Piriformis Syndrome – How to get rid??

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  • Piriformis Syndrome – How to get rid??
  • Doing some basic strengthening around the glutes and stretching the hamstrings and the glutes etc. but getting nowhere, would swear it’s getting worse.

    Going to give acupuncture a try, failing that wondering if it’s worth trying to get a prescription of muscle relaxants from my GP to try and release the spasm.

    Anyone else had this?


    Find a decent yoga teacher.


    I had it a few years back, lots of physio/stretching & strength work as you mentioned. I used to find sitting on a tennis ball to release the tension helped. I use a foam roller periodically now as well as stretching to keep it at bay. Still as stiff as a board mind you!

    Premier Icon oldnpastit

    Yeah, a while ago. Enough that I lost a bit of sensation in the ball of my foot, pretty much permanently now. A very useful reminder to take of myself.

    I did the stretching exercises you describe. I also did some exercises from youtube around “neural flossing”, which I suspect are either complete cobblers, or downright dangerous.

    Pilates, but I couldn’t stand doing the bits that only women can do.

    The other thing I did which finally cured it was going to a proper sports massage guy, who sorted it out.

    Yeah… was worried Yoga would get suggested. Isn’t that just glorified stretching? I’m already stretching throughout the day, not sure if spending money on an extra hour a week at a yoga class would help?

    That being said I think my local council gym does a weekly class, does a (recent) inability to touch my toes count me out?

    Inbred I’ve been trying rolling it on a spikey massage ball and a cog shaped foam roller, neither seems very effective and to be honest I don’t really feel like I’m getting into it very much, not sure how it should feel I guess…

    “neural flossing”

    Ha, yeah, I’ve heard that one before, I was initially doing some pendulum swings with my legs as a sort of ‘flossing’ exercise but my physio never mentioned it and I just sort of got bored of doing it, might look those exercises up just out of interest.

    I’ve had one piriformis specific massage (an elbow in the butt cheek) and one general sports massage, got another booked next week. Acupuncture could be an expensive waste of time but at least I can rule it out.

    Premier Icon MoreCashThanDash

    I have had physio and acupuncture for it. The accupuncture was really effective, but I still need to do regular stretching and foam rollering to keep it under control.

    That’s good to hear MCTD, at least worth a shot then. How many sessions acupuncture did you do, how many days apart?

    Premier Icon cloudnine

    Foam roller, tennis ball, strengthening exercises and seek out a good Thai massage lady. All of these mentioned will hurt. The Thai massage will hurt the most.

    Premier Icon wallop

    Oh god, I had this – dreadful. Always there.

    Until I did yoga – seriously.

    Premier Icon MoreCashThanDash

    Think I had 2-3 sessions. Physio offered me the choice of needles or really deep massage/accupressure. As I hate needles I let her try the accupressure.

    Turns out needles aren’t so bad 😯

    When in doubt find someone who does dry needling. Then buy a good trigger point tool . I find a tennis ball isn’t sharp enough. I have a Lockeroom triangle which hits the spot perfectly. That and maybe a Theracane . And pilates. Your piriforis could be compensating for something weak elsewhere. Find a good physiolo.


    I loved the physio when I had it,” this might be a bit uncomfortable”, while she put her whole body weight behind her elbow as she tried to relax the trigger point, always followed by a,” how was that on a scale of 1 to 10 of pain?”

    Well I had a good dig around with a small pointy foam roller and found a good tender spot to sit on for 30 seconds, still think I need to invest in a tennis ball though.

    Learnt a good stretch as well from one of the videos, the 90/90 or half-swastika.

    There’s a ‘body balance’ class at my local swimming pool which combines Yoga and Pilates to some degree, although last time I attended a class there it was me and lots of very balletic girls or old ladies, and the warm up was lots of stupid dance moves, I felt like some sort of great lummox thumping about at the back… 😳

    Premier Icon oldnpastit

    This is the “neural flossing” video.

    Go very easy on it. Otherwise it might turn into neural snapping-and-leaving-you-unable-to-walk.

