That Pain in the Glute Might Not Be What You Think

Understanding Sciatica, Piriformis Syndrome, and What You Can Do About It

By Dr. Melanie Brown, Chiropractor, Mountain Life Clinic, for The Mountain Times

That deep ache in your glute that won’t go away — especially when sitting or driving — might not just be a sore muscle. For many people, it’s related to irritation of the sciatic nerve, and the source isn’t always where you think.

The sciatic nerve starts in the lower spine and travels through the hip and down the leg. It runs through or very close to a small muscle in the glute called the piriformis. Because of this, irritation can happen either at the spine or in the glute itself.

When the issue comes from the spine, it’s often called disc-related (discogenic) sciatica. This happens when a disc in the low back puts pressure on the nerves as they exit the spine. It can cause sharp, shooting, or electric pain that travels down the leg, sometimes all the way to the foot.

On the other hand, piriformis syndrome happens when the piriformis muscle becomes tight or inflamed and irritates the nerve where it passes nearby. This usually feels like a deep, aching pain in one side of the glute, often worse with sitting or driving.

A simple way to think about it:

• Pain from the spine = irritation at the origin

• Pain from the glute = irritation along the path

Many people experience a combination of both — especially with long hours of sitting.

Why sitting and driving make it worse

Desk jobs and driving keep your hips in a flexed position, tightening the muscles in the glute while also increasing pressure on the low back.

If you sit for work:

• Take breaks every 30–45 minutes

• Use a sit-stand workstation if possible

• Avoid slouching and keep good posture

If you drive a lot:

• Adjust your seat so your hips are level or slightly higher than your knees

• Avoid sitting on a wallet or uneven surface

• Take breaks to stand and move when you can

Use heat to relax the muscle

One of the easiest ways to get relief is using heat while you relax.

I like to use a buckwheat hot pack, folded in half, warmed in the microwave and then sat on. Because it’s firm and moldable, it presses deep into the muscle and can really target that tight, irritated area.

If you’re using a plug-in heating pad, you can get a similar effect by placing it over a folded towel or cushion so it presses more firmly into the glute.

You can also alternate heat with short periods of cold to help calm irritation.

Stretch and release the area

Once the muscle begins to relax, gentle stretching can help restore normal movement. A simple figure-four stretch can effectively target the piriformis. 

Sit up tall in a chair with both feet flat on the ground. Lift the leg on the painful side and place your ankle across the opposite knee, creating a “figure four” shape with your legs. Keep your back straight (don’t round your shoulders) and gently lean your chest forward. You should feel a stretch deep in the glute of the crossed leg. Only go as far as is comfortable — this should feel like a stretch, not pain. Hold the stretch for about 30 to 60 seconds, then relax.

Repeat 2–3 times on that side.

A massage gun can also be useful on a low to moderate setting over the glute.

Support your body from the inside

Muscle tension isn’t just mechanical — it can also be influenced by what’s happening internally. Magnesium can help support muscle relaxation, and staying well-hydrated with adequate electrolytes can make a difference. Omega-3s may also support a healthy inflammatory response.

Sleep and daily habits matter

If you sleep on your side, place a pillow between your knees to keep your hips aligned. If on your back, place a pillow under your knees.

Weight gain and lack of exercise can contribute to this type of pain. Maintaining a healthy weight and adding regular movement can make a big difference.

Don’t forget about alignment

If the body is out of alignment, it can place unnecessary strain on the muscles and nerves in this area. When the pelvis, hips, and lower back aren’t moving properly, it can increase tension and irritation.

Regular chiropractic care can help improve alignment and motion, reducing stress on the surrounding tissues and relieving pressure on the nerve.

The bottom line

With simple changes — like taking breaks from sitting, using heat while relaxing, stretching regularly, staying active, and getting consistent care — most people can significantly reduce that stubborn glute and leg pain.

Note: Be mindful not to use heat that is too hot or for too long, especially if you have decreased sensation in the area. If your symptoms include significant numbness, tingling, or weakness, or are not improving, it’s important to seek a proper evaluation.