Piriformis Syndrome and the Buttafly

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Piriformis is a muscle deep in the buttock and piriformis syndrome is when the muscle is somehow involved in the entrapment or compression of the sciatic nerve causing nerve pain or “sciatica”.

There are many different reasons why the piriformis muscle becomes problematic and in nearly all cases poor alignment of the pelvis is both a major contributing factor and perpetuating factor.

Common chronic conditions affecting pelvic alignment include long-term poor posture, muscle length/strength imbalances – particularly of the spinal muscles, the gluts and/or hamstrings – and lower limb conditions such as arthritis and poor foot biomechanics.

Acute onset of pelvic misalignment is commonly the result of lifting injuries e.g. a forward bending and twisting incident; also, stepping off a curb unexpectedly, missing a step coming downstairs and direct trauma caused by falls directly onto the coccyx and sacrum. For women who are pregnant, breast-feeding or in the pre-menstrual phase, the sacroiliac joint ligaments are more lax than usual making the joints especially vulnerable at this time.

A thorough assessment and diagnosis by a physiotherapist, chiropractor or osteopath is always recommended and effective treatment plans should address the root cause AND alleviate the symptoms. More than likely manual therapy will be used to re-establish correct joint alignment and a programme of home exercises advised.

In many cases using the Buttafly in supine can be hugely effective in facilitating a re-alignment of the spine according to the natural intelligence of the body.  Placed low down under the buttocks – NOT under the lumbar spine and NOT under the sacrum but BELOW it – the sacrum is off-loaded and at the same time a gentle inversion has been introduced – the Buttafly itself does not cause the re-alignment but the lack of pressure on the sacrum presents an invitation for the spine and pelvis to unwind.

Key to its effectiveness are:

  • Correct positioning of the Buttafly, such that a neutral pelvis is achieved with neither anterior nor posterior pelvic tilt – the use of cushions under the legs may well be necessary.


  • Once in position, you should be pain free and relaxed.
  • Keep comfortable and warm – I tend to encourage the use of a blanket.

More information can be found here.


Will sitting on the Buttafly help?

It will vary from person to person whether sitting on the Buttafly – either for use on a hard chair for short periods, or for cross-legged sitting on the floor – will be better than sitting without from the point of view of direct pressure on the buttocks. However, the ergonomic design of the Buttafly aims to improve alignment of the pelvic and spine and this should contribute positively to the overall management of piriformis syndrome.

As with any self-treatment techniques and exercises, please discuss using the Buttafly with your practitioner for best results.

Yours in Yoga

TillyLou x



May you enjoy fabulous health,


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