    Hmm, he seems to suggest the slack then tight approach, another video I saw (and this is how I remembered being taught it) was to literally ‘floss’ the nerve by stretching the leg but correspondingly curving the neck back to give it slack, then do the opposite (i.e. bend the leg all the way and point the toes down whilst curling your chin into your chest).

    Maybe it doesn’t actually matter so long as you’re ‘moving’ the nerve in relation to the muscle. Certainly didn’t feel any worse for trying it earlier so might persist, gently!

    Premier Icon Mary Hinge

    Foam roller the upper outer buttock area, and that stretch did it for me.

    Had really bad sciatic nerve pain from it.

    Gone in a couple of weeks and not returned.

    Kinetic Revolution videos are good for this sort of thing.

    Premier Icon somafunk

    Piriformis exercise, i use a hard rubber dogs ball rather than a tennis ball

    Sun Salutation exercise – very good for pelvis issues


    Pilates Rest Position – good for pelvis

    All recommended by my physio, Dawn Houston (ayr) who also works wonders with “Myofacial Release”, I had 8years of issues with my right foot dragging as i couldn’t lift it up from the ankle, 8years of totally useless NHS physios and trips to various neuro consultants who blamed the issue on the fact that 25 odd years ago i broke my back in a few places and damaged my spinal cord so they always came to the conclusion that my damaged spinal cord was causing the issue and told me i’d just have to live with it.

    A couple of months ago i finally did some research on the best private phyios in scotland for such issues and that led me to Dawn who spent almost two hours working on my pelvis and lower legs using a variety of techniques, i walked in to the session dragging my right foot but walked out totally normal – i still see her once a week as there is a multitude of issues related to my spinal damage and nerve damage to sort out but it is so worth it

    Acupuncture worked for mine. Two or three sessions to loosen it up, followed by about a year of figure 4 stretches and elbow in the butt from my Chiro (amongst other back stuff)


    there’s probably a sore point in one of the muscles around your butt/hips.

    Try and find it and then either get someone to strongly massage it, stick some needles in it, or use a roller if it can get to it, or one of those triangular pressure point massagers, or a tennis ball.

    and do the stretches.

    Can use those thermacare heat pads to stop the muscle spasming whilst out, and microwave heat pads on it when at home, rather than taking pills.

    I had it and the thermacare pads enabled me to have a weekends walking in the lake and stand up on the train for 5 hours coming home (as it was crowded with students).



    La-Cross ball is better for pressure point release massage, £2 from Ebay.


    i’ve had this a few times and it can drag on for months. i’ve come to the conclusion that anything done to the piriformis locally only relieves the symptoms temporarily and does not get rid. mine at least was caused by nerve inflamation higher up in my back. my doctor prescribed me amitriptyline, which in low doses apparently helps switch off aggravated nerves. a side affect of amitriptyline is some of the best sleep i’ve ever had, even with a new born in the house!

    From experience I found the following got rid of it:

    Foam roller on glutes, ITB, hamstrings and calves.
    stretches: piriformis, QL, hip flexors, hamstring and calves
    A baseball/softball rolled around glutes against a wall, holding in tight spots.
    Glute strengthening: clams, bridges and squats.
    Min 20 mins stretching after any bike ride.
    Ditched the road bike ( position is too static and shortens/tightens hip flexors)
    Try to not to sit for long periods of time (easier said than done in the modern day office job)


    Same problem for about 10 years.

    The tension is likely a compensation for some problem in your spine brought on by past injury or lifestyle factors.

    In the short term sports massage can help release the muscles, remove trigger points and get some temporary relief.

    Longer term, you need to find a very good Chiropracter who will radiograph your spine then get you straight. This will cause some muscle tension as muscles adapt, but you need to get your spine back to straight. The adjustments also release the muscle tension. Go 3 times a week for a month then weekly, or minimum monthly, forever.

    I got so fed I paid for an MRI and it showed a disc bulging. My body causes tension in the muscles to help protect the area, but it causes me discomfort. That simply isn’t going go go away.

    After taking a tramadol in desperation and feeling completely knocked out, I found doing some ‘old person’ Pilates (Karen Vight video at home on a mat for lower back) very very effective. Just the next day, I woke up in less discomfort. You do have to make time for this, and accept it. It does help to improve core strength, stretching and muscle balance.

