3 little-known therapies to fix piriformis syndrome pain (2023)

I suffered from piriformis syndrome for at least 7 years before finding long-term relief. I’ll let you guess how much time I spent researching every possible solution online.

I tried everything under the sun, read every post and article online, did a ton of stretches and exercises, and tried every treatment or therapy I was referred to.

This post is for those of you who have also tried everything there is to do to fix piriformis syndrome, and it still won’t go away.

I’m writing this post to provide you with a few alternative healing modalities that helped me recover and heal piriformis syndrome.

As I mention in my originalpiriformis syndrome guide, I recommend you visit your doctor and push for an MRI scan if you can get it. It never hurts to double-check and ensure there is no severe disc issue behind the muscle pain.

This post is specifically for people who have tried and done everything (like myself) and are still struggling with piriformis pain.

I discovered these new treatment modalities later in my healing journey. I hope they can save you some time and energy, so you don’t spend a lot of years in pain as I did.

Assuming the pain is due to a muscular issue (and not a disc condition), for you to fix piriformis syndrome to go away for good, we need to fix the root cause of the pain.

For piriformis syndrome to go away for good, we need to fix the root cause of the pain.

I’ll show you how to do that later in this post. But for now, let’s focus on the list of treatments that worked best for me.

By learning from my mistakes, you can heal piriformis syndrome quickly without wasting years in trial and error as I did.

This post is broken into two parts:the therapies and treatments that helped me heal faster.

The second part will give you some suggestions to do at home to fix the underlying problems that have caused the pain in the first place.

Once you fix the underlying causes, you won’t need any symptom-focused quick fixes. You’ll enjoy long-term relief.

How to heal from piriformis syndrome fast post includes a self-test to the cause of piriformis syndrome.

Typical Treatments For Piriformis Syndrome

Before discovering these new treatments, I felt like I’d done it all.

Let’s assume you’ve tried at least 70% of the following treatments for piriformis syndrome, and nothing worked.

Typical therapies and treatments to treat piriformis pain:

  • Physiotherapy
  • Athletic therapy
  • Massage therapy
  • heat/cold therapy
  • Acupuncture
  • Sitting on a ball
  • Sitting on a kneeling chair
  • Standing desk
  • Pilates
  • Yoga
  • Stretching 10 times a day
  • Chiropractic adjustments
  • Injections
  • Medications

I’ve diligently followed these treatments (except for injections) to fix my pain, and relief was always short-lived.

I want to mention that I only found long-term relief shortly after becoming a strength coach and studying to become a corrective exercise specialist.

I understood why I was having all this pain and committed to fixing the muscular and postural imbalances that contributed and were constantly triggering the pain. And I applied these 3 treatment modalities or techniques along with my corrective exercises.

Don’t worry. You don’t also have to become a specialist in this to heal. That’s why this website exists. I want to show you how to do it too.

Now let me list the 3 alternative treatments you probably haven’t tried yet that may help.

3 little-known therapies to fix piriformis syndrome pain (1)

Piriformis syndrome won’t go away? This recovery program includes everything that’s helped me fix this pain and continue to live pain-free for many years without flare-ups.


  • How to sleep with piriformis syndrome
  • How to sit without irritating the piriformis muscle

How To Heal Piriformis syndrome – Alternative Therapeutic Treatment Modalities

How to Heal Piriformis Syndrome When You've Tried EVERYTHING Else (3 New Things to try!)

Dry Needling

I wish someone had told me about dry needling earlier in my healing journey. I discovered it on a whim and wanted to give it a try. I went to a licensed dry needling practitioner, and after just a few sessions, I started to feel ‘normal’ again.

The main areas that he worked on were the TFL and thoracolumbar fascia. Sometimes the piriformis but more on the areas around the muscle.

Because fascia gets very tight, it can be hard to release it with just a foam roller, just like the muscles.

The TFL (tensor fascia latae) – is a muscle that flexes, internally rotates, abducts the hip and can get extremely tight and overactive.

You may think that dry needling and acupuncture are the same things, but they’re not. I tried both, and dry needling gave me faster and longer-lasting relief.

Here’s the difference:

Acupuncture focuses more on the nervous system. The needles remain in place for about 20-40 minutes (or longer).

Dry needling is more focused on treating musculoskeletal pain. I found that this ‘gentler’ treatment did not result in more spasms, and the relief lasted more than just a few hours.

You’ll also benefit immensely from just relaxing and tuning into your body. Stress can sometimes worsen the pain, and lying down for a few minutes to relax can also positively affect the neuromusculoskeletal system.


Swimming is a fantastic form of exercise to help your body recover from a herniated or bulging disc. Piriformis syndrome and sciatica can often be symptoms of an underlying disc issue.

Due to their structure and location, joints and discs rely on movement to draw in oxygen and nutrients. Cell regeneration and tissue recovery become difficult without proper exercise and regular movement.

However, doing a full workout, lifting weights, or engaging in long cardio routines can be extremely hard when in pain.

This is where swimming can come in. It’s a low-impact form of exercise. Being in the water is a great way to take the load off the spine and joints while also moving your body.
It also helps align and stretch out the back.

It also promotes integrating the whole muscular system without isolation and without loading your spine and causing more disc damage.

The Study of Neuroplasticity

There is a huge benefit to learning and using neuroplasticity to heal piriformis syndrome or any muscle pain. This is even more important if you’ve been in pain for more than a few months or years.

When we injure an area of our body or when pain is triggered for the first time, the brain will build neural pathways associated with that painful feeling. This is called pain-memory. And this process is referred to as neuroplasticity.

Here are a few excerpts from studies done on this topic:

“Neuroplastic changes in brain structure and function are not only a consequence of chronic pain but are involved in the maintenance of pain symptoms.”

