dry needling is appropriate, how nerve symptoms will be monitored, and what changes require urgent review.