    I’ve recently swapped out my soft memory foam mattress for the very firm Hesseng mattress from Ikea and that’s made me wake up with less back and butt tension (mine always came on overnight).

    I’ve also swapped an old office chair for a better tool for the job Herman Miller Mirra and that’s made a difference too.

    As far as cycling goes not being bent over, so a high stack height 630-650, reduces the intervertabral issue on my disc and reduces subsequent muscle tension. Bars level with the saddle or even slightly higher.

    I also have to be carefull which cars I sit in. Ones with seats that push my back out (too much lumbar) make it worse. So consider what your car seat is doing for you also.


    I forgot I had this and after 50 miles of riding my calf tightened up and I had to stretch on the roadside on Saturday.

    You can temporary stretch it off (lie in back and knee to opposite shoulder) but look at the cause.
    Mine was stiff adductor/abductors which caused compensation by the a stability muscle (periformis).
    Also found my car brakes were sponges and I had built up my right leg to be stronger and stiffer by stomping the pedal when late to work. New brake master cylinder.

    Now stretching 3 times a day. Calf feels ok but a little stiff.

    Tried this? https://m.youtube.com/watch?v=CcHVBsxmJXA

    Premier Icon kcal

    I have to get off the bike every so often, and sounds pretty much as you describe.
    Leisure: cycling
    Employment: desk bound IT type

    – result – misery!
    Plus, I think, arthritis diagnosed in one hip..

    on regular trips too sports physio – does good, stretching and exercises do good, but really need to keep on it. tennis ball, cog rollers, weird positions, you name it..


    The tension is likely a compensation for some problem in your spine brought on by past injury or lifestyle factors.

    If only I could find some old sda photos to post 😉

    Haha! That and most of the subsequent years on two wheels probably…


    look what i found….



    I went and bought a tennis ball on the strength of this thread, did a bit of rolling and pressing, and my knackered back feels less knackered than it did pre-tennis ball.



    Spikey ball even better but you have to focus on the sore bit. Get a sports masseur to press their elbow into it. Nice in a painful kind of way.

    Thanks Frankenstein, that seems better than the other stretches I’ve been doing, same movement just more controlled I think.

    Can’t say I’m digging the massage stuff yet, I tried a mate’s lacrosse ball at work and have a tennis ball at home now, I find the ‘tender’ spots but after rolling on them with most of my weight the pain seems to hang around for a while after, not a ‘good’ pain either but the sort of nerve pain. Makes me think I’m aggravating something rather than releasing something, might take it a bit easier for now.

    The ‘flossing’ seems OK, certainly worth persisting with.

    Regarding more upright bikes etc. I’ve already reached this conclusion, I even sold a Cannondale Synapse as it still seemed too prone (plus I’m not riding enought to keep the muscles ‘trained’ to the position). Happily this gives me an excuse to look back in MTBs although I don’t want anything porky, looking at a Trek Superfly but might consider sticking risers on it if needs be to bring the front up.

    First things first though, bring on the needles!

    13thfloormunk. If your muscle are spasmed because they’re protecting something you could indeed be making it worse. I am much accustomed to spasm in lower back and glutes and stretching never feels “right”. Trigger point yes, but only when it has flared down a bit (eg after ibuprofen and heat and cold pads for a few days).


    Nothing helpful to add just bookmarking as post a couple of scans I’m still struggling with a calf issue which is undiagnosed.


    you need to find a very good Chiropracter… Go 3 times a week for a month then weekly, or minimum monthly, forever.

    Haha, that’s like every chiropractor.

    Find a good osteopath instead, preferably one that does a good massage before any manipulation as the muscles are less likely to pull you back into the bad position.

    Lots of people have some sort of hip misalignment, often caused by the fact that you might just always stand with one leg/foot in front of the other.

    Had a colleague at work who always wore cheap suits and they looked like it. He went to an osteo and suddenly his suits looked much better as they hung better!

    I find that, when I find these sore spots, I,or the osteo, have to massage them into submission, which is very painful. They then seem to recover after the initial bruising. I reckon accupuncture works in a similar way, the body healing itself back up after some damage.

    I was getting lots of these sore points last year for some reason and each one was fixed like this.

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