or re-experiencing piriformis syndrome. Other suggestions from some researchers and physical therapists have included prevention strategies include warming up before physical activity, practicing correct exercise form, stretching, and doing strength training, though these are often suggested for helping treat or prevent any physical injury and are not piriformis-specific in their approach As with any type of exercise, it is thought that warmups will decrease the risk of injury during flexion or rotation of the hip. Stretching increases range of motion, while strengthening hip adductors and abductors theoretically allows the piriformis to tolerate trauma more readily. Treatment Immediate though temporary relief of piriformis syndrome can usually be brought about by injection of a local anaesthetic into the piriformis muscle. Symptomatic relief of muscle and nerve pain can also sometimes be obtained by nonsteroidal anti-inflammatory drugs and/or muscle relaxants, though the use of such medication or even more powerful prescription medication for relief of sciatica is often assessed by patients to be largely ineffective at relieving pain. Conservative treatment usually begins with stretching exercises, myofascial release, massage, and avoidance of contributory activities such as running, bicycling, rowing, heavy lifting, etc. Some clinicians recommend formal physical therapy, including soft tissue mobilization, hip joint mobilization, teaching stretching techniques, and strengthening of the gluteus maximus, gluteus medius, and biceps femoris to reduce strain on the piriformis. More advanced physical therapy treatment can include pelvic-trochanter isometric stretching, hip abductor, external rotator and extensor strengthening exercises, transcutaneous electrical nerve stimulation (TENS), and massage physiotherapy of the piriformis muscle region. One study of 14 people with what appeared to be piriformis syndrome indicated that rehabilitation programs that included physical therapy, low doses of muscle relaxants and pain relief medication were effective at alleviating most muscle and nerve pain caused by what the research subjects had been told was piriformis syndrome. However, as this study included very few individuals and did not have a control group not receiving treatment (both serious methodological flaws), it provides no insight as to whether the pain in the piriformis would have simply dissipated on its own without any treatment at all, and is therefore not only uninformative, it may actually be misleading. The injury is considered largely self-limiting and spontaneous recovery is usually on the order of a few days or a week to six weeks or longer if left untreated. Stretching Most practitioners agree that spasm, strain, or pain in any muscle