The piriformis is a flat muscle located deep in the buttock.
Its primary role is to rotate the leg outward and move the leg to the side.
The piriformis attaches to the sacrum, which is the triangular bone at the base of the spine just above the tailbone.
The other end connects to the upper part of the thigh bone, called the trochanter.
It is a strong, thick, flat muscle that is wider at the sacrum and narrows as it reaches the thigh.
Because of its location, the piriformis muscle can affect the sciatic nerve.
The sciatic nerve is a major nerve that carries most of the signals from your brain down your leg.
The piriformis muscle passes directly over the top of this nerve.
In about six percent of people, the sciatic nerve actually passes through the piriformis muscle itself.
If you have piriformis pain, often referred to as Piriformis Syndrome, it can be quite debilitating. Even basic daily tasks can become difficult due to the pain. But you can heal from it. You just need to follow the right steps to recover from piriformis pain. Hint: it is not 90 percent of the bad advice you will find online. Many websites recommend activities and so-called treatments that may actually make things worse.
Piriformis Syndrome is often called Fake Sciatica. The symptoms can be very similar.
But sciatica is usually caused by a bulging disk where the nerve root comes out of the lower part of the spine.
The close relationship between the Piriformis and the Sciatic nerve is the main reason that problems with the Piriformis can become so debilitating.
The Piriformis is directly on top of the Sciatic Nerve.
If the Piriformis is injured it will go through the same swelling and spasming that any injured muscle will experience.
But in this case, it will be right against the surface of the sciatic nerve.
It will narrow the space the sciatic nerve usually passes through and rub against the nerve whenever there is movement of the leg.
Every person's anatomy is different and some people have less space for the sciatic nerve to pass through.
Any spasm would then pinch the nerve where it passes through the muscle.
This makes it more likely in those cases for swelling or tightness in the muscle to irritate the nerve.
Irritation to this major nerve for the leg can cause weakness, "pins and needles", numbness, and pain.
You can see why this condition is often mistaken for Sciatica.
Symptoms of Piriformis Syndrome can vary from person to person.
Your Piriformis injury is unique.
It will likely have some different symptoms from what you read and hear.
That is ok and normal. You can still heal it with the right steps.
The common thread in everyone's symptoms is pain in one side of the buttock.
After that, many people describe many different related pains that can range from the top of the hip to the end of the toes.
Usually, it is sensitive to pressure.
One quick Piriformis test is to press on the spot and it will hurt and may even aggravate symptoms for a while.
It can be dull pain or stabbing pain or may include that "pins and needles" sensation that comes with nerve pain.
Some people have numbness and pain down the leg.
That numbness will make it difficult to do many normal daily tasks.
Some people have trouble walking or going up stairs.
Sitting can be an issue. The prolonged pressure on the buttock can aggravate the Piriformis making pain worse.
Many people have weakness in the leg on the same side.
A Piriformis Injury is ultimately a muscle strain. This is what causes Piriformis Syndrome. The strain can cause muscle tightness, swelling, spasms or other symptoms. If the strain is severe enough there may be torn fibers in the muscle which can cause bleeding as well as the other symptoms.
Muscle strains come in three classes. Typically, they are called degrees or grades.
This is common to all muscle strains.
A grade 1 muscle strain is a minor overstretch of the muscle.
It can cause mild tightness and swelling and it usually heals quickly if you do not reinjure it.
You probably don't have a grade one strain if you are looking online for information since it is usually only mildly irritating.
Since you are online reading about Piriformis it's a good bet your strain is a grade 2 and maybe a grade 3 in some people.
A grade 2 injury is significant overstretching along with some tearing of the muscle.
This injury takes longer to heal.
You may have pain for a few weeks.
It is very easy to reinjure this strain so a plan to minimize reinjury is key for this one.
Grade 3 means you have a torn Piriformis with considerable tearing of fibers and in some cases your doctor may say it needs surgery to correct.
It takes much longer to heal from this type of injury.
No matter what type of injury you have in your Piriformis muscle, what makes it unique is how close it is to your sciatic nerve.
