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Piriformis Syndrome: How were you diagnosed and what helps?
Spine Health | Last Active: Sep 5, 2024 | Replies (38)Comment receiving replies
I'm confused. When I had piriformis syndrome, the treatments were PT, walking & x-ray guided steroid injection. As far as I can see, everywhere I look, that is still the recommendation.
---- https://www.spine-health.com/conditions/sciatica/symptoms-and-diagnosis-piriformis-syndrome
In over 5 years of struggling, none of these therapies was successful for more than a few weeks for me because the underlying cause was a hip badly deteriorated by severe osteoarthritis. At 54, the surgeon said I had the hips of an 85 year old. The problem was that the unstable hip was causing the piriformis to repeatedly press on the sciatic nerve. The solution was hip replacement, and 17 years later I have not had a recurrence of the piriformis issue.
I think you mentioned in another discussion that your ortho diagnosed osteoarthritis in your hip, and suggests it is the cause of your pain. The doctor should be able to show you the x-rays that show the damage, and compare them to a normal joint.
What exactly makes you question the arthritis diagnosis? Where did you learn about a specific MRI to diagnose piriformis syndrome?
I understand reluctance to undergo unnecessary surgery, but if you have exhausted the "usual" treatments without success, maybe it is time to consider the joint replacement. Has this been recommended by more than one of the orthopedists you saw?
Sue
Replies to "I'm confused. When I had piriformis syndrome, the treatments were PT, walking & x-ray guided steroid..."
Four months after laminectomy surgery, L3,4,5, I've developed piriformis syndrome which is every bit as painful as my back problems prior to surgery. Two months post surgery, I returned to physical therapy and although not diagnosed with PS, have been questioning stretching and the usual exercises. So far, it's not been much help for the past month that I've been stretching with PT. To me, walking seems the best relief. Yesterday, I stumbled across Botox as a possible treatment. Has anyone had experience with Botox?
https://journals.lww.com/ajpmr/Abstract/2004/03000/Botulinum_Toxin_Type_B_in_Piriformis_Syndrome.7.aspx
A small study but does anyone have experience with this? Thank you.
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Thanks for all this Sue. I have done massive extensive research on piriformis syndrome. I can’t walk; in a wheelchair and sleep in a recliner. I’ve been through PT and then was told that was the worse thing I could have done; the piriformis should not be stretched; it just causes more pain, PT never relieved me of any pain, I’ve also done numerous injections; none of which helped the pain for more than 2 days. That’s what the piriformis syndrome is, but in reverse of how you stated; the sciatica nerve actually presses on the piriformis muscle. The doctor did show me the X-ray and the MRI and it’s not that I don’t agree that I could have a bad hip, but no one is looking or has the ability (right equipment-which is “diagnostic ultrasound”) to focus on what I need to know. I’m on a FB forum for piriformis syndrome and have gained a lot of knowledge about this muscle from that page. There are only 5/6 doctors in the US that have experience in removing it, and they don’t take my insurance. If a “release” is needed, I think Mayo may do that which is what I’m trying to find out. Yes I’ve been to 2 ortho’s. I’m not a bit reluctant to undergo surgery again, I just want it to be 100% the right surgery.