Originally Posted by msabona

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.

Originally Posted by msabona

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.

Originally Posted by msabona

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