The location means any swelling or spasms will cause pressure against the sciatic nerve which will cause irritation and tenderness.
This is the reason that some people refer to Piriformis as fake sciatica.
Healing the muscle strain will stop the spasms and ease the swelling resulting in no more pain and numbness.
For an excellent, in-depth explanation about how an injury heals click here for our Tissue Healing Page.
Your Piriformis needs your help to heal.
But it does not need you to just start randomly doing stretches and exercises you find on the web.
This is a great way to keep your injury going.
Reinjuring the muscle is the number one thing prolonging your healing time.
The piriformis muscle is one we use every time we get up and move around.
So, it does not get to rest, unless, you focus and make a point of resting.
Another complicating factor is that many people find that sitting irritates the Piriformis.
It is located right there in your buttock so sitting, especially for long periods, can make it worse.
You may need to either find a way to change your sitting position, so you alleviate pressure on one side of the buttock, or move frequently.
But obviously, if both sitting and walking cause irritation, it will take some planning to get some time to rest your piriformis.
At first, you want to focus on three things.
Reduce pain with cold compression not medication.
Avoid reinjuring the muscle.
Increase blood flow to the muscle to stimulate rapid healing.
Pain reduction is important.
When the Piriformis hurts, you need to reduce pain so you can go about your day and do the things you need to do.
But masking pain with pain medication is not recommended because it can lead to you being unaware of the damage you are doing to a muscle.
This is a very common way people get caught in an injury and reinjury cycle.
Don't get caught in this loop.
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Get some initial rest of the muscle and give it time to heal.
Find ways to protect the muscle from too much use during the early healing phase.
Use cold for pain during the day.
If you do use pain medications, use them at night for sleep.
Don't use them during the day since they greatly increase your chances of adding more damage to the muscle strain.
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Some pain medications can help - if you use the right one at the right time.
Call us and speak to one of our trained treatment advisors about which pain relievers work best.
We are here to help.
TENS is an acronym that means Transcutaneous Electrical Nerve Stimulation.
The TENS machine is designed to overstimulate the nerves to relieve pain.
It deadens the nerves and that's it.
Yes, you want to reduce pain.
The pain with Piriformis Syndrome can be debilitating for sure.
But TENS machine use over an injury is a very bad idea.
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TENS causes your muscles to spasm during treatment.
That's bad.
Having your Piriformis pulse and flex uncontrolled will cause further tissue damage and slow down healing.55x
It will also cause the Piriformis to spasm directly against the sciatic nerve, which is exactly what is causing most of the pain with Piriformis Syndrome.
Avoid this treatment as it can make things significantly worse for this condition.
Continuous mild pressure on a body part when it is not moving can lead to an injury called Isometric Strain Injury.
If you are inactive for a long period of time, and your leg is held in a position where you are putting pressure or stretch on the injured area, you may be hurting yourself.
With Isometric Strain, you usually don't notice it when you're actually doing the damage.
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You know how when you sit in a position for a long time, and then when you go to get up, parts of your body are stiff and a bit painful?
That's Isometric Strain.
You don't feel it when you're doing the damage, only later.
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When you're injured through isometric strain, you might not even notice it right away after moving.
Often you notice later that you are having a flare up and are not sure why.
With Piriformis this will most commonly happen with sitting or sleeping positions.
Sitting can be a real issue since many of us have jobs that require extended sitting.
The main thing for sitting is to notice if you are putting pressure on the buttocks. If you can feel pressure in that painful area of the piriformis, you may be straining the tissue. Or, if you are putting stretch into the area for extended periods, you may be straining the tissue. Either way, this can cause irritation to the strained piriformis muscle and make it worse.49x You may need to try a sitting pillow or find a good foot rest to get just the right sitting position. But it is not just sitting. Be mindful of any time you are stationary for an extended period and how you are positioning your leg on the injured Piriformis side. Notice any pressure or stretch, and move to a more neutral position to avoid isometric strain.
One common mistake is not considering how you may be straining the Piriformis Muscle while you sleep.
You may need to find a sleeping position that does not stretch or pressure the area.
