Have you read that 8% of people have a sciatic nerve that pierces their piriformis muscle. I can't remember the percentage of that group that suffers for it, but I did treat someone who had zero relief from physio et al for years until she had the surgery, cutting the piriformis a smidge releasing the sciatic nerve. I tried to fire them as a client because I hated the business side of being a therapist and I wasn't fixing their problem, they refused as I was having the best results dry needling their piriformis medial and laterally.