I was diagnosed in early Dec with Piriformis syndrome. This came out of nowhere as I am not an athlete. I had excrutiating pain in left glute--like a charleyhorse that wouldnt quit--for over seven days. I also had numbness and loss of motor control in L4/L5 area. After MRI showed only very mild degenerative disc disease I was tossed aside by my fam. doc. to find relief on my own. Found a great chiro. who was able to relieve my pain. My question to any of you who may have experienced loss of motor control...does it ever come back?? I am seeing a neurologist in a couple weeks but I am a bit panicked. I can not walk on left heel. Though it has gotten a bit better it worries me that it will not come back. Anyone share anything remotely similar to this? I would appreciate any feedback.

Thanks.
Deetee

http://orthopedics.about.com/cs/spra...piriformis.htm

I get a similar thing, but no numbness or loss of control.
My chiro takes care of mine when it is acting up.

If hyper-mobile it may be an ongoing thing - chiro adjusts and then depending on what you do it can go out again... and sometimes it just takes some retraining of the muscles & time to keep the adjustment.

Can't believe drs that won't at least send you for a PT evaluation....glad you have helpful chiro though.

I looked up online videos for stretches, maybe some of these will be of help-
http://video.google.com/videosearch?...8&sa=N&tab=wv#

Hope you are still visiting this forum ..... I have posted exactly that question on other pain forums but have only just found this one . I have PS and like you have major problems with my heel. I have not found any treatment that will help me yet (always positive tho'. . . . well mostly)
Would love to hear from you.
Helen

I'm a 39 year old male. I was very active prior to the chronic pain. I'm at my wits end. My anxiety and depression are at their worst. I'm now in psychotherapy, but I don't think one hour a week of talking about how my pain is degrading my mental capacity is helping me. I'm not criticizing all therapy; it's just not helping me with pain. I need to find a way to stop the pain or I fear that I will simply give up on everything.

My pain is in my right buttock daily, and often travels down into my right hamstring. After golfing 18 holes, my pain will manifest itself in my groin for up the three days.

I wake up every day at a 2/3 on the pain scale. Sitting in an office chair or in a car cause my pain to rapidly increase from a 2/3 to an 8/9. When I say rapidly I mean 10 to 30 minutes. My right butt muscles spasm randomly every day from one spasm episode to multiple episodes lasting anywhere from 1 to 10 seconds. The spasms do not trigger painful sensations. I take Baclofen to stop the spasms but the pain is not relieved.

My relentless journey to find the reason and cure for this pain includes:

Imaging
Over the last 4 years I’ve had several MRIs (with and without contrast) of my lower back, right hip and hemi-pelvis, x-rays of lumbar spine, ultrasound of ischial bursa area, and whole body bone scans. The MRIs show:

L4-L5: minimal posterolateral disk bulges are identified bilaterally. There are no focal significant disk herniations or evidence of central canal stenosis. There is mild narrowing of the neural foramina bilaterally.

L5-S1: There is a small broad-based posterior central disk protrusion at this level. There is no evidence for compromise of central canal or nerve roots. There is no significant foraminal narrowing.

Treatments

Over the last 4 years I’ve tried the following treatments, and have summarized each treatment’s effectiveness.

Cold and Heat Therapy: Doesn’t relieve the pain.

Piriformis Stretching and Neural Flossing: Provides immediate relief, but only temporarily.

Core muscle strengthening: Doesn’t relieve the pain.

Psoas muscle release: Doesn’t relieve the pain.

Piriformis muscle release: Provides immediate relief, but only temporarily.

About 3 months of weekly Physical Therapy: Doesn’t relieve the pain.

TENS unit: Delays the onset of the pain, but causing skin irritation and discomfort.

Sitting on a 70cm exercise ball versus office chair: Doesn’t relieve the pain.

Sitting on a FitBall disk on top of office chair: Doesn’t relieve the pain.

Sitting on pillow on top of office chair: Doesn’t relieve the pain.

About 3 years of weekly Chiropractic manipulation: Doesn’t relieve the pain. I did learn that I had fallen arches, specifically on the same side as the pain. I have ortho inserts and wear them daily now.
Acupuncture (3 visits): Doesn’t relieve the pain.

CT-guided Epidural steroid injections in L4, L5, S1: First injection relieved the pain for 6 months, second injection relieved the pain for 3 months and third injection relieved the pain for 2 weeks.

CT-guided Ischial bursa injection: Doesn’t relieve the pain.

CT-guided Piriformis injections (steroid and Botox): First steroid injection relieved the pain for a couple of months; second steroid injection relieved the pain for 2 weeks. Botox injection doesn’t relieve the pain.

RF Ablations of T-11 through L3 twice with 3 month periods (Sept 5 and Dec 2, 2011), Doesn’t relieve the pain.

Pain Management

Ibuprofen/Aleve/Tylenol: Doesn’t relieve the pain. Took Ibuprofen almost every day for 1 year and ended up with Gastritis. I stopped taking NSAIDs. I cured my Gastritis by drinking Aloe Vera Gel over a 3-week period.