Strain could be caused by positions where your leg is pulling to the side, or by pressure on the buttocks.
Most people find sleeping on their back relieves most of the pressure.46x 47x
You may need to experiment to find just the right position for you.
You can try on your side with your leg supported by a pillow.
Or you might find that sleeping on your back is best, but only with a pillow slightly elevating the knees.
It is definitely worth taking the time to find a position that minimizes the strain at night.
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No doubt, you have seen all the recommendations online for specific stretches to do.
They claim it will be a quick fix, once and for all, "if you just do this stretch".
But this is mostly Misinformation.
Yes, if the Piriformis is spasming, it can cause pain.
And yes, stretching is one way to get a muscle to relax.
But not too soon.
Stretching a muscle already suffering from an overstretch injury or tear is a really good way to get it to spasm, swell and cause more pain.
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Bottom line: if you stretch too early you will find yourself causing more injury.
Wait until you are later in the healing process when most of the pain is gone.
Even then you want to take it slowly and listen to your body.
A better way to get a muscle to relax is to work on healing the muscle fibers with increased blood flow and rest.
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Many people ask about Piriformis Massage. This is another area where timing is important. If you have a fresh muscle strain with some torn muscle fibers in the Piriformis, you are looking at a good chance of making it worse with premature massage.32x Massage can help to relax a muscle later when it is more healed. This should be much later in the process, ideally when most of the pain is gone. If you get a massage and it causes pain or does not feel right, stop it immediately and wait until a later date after more healing.56x This includes deep tissue, trigger point, etc.
For a piriformis injury, exercise falls in the same category of things that might be right at a later point. You do not want to exercise a muscle with a recent strain. If it hurts a lot, then rest it. Give it time to heal. 32x
Some sites online recommend lifting weights or even doing things like squats with weight to heal.
That's really bad advice.
If you just tore your Piriformis muscle recently and you go and do something like this, it could easily cause the injury to become worse.33x
Understanding that this injury is a muscle strain should help you understand why you should not lift weights or do other exercises until you are healing.
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Later, after you are healed, strength exercises and stretching can be a great way to protect yourself from future injury.
But during the first few weeks of your healing stay away from this kind of thing.
If you have any doubt about whether you are healed, give it more time.
Physiotherapists and doctors recommend stretching and strengthening exercises because they help to promote blood flow through your injured buttock.
Motion in the muscles assists with the circulation of interstitial fluid, which is essential for healing.
When you are injured, activity usually decreases, and this leads to muscle weakening, a process known as atrophy.
In the early stages of recovery, light motion is all that is needed to help maintain fluid movement and circulation.
You do not need to bear weight or do intense activity to support healing in this phase.
As long as you are not feeling pain, mild activity is generally safe.
In the early days of physical therapy, the focus should be on gentle motion, not exercise.
Physiotherapy is also intended to help rebuild lost muscle strength once your piriformis injury is more stable.
But starting aggressive stretching or strengthening too early can be harmful.
The muscle must first stabilize and begin healing.
Pushing too hard before the muscle has regained integrity can increase inflammation, trigger spasms, or lead to reinjury.
This is a known risk in soft tissue recovery, especially with muscle strains52x.
If you are still experiencing significant symptoms, any physiotherapy should begin with light, controlled movements only.
Recovery is a process, and the goal is to avoid setbacks by respecting the healing timeline.
Our advice is, don't start Physical Therapy until your condition has stabilized. When you start, if you feel pain during or after PT, speak up! Your clinician can't feel what you feel, so it is very important to advocate for yourself during physio. Let them know how it feels at each stage so they can use that as a guide to treat you properly. PT is not supposed to hurt and if it does you may be re-injuring your piriformis. Never drive through the pain. If your physio recommends you work through the pain you should consider a different therapist.
