Piriformis Syndrome – A Nerve-Wracking Pain In The Buttocks

Anatomical Display of the piriformis.

© Kjpargeter  | shutterstock.com

download your Free pdf Guide

A preview of the Liebscher & Bracht's guide against piriformis syndrome with the front page on the left side.

Receive the 6 most effective exercises to relieve buttock pain and take care of your piriformis muscle!

Download now

If you often experience an unpleasant pulling sensation on one side of your buttocks, you’ll know that sitting on your office chair becomes a torment for the rest of the day. You can either turn the other cheek OR continue reading this article to find out:

  • why discomfort in the gluteal area repeatedly occurs,
  • what causes physical discomfort in the gluteal muscles,
  • how to treat yourself at home,
  • how to effectively prevent discomfort with simple stretches.

Read this whole article for more information about the buttocks or, if you’re in a lot of discomfort, skip to the exercises.

Roland Liebscher-Bracht

Roland Liebscher-Bracht

Germany's most trusted pain specialist and author of several bestselling self-help books on the treatment of pain conditions.

Read more

Roland Liebscher-Bracht is Germany's most trusted pain specialist and author of several bestselling books on pain treatment. Together with his wife, Dr. med. Petra Bracht, he has developed a revolutionary method to treat pain conditions. With the help of the so-called "osteopressure", where you press specific points on your body, and special stretching exercises, pain can be stopped entirely without medication or surgical intervention. This pain treatment allows you to alleviate pain by yourself. Find out how exactly this works in this article or our numerous YouTube videos.

Roland Liebscher-Bracht

Germany's best-known pain specialist and author of several bestselling books on self-help against pain.

Read more

Roland Liebscher-Bracht is Germany's best-known pain specialist and author of several bestselling books on pain treatment. Together with his wife, the physician Dr. Petra Bracht, he has developed a revolutionary new form of pain treatment: With the so-called "Osteopressur", in which certain points on your body are pressed, and special stretching exercises, pain can be stopped completely without medication or surgical intervention. It is particularly important that this pain treatment gives you the opportunity to help yourself against your pain in a self-determined way. You can find out exactly how this works in this article and in the numerous YouTube videos.

1. The Piriformis – Location and Function

The piriformis muscle lies under the gluteus maximus.

Vector graphic of the piriformis.

© Sebastian Kaulitzki | shutterstock.com (edited)

Positioned deep in the hip muscles along the inside of the pelvis, it connects the sacrum with the thighbone. The sciatic nerve is the decisive factor in the development of agonizing discomfort. As soon as problems such as tension in the gluteal muscles or inflammation occur, this area is also highly likely to be affected.

2. Symptoms of Piriformis Syndrome

Most patients show the following symptoms:

  • Stabbing or pulling sensations in one side of the buttocks, which increases in a sitting position,
  • Sciatic discomfort,
  • Discomfort in the lumbar spine,
  • Difficulties with movement on the affected side,
  • Discomfort when climbing stairs, during external rotation of the legs or when bending down,
  • Discomfort at rest and movement in the SIJ (sacroiliac joint) radiating to the groin,
  • Pain sometimes radiates, mainly into the back of the thighs, and in some cases the feet,
  • Discomfort such as tingling and numbness in the legs, and sometimes in the feet.

The majority of cases are triggered by compression. This is caused by sitting for a long time, standing with your weight on one side, or by strongly one-sided movement patterns that trigger discomfort. Depending on sitting position or posture, the nerve in the buttocks is strongly irritated and compressed. Discomfort and pain can increase depending on the strain to the gluteal muscles.

Illustration of the sciatic nerve.

© Lightspring | shutterstock.com

2.1. Sciatica and Piriformis Syndrome

Many indicators of this condition suggest a pinched or irritated sciatic nerve, called sciatica. Typically this is a stabbing sensation, which is usually triggered by getting up or by jerky movements. If the sensation moves into one leg – the feet may be numb or tingling – then it’s highly probable that the large sciatic nerve is affected. Overstretched and unyielding muscles and fasciae play a decisive role in the development of discomfort.

