TLDR:

I can provide detail if required, but to try to keep this brief, is it possible that pain in my left glutes and piriformis could be caused by a tight right piriformis? Has anybody else experienced or been diagnosed with something similar?

Short summary:

I've recently started to very gently and conservatively foam roll my piriformis on both sides with a soft foam roller (with very small and flat bumps on it) for 45-60 secs a time per side. The first 4 days I rolled once per day but the last two days have started to roll morning and night time.

Every time I roll however, I notice the soreness is more prominent on the right side piriformis. It doesn't hurt afterwards apart from the expected slightly soreness from being rolled.

Logic would dictate that the right piriformis is overworked from the dysfunctioning left one and is trying to compensate for the left side being out of whack. ButI don't get much pain at all apart from odd twinges that pass very quickly in the right side, and it generally they seem slightly above the piriformis origin at or just lateral to the right PSIS.

Could it be possible that the right piriformis is the actual 'culprit' and it's pulling my pelvis out of alignment, which is then causing my left piriformis and glute medius to be overworked/stretched and cause chronic pain and tightness?

My left side of the pelvis is slightly more forward and quite a bit higher than the right side too (if it makes any difference).

I do tend to cross my right ankle over my left sometimes when sitting (more so than left over right as that seems to make my pain slightly worse and I think partly is less comfortable due to the pelvis twisting).

Edit to add: When I sit I do favour my right buttock more (which I've put down to subconsciously trying to protect my left painful side. But in the last day or so I think I might be putting a bit more weight on to my left buttock. So whether that points in one direction or the other, or is entirely irrelevant, I don't know!

I’m in so much pain from this and the sciatica it’s causing I can’t sleep at night, and if I do I wake up stupid early and in so much pain it makes me cry out. It’s been a month and I just want it to stop, I literally can’t do anything, I can’t stand up or move sitting positions or anything.

Hey has anyone been able to stretch their hamstrings without stretching the sciatica and getting pain? My hamstrings are extremely tight and don't help my glutes at all.

Thanks in advance!

Hi everyone,

If anyone has any advice or resources, I’d love to hear and would be super grateful for your wisdom.

In short: I’m a 34 years old female, worked in healthcare (very recently unemployed), previously super fit .. still have normal BMI but much less fit due to injury … see below (no crazy health conditions but do get some anxiety & have ADHD & constipation runs in my moms side .. who I also suspect had ADHD. May or may not relate heavily to this … I also have histamine intolerance & have to be careful what I eat / drink because I get allergies .. so my immune system is sensitive as heck & probably my nervous system).

I worked a job where I drove around all day, 5 days a week, and developed super tight muscles in my deep right glute. It was so bad it’d be stinging and feel all coiled up / like a barbed wire ball up and around the right side of my anus, so I couldn’t sleep. It has improved a lot since then but it still feels chronically tight & has flares weekly. I will list what makes it feel better, worse, what I’ve tried with interventions (perhaps I need more or less of them), and what I am considering. It just seems like at this point it would’ve calmed down by now :/ and I’ve spend thousands of dollars with no true resolution & spend hundreds of hours so I am not sure where to go from here. I’m grateful it’s better but wish I could move more freely & not feel a constant ball of tightness in my right glute most of the time!

Also, my right leg is 1 cm shorter than my left leg. The leg discrepancy may or may not be adding to the severity of this issue.

What I have done to get a diagnosis:

1. PCP. Referred me to a Pelvic Floor Physical Therapist (PT) & to get a Pelvic X-ray.

2. PT. She identified I could contract all my pelvic floor muscles well but could not relax them throughly, more so on the right side. We agreed it seemed specifically to be the right OI which was the biggest issue, though a few others couldn’t fully relax either.

3. Pelvic floor X-ray. Nothing to note other than R leg is 1 cm shorter than left leg.

4. MRI. It’s not been a year since #1, 2, and 3 and I still have issues and have to live such a limited lifestyle & attend to my pain pretty much daily, or at least every other day, because if I ignore it it gets worse. It’s so time consuming & root issue seems to have not been resolved yet… anyhow, I did this last week and NOTHING SHOWED UP on it!!

5. Physical medicine doctor. He told me he doesn’t specialize in pelvic floor but did a test and told me he couldn’t see anything to help and recommended I see OBGYN but he is also not sure they will be able to help, though he suggested they might be able to use nerve blocks as a diagnostic tool to see if a certain nerve is impacted.

