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Sleep Tips to Reduce Piriformis Syndrome Pain and Sciatica

The sharp, searing pain and numbing symptoms of piriformis syndrome often flare during the day with simple activities such as sitting, walking, driving, or lying down to sleep. If left untreated or ignored, these ongoing symptoms can worsen over time, resulting in chronicity and pain lasting up to 2 years in some individuals. 1 Ro TH, Edmonds L. Diagnosis and Management of Piriformis Syndrome: A Rare Anatomic Variant Analyzed by Magnetic Resonance Imaging. J Clin Imaging Sci. 2018;8:6. Published 2018 Feb 21. doi:10.4103/jcis.JCIS_58_17 , 2 Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Journal of Orthopaedic & Sports Physical Therapy. 2010;40(2):103-111. doi:10.2519/jospt.2010.3108

Read more about Symptoms of Piriformis Syndrome

Being mindful of your posture and engaging in simple piriformis exercises, such as walking or piriformis stretches, can provide meaningful relief from piriformis syndrome pain.

This blog discusses effective self-care remedies that help control the symptoms of piriformis syndrome in routine day-to-day activities. 

Sitting postures to reduce tension on the piriformis muscle

Sitting applies direct pressure on the piriformis muscle, and the inability to sit for a long period is a classic symptom of piriformis syndrome. 3 Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.

A supported posture maintains equilibrium in the spine and keeps the muscles, nerves, and bones in a balanced state. Follow these tips to prevent your piriformis pain from flaring when you sit at work or at home. Watch: 6 Tips to Improve Posture While Sitting Video

Piriformis muscle pain while sitting may be relieved by following these tips:

  • Sit with a neutral, upright spine and avoid slumping or bending forward to help distribute weights evenly through the spine and across the pelvis.
  • Ensure your feet are flat on the ground and your thighs are parallel to the floor.
  • Use a footstool, if needed, to elevate the feet and reduce pressure on the pelvis and legs.
  • Adjust the armrest of your chair so that it just slightly lifts your arms at the shoulders and helps take the strain off the shoulder and upper back.
  • Place a rolled-up towel or lumbar support cushion to help maintain the arch in the lower back and prevent slumping forward.
  • Avoid sitting in a cross-legged position, which may further irritate the piriformis muscle and sciatic nerve.

See Types of Lumbar Support and Ergonomic Office Chairs

In general, if you have piriformis muscle pain, avoid sitting for long periods and take short walks or alternate between sitting and standing, if possible. 

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Driving tips to minimize piriformis syndrome pain

Driving may flare piriformis muscle pain due to a constant seated position. Additionally, leg movements to use the pedal may worsen the symptoms, especially when the drive is long. 

Here is a list of useful tips to help relieve piriformis syndrome pain while driving:

  • Keep your left foot on the rubber pedal throughout the drive. This position ensures that your legs are positioned symmetrically, and your pelvis is balanced equally on both sides.
  • Find the right distance between the seat and the pedal to prevent your leg from being extended too much or too little. 
  • Use a heat pack on the affected side while driving. Heat therapy can help calm the muscle fibers and soothe the sacral area of the lower spine, preventing piriformis muscle pain from flaring.

See Office Chair, Posture, and Driving Ergonomics

For ongoing piriformis muscle pain, consider applying topical pain medication such as a pain-relieving gel or cream over the affected side and gently massaging the area to soothe the muscle and prevent it from becoming painful during the drive.

Sleeping better with piriformis syndrome

Lying down can place pressure on both the piriformis muscle and the sciatic nerve. Consider the following tips to help prevent piriformis syndrome pain while lying down and promote better sleep at night:

  • Use a heat pack for 10-20 minutes on the affected side before sleeping to help soothe the muscle and soft tissues, preventing a flare-up of pain at night.
  • Elevate your knees using a pillow if you’re a back sleeper.
  • Place a pillow between your legs if you’re a side sleeper.
  • Invest in a good-quality, medium-firm mattress for optimal spinal support. Research suggests that using a medium-firm mattress may help reduce lower back pain. 4 Ancuelle V, Zamudio R, Mendiola A, et al. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders. Sleep Sci. 2015;8(3):115–120. doi:10.1016/j.slsci.2015.08.004 , 5 Radwan A, Fess P, James D, et al. Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep Health. 2015;1(4):257-267. doi:10.1016/j.sleh.2015.08.001 , 6 Jacobson BH, Boolani A, Smith DB. Changes in back pain, sleep quality, and perceived stress after introduction of new bedding systems. Journal of Chiropractic Medicine. 2009;8(1):1-8. doi:10.1016/j.jcm.2008.09.002

In general, avoid sleeping on your stomach. This position disturbs the spine's normal alignment and may aggravate musculoskeletal pain. 7 Pavilack L, Alstedter N. Pain-Free Posture Handbook, 40 Dynamic Easy Exercises to Look and Feel Your Best. Althea Press; 2016.

