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non-operative management of piriformis syndrome involves

  • the use of NSAIDs
  • abbnormal biomechanics caused by pelvic obliquities, leg length discrepancies and posture need to be corrected
  • physiotherapy treatments include cryotherapy, ultrasound, stretching and strengthening exercises and heating modalities
  • if non-invasive measures fail, local anaesthetic and corticosteroid injections can be tried

Failure of conservative measures may require open or arthroscopic surgical release of the piriformis muscle/tendon

Sciatic neurolysis has been used


  • 1) Kobbe P, Zelle BA, Gruen GS. Case report: recurrent piriformis syndrome after surgical release. Clin Orthop Relat Res 2008; 466: 1745-8.

Last reviewed 10/2020