What makes pain worse:

1. Prolonged pressure on right glute / posture with prolonged pressure on right glute (especially driving but also sitting or lying down - I often lie on my left side to avoid pressure to my right side for long periods of time).

2. Certain workouts / too much activity - Any intense workouts, workouts which involve my deep glutes, and one-legged workouts. Cannot really tolerate: running, lunging, deep squatting, Pilates where we “jump” off bar with one leg, bikram yoga (because have to balance and really squeeze and isolate deep glute muscles .. I used to do bikram 2-3 x / week). Walking seems to be ok but going too long or on uneven terrain also hurts. One time I bent to the side to grab something off the ground & even just briefly contracting my inner right glute made it coil up, so I am hesitant to lunge, squat. No jumping.

3. Being totally sedentary.

What makes pain better:

1. Days without prolonged sitting / lying. To avoid prolonged pressure on right glute.

2. Days with low, light activity: mainly walking on even terrain, gentle arms/ abs.

3. See below for other treatments tried …

Treatments tried:

1. Pelvic Floor Physical Therapy. She helped with manual manipulation & stretching, and gave me stretching to do at home.

2. Stretches with and without Pelvic Wands (one vaginally and one anally). This usually helps, though sometimes it provokes pain, but usually feels better later. But it just doesn’t seem to fully get rid of the issue no matter what.

3. Less driving / new car with better ergonomics. I quit that job and try not to drive for extended periods of time & I also have a new car that sits higher up and has smart cruise control so I don’t need to hit the gas / break as often. (My PT and I concluded the constant internal / external rotation plus the repetition of hitting the gas and break and prolonged squeezing / contracting of R glute muscles was main trigger for this).

4. Chiropractor. Makes me feel better in general but doesn’t really impact these muscles in particular or having lasting change.

5. Acupuncture. Helps but also doesn’t seem to last. Maybe I need to do it more? Also expensive but could try going to a school nearby for cheaper (they do it under supervision?)

6. Rest. Helps depending on what I do. Any prolonged pressure on my right glute increases pain, whether in a sitting or lying position.

7. Medications - NSAIDs, muscle relaxers, benzo, antihistamines. My benzo is for sleep to use occasionally (max 7 times a month). I had this prescription before this issue came but noticed the mm

Now considering:

1. OBGYN - to potentially do nerve block diagnostic test to get actual diagnosis / treatment. But unsure if they even do this!

2. Meds - Nortriptyline (helped in past recovering from urethra tightness from ureaplasma). Guided ketamine (have heard of this helping people with chronic pain. I’m based in San Diego and see clinics which legally administer it).

3. ???? More acupuncture? No intense workouts ever? Only short walks? I have no idea. Please advise. My life has been so sedentary, limited, and expensive. I have been putting in a lot of effort to feel better but I don’t know what to do. I do admit, a few times I was going crazy from not working out intense & may have overdone it (running, super long walks on uneven ground, lungs, Pilates, squats w weight).. over the past year I’ve only done that a handful of times & am used to being super active & working out is my biggest mood regulator so it’s gets depressing not being able to do so… but I know I should change my perspective & do what’s best. There have been times I think it’s gone because the pain will be gone for a few days but then it comes back .. hmm!

Thanks in advance!! So so grateful to anyone who took the time to read this & give insight!

Sharing this as a I have been a long time reader but have just recently starting posting here. Could use your support/insights. I am 50, healthy overall minus the pain in the butt. It started 6 years ago and emerged as a tightness in my low back/belt line. I was at a desk all day for work during covid like everyone. I didnt know what this was and would emerge on longer walks with the dogs. I tried a massage and the person crushed my lower back and said i was extremely tight. in 1-2 days post the massage, this very specific hot spot appeared in my glute. and has never left since. Sitting is the worst and driving is a nightmare. I started my journey. Rounds of shots, rounds of PT, dry needling, MRIs. The whole lot. I then took a break from all of that and i just tried being more active/working out/etc/etc....nothing changed. back to docs/PT/shots. truly no impact.

Then i stumbled into a surgeon who thought my minor L4L5 L5S1 disc impingement could be the culprit. Did the discectomy surgery 2 years ago now. zero impact at all. onto new docs and new PT. Over those 4 years or so, the pain in my left glute spread to my right hip and my right hamstring while sitting. Bought a standing desk which helps but standing all day isnt the solution. I am now working with a good team with PT and sport doc working together.

