The first thing I would like to say is that I am not a doctor, this is just what I have personally experienced and what works for me may not work for you.
I am 21 years old, and I injured myself in November of 2017 while I was squatting at the end of a workout. I did not notice the pain until I sat in my car, my back was extremely stiff and I had a tingling/burning sensation that went down to the bottom of my left foot. I didnt think much of it for the first few days, but eventually decided to get it looked at. I was prescribed some muscle relaxants and told to rest and ice. This helped a little bit but I could tell that it was something much more serious. I turned to the internet (somewhat of a mistake) and convinced myself that I had a herniated disk. A month or so went by and at this point I decided that it was time to go see an Ortho. I got an MRI and I thought for sure I was going to be setting up a back surgery over my winter break. Thankfully I got some fantastic news that my back was perfectly healthy! However, this still didnt solve the problem of my chronic pain. Off I went to do a round of Physical Therapy.
I worked with the physical therapist for a couple of months, and this is when I first learned about what piriformis syndrome was, and some ways I could help it get better. with the help of the PT and what I was doing at home, I started to make significant progress.
This is what I typically do to help prevent the pain from returning to the full force that it once was.
The first thing I did was purchase a heating pad to use on my lower back/ glutes every morning before I stretched.
In my opinion this is one of the single greatest purchases I have made. I use the heating pad every day, to this day, 8 months later. I have found that putting some water on it before you put it on your low back helps the heat to penetrate deep into the glutes where the piriformis muscle is located.
After this I will do some foam rolling, and stretching exercises that I was assigned during PT. Then I drink some coffee and hit the gym. I have yet to return to doing real weightlifting for my lower body, so I just stick to a warmup of a 15 minute brisk walk on the treadmill, and they do an upper body workout followed by a 10 minute cooldown walk on the treadmill.
Once I get home, I take an ice cold shower, which really helps me to mentally turn off any pain I have if my symptoms flare up after a workout. I then go throughout my day as a student.
At night I again do some foam rolling and stretching, and take another ice cold shower before bed. Then I apply some Tiger Balm Sport Rub to where the piriformis muscle is located( see below).
Tiger balm is kind of like an extra strength icy hot and feels pretty good, dont go overboard on it, especially if you have sensitive skin. I apply it directly where the two Xs are on the picture below.
I then have a glass of ginger tea, which is said to help relax your nerves. Whether or not it actually helps with the nerve pain, it does help me to relax before bed, making it easier to fall asleep.
Lastly, as I am drinking my tea, I like to apply an ice pack on the same spots I applied the Tiger balm, but only for about 10-15 minutes. I have found that if i leave the ice on for too long, I am very stiff in the morning.
By staying active, and following my PT as much as I possibly can, I have very, very slowly started to recover. My understanding is that many people can be rid of this in just a couple of months, but for others, (myself included) it takes many months to see any real progress. The important thing to remember is that no matter how bad it hurts, the pain will never go away if you give up. I hope that if by sharing my experience I can help just one person with this literal pain in the ass, then I know I have accomplished something.