When you rest, your blood flow slows down which doesn't help your injury heal. This is why BFST® is so important to start early on in your recovery. The BFST® will increase blood flow when you can't exercise and stretch aggressively.2x This enables exchange of nutrients and waste with the interstitial fluid - to promote the healing process. So, with BFST, you can have increased circulation for hours even though your actual motion of your joint is quite light and that is invaluable to your piriformis.7x
BFST stimulation also helps prevent reinjury when you become more active. Giving your piriformis muscle BFST before any activity triggers the muscle circulation as though there is significant exercise going on.8x Think of it as a warm-up lap for your muscle before you actually start the exercise. That warm-up is invaluable in preventing reinjury, particularly if you were fairly immobile before hand. Start BFST early. The earlier the better! Use the BFST® to warm up your injured area before PT and before any other heavy activity. This will help prevent further injury as a result of the PT activity.8x
At the beginning of your injury, even before the injury has had a chance to stabilize and long before you start physio, the ColdCure® Wraps will help keep the pain and swelling under control.
Cold compression is highly recommended to stabilize a fresh injury26x 27x 51x.
And when you are active, invariably, you are going to aggravate your condition to some degree.
If you are very active, you may aggravate it a lot.
After any activity where you may have aggravated your injury, use cold compression to minimize the negative impact and stabilize your piriformis muscle.
Always use your ColdCure® wrap after any heavy activity and after PT.
The KB Support Tape® should be applied every morning and worn all day long to help prevent re-injury, including to PT.
It protects you when you move.
KB Tape is armor for your injury.
For many people, King Brand® products, used in the comfort of your own home, are all that is required without having to attend and pay for Physical Therapy appointments.
Because you don't have to move to use them, the King Brand BFST® and ColdCure® Wraps can be started any time in your recovery process.
There are 3 Key Factors:
1. The severity of your injury.
2. The amount of reinjury you do.
3. Proactive treatments you apply.
What people really want to know is, "When will the pain be gone and I can return to normal life?".
That's very different than when your tissue is actually fully healed.
Long before the Piriformis strain is fully healed, you will be doing most of what you could do before.
If it's a very minor tear and you really protect it to not reinjure it, the pain can subside in 3 weeks.
Once the pain is gone, you can start to slowly go back to normal life.
If you do it carefully, you will probably be doing what you did before the injury within 2-3 months.
Even though you return to normal activity and have no pain, the tissue is still healing underneath and it probably will be doing so for an additional 6 months after that.
So, for a minor tear, pain gone: 6 weeks, Normal life: 12 weeks, tissue as-good-as-new: 1 year
If it's a moderate tear and you really protect it to not reinjure it, the pain can subside in 12 weeks.
Once the pain is gone you can start to slowly go back to normal life and be doing what you did before within 4-5 months.
Fully healing the underlying tissue to good-as-new in about 12 months.
For a major tear and you really protect it, the pain can largely subside to almost nothing in 6 months.
Once the pain is gone, slowly go back to what you did before within 10-16 months.
Fully healing the underlying tissue to good-as-new in about 2 years.
You've just digested a lot of information! At this point, people want to know what they can do to speed up the process. You can be proactive, but what's most important is to avoid the things that will slow down the healing process or prevent it all together.
There are things you can do to speed up your healing.
Stabilize the injured area and protect it from reinjury with KB Support Tape.
Use ColdCure® to reduce pain and inflammation 27x 26x.
Use BFST® to bring blood flow to the area and speed healing 1x 2x 7x.
For more about these proactive treatments,
click here for our Recommended Treatments page.
For a little while - not forever - it is really helpful to give your piriformis muscle a rest.
In many cases, resting your piriformis for a few weeks will give it time to heal enough that your body gets ahead of the healing and reinjury cycle 33x 52x.
It's important to understand that once the pain and swelling go away, your underlying injury is not fully healed.
So take it easy.
Return to regular life gradually, once your symptoms have resolved.
If you want your piriformis injury to go away as quickly as possible, you need to rest the affected area.
Avoid any physical activities that could cause further injury.
Do your best to avoid the activity that caused the tear in the first place.
Do regular ColdCure® treatments to control the pain and swelling 27x 26x.
You can also focus on healing the strain with regular BFST® treatments.
This combination will work to accelerate the healing process 1x 2x 7x.