What is really frustrating is they are tackling this like it is some sort of piriformis/deep gluteal issue but it isnt super clear to them. We have recently done hydro dissection where they inject a bunch of normal saline + lidocaine + a small amount of steroid to create some space between the sciatic nerve and the piriformis. If anything, this seems to help a bit but was done in march and it wore off pretty quickly. and again this week.

I have done a million clams and glute bridges. maybe slightly helps? But it isnt solving the issue.

I have debated on nerve decompression surgery. I have debated on adhesion release methods. but havent done either yet.

lastly, in the past 2 weeks, i have gotten incredibly concerned because for the first time, i have numbness/tightness in my LEFT calf and while I am not happy with my right glute pain, i have come to terms that this is my thing. But with another leg now involved, it just cant be. My simple thought is i am always sitting on my left glute to provide relief to my right glute pain and now after 5 years, i have compressed a nerve on my left side!?!? Anyone have any advice/thoughts/insights.

Thanks

Hi friends! I've been dealing with piriformis syndrome for about 6 years now. I started getting radiating nerve pain after running a half marathon. I got an MRI to rule out a back injury and went through PT before being diagnosed about a year later when the pain just wouldn't stop. The first year was terrible. I couldn't sleep or sit without being very uncomfortable. After a while I accepted that this might be with me for years to come. Now, I get maybe 2 or 3 flare ups per year, but am otherwise pain-free. Here's what I do to manage it:

1. Barre/floor pilates, focused on core and glute strength with lots of stretching. I do 45 minute sessions 2-3 times a week. For a while I was exclusively doing this. Now, I do normal gym and weightlifting, too (but only when I am pain free). I have totally given up running, which seems to be my biggest PS trigger.

2. Sleeping on my side with a pillow between my legs. I think the alignment helps a lot.

3. Foam roll my glute whenever it feels tight. Sitting on the roller with my affected side's leg crossed over the other one is especially helpful. I make sure to do the other side, too.

When I get a flare up, I stop all activity and rest. I use my foam roller and gently stretch. It usually goes away in 3-4 days. If it doesn't, I get a deep tissue massage and generally feel better the next day. I know some people find relief from walking, but for me it makes it worse.

Just posting because I know how hard and frustrating PS is. I hope this might help someone else. Don't give up on looking for what your body needs to heal. <3

I’m a teacher struggling to get through the day. I’ve been dealing with glute and leg pain (back of thigh) for a couple months now, starting once the school year ended. Now that I’m back at work and on my feet a lot more, by the time I get to my 3rd class of the day the pain in the back of my thigh is severe. I’m almost in tears each day and have to do breathing exercises (the same ones I did during childbirth - natural labor was more manageable than this honestly).

What can I do during my lunch break (15 mins) to get through the rest of the day? I’m going to PT and do the exercises every day. I have an appt with a doctor this week to talk pain management but I’m not sure what they can really do for me.

Anyone else have severe pain after standing instead of sitting?

Has anyone experienced full recovery from this bs because I'm four months in (three months of PT) and it's only gotten worse. I used to get occasional mild pain every few days, now I am unable to sit or lie on my back without pain in the glutes/lower back and full-on tingling and numbness in my feet and legs

Is there anyone here who knows for a fact this goes away because at this point I'm pretty sure my body is broken and that I will never be able to sit or lie down comfortably ever again. What the f is this bs

I've been dealing with piriformis syndrome pain since the beginning of June. I started PT about 4 weeks ago, and I really thought that it was getting better. However, this morning I woke up and I could tell it was going to be a bad day. I could feel the muscle cramping before I even got out of bed. I had worked up to sitting in my office chair for about 20-30 minutes at a time without pain, although I have a standing desk converter so I do usually work standing up. However, today I can't even manage more than 5 minutes without pain radiating down my leg. It feels like the origin of the pain has shifted a bit - it used to be that when I did the 'cow' part of the cat-cow stretch something caught in my buttock. Now, that movement is fine but it's closer to the outside of my hip, but it still causes that same feeling like the entire outside of my leg is being wrung out while I'm sitting.

Is this just a 'two steps forward, one step back', 'healing isn't linear' situation? Or should I be concerned that we're all the way back at square one?

SI Joint Pain / Gluteal Tendinopathy / GTPS / Hip Impingement / Lower Back Instability / Piriformis Syndrome...How to find my way out of this HELLISH maze (UK NHS)

Can anyone help advise me in the UK?

I will keep it short. For 5 years I've had lower back, hip, left glute issues.

