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Effective Piriformis Syndrome Treatment Options

by Patty Weasler, RN March 31, 2022 0 Comments

Using peanut massager

Piriformis syndrome is a condition characterized by back, hip, and buttock pain that moves down the back of the leg. Injury to the piriformis muscle or compression to the nerve through a muscle spasm or contracture can cause piriformis syndrome. Since the sciatic nerve is involved, the pain can be confused with sciatica. With piriformis syndrome treatment starts with rest and simple home treatments. Combined with exercise, stretching, and in some cases medication, the pain and discomfort can be remedied allowing you to live a full and active life. Read on below to learn more about piriformis syndrome treatment.

Rest

One of the first treatments for piriformis syndrome is rest and avoiding the activities that trigger pain. Resting can be one of the hardest treatments but is necessary to allow your muscle to relax and let the irritation in the nerve subside. Some people find that sitting for long periods of time causes pain, so while rest is an important treatment, make sure to keep moving just more slowly.

Ice & Heat

Ice and heat are great treatment options in managing the symptoms of piriformis syndrome. 

Cold Therapy

Cold therapy with an ice pack applied to the lower back or back and back of the thigh can numb the pain. The cold interrupts the pain signal providing you with temporary pain relief. Use an ice pack for 20 minutes at a time several times a day.

Heat Therapy

Heat therapy relaxes tense muscles and can alleviate muscle spasms, one of the causes of piriformis syndrome. The warmth will encourage blood flow to the area which can also improve healing time. Use a heating pad or warm towel over your hip joint, lower back, and thigh. You can use the heat almost any time of the day, just don’t sleep with it as it can cause skin injury.

When to Use Heat for an Injury

Alternating Hot & Cold Therapy

Alternating hot and cold therapy, also known as contrast therapy, takes advantage of both heat and ice to relieve your pain. Use an ice pack for one minute and then heat for three to four minutes. Alternating between the two temperatures can reduce irritation of the sciatic nerve reducing your piriformis syndrome symptoms.

Here’s everything you need to know about alternating hot and cold therapy

Stretches & Exercises

Stretching and exercise are primary treatments for many sufferers of piriformis syndrome. Stretching will loosen tense muscles and help you maintain your range of motion. Exercise will work to strengthen the piriformis and surrounding muscles. These movements can be done in the comfort of your own home or can be done in a physical therapy office.

Effective Piriformis Syndrome Exercises

Avoid Certain Exercises

When you have piriformis syndrome there are certain exercises you should avoid to prevent further irritation to your injury. Avoid prolonged sitting and exercises that cause pain in the gluteal area. Movements that require you to lift both legs while on your back or leg circles should also be avoided. Talk to your physical therapist if you have any questions about which exercises are safe for your situation.

Massage Relief

Massage is a great treatment for piriformis syndrome. Massage will relax tense muscles which can alleviate the irritation of the sciatic nerve. You can perform a glute, lower back, and upper leg massage at home with a massage tool. Start slowly and press gently against your muscles. Stop if you feel pain. Another option is using a TENS unit. This small device delivers an electrical signal to adhesive patches that are placed on your skin. The signal provides temporary pain relief and is a great addition to massage therapy.

Effective piriformis syndrome massage

Tips for Self-Massage

Compression Therapy

Pain from piriformis syndrome can make you feel uneasy about moving about. Use compression with a compression sleeve or elastic bandage can put a bit of counter pressure on your thigh, hip, or lower back. This small amount of support can give you a sense of stability and support.

About Compression Therapy

Braces & Supports

Wearing a hip brace can support you to keep you active throughout the day. The brace will help you maintain proper posture and body alignment which can put less pressure on the sciatica nerve, reducing your pain. Most braces can be worn any time during the day and can be hidden under clothes.

Kinesiology Taping

Kinesiology tape is used for sports and similar injuries to support the muscle and joint and improve healing. For piriformis syndrome, kinesiology tape can be applied over your hip, upper leg, and low back. When used in these areas it will increase your proprioception (body awareness) and the gentle tug from the tape increases lymphatic and blood flow. Many people find this reduces low back pain and symptoms of piriformis syndrome.

More on Kinesiology Taping

Seat Cushions

One of the triggers of piriformis syndrome is sitting for long periods. People who place their wallets in their back pocket can put pressure on their glute muscles and cause additional pain. Use a seat cushion if you plan on sitting for a long time, especially on long car rides or in your office chair. The cushion will reduce pressure on the lumbar area and distribute pressure over your bottom minimizing pressure points.

How to Relieve Piriformis Pain when Sitting

See Variety of Seat Cushions Here

Sleeping Posture

The best position to sleep in with piriformis syndrome is on your back with your legs supported by a pillow or folded towel. This position places the least amount of stress on your sciatic nerve and reduces stretching and stress in the surrounding muscles. Learn more about proper sleeping posture.

Check out this article to find out more about how to sleep with piriformis syndrome

Anti-inflammatories

Anti-inflammatory medications like NSAIDs provide pain relief by reducing the inflammation and swelling within the body. Examples of these medications are ibuprofen and naproxen. These medications are a good adjunctive therapy to exercise and stretching. If you have never taken an NSAID or take other medications, talk to your doctor or pharmacist to ensure you won’t have any unintended side effects.

Injections

There are two types of injections that can be used for piriformis syndrome. The first, and more common injection, is a corticosteroid. This injection uses a powerful steroid medication that is put directly into the piriformis muscle. The health care provider uses this to decrease pain and inflammation in the muscle to reduce nerve irritation. This anti-inflammatory drug does have some risk factors that need to be weighed before use.

Another type of injection is botulinum toxin or Botox. This medication weakens the muscle which causes it to relax and minimizes pressure against the sciatic nerve. After either injection, you should work with a physical therapist to continue stretching and exercise.

Relieve Piriformis Pain

Piriformis syndrome is a condition where the sciatic nerve is compressed or irritated and causes pain in the back, buttock, and upper leg. Sufferers often times find relief with rest, ice, heat, stretching, and exercise. If those treatments don’t alleviate the pain then medical injections may be necessary. Always talk to your doctor before you begin treatment to ensure you are on the right path to recovery.

Resources:

https://www.physio-pedia.com/Piriformis_Syndrome

https://www.medicinenet.com/piriformis_syndrome/article.htm

Products for Hip Pain

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Patty Weasler, RN
Patty Weasler, RN



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