Around the 4 to 6 week mark, not before, you can start doing some light stretching and strengthening exercises.
Slowly work your way back to your regular level of activity.
Continue doing BFST® treatments long after the pain and any swelling disappear to maintain the healing you have done 52x.
Do a ColdCure® treatment if you experience any flare-ups of pain and swelling and after any significant activity.
You don't have to undergo surgery in order to recover from most piriformis injuries.
Most tears will heal with conservative treatments.
However, it's possible that your situation does require surgery, but do get a second and maybe even a third opinion as surgery is a big step and not all doctors will agree that it is needed.
If surgery is your only option, make sure your post-surgery recovery goes as smoothly as possible by using BFST and ColdCure.
Use a ColdCure® Back and Hip Wrap to reduce the inflammation and relieve the pain for the first few days following surgery 26x 27x.
Once the inflammation has gone down, promote blood flow to the injured area using a BFST® Back/Hip Wrap.
This will improve your circulation and help you heal faster 1x 2x 7x.
Always get an opinion from more than one orthopedic surgeon before committing to surgery.
Consider what each one has to say.
Painkillers mask the pain, causing you to continue to stress and injure your piriformis muscle.
This will only make your condition worse.
It is understandable that people need relief from the pain, so if you have to take painkillers, restrict them to times when you are off your feet.
You can use painkillers to help you sleep, but using them while active can lead to further damage. 25x Your choice of painkillers is important.
You can give us a call to discuss which ones are best.
The ColdCure® Back and Hip Wrap is designed to relieve the pain associated with piriformis syndrome. 26x This safe and effective pain reliever is also great at bringing down swelling and inflammation. 27x The ColdCure® Wrap is incredibly soothing and provides support and protection for your lower back and buttock region.
The pain relief is powerful and works instantly - there is no 20 minute wait like with pills. 51x
Piriformis syndrome can be extremely painful and debilitating.
Painkillers are often used to address the pain, but these drugs do nothing to treat the actual condition. 25x In fact, some painkillers are blood thinners and may make bleeding worse in fresh soft tissue injuries.
Cortisone injections are used in extreme cases, but these too only address the pain.
They do not promote healing of the muscle strain and they put you at a very high risk of further injury. 37x
For proactive treatments, click here for our Recommended Treatments page.
There's no doubt about it, for healing most tissue injuries in the body, blood flow is the most critical element in rapid recovery.
The blood flow brings the building blocks for new cell growth.
It carries away the waste and damaged tissue.
It brings antibodies to protect against infection.
Your blood flow supplies the cells in your body with everything it needs and removes much of what needs to be taken away.
While your heart ensures a sufficient supply to your body as a whole, in the individual parts of your body there are a lot of factors that determine how much that area receives.
Motion in local tissue can play a significant role in blood supply, but when you are injured, that motion is reduced, and so is the trigger to bring blood to the area.43x
People often don't understand that motion alone is enough, and that does not mean putting a heavy load on your joint.
When you swing your leg gently and with limited range, that's enough.
Adding the weight of your body or doing stressful exercise doesn't improve the motion, and the added loads can end up resulting in reinjury.33x
Find light, gentle motions that you can do with no pain at all and do those several times each day.
If you're using crutches, the swinging of your leg through the day is enough; you don't need to add more load.
Diathermy is a medical process to promote blood flow in tissue that is at rest.7x
Diathermy is a process by which energy is sent deep into the body to stimulate blood flow in tissue far below the skin.1x 2x
An example of diathermy is ultrasound treatment, commonly used in physiotherapy.13x The challenge with ultrasound is that all diathermic treatments are effective for only up to 4 hours, whereas most people go to the clinic once every couple of days.
Also, ultrasound is an older, more risky process that can damage subdermal tissue, so it needs to be performed by a trained technician.
That means you can't do it at home.
The good news is that you have an option other than ultrasound.
BFST® devices from King Brand are diathermic devices that people can safely use at home to promote healing.1x 2x
With a home diathermic device, you can apply treatment multiple times each day, which significantly improves blood flow and accelerates the healing process.7x
And they are more powerful too, providing deeper stimulation than traditional clinic-based treatments.13x
An ultrasound device is highly focused, and the effective treatment area may be less than 1 square inch beneath the surface.