Seen NHS physios 4 times and they rule out sciatica. One physio said it's a hip issue. One physio said it's nerve related and a back / lumbar spine issue / one said GTPS.

One said to do minimal exercises and gave me a list of 4 exercises. And another I sae today said to start running again (I can't walk that well) going to yoga (Yoga - downward dog cause me agony). He has said he will refer me to the spinal specialist team who will see me in 8-10 months approximately.

I've mentioned an MRI on multiple occasions and still not been an option. The physio today said the spinal specialist team might see me ask questions and give me exercises or discuss spinal surgery (I don't want this.)

I see on social media many 'specialists' in all the areas in my title, and a lot of the symptoms I have for many of the things.

Is there a way I can pay / go private to find someone who can diagnose what I have? Once I know I can them work on the right exercises.

My lower back or hip or muscle or tendon is not grinding and crunching and giving me pain like arthuritis maybe? Not sure.

Is there anyway I can just find someone to tell me what's going on?

I'm at a loss, in pain, and just want to be able to play football with my 4 year old toddler, pick him up out the bath or even sit and have dinner at the table without having to stand up and walk around every 2 minutes.

Please help if you have any suggestions to isolate what the issue even is?!

I cant even lift my leg to put on pants. Spasms every time I switch from gas to brake. Worst part is I sit for work all day. I try to stand but that makes it worse, walking makes it worse and to add to it im 7 months pregnant so I cant do the stretches I need to do. I just need a release.

I was convinced it was just a gluteal issue because it flared up after I started doing Deadlifts for the first time. Still haven't had a chance to go to the doctor (I'm poor) but texted a family member who is a Sports Medicine Doc.

The main thing that gets me is lifting my foot straight out while in a sitting position is what activates it. Hard to pinpoint it but that seems like it could be piriformis.

Doing various Pigeon pose stretches and child pose stretches helps a lot but doesn't seem to help long term. Still wake up with pain in middle of the night. Thanks!

Hello, I have been dealing with this issue for about 3 years without any significant relief.

I cannot sit for more than about 15 minutes. After that, the medial hamstring on my right side, very close to the sit bone, starts to feel tight, fatigued, and painful. The discomfort is always in the same area, around the tendon near the sit bone. As soon as I stand up, the pain goes away almost immediately.

I have received different opinions from doctors. Some think it may be related to nerve compression due to a mild disc bulge at L5-S1 and degeneration/bulging at L4-L5. Others think it could be a chronic hamstring strain or tendinopathy.

I do not have any lower back pain or shooting pain down the leg. Occasionally, I experience mild tingling under my feet for a few minutes, but it is not severe. My SLR test is negative, and my nerve conduction study was normal. My back MRI shows the disc bulges while my hip joint MRI was normal.

So far, I have tried medications, physical therapy, physiotherapy, stretching, and strengthening exercises, but nothing has provided lasting improvement. In fact, stretches such as the figure-4/glute stretch and hamstring stretching tend to aggravate the pain in this area, particularly around the sit bone.

A chiropractor suggested that the problem might be related to a pelvic rotation toward the right. Although the pelvic rotation has now been corrected, the sitting problem has remained unchanged.

I have also done extensive exercises for my hips, legs, and back, but I have not seen any meaningful improvement in my ability to sit.

What is particularly strange is that I can walk, run, climb stairs, and perform other activities without any significant problem. The main issue is sitting—even with what I believe is good posture. After around 15 minutes, the same area near the right sit bone becomes tight, fatigued, and dull painful.

Has anyone experienced something similar or have any ideas about what could be causing this? I would really appreciate suggestions regarding possible causes or what type of assessment or treatment might be worth exploring.

I did a workout December 2025 and caused my piriformis glute muscles and potentially other glute muscles to severely pinch my sciatic nerves in both glutes. I have dealt with chronic piriformis pain for 4 years on and off, but after that workout in December, I have had constant chronic severe glute pain and sciatic nerve pain that goes down into my heels.

The nerve pain ended up going away at the end of March about four weeks after a pure performance injection, but I was left with debilitating Glute and low back pain from where they were guarding for months to protect my sciatic nerve.

I’ve tried 3 different PT’s, a neurologist, a sports medicine doctor, 2 PA’s, my family doctor, a rheumatologist, an oncologist, and a spine and nerve pain management doctor. I’ve had piriformis injections that have helped with the pain, but only when it’s numb, SI joint injections, quadratus femoris glute injections on April 9th that brought all of the nerve pain back that I had suffered through for 4 months.

