Piriformis Syndrome: How to Treat the Pain in Your Butt for Good Without Relying on Stretching Alone

Tired of That Deep, Nagging Glute Pain? You Might Be Missing the Real Culprit

If you’ve been feeling a deep ache or sharp discomfort in your buttocks that radiates down the leg, especially after sitting too long, running, or lifting weights, there’s a chance you’re dealing with Piriformis Syndrome.

This condition is frustrating. It mimics sciatica, confuses MRI results, and often gets dismissed with advice like “just stretch more.” But here’s the truth: chronic gluteal pain is not solved with stretching alone. At Peak Performance Sports Therapy in Blue Ash, Ohio, we frequently treat runners, weightlifters, and desk workers struggling with piriformis-related pain. Our clinical experience and evidence-based methods show that lasting relief comes from targeted, hands-on therapy and structured rehab.

In this guide, we’ll break down:

What Piriformis Syndrome really is
Why it happens
Common myths and misdiagnoses
Long-term fixes beyond the foam roller, including shockwave therapy
How we address it at our Blue Ash clinic for real, lasting results

What Is Piriformis Syndrome? Understanding the Real Source of Pain

The Anatomy: A Small Muscle with a Big Impact

The piriformis is a small, pear-shaped muscle located deep in your glutes. It plays a key role in hip rotation and pelvic stability, especially during walking, running, and lifting. Depending on your anatomy, the sciatic nerve may run underneath, around, or even through the piriformis.

When this muscle becomes tight, inflamed, or overloaded, it can irritate or compress the sciatic nerve. The result is a cluster of symptoms often mistaken for sciatica:

Deep buttock pain
Pain radiating down the leg
Tingling or numbness
Weakness when walking, standing, or climbing stairs

The pain may feel dull, sharp, or burning. It often gets worse with prolonged sitting or activity, but may also flare up at night or after driving.

Who’s Most at Risk for Piriformis Syndrome?

At our clinic in Blue Ash, Piriformis Syndrome is most common in:

Runners with poor hip and pelvic control
Athletes who train hard but neglect recovery or mobility work
Desk-bound professionals with tight hips and shortened hip flexors
Post-injury clients who develop compensatory movement patterns
People with altered biomechanics, such as leg length discrepancies or flat feet

Piriformis Syndrome doesn’t just happen overnight. It typically builds slowly due to repetitive stress, prolonged sitting, or biomechanical dysfunction that places extra demand on the glutes and deep hip rotators.

Common Misconceptions About Piriformis Syndrome

Myth 1: “Just Stretch It Out”

Stretching may offer temporary relief, but it’s often not enough. Overstretching can even increase nerve irritation if the sciatic nerve is already compressed.

The Better Approach:
Targeted manual therapy, nerve glides, and strengthening exercises provide more durable results. These techniques help reduce compression and restore normal function without aggravating the nerve.

Myth 2: “It’s Just Sciatica”

Although the symptoms feel similar, true sciatica usually originates from spinal issues like a herniated disc or spinal stenosis. Piriformis Syndrome is peripheral, meaning the compression occurs at the muscular level in the glutes, not the spine.

At Peak Performance Sports Therapy, we conduct thorough assessments to determine whether the cause is central (spinal) or peripheral (muscular), so you’re not wasting time treating the wrong issue.

Effective, Long-Term Fixes for Piriformis Syndrome

Our clinic takes a comprehensive, personalized approach to treating Piriformis Syndrome. We look beyond temporary pain relief and focus on addressing root causes to prevent recurrence.

1. One-on-One Physical Therapy

No two bodies move the same. That’s why we begin with movement screens, gait analysis, and strength testing to understand your mechanics. Our physical therapists use these insights to:

Identify faulty movement patterns
Restore proper hip alignment and glute activation
Build core stability and pelvic control
Design mobility and strengthening routines tailored to your body

2. Sports Massage and Myofascial Release

Manual therapy is a cornerstone of our approach. Hands-on techniques help release soft tissue tension and decompress the sciatic nerve by targeting:

The piriformis
Adjacent deep hip rotators
The gluteal complex and thoracolumbar fascia

Our therapists use advanced soft tissue techniques like active release, cross-fiber friction, and neuromuscular therapy to address both the symptom and the source.

3. Shockwave Therapy: A Modern Game-Changer

When conservative methods have plateaued or symptoms persist for more than 3 months, shockwave therapy can be a highly effective solution.

This non-invasive treatment delivers high-energy acoustic waves to:

Break up soft tissue adhesions
Improve blood flow and nutrient delivery
Stimulate tissue regeneration and repair
Calm hypersensitive nerve pathways

Shockwave therapy is particularly effective in cases of chronic piriformis tension, where scar tissue or chronic tightness has built up over time. When paired with exercise and manual therapy, it often accelerates recovery dramatically.

Frequently Asked Questions

Q: Is Piriformis Syndrome permanent?
No. With the right combination of manual therapy, targeted rehab, and sometimes shockwave therapy, most people make a full recovery.

Q: How can I tell if it’s piriformis syndrome or sciatica?
If bending forward increases your pain or you feel shooting discomfort down the entire leg, it may be spinal sciatica. But if the pain is deep in the glute and radiates down the back of the leg without low back involvement, the piriformis is often the culprit. We perform specialized differential testing to confirm.

Q: Does insurance cover this treatment?
Yes. Most insurance plans cover physical therapy. We also offer out-of-network options and affordable self-pay packages for services like dry needling, massage, and shockwave therapy.

Why Choose Peak Performance Sports Therapy in Blue Ash, Ohio?

At Peak Performance, we believe in precision, not guesswork. Every session is one-on-one with an experienced therapist who customizes treatment to your specific pain, goals, and lifestyle.

You won’t get generic advice or rushed visits. Instead, you’ll receive evidence-based care built on years of experience helping athletes, professionals, and active adults recover from stubborn conditions like Piriformis Syndrome.

We combine advanced techniques with compassionate care so you can get back to moving, training, and living without fear of pain returning.

Ready to Sit, Move, and Train Pain-Free Again?

Piriformis Syndrome doesn’t have to become your new normal. If you’re tired of pain that flares up every time you sit, squat, or run, it’s time for a different approach.

Contact Peak Performance Sports Therapy in Blue Ash, Ohio today to book a comprehensive evaluation. We’ll help you determine if shockwave therapy, manual treatment, and rehab training are the right fit for your recovery.

Don’t settle for stretching alone. Let’s fix it at the source.