That is why it must be constantly moved around during treatment, both to cover the entire injury and to avoid overheating or burning tissue.
BFST® devices offer a major improvement.
They treat up to 70 square inches of tissue at once, without requiring any movement.
This means your piriformis injury can be treated more completely, with better safety and far less effort.1x 2x
They are typically up to 10 times more powerful than ultrasound and completely safe for home use.13x
BFST® brings extra oxygen and nutrient-rich blood to the injured area - a requirement for the body to heal itself.1x Unfortunately, an injured hip at rest often has restricted blood flow, which extends your healing time.33x
With a King Brand® BFST® hip Wrap, blood flow can be stimulated in the area of injury while you are at rest.
With improved blood flow and reduced strenuous activity, you reduce the risk of re-injury and you can recover from your hip injury at a surprisingly rapid rate.
For proactive treatment advice click here for our Recommended Treatments page.
For more in-depth information about how an injury heals click here for our Healing Page.
To minimize pain and swelling, use a ColdCure® any time your pain level increases, or if you have been active.
The ColdCure® Back and Hip Wrap provides effective relief of the swelling and pain that comes with a Piriformis injury.
ColdCure® Wraps use cold and compression together, because cold and compression are the two things you need to help reduce pain and swelling as quickly and effectively as possible
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The application of cold compression must be uniform and complete if it's going to work the best.
This is why the ColdCure® Back and Hip Wrap has been custom designed to perfectly fit the side and back of the hip, over your buttock, to ensure that your injury receives an even distribution of cooling power.
ColdCure® Back and Hip Wrap - Versatile and Effective!
If your biggest issue is the pain, then you definitely want the ColdCure® wrap. The ColdCure® Back and Hip Wrap comes with 3 swappable cold packs that contain our unique XC RigiGel® formula. This isn't that 'blue goo' that you get from the drug store, no way. This is super gel. It holds tons more cold and stays cold much longer. It's ice that bends like rubber. It's amazing. The elasticized wrap holds the cold firmly in place against your injury sucking away the pain while it gently reduces swelling. If pain is your #1 concern, this is your #1 solution. With extra gel packs included you can treat the pain over and over again, never running out of ice.
The King Brand Recovery Packs listed below include our full list of products to heal as quickly as possible from your Piriformis Syndrome. As an added bonus, the Recovery Packs include a discount that's been built into the package price.
Three Piece Recovery Pack - Save BIG on the Essentials
The Three Piece Recovery Package deal includes the Back BFST®, Back ColdCure® and KB Support Tape™.
These are the three most important tools we can recommend for your Piriformis injury. They work together to help heal you, protect you, and reduce the pain.
Four Piece "On The Go" Pack - The Biggest Savings Including Battery
The Four Piece Recovery Pack is designed for people who are always on the go, and want the convenience of treatments anywhere and at any time.
This bundle includes everything mentioned in our Three Piece Recovery Pack, and also includes our BFST® Battery Pack.
With the BFST® Battery Pack, you don't need an outlet.
You can take your treatments in the car, on the plane, or wherever your day takes you.
With a full charge on your BFST® Battery Pack, you will have more than enough power to complete all of your treatments for 2 or 3 days between charges.
King Brand® soft tissue rehabilitation medical products are the choice of many top Athletic Therapists and Medical Practitioners. We provide guaranteed results and customer satisfaction. Like all King Brand® products, there simply isn't a better performing option. All King Brand® products come with a 100% satisfaction guarantee. Try our products and if you are not completely impressed, you can send them back for a full refund. We know you will love them though, because thousands of people already use them and rave about the results.
Click here to see our Customer Testimonials
King Brand® BFST® and ColdCure® Wraps are FDA Registered medical devices. They are intended to prevent, treat and cure soft tissue injuries and chronic conditions. Part of being an FDA Registered company means that our products are made from high quality, biocompatible materials. These devices are manufactured and tested to the highest safety standards in the industry.
