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Fig. 3. Dynamic piriformis stretch. To stretch the left piriformis, get on all fours with your weight supported by the left knee. At first, the right leg is held in a horizontal position. By using the left piriformis muscle, raise and lower the right hip up and down (arrows).
Both muscles assist in the external rotation and abduction of the thigh. The primary symptom of piriformis syndrome is buttock pain, with or without posterior thigh pain, that is aggravated by sitting or activity. Associated low back pain is common and can be a result of piriformis pain, but it can also suggest the involvement of other structures, such as facet joints or iliopsoas muscles.