Illustration of a herniated disc.

© Lightspring | shutterstock.com

2.2 Slipped Disc and Piriformis Syndrome

The symptoms of this condition can cause a patient to panic as tightening in the buttocks and lower limbs is usually associated with more serious problems in the lumbar spine.

These spasms can be the consequences of a herniated disc but, in our experience, more often the muscles are strained due to unilateral movement patterns – or insufficient movement – which constrict the nerve and impact physical health.

Note: If you experience numbness in your limbs, we strongly advise you to consult a doctor.

Relieve Piriformis Syndrome

Download our FREE PDF guide featuring our 6 most effective exercises against Piriformis Syndrome and buttock pain. 

A preview of the Liebscher & Bracht's guide against piriformis syndrome with the front page on the left side.
All gain. No pain.

3. Origin and Cause of Piriformis Syndrome

If you spend a lot of time in an office chair and rarely move around, the probability of developing this condition is relatively high. Sitting for long periods often leads to poor posture and one-sided strain. Over time, excessive tension of the piriformis muscle then causes direct pressure on the nerves.

What does this mean exactly?

You will have heard of herniated discs or sciatica. However, in our experience, that medical diagnosis is not necessarily decisive. Often the cause is the same: strained muscles and tangled fasciae!

A woman is clutching her aching back.

© Alliance | shutterstock.com

If you work in an office, you spend hours of your time in the same position. The one-sided posture caused by crossing your lower limbs can quickly lead to stress. In the long term, this “incorrect posture” leads to the indicators described above.

The muscles and fasciae in the gluteal area “shorten” if not stretched sufficiently. Without targeted compensation and changes in your movement patterns, your muscles become increasingly unyielding. Our exercises aim to relax and stretch the muscles and fasciae, easing irritation and inflammation.

📌 How is Piriformis Syndrome conventionally diagnosed?

If this condition is suspected, medical specialists – such as orthopedists and physiotherapists – carry out muscle tests on the patient. It is not easy to find the exact trigger for the symptoms, since the musculus piriformis is considered to be the external rotator when the hip is stretched and the abductor when it is bent.

4. Treatment of Piriformis Syndrome

On this page, we introduce our effective treatment approach. Our goal is to give you all the information you need to lead a pain-free life, ameliorating the impact of these health conditions.

4.1 Self-Help for Piriformis Syndrome with Liebscher & Bracht

The most important component of our therapy for better health and long-term freedom from discomfort is our specific exercises. It is important to keep the muscles and fasciae in your buttocks flexible and agile.

Our exercises start with tensing and stretching your buttocks. This helps you to prevent muscles and fasciae from contracting, cramping or shortening, and exerting pressure on the sciatic nerve.

The pain-reducing effect of stretching exercises has been scientifically proven. In one study, isometric strengthening exercises were applied to tense, sensitive muscles that are often associated with discomfort in the musculoskeletal system. This was done systematically on 351 muscle groups in 244 patients.

This method led to immediate relief in 94 percent, permanent relief in 63 percent, and permanent sensitivity relief in 23 percent of the treated areas. Patients who continued their self-healing process at home were more likely to notice permanent relief.1)

Additionally, a 10-year study on the condition by New York scientists suggests that even “normal” three-month physiotherapy with several sessions per week will result in an improvement of about 60-70 percent in most patients.2)

So if your indicators are not too bad, jump straight to the information about our exercises and start to eliminate tension. Or, if you have agonizing sensations radiating into your legs or your feet, then osteopressure will be more appropriate.

Our manual therapeutic technique of osteopressure has been used successfully for decades. The focus is on signal pain receptors in the periosteum which, when pressed, transmit a message to your brain that muscles and fasciae in the corresponding area should be less tense.

