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What is Hip Bursitis? Injury Overview

Are you worried about hip bursitis?

Read on to find out what causes hip bursitis, how to treat it, and everything else you need to know.

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A woman sitting at a desk with back pain.

How to Sit with Piriformis Syndrome

Piriformis can make sitting painful. This article offers essential tips to make sitting more comfortable.

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The piriformis muscles help you rotate your hips and allow your foot and leg to turn outward. Piriformis syndrome is a condition involving the piriformis muscle, which is located in the buttocks. Injury, tightness, and overuse can lead to inflammation and spasms of the piriformis.

When the piriformis muscle becomes irritated, inflamed, or spasms, it can compress the sciatic nerve. This large nerve runs from the lower back and extends through the leg.

The exact incidence of piriformis syndrome is not entirely clear, Some cases may go undiagnosed. Estimates are that piriformis syndrome affects about 2.4 million people in the United States each year.

Piriformis syndrome can occur for several reasons. However, research indicates that about 50% of cases of piriformis syndrome develop due to microtrauma to the buttocks. Causes of microtrauma leading to piriformis syndrome may include overuse injuries from repeated activities, such as cycling and long-distance running.

Direct compression of the muscle can also cause piriformis syndrome. This can include sitting for long periods on a hard surface. Abnormal location or development of the piriformis muscle or sciatic nerve may also make someone more susceptible to developing piriformis syndrome.

Symptoms of piriformis syndrome may include:

  • Persistent glute pain
  • Pain in the lower back
  • Numbness or tingling in the glute that may radiate to the legs
  • Difficulty with sitting

Sitting can increase piriformis syndrome pain and can be challenging. While you cannot stand up all the time, there are tips to help with sitting and piriformis syndrome.

The article below covers all about sitting and piriformis syndrome, including the best ways to sit and ways to avoid sitting.

Why Does Sitting Make Piriformis Worse?

If you have piriformis, you may notice sitting can become a challenge. Sitting can increase pain and make symptoms of piriformis worse, such as numbness and tingling. Sitting with piriformis syndrome may be worse for a few reasons, including the following:

  • Shortens the piriformis muscle: The sitting position shortens and tightens the piriformis muscles. In fact, one potential cause of piriformis syndrome is sitting too long because it can lead to tightness.
  • Decreases blood flow: Sitting also decreases blood flow to the area, which may increase the likelihood of developing irritation of the piriformis.
  • Pressure on the sciatic nerve: Sitting puts pressure on the piriformis muscle and the sciatic nerve. An inability to sit for a long period of time is one possible symptom of piriformis syndrome.

The Best Ways to Sit with Piriformis Syndrome

It is impossible to avoid sitting every day, but there are things you can do to decrease pain and place less pressure on your sciatic nerve.

The best way to sit with piriformis syndrome includes the following tips:

A woman sitting holding her lower back in pain

Be Mindful of Posture

The best sitting position for piriformis syndrome always includes using good posture. Poor posture can place additional pressure on the muscles and, in turn, the sciatic nerve.

Sit with an upright spine and avoid bending or slumping forward. Try to keep your weight evenly distributed across your pelvis. Your feet should be flat on the ground, with your thighs parallel to the floor. Poor posture can adversely affect muscle balance and trigger pain.

A blue back cushion

Use a Back Support or Cushion

A back support can help you maintain correct spinal alignment. Several types of lumbar support cushions help prevent slumping forward. If you do not have a lumbar support cushion, you can use a rolled-up towel.

A woman at a desk holding her back in pain

Avoid Sitting for More than 60 Minutes at One Time

Since sitting for too long can place added stress on the piriformis muscles, it is helpful to avoid sitting for longer than one hour at a time. If you have a job that involves sitting at a desk, try to get up every hour for a few minutes to walk around and stretch your legs. Remember, sitting can also change the way you hold your core muscles, which may make you susceptible to back issues. If you are busy with work, you may not notice you are hunching over or using poor spinal alignment.

A woman stretching in her living room

Stretch Daily

Stretching the piriformis muscle can help loosen it and reduce tightness. It may also help relax the leg and lower back muscles. Many piriformis stretches can help loosen the piriformis, hamstrings, and lower back simultaneously. Try to hold each stretch for at least 30 seconds and stay consistent in daily stretching, even when pain is reduced.

