The piriformis is a small deeper muscle in the glutes (buttocks) that rotates the thigh outward (externally) and when the leg is bent at the hip it helps abduct (move away from the body) the thigh. It prevents the hip from rolling inward when doing an activity like running.
The sciatic nerve runs under the piriformis muscle and down the leg. However, for about 20% of people the sciatic nerve actually goes through the piriformis muscle.
A tight piriformis can sometimes compress and impinge on the sciatic nerve which will cause those commonly known symptoms of pain and pins & needles or numbness down the back of leg, glutes, and low back. If it’s severe it may cause some weakness in the lower leg.
Pain can be aggravated by sitting, sit-to-stand, standing, bringing the leg inward to the body, and having prolonged hip flexion.
Remedial massage therapy can be a great way to treat this piriformis syndrome and alleviate the pain and symptoms. The therapist will target the affected side working on the upper gluteal muscles (including the piriformis) with massage techniques and trigger point release work to help decrease tension in the soft tissue. They may work around the lower back, the opposite side and through the posterior leg too depending on time. The muscles around the hip and pelvis can often be quite a tender area so make sure to tell your therapist if the pressure is making you too sore, or if you are struggling to relax under the pressure, or if you are uncomfortable in anyway. Focus on your exhalations as you breathe to help your muscles “let go”.
You can self-massage into the middle of the gluteal muscles using a tennis ball or spiky massage ball to pinpoint the tight areas. Stretch the muscles with your knee towards chest and across the body – feel for the stretch sensation in the buttock and don’t push into pain. You can use a pillow between your knees if you are a side-sleeper to make sleeping more comfortable while the area is aggravated as well. Try to avoid sitting for long-periods, take regular breaks to move and stretch.
If this is a recurring issue then it is worthwhile to see a physiotherapist for further assessment and treatment.