Piriformis Syndrome Massage

A Piriformis Syndrome Massage is a focused manual therapy intervention aimed at reducing pain, muscle tension, and sciatic nerve compression caused by piriformis muscle dysfunction. Properly applied, massage can relieve tightness, release trigger points, and improve hip and leg function for those experiencing this syndrome.​

Signs & Symptoms

• Deep, aching pain in the buttock, often radiating down the back of the leg

• Pain aggravated by sitting, climbing stairs, or prolonged hip movement

• Tingling, numbness, or burning along the sciatic nerve pathway

• Localized tenderness or spasm in the piriformis muscle

• Reduced hip flexibility and discomfort during internal rotation or abduction.​

Contraindications

• Avoid deep pressure or aggressive techniques during acute inflammation or severe pain

• Do not apply massage over areas with active infection, bruising, or recent trauma

• Caution in clients with recent hip surgery, significant nerve impingement, or suspected lumbar disk pathology

• If symptoms worsen sharply during treatment, discontinue and reassess.​

Assessment

• Palpate for tension, thickening, or trigger points in the piriformis muscle and surrounding gluteals

• Assess hip and leg range of motion, strength, and pain reproduction on movement (especially internal rotation, flexion, adduction)

• Evaluate for sciatica signs: neurodynamic tests (e.g., straight leg raise)

• Review onset, activity patterns, aggravating/alleviating factors, and previous treatments.​

Treatment

• Begin with gentle effleurage and gluteal warming strokes to relax affected tissues

• Deep tissue and trigger point release targeting the piriformis and surrounding gluteal muscles, progressing only as tolerated​

• Cross-fiber friction, longitudinal stripping, and myofascial release to break down adhesions and restore muscle mobility​

• Neuromuscular therapy: sustained pressure to trigger points (30–60 seconds per site) to relieve persistent spasms​

• Passive stretching for hip external rotators and abductor muscles

• Foam rolling and tennis ball self-massage for ongoing home care follow-up​

Self Care

• Daily stretching routines for piriformis, gluteals, and hip external rotators​

• Self-massage using tennis ball or foam roller, avoiding excessive pain or irritation​

• Alternate heat and gentle movement to manage muscle tension and discomfort

• Good posture and movement habits: avoid prolonged sitting, take frequent breaks, and modify aggravating activities

• If symptoms persist or worsen, consult a healthcare provider for further assessment or complementary therapie