David R. Beatty and Camilia Makyhoun

David R. Beatty, DO, Professor of Osteopathic Principles and Practice, WVSOM

Camilia Makyhoun, Assistant Editor, WVSOM Class of 2016

Tuesday, February 26, 2013


Piriformis tender point location and
counterstrain position (WVSOM)

Sciatica is a real pain in the buttocks, and sometimes that's where the cause is too. Piriformis syndrome occurs when the hip muscle by that name is tense or in spasm, compressing or irritating the nearby sciatic nerve to produce back and thigh pain and numbness. Such sciatica can also be caused by nerve compression in the back or pelvis, which might also produce leg weakness not present with piriformis syndrome.

DOCTOR'S NOTE: Seek evaluation by a health professional if your back and leg pain are associated with leg weakness, incontinence, fever, or weight loss, or if it doesn't improve with self-treatment for piriformis syndrome.


Piriformis position of ease (WVSOM)

  1. Lie on your back with legs propped up on a chair or stool;
  2. Cross your ankles with the foot of the pain side on top;
  3. Let your knees fall apart and relax;
  4. If comfortable, take a few deep breaths and rest in this position for 2-5 minutes or until pain is completely resolved;
  5. Slowly uncross your legs, bring your feet down to the floor, and proceed to the Piriformis Stretch or roll to one side before getting up;
  6. Use this position 2-4 times a day or as needed for pain relief.


Right piriformis stretch (WVSOM)
  1. Lie on your back and place the foot on the side of leg pain on top of the other knee;
  2. Grasp the outside of the bent knee with your opposite hand;
  3. Allow your bent leg to slowly fall over the other leg as far as it will go;
  4. If comfortable, take a few deep breaths and slowly pull the bent knee down toward the floor for 10-20 seconds;
  5. Slowly release the pull and straighten out the leg;
  6. If no increase in pain, proceed to the Sacroiliac Mobilization;
  7. Do this stretch 1-4 times a day.

Sacroiliac stretch (WVSOM)

  1. Lie on your back and bend one leg up, grasping the knee with both hands;
  2. Pull the knee toward your opposite shoulder as far as it will comfortably go. If leg pain worsens, stop the exercise;
  3. Take a few deep breaths and with each exhalation pull the knee a little farther toward the opposite shoulder;
  4. Release the hand on the side of the bent knee and use the other hand to pull the knee across your abdomen as you slowly straighten the leg;
  5. Repeat for the other leg;
    Sacroiliac mobilization (WVSOM)
  6. Do this stretch and self-mobilization up to twice a day if helpful.


  1. Hi, its really nice skills for getting thigh pain relief. muscle pain relief in Taiwan is a non-invasive pain therapy treatment for individuals desiring general physical health maintenance and enhancement or relief from chronic pain.

  2. Amazing article.loved reading every bit.