A deep ache in the middle of your buttock that builds the longer you sit, sometimes spreading down the back of your thigh. Piriformis pain can make long meetings, car journeys and evenings on the sofa uncomfortable. Understanding what is going on can help you find more comfortable ways to sit and move.

What the piriformis is

The piriformis is a small muscle deep in your buttock. It runs from the base of your spine to the top of your thigh bone and helps turn your leg outwards and steady your hip.

The sciatic nerve, the large nerve that runs down the back of your leg, passes very close to this muscle. When the area becomes sensitive, you may feel a deep ache in your buttock, and sometimes tingling or aching that travels down the back of your thigh.

Piriformis pain is often made worse by sitting for long periods, especially on hard chairs, or by activities that load the hip a lot, like running, climbing stairs or lots of driving.

Why it usually settles

Piriformis pain usually settles with changes to how you sit and move, along with gentle stretches and strengthening. If you have been given advice or exercises by a physiotherapist, keep following those.

Sitting more comfortably

Sitting is often what brings piriformis pain most. Some things to try:

• Get up and move every half hour or so.
• Use a cushion on hard chairs. Some people find a cushion with a cut-out in the middle helpful.
• Check your back pockets, as a wallet or phone can press on the sore area.
• Sit with your weight even on both sides and your feet flat on the floor.
• Avoid sitting with your legs crossed for long periods.

On long car journeys, taking regular breaks to get out and walk can help. VIDA’s Pomodoro stretches, in the top right corner, can remind you to pause and move during focused work.

Stretches that help

Unlike some other buttock pain, piriformis pain often responds well to gentle stretching. Something to try a couple of times a day, holding each for 20 to 30 seconds:

• Seated stretch. Sitting on a chair, cross your sore leg over so your ankle rests on your other knee. Sit tall and gently lean forward until you feel a stretch in your buttock.
• Lying stretch. Lie on your back with your knees bent. Cross your sore leg over so your ankle rests on your other knee, then gently draw your other knee towards your chest.
• Knee to opposite shoulder. Lying on your back, gently draw your sore knee up and across towards the opposite shoulder.

Keep the stretch gentle. If it brings on tingling or sharp pain down your leg, ease off. If you would like a guided stretch, VIDA has short videos you can follow at your own pace.

Building strength

Strengthening the muscles around your hips and buttocks helps them share the load, so the piriformis does not have to work as hard. Something to try two or three times a week:

• Bridges. Lie on your back with your knees bent, lift your hips, then lower slowly.
• Side-lying leg lifts. Lie on your side and slowly lift your top leg a little way, then lower.
• Sit to stand. Rise from a chair without using your hands, then lower slowly.

If you would like to follow along, VIDA has short videos of bridges and sit to stands you can use at your own pace. Start with a few repetitions and build up gradually.

Staying active

Walking is usually a good way to stay active with piriformis pain, and many people find it eases the ache after sitting. If running or hill walking brings it on, you could reduce the distance or choose flatter routes for a while, then build back up gradually.

Using warmth

A warm bath, shower or heat pack on your buttock can help the deep muscles relax, especially before stretching.

When to get it checked

If you notice numbness or weakness in your leg or foot, it is worth speaking to your GP.

Your VIDA pain check-in can help you notice which activities help and which bring on pain.

What to take away

• Piriformis pain is a deep buttock ache, often worse with sitting.
• Get up and move regularly, and use a cushion on hard chairs.
• Gentle stretches often help this kind of buttock pain.
• Strengthen your hips and buttocks to share the load.
• Use warmth to help deep muscles relax.

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