At Thrive Body Clinic, we often see patients who come in complaining of a deep, nagging pain in the buttock that radiates down the back of the leg. They may have been told it’s sciatica – and they’re not wrong. But in many of these cases, the underlying culprit is a much lesser-known issue: piriformis syndrome.

Despite being a small, deep-set muscle, the piriformis can pack a powerful punch when it comes to discomfort and dysfunction. In this blog, we’ll take a closer look at what piriformis syndrome is, why it can be so disruptive, and how three simple stretches can help relieve the pressure and reduce pain. We’ll also explore how osteopathy can provide further relief and long-term resolution.

What is the Piriformis Muscle?

The piriformis is a small muscle located deep in the buttock, underneath the larger gluteal muscles. It runs from the sacrum (the base of your spine) across to the top of your femur (thigh bone), and it plays a key role in rotating your hip, stabilising the pelvis, and allowing you to move your leg out to the side.

The sciatic nerve – the longest and thickest nerve in your body – typically runs just beneath the piriformis muscle. In some people, it may even pass through the muscle belly. This close relationship between muscle and nerve is what causes so much trouble when things go wrong.

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What is Piriformis Syndrome?

Piriformis syndrome occurs when the piriformis muscle becomes tight, inflamed, or irritated, leading it to compress or irritate the sciatic nerve. The result is a familiar constellation of symptoms that mimic sciatica:

• Deep buttock pain (often on one side)
• Tingling, numbness, or shooting pain down the back of the leg
• Discomfort when sitting, especially for long periods
• Pain that worsens with walking, climbing stairs, or rising from a chair

Unlike true sciatica, which is usually caused by a herniated disc or spinal issue, piriformis syndrome is a neuromuscular problem – the muscle is compressing the nerve, not the spine.

Why Does It Happen?

There are several reasons why the piriformis muscle might become overactive or irritated:

• Prolonged sitting: Desk jobs, long drives, and general inactivity can shorten and tighten the piriformis over time.
• Overuse injuries: Runners and cyclists are especially prone to piriformis issues from repetitive motion and muscle imbalances.
• Poor posture and biomechanics: Imbalances in the pelvis, weak glutes, or a rotated sacrum can put added strain on the piriformis.
• Direct trauma: A fall onto the buttocks can cause inflammation or spasm in the muscle.

It’s also worth noting that women are more commonly affected than men, likely due to differences in pelvic structure.

How Can Osteopathy Help?

At Thrive Body Clinic, we take a whole-body approach to diagnosing and treating piriformis syndrome. That’s because this little muscle rarely acts alone – its dysfunction often arises from wider patterns of movement, posture, and tension.

Here’s how osteopathy can help:

• Assessment of posture and gait to identify contributing factors like a tilted pelvis or leg length discrepancy.
• Hands-on techniques to release tension in the piriformis and surrounding muscles, including deep tissue massage, myofascial release, and muscle energy techniques.
• Joint mobilisations to improve hip and sacroiliac function.
• Advice on ergonomics and movement to reduce recurrence and support long-term recovery.
• Rehabilitation guidance, including strengthening the glutes and improving pelvic stability.

The goal isn’t just to relieve your pain in the short term – it’s to correct the underlying imbalances that led to the problem in the first place.

3 Stretches That Can Help Relieve Piriformis Syndrome

In addition to hands-on treatment, self-care is essential for managing piriformis syndrome. Below are three stretches we often recommend to help release tension in the piriformis muscle and ease sciatic irritation.

Important: Never force a stretch. You should feel a gentle pull, not pain. Hold each stretch for 20–30 seconds and repeat 2–3 times per side.

1. Figure-Four Stretch (Seated or Lying Down)

This is one of the most effective stretches for targeting the piriformis directly.

How to do it:

• Lying version: Lie on your back with knees bent and feet flat. Cross your right ankle over your left knee to make a figure 4 shape.
• Reach through your legs and gently pull your left thigh towards your chest.
• You should feel a stretch deep in the right buttock.
• Repeat on the other side.

Variation (Seated):

• Sit tall in a chair, cross your right ankle over your left knee.
• Gently lean forward while keeping your back straight until you feel a stretch in the glute.

2. Knee-to-Opposite-Shoulder Stretch

This stretch targets the piriformis by pulling it across the body.

How to do it:

• Lie on your back with legs extended.
• Bend your right knee and gently pull it towards your left shoulder.
• Keep your shoulders flat on the ground.
• Hold, then switch sides.

This is a gentle but effective way to lengthen the piriformis and reduce pressure on the sciatic nerve.

3. Supine Spinal Twist

This stretch combines rotation with hip movement to release tension in the lower back and piriformis.

How to do it:

• Lie on your back and bring both knees to your chest.
• Let your knees fall to one side while keeping your shoulders grounded.
• You can place your opposite hand on your knee to gently deepen the stretch.
• Turn your head in the opposite direction for an added spinal twist.

This movement also helps improve spinal mobility and can ease tension across the entire lower back.

Final Thoughts: Don’t Let a Small Muscle Cause Big Problems

Piriformis syndrome is a great example of how “small” doesn’t mean “insignificant.” When this tiny muscle becomes tight or inflamed, it can trigger pain that disrupts your day-to-day life – from sitting at your desk to walking around the shops.

If you suspect piriformis syndrome, don’t ignore it or try to push through the pain. Early intervention makes a big difference. At Thrive Body Clinic, we’ll help you pinpoint the root of the issue, relieve your symptoms, and get you moving freely again – without relying on painkillers or invasive procedures.

And remember, a little daily movement – especially stretching – goes a long way toward preventing recurrence.Book your appointment today at Thrive Body Clinic and let’s help your piriformis finally relax.