Great question. And this is where it gets interesting.

Here's what most people are never told: the piriformis sits about 3 to 4 inches lower — and far deeper — than where every common back treatment lands.

That single fact explains the entire frustrating pattern you've probably already lived through:

→ Stretching and foam rolling. You did the stretches. You rolled it out. And you got a little relief… for about an hour. Then it came right back. That's because a foam roller spreads pressure across too wide an area to ever reach a muscle buried that deep. As one trainer put it bluntly, foam rollers "can't reach deep enough."

→ Heating pads and back belts. They sit on the surface of your lower back — warm, soothing, and a good few inches above the muscle actually causing the problem. They feel nice. They never reach the spot.

→ The chiropractor. An adjustment can give you real relief. But it's working on your spine — and you walk out feeling great, only to be back in a few weeks needing another "tune-up." Month after month. Because the spine was never the source.

→ Cortisone shots. This is where the pattern gets expensive. The first one might feel like a miracle. The second one wears off faster. The third? Often nothing — because, as more than one person has put it, "it takes away the swelling… but it does not fix the problem."

After all that, plenty of people have spent hundreds — sometimes well over a thousand dollars — on appointments and gadgets and still wake up with the exact same ache.

Sound familiar?

Here's the pattern nobody points out:

Every single one of those treatments targets your back or your spine. Not one of them reaches the deep glute muscle that's often the real source of the trouble.

It's like turning up the radio to drown out a rattle in your engine. You stop hearing the noise for a while — but nothing under the hood has actually changed.

So the real question isn't "why hasn't anything worked?"

It's: what finally reaches the one spot everything else has been missing?