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
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.
Thank you Kimberly, I’ve found out that an MRI cannot diagnose piriformis syndrome. I need a “diagnostic ultrasound for this specific muscle”… and I’ve not found a place that does this near me, I’m sending a note to Mayo today if I can remember how to do that to see if they have a machine that does this,
I’m not surprised Kimberly… I don’t really trust doctor’s anymore; from the MRI is clearly told me (ortho) he could not tell if the sciatica was resting on the piriformis. Just said, “you need a hip replacement; you have osteoarthritis.
I STRUGGLED with what I told was piriformis syndrome but was later diagnosed by a doctor as having a pinched nerve in my spine. However, I was given exercises for PS by a physical therapist and they greatly relieved my pain.
I was also given steroid shots in my spine (6 in one year 🙁 that took away the pain for awhile but it always came back and I paid for it by having hair skin and nail and hair issues afterwards. I suffered with it for about a year and it slowly went away if I stuck with the exercises and occasionally I'll still get a sharp pain and start the exercises again. I've been free of the "red hot poker" kind of pain for about 5 years.
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
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.
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.
I had the same syndrome. Very painful and limiting, I feel for you. I have no experience with Botox but an alternative to share.
My trainer recommended a local sports chiropractor. He used a needling technique (sorry, don't recall type or if electric; only lasted a few minutes). This did an initial release. We did once a week, for several weeks. In between sessions, he recommended some simple but different stretches from the usual routine ones, about 10, which I did twice daily. The combination brought such relief that I only had to go back once, a month later, for a "refresher". I have no symptoms now. Best wishes for your recovery.
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.
From what I’ve read on a FB forum on Piriformis Syndrome, injections, botox, dry needling all are a bandage for a short period of time. I’m trying to get my situation diagnosed but the proper machines (diagnostic ultrasound specifically for muscles or a MRN (Magnetic Resonance Neurography) are not available, even at Mayo; I’ve already spoken to the radiology department.
I first had Piriformus Syndrome when pregnant 22 years ago. Have gone through 3 bouts since. I am active and had some "bad" exercises in classes that seem to tip me into it-- too much pressure on pelvis, or injury to sacrum from a fall.
What solved it? Rolling and certain stretches. Much like Loreliks above. Seemed to simple to be true. the technique also worked for some fellow exercise buffs who were finding it difficult to even walk, sit or stand-- we were ready to quit a dance class.
Stretching and some gentle movement in the muscles around the hip warm the area up. The then rolling took out the knots in the piriformus muscle. I first used a soft 6" roller at the Y; I now have a denser knobby one.
For right side: sit with your buttock on the roller. Have the roller at a 45-degree angle to your thigh, lateral side toward the foot and inner (left) side behind you. Keep left knee bent to help you move. Lift your right foot so your leg is straight and about 3" off the ground (may need someone to gently support it). Put your hands on the floor or therapy table behind you for gentle support. Slide slowly forward a few inches, letting the roller roll over the sore piriformus-- you will wind up leaning backward some; then slide back (push with your left foot) so the roller again goes over the sore point and to a spot just below your "sit bone" and you are upright. Repeat 5-6 times as you can tolerate. Twice a day is often enough.
Key seems to be having the roller at the angle to your leg so it hits some pressure points in and around the piriformus. Some of the stretches I learned involve not just back muscles, but loosening the hip flexors and the IT band down the side of my thigh. The time I discovered the roller technique, I was healed in less than a week. Now at the first twinge, I take the time to do the warm-up and rolling and have had no more full-blown incidents. I also remember to walk with my knees and toes forward instead of pointing out to the sides (the movement the piriformus does).
I totally feel for you suffering this! Try the rolling if you can, or get an exercise / Physical therapist to help you try.
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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.
Interesting, here in acanada I was told that MRI could diagnose piriformis as it is why I had one done!
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1 ReactionI’m not surprised Kimberly… I don’t really trust doctor’s anymore; from the MRI is clearly told me (ortho) he could not tell if the sciatica was resting on the piriformis. Just said, “you need a hip replacement; you have osteoarthritis.
Did your doctor tell you from the MRI that you had piriformis syndrome?
No they thought I had due to symptoms. Turns out it is RA and a labrum tear, and bursitis. As well as the PMR. 🙄
I STRUGGLED with what I told was piriformis syndrome but was later diagnosed by a doctor as having a pinched nerve in my spine. However, I was given exercises for PS by a physical therapist and they greatly relieved my pain.
I was also given steroid shots in my spine (6 in one year 🙁 that took away the pain for awhile but it always came back and I paid for it by having hair skin and nail and hair issues afterwards. I suffered with it for about a year and it slowly went away if I stuck with the exercises and occasionally I'll still get a sharp pain and start the exercises again. I've been free of the "red hot poker" kind of pain for about 5 years.
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.
I had the same syndrome. Very painful and limiting, I feel for you. I have no experience with Botox but an alternative to share.
My trainer recommended a local sports chiropractor. He used a needling technique (sorry, don't recall type or if electric; only lasted a few minutes). This did an initial release. We did once a week, for several weeks. In between sessions, he recommended some simple but different stretches from the usual routine ones, about 10, which I did twice daily. The combination brought such relief that I only had to go back once, a month later, for a "refresher". I have no symptoms now. Best wishes for your recovery.
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2 ReactionsFrom what I’ve read on a FB forum on Piriformis Syndrome, injections, botox, dry needling all are a bandage for a short period of time. I’m trying to get my situation diagnosed but the proper machines (diagnostic ultrasound specifically for muscles or a MRN (Magnetic Resonance Neurography) are not available, even at Mayo; I’ve already spoken to the radiology department.
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3 ReactionsI first had Piriformus Syndrome when pregnant 22 years ago. Have gone through 3 bouts since. I am active and had some "bad" exercises in classes that seem to tip me into it-- too much pressure on pelvis, or injury to sacrum from a fall.
What solved it? Rolling and certain stretches. Much like Loreliks above. Seemed to simple to be true. the technique also worked for some fellow exercise buffs who were finding it difficult to even walk, sit or stand-- we were ready to quit a dance class.
Stretching and some gentle movement in the muscles around the hip warm the area up. The then rolling took out the knots in the piriformus muscle. I first used a soft 6" roller at the Y; I now have a denser knobby one.
For right side: sit with your buttock on the roller. Have the roller at a 45-degree angle to your thigh, lateral side toward the foot and inner (left) side behind you. Keep left knee bent to help you move. Lift your right foot so your leg is straight and about 3" off the ground (may need someone to gently support it). Put your hands on the floor or therapy table behind you for gentle support. Slide slowly forward a few inches, letting the roller roll over the sore piriformus-- you will wind up leaning backward some; then slide back (push with your left foot) so the roller again goes over the sore point and to a spot just below your "sit bone" and you are upright. Repeat 5-6 times as you can tolerate. Twice a day is often enough.
Key seems to be having the roller at the angle to your leg so it hits some pressure points in and around the piriformus. Some of the stretches I learned involve not just back muscles, but loosening the hip flexors and the IT band down the side of my thigh. The time I discovered the roller technique, I was healed in less than a week. Now at the first twinge, I take the time to do the warm-up and rolling and have had no more full-blown incidents. I also remember to walk with my knees and toes forward instead of pointing out to the sides (the movement the piriformus does).
I totally feel for you suffering this! Try the rolling if you can, or get an exercise / Physical therapist to help you try.
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