• Employ dynamic rest. Stop the offending activity (if your pain is moderate to severe, you’ll want to anyway). Use upper-body workouts to maintain fitness. Core work will probably be a problem because your lower back and glutes will hurt. Let the pain be your guide and back off immediately if you do anything that hurts.
• Try an NSAID. An anti-inflammatory like ibuprofen or naproxen can help with swelling and inflammation.
• Stretch your hip rotators. As pain allows, try to gradually open up your hips by stretching your hip flexors and rotators. These two stretches can help:
Seated Piriformis Stretch
While sitting in a chair with your back straight, rest your ankle on your opposite knee. Then gently press down on your knee until you feel a stretch in your hip. Hold for 10 to 15 seconds. Repeat several times for each hip.
Lying Piriformis Stretch
Lie on your back with your knees raised and your feet flat on the floor. Put your right ankle on your left knee. Raise your left foot while pressing down on your right knee until you feel the stretch in your hip and buttock. Hold for 10 to 15 seconds. Repeat several times, then reverse the leg positions to stretch the left side and do a few reps.
Many of the interconnected muscles in this region—piriformis, glutes, hip flexors, hamstrings, quads—support one another, and weakness in one area can mess up the works. In short, if you want healthy piriformis muscles, you need to prioritize total-body fitness.