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Piriformis Syndrome: Care Instructions

A woman stretching piriformis muscle

Overview

The piriformis muscle is deep under your rear end (buttock). One end of the muscle connects deep inside the pelvic area, and the other end attaches to the top of the thigh bone. This muscle can press on the sciatic nerve that runs from your spine down your leg. When this happens, you may have pain, numbness, and tingling in the buttock and down the back of your leg. This is called piriformis syndrome. The pain may get worse when you sit for a long time or climb stairs. Also, you may be more likely to develop piriformis syndrome if you run or walk often.

Your doctor will check for other causes of your pain before treating this syndrome. Treatment may include stretching exercises, massage, and medicine for the pain and swelling. If these do not help, you may get a shot of steroid medicine. Until the pain is gone, you may need to rest the muscle and limit activities like running. Exercises and a change in how you move and sit may be enough to stop the pressure on the nerve.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • If your doctor thinks that strenuous exercise is causing your problem, stop or cut back on activities such as running. You may find swimming to be a good exercise for a while.
  • Stretch the piriformis muscle.
    • Lie on your back.
    • Bend one leg at the knee and keep the other leg flat on the ground.
    • Raise your bent knee up and then move it across your body. Hold the outside of the knee with the opposite hand.
    • Gently pull the knee with your hand toward the opposite shoulder.
    • Hold the stretch for at least 15 to 30 seconds. Switch legs.
    • Do the stretch several times each day.
  • Massage the muscle to relieve pressure.
    • Sit on the floor. Lean to one side so that the hip on your sore side is off the ground. Put a tennis ball under your buttock on that side.
    • As you put weight onto the tennis ball, you may find spots that are especially sore. Move gently so that the tennis ball gently massages each of the sore spots.
  • Use ice or heat to help reduce pain. Put ice or a cold pack or a heating pad set on low or a warm cloth on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice pack or heating pad and your skin.
  • Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
  • Have your doctor watch how you move. You may need physiotherapy or special inserts in your shoes (orthotics) to help you move in a way that does not put pressure on your nerves.

When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

  • You do not feel better after several weeks of home care.
  • Your pain gets worse.
  • Your leg becomes weak or numb.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.