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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).
Piriformis syndrome is a complex condition that is often not considered in the differential diagnosis of chronic hip and low back pain. To aid diagnosis, several tests have been developed to recreate the pain by actively contracting or passively stretching the piriformis muscle and compressing the sciatic nerve.