See Best Sleeping Position for Your Back Pain and 3 Tips for Sleeping with Sciatica Video

 

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Should You Avoid Walking with Piriformis Syndrome?

Walking tips to reduce piriformis syndrome pain 

It is common for people to wonder if walking is good for piriformis syndrome pain or makes the condition worse. The answer to this question lies in how your symptoms are affected while walking. 

  • If walking helps relieve your piriformis muscle pain, take a few long walks or multiple short walks throughout the day. 
  • If walking neither improves nor worsens your piriformis muscle pain, take as many tolerable short walks as possible throughout the day.
  • If walking worsens your piriformis muscle pain, take 3 to 4 small walking breaks throughout the day that range from 30 seconds to a minute.

See How Your Walking Posture Affects Your Sciatic Nerve

The goal is to keep moving, which helps maintain back mobility, prevent stiffness, and promote the body’s natural healing processes. 8 Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. Published 2016 Apr 25. doi:10.3390/healthcare4020022 , 9 Valdivieso P, Franchi MV, Gerber C, Flück M. Does a Better Perfusion of Deconditioned Muscle Tissue Release Chronic Low Back Pain?. Front Med (Lausanne). 2018;5:77. Published 2018 Mar 20. doi:10.3389/fmed.2018.00077  If walking is not possible, try a recumbent bike, which is more comfortable and provides the benefits of walking.

Watch 2 Walking Tips to Avoid Sciatica Pain Video

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Quick one-minute stretch to relieve piriformis muscle pain 

A quick and effective way to relieve piriformis muscle pain is to stretch the muscle. The following stretches are easy to perform and depending on your convenience and location, you can choose the sitting stretch or standing stretch. 

Sitting piriformis muscle stretch

For a sitting piriformis stretch, you’ll need to:

  • Sit comfortably on a chair with your feet flat on the ground and thighs parallel to the floor.
  • Cross your right leg over the left with the right ankle over the edge of the left thigh.
  • Keep your back straight and your hands on your waist.
  • Gently fold forward at your waist without bending the back until a stretch is felt in the right buttock.

Hold the stretch for 10 seconds; repeat the exercise 3 times. Switch to crossing the left leg over the right and repeat 3 times. 

Standing piriformis muscle stretch

For a standing piriformis stretch, you’ll need to:

  • Stand near a chair or table.
  • Hold the chair or table with your right hand for support and bring your right ankle over your left knee.
  • Hold the ankle with your left hand and gently bend forward at your waist without curving your back until a stretch is felt in the right buttock.

Hold the stretch for 10 seconds; repeat the exercise 3 times. Switch to the opposite side and repeat 3 times.

Watch 4 Easy Stretches For Piriformis Syndrome Pain Relief Video

Try a combination of these tips to see what works best to relieve your piriformis muscle pain. If your pain gets worse and/or considerably disrupts your daily life, check with your doctor about additional pain relief options, which may include medications, guided physical therapy, piriformis injection treatments, and more.

Read more about Piriformis Syndrome Treatment

Learn more:

2 Essential Stretches to Relieve Piriformis Syndrome Symptoms

How Long Does Piriformis Syndrome Pain Last?

  • 1 Ro TH, Edmonds L. Diagnosis and Management of Piriformis Syndrome: A Rare Anatomic Variant Analyzed by Magnetic Resonance Imaging. J Clin Imaging Sci. 2018;8:6. Published 2018 Feb 21. doi:10.4103/jcis.JCIS_58_17
  • 2 Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Journal of Orthopaedic & Sports Physical Therapy. 2010;40(2):103-111. doi:10.2519/jospt.2010.3108
  • 3 Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.
  • 4 Ancuelle V, Zamudio R, Mendiola A, et al. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders. Sleep Sci. 2015;8(3):115–120. doi:10.1016/j.slsci.2015.08.004
  • 5 Radwan A, Fess P, James D, et al. Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep Health. 2015;1(4):257-267. doi:10.1016/j.sleh.2015.08.001
  • 6 Jacobson BH, Boolani A, Smith DB. Changes in back pain, sleep quality, and perceived stress after introduction of new bedding systems. Journal of Chiropractic Medicine. 2009;8(1):1-8. doi:10.1016/j.jcm.2008.09.002
  • 7 Pavilack L, Alstedter N. Pain-Free Posture Handbook, 40 Dynamic Easy Exercises to Look and Feel Your Best. Althea Press; 2016.
  • 8 Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. Published 2016 Apr 25. doi:10.3390/healthcare4020022
  • 9 Valdivieso P, Franchi MV, Gerber C, Flück M. Does a Better Perfusion of Deconditioned Muscle Tissue Release Chronic Low Back Pain?. Front Med (Lausanne). 2018;5:77. Published 2018 Mar 20. doi:10.3389/fmed.2018.00077
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