Darvocet 10MG: Decreased the pain by 1-2 points for 30 to 60 minutes.

Hydrocodone/APAP 10MG: Decreased the pain by 2-3 points for 30 to 60 minutes.

Oxycodone/APAP 10MG: Decreases the pain by 4-5 points for 1 to 1.5 hours.

Lyrica: No pain relief.

Gabapentin: Couldn't tolerate.

Topirimate: Only been taking it for one month. Haven’t noticed any pain relief from it.

Lidoderm Patch: Just started wearing these five days ago. Doesn't relieve the pain when sitting, however, when I wear the patch and don’t sit upright I feel great.

Baclofen: Stops the buttock muscle spasms but doesn’t relieve the pain.

Lidocaine: Had 10cc injected about ½ inch below the skin above the center of the Piriformis (my wife is in the medical field) and all of my pain went away for about 45 minutes. I even went for a long drive after making sure my leg wasn’t numb and no pain was triggered.

I’m now thinking of having Piriformis Release Surgery. I live in Milwaukee, WI. Does anyone have any advice for my after reading my story? My anxiety and depression are winning the battle at the moment. It’s affecting my work and my family life. I’m losing myself. I’m not suicidal because I have kids that need and deserve their father, but if it wasn’t for them there would be no reason to continue this suffering.

I've attached a .zip file of my scans in case I'm lucky enough for someone to come across this post, read my images, and find something helpful.

Aaaah mannnn, I feel for you guys suffering through this!!! That's how all my issues started!!! Be EXTREMELY glad your MRI's don't show any issues with your lower spine though! In my case, my GP thought it was a pirifomis muscle problem BUT couldn't understand why it was affecting BOTH sides. No heel pain though. He sent me to an OS who prescribed P/T + ultram. As it worsened, the GP then thought it was sciatica, but then the problem GREW! Don't mean to scare you - this is just my particular issue.

Do you get nerve or muscle spasms in your leg / legs? Can you identify anything that may have precipitated your pain - a fall, stepping in a hole, picking up something heavy, etc.?

Thank you for replying and your kind words. I did have a minor injury during exercise to my right inner groin while doing Pilates. I have sapams every day in one of my butt muscles but they dont come with pain. The baclofen keep the spasms at bay. However, the pain is chronic.

You can injure tendons in the groin, and when that happens, it can last a LONG TIME.
It might not be piriformis at all.

I had a fall and strained some ligaments there, and had IFc electrical stim and ultrasound and the pain went away. I was unable to return to the same flexibility however after 3 months of PT. I think you may have a groin injury and not piriformis at all.

The lidoderms need to be applied to the lower sacral area on your back for best results. That is where I used mine. This intercepts the nerves before they enter the spine.

I will say a groin strain takes forever to heal up. When mine occurred I couldn't even roll over in bed !
Of all pain relievers, aspirin worked best 3 times a day. I used Alka Seltzer original formula because the aspirin in it is soluble and doesn't affect the stomach so much. This simple thing gave me a bit a relief until I could get home (we were on vacation in the boonies) to PT.

For spasms I'd look into magnesium to relax those muscles.
Topical works very well in lotion form. CVS has an Epsom lotion, which they are foolishly discontinuing, but some stores still have it on the shelves. Another topical is called Epsom-It. It is made for feet but it will work anywhere you need it like the CVS one.

Oral magnesium will work too, but avoid mixtures or any that say OXIDE on the label (oxide is not absorbed from the GI tract). Don't do HEAT... but try some ice once or twice a day. Heat stimulates nerves and injuries. Try the ice in the groin area, or on your lower back. When I had the IFc (inferential current --which is different from TENS) the therapist put an ice pack over the electrodes to ramp up the current and suppress pain . It worked really well for the acute stages of pain that were incapacitating. Since all your interventions for piriformis are FAILING, I'd look at the groin area instead. That may be where the pain generator really is.
Just my opinion.

Just throwing some things out there that I was told/advised when doc suspected my issue was piriformis - Please let docs know if you did do anything odd or accidently prior to pain (sure you probably already got that covered!), was told not to use heat as that INCREASES inflammation - use ice instead, and Voltaren Gel was prescribed (it's a script only NSAID - I can't take oral anti-inflammatories). Oh, and was told to cut my exercise in half - I walk, or did, walk 4 miles in one hour. Never considered that as athletic, just walking like I had somewhere to go and I was late, but have since learned that does qualify as athletic.

Wish I could be of more help.....

Absolutely. Thank you seahorse02. I will quit using the heated seats in my car immediately and start bringing an ice pack to work. Still in search of diagnosis and cure...

I've just been diagnosed with this as well. I have some spinal degeneration but nothing that would indicate the numbness and loss of reflex I'm having in my heel. My physiatrist thinks it must be piriformis.

She mentioned myofascial release therapy/massage. Anybody tried that?

I've already been through lots of PT and it seems to either not help or make it worse -- stretching in particular.

Can the sensation and reflex in my heel come back, or are they permanently gone?

The only kind of exercise I can do anymore is pool walking or aerobics. Even walking down the block is too painful. I used to walk every day, and this is very very frustrating.