A woman with a warm compress on her back

Use Heat Therapy

Applying heat can increase the blood flow to the area and may help promote healing. Try using a heating pad, water bottle, or applying moist heat to the painful area for about 10 minutes a few times daily.

Use a Footstool

Elevating your feet while sitting helps reduce pressure on the legs and pelvis. A footstool is especially helpful if your feet do not touch the ground.

A white desk chair with adjustable arms

Adjust Your Armrest

Adjust the armrest of your chair so that it lifts your arms slightly. This helps keep pressure off your upper back. Although it may not directly affect the piriformis muscles, alleviating pressure on the upper back is good for overall spinal alignment.

A man standing in front of a standing desk and a woman sitting on a stability ball

Consider a Standing Desk or Stability Ball

If you have a sedentary job where you sit at a desk for many hours a day, consider getting a standing desk. A stability ball may also help you engage your core as you sit and provides an alternative to a chair. Alternating between sitting and standing at work will reduce your overall sitting time and may help decrease pressure on the piriformis.

How Not to Sit With Piriformis Syndrome

Just as there are best ways to sit with piriformis syndrome, there are also things you should not do. Sitting in certain ways can exacerbate pain and make symptoms of piriformis syndrome worse. Consider the following suggestions:

  • Do not sit cross-legged: Sitting with your legs crossed can increase sciatic nerve irritation and may lead to further compression.
  • Avoid couches with too-soft cushions: If a chair or couch cushion is too soft, it can promote poor posture and, in turn, more pressure on the piriformis and the sciatic nerve.
  • Do not slouch: As mentioned above, sloughing is a recipe for disaster when it comes to making piriformis syndrome worse. Sit straight and remember good posture is vital for sitting and piriformis syndrome.
  • Avoid tucking your feet under your glutes: Sitting in an awkward position, such as with your feet tucked under your glutes, may cause incorrect alignment.

Driving and Piriformis Syndrome

There is no way to avoid sitting when you must drive. However, most vehicles allow for an array of adjustments to both the steering wheel and seat. This allows you to find an ideal position for good posture, which may help reduce excess pressure on your sciatica nerve.

If you travel by car often or your job requires extensive driving, keep a few additional things in mind to sit with piriformis syndrome.

  • Don’t drive in bulky coats: Remove bulky coats while you drive, which can interfere with maintaining good posture.
  • Adjust the seat height: Adjust the seat height so that your hips are at least as high as your knees. This helps promote less pressure on your sciatica and prevents hunching.
  • Take items out of your back pockets: Sitting on items in your back pocket, such as a cell phone or wallet, can place extra pressure on your piriformis and sciatic nerve.
  • Add lumbar support: Like sitting in a chair, adding lumbar support while driving can help reduce pain associated with sitting and piriformis syndrome.
  • Take driving breaks: Driving for long periods of time can aggravate piriformis pain even further. Between sitting for hours and bumps in the road, pain can become worse. If possible, take a break from the road at least every few hours. Stand up, move around, and do a few stretches.

Sit Comfortably with Piriformis Syndrome

Sitting is part of everyone’s daily life. Some people may spend several hours each day sitting at their jobs. If you have piriformis syndrome, sitting for long periods may tighten the muscles and worsen symptoms.

Learning how to sit with piriformis syndrome is helpful as part of an overall treatment plan. Using good posture, avoiding sloughing, and taking frequent breaks to avoid sitting too long is important.

Other treatment approaches for piriformis syndrome, such as ice, heat, lumbar support, and stretching, can ease symptoms. Using the tips above, you may reduce discomfort when sitting with piriformis syndrome.

If you develop symptoms of piriformis syndrome that are getting worse even after home treatment, it is best to see a medical professional for additional treatment.

About the Author

MaryAnn DePietro CRT

MaryAnn DePietro CRT is a licensed respiratory therapist with over 15 years of clinical experience in critical care, emergency medicine, and pulmonary rehabilitation. She is also an American Council on Exercise certified personal trainer and holds specialty certifications in orthopedics, senior fitness, and weight management. MaryAnn has a degree in Rehabilitation from Penn State University and a degree in respiratory therapy.

In addition to her clinical experience, she has written extensively about all things medical, as well as health, fitness, and aging for various websites, magazines, and newspapers.

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