As a result, the excessive tension in the muscular-fascial network of your buttocks normalizes and the surrounding structures are given more space. Your brain registers that all structures have more space and freedom of movement, and stops the pain.

Roland Liebscher-Bracht has developed special stretching exercises that will help you to remain permanently pain-free. With the right exercises for your individual problem zones, you can not only bring movement to your hardened buttock muscles but also take the strain off the affected areas.

You will find suitable exercises to alleviate this condition in the next chapter.

Learn more about our therapy

4.2 Treatment of Piriformis Syndrome

In severe cases, anesthetic and corticosteroid injections into the base of the muscle, the abdomen, the muscle sheath, or the sciatic nerve sheath are also possible, as well as computer-assisted injections with Botox. The results of such injections are assessed differently in the specialist literature. However, Botox injections seem only to achieve acute pain relief in the rarest cases. Even if the indicators subside, in most cases it is only a matter of time before they return. Even the “best” painkillers will not change patterns of lopsided movement.

The severing of the muscle with neurolysis (exposure) is also occasionally discussed. This procedure is associated with high expenditure and the usual health risks of surgery and anesthesia.3)

If you want to achieve long-term freedom from pain without anti-inflammatory medication or having an operation, then use our exercises to specifically counteract the shortened structures of your muscles. This will prevent long term irritation to your back, improving your health and well-being overall.

Relieve Piriformis Syndrome

Download our FREE PDF guide featuring our 6 most effective exercises against Piriformis Syndrome and buttock pain. 

A preview of the Liebscher & Bracht's guide against piriformis syndrome with the front page on the left side.
All gain. No pain.

5. Exercises to Prevent Piriformis Syndrome

If this is your first time doing our exercises, watch the video, and read the instructions under the exercise description to be prepared.

A woman is stretching her piriformis on the floor.

Exercise #1: You can do this exercise anywhere. We recommend that you use a mat, but you can also do it on the carpet or the floor.

First, lie down flat. Stretch out your lower limbs and lift your upper body with your arms. Now push your groin forward and try to straighten your upper body as much as possible until you feel a clear stretch. To increase the stretch, you can also stretch your head back. For this exercise, we recommend that you stay in the stretched position for two to two and a half minutes.

A woman is angling her leg to stretch her piriformis.

Exercise #2: Stay on a mat or the floor.

Continuing the previous exercise, stay in its position. This time, stretch out one knee. Put the foot of that leg on the lower part of your other leg. Breathe in and out steadily and keep stretching. After a minute, switch sides. Stay like this for another minute. Afterward, assume the diamond pose to relax. Put your head on the mat and place your hands next to your body.

A woman is performing a piriformis exericse.

Exercise #3: Assume a quadruped pose.

Now stretch out one leg. Tense up and keep the leg stretched out slightly to the side. If your piriformis syndrome is on the right side, lift up your left leg to the right. Do this for two minutes.

A woman is massaging her buttock with a massage ball.

Exercise #4: Foam roller massage with our Fascia-Fit midi massage ball.

Place the massage ball underneath your buttocks. Now put your hands on the ground to keep your balance. Roll around on the ball with slow circular movements to massage your piriformis. Focus on the sensitive spots.

Relieve Piriformis Syndrome

Download our FREE PDF guide featuring our 6 most effective exercises against Piriformis Syndrome and buttock pain. 

A preview of the Liebscher & Bracht's guide against piriformis syndrome with the front page on the left side.
All gain. No pain.

If you have piriformis syndrome, you might also be interested in the following topics: 

Piriformis Stretch Exercises

Once you dread hearing the words “Please, have a seat,” it’s time to do something about your aching behind. Luckily, this couldn’t be easier! 


Continue reading

Sciatica Stretches

Are you plagued by constant pain in your buttocks, the hips, and the lower back region? Then you might be all too familiar with sciatica.


Learn more about it here

Tailbone Pain Exercises

Located at the very end of your spine, the tailbone (or coccyx) is a very delicate bony structure— and the remnant of a tail. 


Read more