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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).
The most common presenting symptom of patients with piriformis syndrome is increasing pain after sitting for longer than 15 to 20 minutes. Many patients complain of pain over the piriformis muscle (ie, in the buttocks), especially over the muscle's attachments at the sacrum and medial greater trochanter.