Piriformis Syndrome – A Nerve-Wracking Pain In The Buttocks

1. The Piriformis – Location and Function

The piriformis muscle lies under the gluteus maximus.

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.

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.

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.

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.

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.