l am famililar with Piriformis syndrome and generally don’t touch it. I wait until they are pain free in order to work with them.
However, if, as you mention, someone is “suffering” and having “pain” I generally tell them to go see their physician. in the textbook “Diagnosis and Treatment of Movement Impairment Syndromes” written by Shirley A. Sahrmann states:
“The length of the piriformis muscle needs to be considered carefully in the piriformis syndrome.” She further states, “Although the piriformis is commonly considered to be short when this syndrome is present, Kendall reports that symptoms of this syndrome can also be found in the patient who has a lengthened piriform muscle. In the clinical experience of the author of this text, this syndrome is found more frequently in the patient with a lengthened piriformis muscle than in the piriformis of the patient with a shortened muscle. The therapist must carefully examine the length of the muscle before planning intervention for the syndrome.
Ruti, I wish you the best with your client.