“Changes are positively associated with duration, intensity, and pain-related learning and memory which facilitate the maladaptive plasticity. Essentially, the brain becomes an expert in pain.”

“Effective neuroplastic interventions that are non-invasive, and reasonable to implement and maintain would represent a significant clinical asset in the treatment of chronic pain.”

Now the good news is…we can use the same process of neuroplasticity to build new neural pathways associated with the non-pain feeling and to weaken the existing neural pathways related to the pain memory.

The easiest way to do this is through visualization and focusing more on the areas that feel pain-free through mindfulness meditation.

I’ve developed a full program to help you with this, including visualizationmeditations to reprogram the nervous systemthrough neuroplasticity here.

Here’s an exercise for you to kick start this process:

1.Try to focus for a few minutes on an area of your body that actually feels good or is entirely pain-free.

2. Now start to expand that pain-free feeling to the other areas of your body. This will help you relax and start reprogramming your whole body to feel pain-free again.

This may be hard to do when you’re in a lot of pain so try to do it early in the morning or before going to bed when you’re the most relaxed.

When Piriformis Syndrome Won’t Go Away

Now I want to give you a few tips on fixing some of the underlying postural or muscular imbalances that have contributed to the constant piriformis pain.

If you already know exactly what’s causing the pain in the piriformis or your hips, and it’s not related to a disc problem, don’t ignore this section. Let me explain why…

When you experience a back or hip injury, you start to move differently. For example, you’ll start using the opposite leg more to try to avoid pain.

You’ll also experience what is referred to as relative flexibility. And here’s what it means…

It means that when a joint or an area of the body is hurt, strained, or just very tight, the adjacent joint will compensate for that and become hypermobile. An example of this is…

If your hips are extremely tight, you’ll notice your knees are now compensating for that. Unless you pay close attention to this, you won’t notice it. This even happens at shoulder level. Very tight shoulders and upper body will affect how the hips are moving.

The body is a kinetic chain so don’t ignore the other areas of your body when trying to fix any kind of joint or muscle problem.

Assess Hip Weakness Causing Piriformis Pain

Using one leg or hip more and compensating for the weaker (or hurting) hip will create muscular imbalances.

I have a simple exercise you can do right now to test for piriformis weakness or overactivity. This will help you get some clarity on why the heck you’re not getting long-term relief. You’ll be able to fix the weakness and the root cause.

Muscular Imbalances Test

You’ll need to film yourself with your phone from the front and the back as well.

Stand nice and tall, feet shoulder-width apart, feet facing forward (not rotated out or in). Raise your hands up (not flexed at the elbow).

Now complete 5 repetitions of the bodyweight squat. Don’t squat too low. Squat as if you’re going to sit on a chair. We want to assess any hip instability here.

Some important notes:

Don’t look down or to the side (mirror) to watch yourself squatting. This is why you need to film yourself and then you can watch and review your form.

Here’s what to look for:

  • Do the feet flatten as you’re squatting down?
  • Do the knees cave in and internally rotate as you’re squatting down?
  • Do the feet and knees externally rotate instead?
3 little-known therapies to fix piriformis syndrome pain (2)
3 little-known therapies to fix piriformis syndrome pain (3)

If you do notice that one foot (or both feet) is rotating out as you’re squatting down, the piriformis on that side is overactive. The piriformis muscle is a hip external rotator, so when overactive, it’ll tend to drive the foot and hip out during transitional movements like the squat.

Correct Muscular Imbalances

If your feet flattened as you were squatting down. Then you definitely want to start at the base and fix that imbalance. Imbalances at the base (feet) will have an effect on the adjacent joints (knees and hips) so you need to be releasing the peroneal muscles and strengthening the posterior and anterior tibialis.

If your knees started caving inwards as you’re squatting down (with or without your feet flattening), this is an indication of an overactive TFL (tensor fascia latae), adductors and a weak glute medius.

You should not be stretching the piriformis here. Clearly, it’s lengthened and weak. Stretching it will only lead to more weakness and tightness.

Click here to watch a video tutorial on how to release the TFL muscle.

If the opposite happened and your feet or knees started to externally rotate, then you should spend some time releasing the piriformis muscle.

As you can see, we don’t just stretch the piriformis for the sake of it, you need to assess first and there needs to be a need for stretching.

As you release the piriformis muscle, you should also activate and strengthen the glute medius and glute maximum to help stabilize your hips and re-awaken these muscles so they’re firing up when needed.

Fixing piriformis syndrome isn’t going to happen if you don’t fix the muscular imbalances that caused it, so please don’t ignore these steps. The treatments I mentioned, in the beginning, will help you get relief but they won’t fix weak muscles that aren’t working properly.

To get long-term relief, you should check out Piriformis Control.

I hope this post was helpful.

Don’t forget to also refer to my guide: how to heal from piriformis syndrome quickly… I explain the location and functions of the piriformis muscle, how to fix the underlying muscular imbalances and mistakes to avoid flare-ups and setbacks during your recovery.


Melzack R, Coderre TJ, Katz J, Vaccarino AL. Central Neuroplasticity and Pathological Pain.Annals of the New York Academy of Sciences.

Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain.Nature Reviews/Neuroscience.

Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: Specificity and plasticity of the brain in clinical chronic pain.Pain

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Coach Sofia

Certified Strength Coach | NASM Corrective Exercise Specialist & Founder at Coachsofiafitness

Hey there, I'm Sofia. Welcome to my blog! I'm here to help you get permanent relief from piriformis, hip, and lower back pain without spending years in pain suffering through information overwhelm or temporary fixes. I've been through the chronic pain journey myself. I know how lonely and hard it can get... Click here to read about my story and how I healed after 7 years of chronic pain, against all odds.

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