Exercise for sciatic pain from piriformis syndrome

Differences between piriformis syndrome and sciatica
A common symptom of piriformis syndrome is pain along the sciatic nerve, so it is often thought that piriformis syndrome causes sciatica. However, piriformis syndrome does not involve a radiculopathy—a disc extending beyond its usual location in the vertebral column that impinges or irritates the nerve root—so it is technically not sciatica. Instead, with piriformis syndrome, it is the piriformis muscle itself that irritates the sciatic nerve and causes sciatic pain.

The piriformis is a muscle located deep in the hip that runs in close proximity to the sciatic nerve. When the piriformis muscle becomes tight and/or inflamed, it can cause irritation of the sciatic nerve. This irritation leads to sciatica-like pain, tingling and numbness that run from the lower back, to the rear and sometimes down the leg and into the foot. For more information on piriformis syndrome, see Piriformis syndrome—another irritation to the sciatic nerve.

Stretching exercises for sciatic pain from the piriformis muscle
Stretching the piriformis muscle to is almost always necessary relieve the pain along the sciatic nerve and can be done in several different positions. A number of stretching exercises for the piriformis muscle, hamstring muscles and hip extensor muscles may be used to help decrease the painful symptoms along the sciatic nerve and return the patient’s range of motion. 

Several of the stretching exercises commonly prescribed to treat sciatica symptoms from piriformis muscle problems include:

Supine piriformis stretches:

• Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of the body and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle (Figure 17).

• Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed (Figure 18).

• Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body (Figure 19).

Buttocks stretch for the piriformis:

• Begin on all fours. Place the affected foot across and underneath the trunk of the body so that the affected knee is outside the trunk. Extend the non-affected leg straight back behind the trunk and keep the pelvis straight. Keeping the affected leg in place, scoot the hips backwards towards the floor and lean forward on the forearms (Figure 20).

All of the piriformis stretching exercises should be held for 30 seconds and repeated 3 times.