Piriformis Syndrome Anyone???
 

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 think I have Piriformis Syndrome and it's runining my life.
 

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.

Yes, and under the right circumstances, it can work great. It's important to get a good certified myofascial triggerpoint therapist - not just a PT who thinks they know what they're doing. The right training and experience make all the difference. Of course I can't make any promises; I'm not a doctor, and I don't know your particulars, but if your symptoms are caused by the piriformis muscle being in spasm, myofascial release may release that spasm and ease the pressure on the nerves. It may work for a long time, or temporarily (a few days) but the therapist should be able to show you how to help yourself if/when it happens again. It will hurt like cuss when they're doing it, and be sore afterward, and it will involve some stretching, but if it works (and IMO it's definitely worth a try) it'll be worth it.

http://www.myofascialtherapy.org/

Doc

Darn it. There is not a single one in my state listed on that website. x-(

Re: welcome Deetee
 

Welcome to Neuro Talk. You have found a site that should help you to find some answers about this condition. This is the first time I have heard of piriformis syndrome. I will look it up however. There will be others that know alot more about it that I do. You will find help and compassion here, and a few new friends. Feel free to explore all the forums and join in any conversation you want to. I hope someone will help you out soon with your questions. ginnie

Piriformis Syndrome Non-Surgical Treatment
 

Dr. Russ Schierling in Mountain View, Missouri can treat PS in a non-surgical treatment. Please do yourself a favor and contact him to see if he can help you. Here's his website:

destroychronicpain.wordpress.com

I don't know what the particulars are with that organization. My therapist is a listed member, but she was not always listed, so it may be possible that there are certified therapists in your state who don't belong to that organization, or for some reason aren't listed. ($?)

You might try phone directories, Google: myofascial trigger point therapist [your state] and ask the physiatrist who mentioned it (she may know one, or have her staff find one for you).

Doc

Yep, the physiatrist referred me to PT for myofascial release and had me download an iPhone app called Trigger Point that I can play with at home if I want. She's also sending me for pool therapy and core strengthening. She thinks that most of my pain is related to myofascial muscle spasm, though.

Good morning and welcome deetee
 

Happy Valentines day, and welcome to Neruo Talk. You will find alot of people who will address some of your medical issues. I am sorry that pain has brought you here, but you found a good group of caring individuals. I wanted to stop in and Welcome you here. I hope you get lots of replies and some good information. ginnie

That's actually (IMO) good news - very good news relative to what else it could be!

Here's hoping it works as well for you as it does for us! :D
(You know where to find us for support. :cool: )

Doc

Please ** look for Piriformis syndrome Dr. Arron Filler. You will get to his informative video that explains and show options for this syndrome.
For your information that you really need. Best wishes

Piriformis syndrome
 

I live in Milwaukee, WI and have been through everything you have tried -

First of all I have found that walking slowly on a mini tramp with socks only - start off with as many minutes as you can tolerate, only walk do not bounce or run - you will know within minutes if it is your piriformis that is the problem because it will pull/hurt like hell -

I am a life long athlete and exercise is both my daily saviour and my daily curse.

After 20 years of trouble from 9 major spinal surgeries being fused from head to toe with only two moveable levels left in my spine - I can tell you sometimes the simplest technique - something you don't even want to try turns out to help the most.

I also would like to point out that anytime you have a disc bulge - MRI's don't show if nerves are being impinged - or pressed etc....there are tons of nerves that branch out from the spinal cord - and your MRI results could be causing lots of pain from nerve impingement that is very difficult to see unless you have a myleogram which you don't ever want to do in my opinion having had 4 of them -

Try the mini tramp thing - make the investment - can't hurt - also meditation - now don't immediately roll your eyes - I used to think meditation was for "those types of people" not me - however - now I practice it daily and it has awesome results not only in terms of pain but all daily life situations....you become calmer - more at peace during situations that usually stress you out - you react slower with more thought - totally amazing...but difficult to learn and master - stick with it -

I see Advanced pain Management in Greendale WI - you may want to see them and see if they can offer you any other alternatives.

kelli

Good to know that the mini-tramp works. We actually have one!

I'm a couple weeks into physical therapy after seeing a physiatrist. They have the piriformis loosened up pretty well, and I've been exercising in the therapy pool. They also have me gradually resuming my walking program on land.

It looks like there might also be some IT band problems that are coming to the surface now that the piriformis is calmer. Such an adventure!

Sounds like you have been through more with your PS than I have with 3 spine surgeries and PS.

I learned from a very good PT that stress can make your pain more difficult. Sounds simplistic but he taught me how to breath. I was holding my breath when I hurt. So deep slow breathing and visualizing no pain (which isn't easy) helps it to calm down. I also go to a really good pain Doc. She's an anesthesiologist pain specialist. And we keep a good supply of icyhot in the house.

I thought I would be in a wheel chair until I met her. I seldom take pain pills now. I am so glad. I wish you could find one specialist who could coordinate your care and give you relief.

