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If you have been diagnosed with piriformis syndrome, your initial goal should be to reduce swelling or inflammation of the piriformis muscle to ease the pressure on your sciatic nerve. This can be accomplished with a combination of several treatment methods:

   Taking non–steroidal anti–inflammatory drugs such as ibuprofen, or other prescription medications.

   Reducing or modifying your level of physical activity, particularly if you participate in sports that require twisting motions.

   Having your physician or physical therapist examine your posture and gait, with the aim of correcting any errors or imbalances that could be exacerbating your symptoms.

   If the pain is severe, it may be necessary to use a cane when you walk.

In rare cases where these treatments are not effective, your physician may suggest an injection of corticosteroid directly into the muscle to relieve inflammation. This involves some risk, however, due to the close proximity of the sciatic nerve.

Your first goal in rehabilitation after being diagnosed with piriformis syndrome is to restore normal range of motion and function to your hip and lower back. Once this is achieved through stretching and range of motion exercises, you can progress to strengthening the muscles to correct any imbalances. A stretching routine normally involves movements such as hip flexion and extension (bending and straightening the hip), abduction (moving your leg away from your body) and adduction (moving your leg toward the midpoint of your body from an external position). Some of these stretches can cause discomfort in your lower back if they are not done correctly. Your physician or physical therapist can assist you and demonstrate how to perform them properly to avoid aggravating your injury. Your physician or physical therapist may suggest applying heat to the affected area before stretching, to loosen up the muscles. A heating pad or a towel soaked in hot water can be used, but should not be applied for more than 15 minutes at a time. Modifying your training while you are undergoing rehab can help you to maintain fitness. If you run regularly, for instance, you may want to explore running in the shallow end of a pool, which will put less stress on your hips and lower back. Ask your physical therapist for recommendations.

Since piriformis syndrome can be caused by a variety of factors, preventing its recurrence may require you to examine the way you work and play. Your physician or physical therapist can check to see if you have a leg–length discrepancy that may contribute to the development of this and other musculoskeletal problems. If present, it can be corrected with a lift, which can be worn inside or outside of the shoe on the shorter side. If a muscle imbalance is contributing to the problem, your physical therapist can recommend a strengthening program to correct the disparity. Incorrect posture when you are sitting, walking, or running can lead to piriformis syndrome. If you sit for prolonged periods, have an expert assess your posture. Try to shift positions, and take regular breaks where you get up and walk around. Make sure your chair is ergonomically correct. Have your walking and running gait checked for any abnormalities that may contribute to the development of an injury. Orthotics may be necessary if there are problems that can be corrected. If you are going to engage in physical activity, particularly in sports that involve running, jumping, and twisting, make sure to adequately stretch the muscles in your hips and lower back before each workout.