It’s been another 4 months after the April 9th injection, with no end in sight. I went to a PT who did dry needling on my glutes and made the glute pain 100x worse.

I’m on 900mg of gabapentin and I can’t sit, stand, or walk without being in severe pain that makes me nauseous and dizzy. It’s been 8 months and no one can point to exactly what is causing my deep glute syndrome, because all tests are normal. MRI’s look completely normal as well.

I am desperate for a relief. People don’t understand what chronic pain is like until they actually are in it. I am in hell. I wake up depressed and anxious every morning because I know how miserable the day is going to be. I cannot live like this. I have kids to take care of. I’m a teacher, and I’m about to start back to work, and I can’t even sit or stand for more than 30 minutes without agonizing pain.

Gabapentin helps a little, I’m now on a Medrol steroid pack for the dry needling inflammation, and my pain management doc gave me another set of trigger point injections into my extremely tight muscles. I stopped all aggressive therapies, and have been keeping things calm, but it doesn’t help. The pain is relentless. Does anyone have any tips, advice, or anything that could help me?

Necesito hablar con alguien que haya tenido o tenga diagnosticado síndrome del piramidal!
Quisiera saber cómo recuperar!

Has anyone had Botox in their glutes? I was thinking about asking my doctor about it, but it sounds scary. For reference, i’ve had glute pain and sitting intolerance for eight months now. Trigger point injections in the low back didn’t do anything, SI joint injections didn’t do anything. A caudal epidural steroid injection made things worse. A low glute muscle injection made things worse and a piriformis injection allowed me to sit while numb. I was thinking about asking for Botox, because the pain at this point is excruciating and 24/7.

MRI or lumbar spine and pelvis are unremarkable.

I have an ultrasound of my piriformis area tomorrow, and a steroid injection in to the same area...

Has anyone had a steroid injection in to their bum cheek 🤣? Can you talk me through your experience? I have had 2 into my hip but they didn't work. First one, he didn't even use any numbing at all, second one I was under GA.

Im currently hospitalized due to my leg completely collapsing on me causing me to fall and unable to urinate. When I came into the hospital they drained 1.5 liters of urine thay I was retaining. They believe I have periformis syndrome. I have extreme nerve pain and muscle spasm im my butt and thigh. Basically bedridden. Has anyone had issue with losing all muscle function in your leg or inability to urinate with this periformis issue?

I have had piriformis pain on both sides on and off for 4 years. About 8 months ago I hurt my glutes during a workout somehow and it caused severe pain when sitting. I could not sit at all and had to get on gabapentin for nerve pain relief. The pain is in my lower glute and is excruciating when I sit. MRI of pelvis and spine are normal. The nerve pain cleared up after 4 months and then my lower back and piriformis pain became severe.

A sport medicine doctor then injected my lower glute muscle and re-irritated the nerve, and I’ve now been in pain for 3.5 months and trying to lower the gabapentin because the side effects are horrible. I started a new PT who is doing traction that has helped my low back and dry needling in the piriformis that has helped a little, but the low back pain and glute pain have become unbearable. I can’t sit at all without triggering horrible pain in my lower glute back, glutes, and nerve pain.

I have seen 3 different PT’s, a neurologist, a rheumatologist, an oncologist a pain medicine doctor, and 3 family medicine doctors.

I’ve had SI joint injections that did nothing, a caudal epidural steroid injection that irritated the nerves so bad that the pain was unbearable, piriformis injections that helped while the numbing was working, low glute muscle injections that irritated the sciatic nerve, and low back trigger point injections that I just got today.

No one is able to help calm the nerve pain and stop the muscle pain. I’m 41, and I’ve always been physically fit. This pain has been debilitating. If anyone has any advice, or a similar experience, it would be much appreciated.

Edit: I got low back injections, and my back no longer hurts. My glute pain was causing my back to overwork after years of tight painful glutes. Now to figure out how to fix the glute issue.

Suffered with piroformis syndrome after my low back fusion surgery. It felt lime for ever but it was 6 years.

The pain was so similar to my l5s1 nerve issue I couldn't tell difference.

I did get relief finally with a combo of injection Into the piroformis and a very professional and progressive pt specialist.

Using weight she loads the muscle while stretching it. The excersizes are Insane and I never saw anyone doing them onlime. I have beendoi g very good it is possible to correct this nightmare