Here's hoping you get the help you need.

Hi. I am 47 y/o and also live in WI. I have a horrid pain in my right buttox.I do believe I have piroformis syndrome. I have had it for eight years and it is ruining my life. My wife is leaving me after 26 years because this has changed me dramatically. I have had several MRI's, at least 4 cortisone injections into the piroformis with diminishing relief. (5 months max) I have some relief with Tramadol & Hydrocodone. Stretches & Chiro SI joint manipulation also helps. I want Piro release as well. Have you found a diagnosis? I'd go to Mayo and get fresh start. Yours sounds worse than my pain. I was going to try Mayo but just lost my job and quite likely the cabin too. No wonder I'm slightly depressed. Having a bone scan tomorrow & some x-rays hunched over. Sitting is terrible.

teacher61
 

Please see my information. I went through exactly what you have for forty years. I no longer have problems due to a tiny little implanted computer. Pre-program electrodes send messages to my brain whenever pain begins. As you may know, the brain is REALLY what lets you know you are hurting. Must go to a reputable Pain Managment Specialist. They will insist you have a psychological exam to make sure you understand this procedure. It has saved my life, my career, and I can do most anything - including riding a camel across the Egyptian desert. I can stand for long periods, bend over without pain, participate in sports, and sitting and sleeping without problems. My pain is 95% gone - I actually was put on disability before I had this procedure done. I had similar symptoms as yours, and additionally discovered the piriformis muscle also interfered. Hope this is helpful.
BLM

Maybe this will help?
 

I'm a 52 year old female. Fairly athletic, 128 lbs, work out regularly.

2 months ago, I woke one day with pain in my left glute and running down my left hamstring. As mentioned by everyone above, painful 24/7.
I went to a general practioner 2 weeks into this and was prescribed pain meds. That helped me to be able to get some sleep, so at the time it was an ok thing. Those ran out and I was taking 8-10 advil every single day to get some relief but always waking up to the same unbearable pain/ache.

Prior to this injury, every pulled/strained muscle I ever had gradually got better and went away with in a week. Not this.

For the first time, I went to a chiropractor. After alot of initial questions/answers regarding my pain, and some leg bending, hip feeling, they took some xrays.
Turns out my left hip was 1/2" higher than my right hip. She said it's probably been this way for a while and my body had been compensating for it until one day I did something (aka rowing machine) that was the "last straw" and boom - pain.
The pain is a symptom of another problem and in my case my hips not being aligned. She said this happened, just from life - sitting with crossed legs or maybe driving leaning to one side all the time, etc... just living.

So, now the regime is 12 visits within 1 month to manipulate my hip back to where it should be and to do it enough times so that it stays there for good.
I already feel 30% better and she assures me after a month I'll be pain free.
At that point the visits turn into 1 a week and then at my discretion.

Hopefully this will help someone else. It was a TOTAL pain in the butt!

Piriformis
 

My husband was diagnosed with piriformis syndrome.

Feedback re: Dr. Schierling
 

Hello,

I wanted to get any feedback on your experience with Dr. Schierling. I have read his website and will be calling his office on Monday. Did you see him? What was your experience? No answer is too short! I love details and your intuition.

I have longstanding Thoracic Outlet Syndrome or TOS ( on list of his treatments) and have had 4 surgeries for the condition. 20 years of pain. Some associated with TOS, some I"m not convinced is from the surgery, stress, chronic pain. I have had every treatment you can imagine. P.T., Accupuncture, trigger point, botox, dry needling, TENS unit, biofeedback, Feldenkrais ( which I liked), Blah.. blah.... blah...... etc.......

I am at my wits end with chronic pain.

I live in Southern California - 100 miles north of Los Angeles- so I would like to find a practitioner in my area but I'm not sure if there is one. I would rather travel and spend the money on the air ticket then spend it going to practitioners that don't/can't help me.

Please let me know your thoughts.

Thank you
MarcB

piriformis
 

after taking anti imflamitories a few days to relive pain i decided to stop. because they inhibit healing and repair. I also started taking a gram of magnesium a day im seeing a sudden steady improvement

Piriformis Pain
 

Hello,
My name is Christina, 28 yrs old. I had no idea people were going through the same thing as me! Some days I think I'm going crazy and others I fear that the pain will never go away. I was diagnosed with performs syndrome about 3 years ago. I used to be very active with things like acrobatics, dance, yoga, and weight lifting. Since my injury I have gone through 3 rounds of physical therapy with only minimal results. I've also tried chiropractic and massage therapy. I have been in pain every day for almost 3 years and it has taken a toll on my body. I've had problems with over compensation and it's hard to get through basic activities like sitting, driving, and walking. I just wanted to give some support to others who are going through this and seek out some support of my own. I would truly not wish this on anyone.

I read your post from 2010. Do you mind sharing how you have been doing since the original post? Could I contact you directly?