What Is the First Treatment for Piriformis Syndrome?

The piriformis is a deep buttock muscle close to the sciatic nerve. Irritation in this area can cause aching in the buttock and sometimes pain, tingling or altered sensation down the leg. Early treatment aims to reduce pressure from prolonged sitting, repeated climbing, running or positions that reproduce symptoms. A clinician also checks the hip, lower back and nerve function because similar symptoms can have other causes.

Break up long periods of sitting, avoid stretches that send pain down the leg, and keep movements gentle. [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/) can guide hip mobility, gluteal strength and gradual return to activity. [Dry Needling](/treatments/physiotherapy-and-rehabilitation/dry-needling/) or a [Cortisone Injection](/treatments/non-surgical-orthopedics/cortisone-injection/) may be considered when symptoms continue despite an appropriate rehabilitation plan. Read more about [Piriformis Syndrome](/conditions/piriformis-syndrome/) to understand the pattern clinicians assess.

Book an assessment when buttock pain keeps returning, limits sitting or walking, or is accompanied by persistent tingling or weakness. Seek urgent care for new loss of bladder or bowel control, numbness around the saddle area, rapidly worsening leg weakness, or severe back and leg symptoms after significant injury.

Ask how piriformis-related pain was distinguished from a spinal nerve problem, which positions to avoid, how to progress exercises, and when an injection or further testing would be appropriate.