Hi... I have run the gamut of every injection, epidurals, epidurals again, nerve blocks and more...the only time I felt relief was the day of when I was numb, I a not familiar with this piriformis muscle.. have you had the MRI does it show your spinal condition.. With me It all started during and after 18 months of intensive chemotherapy that every 8 hour day went straight to my bones,, heating pads all over were my only relief. Mind you , I had scoliosis all these years that was ignored as I had perfect posture, but then the scoliosis started moving and rotating my spine...Then I developed everything with an S.,, Stenosis, Spondylosis, spondy whatever, , I just had an abd. ultrasound and she couldn't find my spleen..all of myy organs have shifted to the right and none are where they are supposed to be,,, WTH!! and no one seems to think this is an issue,. Last year I started getting sciatica attacks that were so horrific, bulging of my spine, My spine is visible through any top that lays on it,,crooked and boney,, Several orthos wanted to do the whole package with poles to straighten my spine, basketsm nuts bolts,, 12 hour surgeries,, money for them and lots of it, hell for me,,, I run my own businesses I can not take off or close the doors,,, I saw the only Neuro surgeon here,,, i have had 8 surgery in the past less than 9 years due to cancer,, I am tired but the pain became too much, I could no longer walk on a street or stand at my shop with out extreme pain and no quality of life...nor does my dog as I cant walk her but I do 2 hours a night on my treadmill... Last October I had this Dr do what ever was the least invasive to get me out of pain,,. it was a l345 laminectomy plus baseball size arthritis on and around my spine,., aside from the surgical pain which I had one intense day at the hospital I was out grocery shopping by day 6..not lifting or driving.., I had pt at home which I did great it wasnt easy but I wanted it... I also got back on my treadmill that same weekend just slow walking,.... Sometimes being alone with no one around to help There are things I have to do .. sweeping is a trigger,,, avoid it!! vacuum instead,,, I started getting deliveries and I would tip , still do , to have them put the heavy stuff on shelves so I dont have to ,,I do a lot of ebay business and if an item a=has to be packed I do it,,, sometimes 30-40 lbs and I know I am hurting myself,, I bought a rowing machine, per Drs permission,, I think that did a number on me as about 5 months ago that sciatica attack on my right thigh and cheek was back 10 fold and so was the extreme,,, pain,.. New MRI,,,,Now all disks L1 to S! are all herniated m bulging , more arthritis,, Iwas going to jump right into surgery 2 weeks ago after my DR said we will have to keep going up????? I gave it great thought,, I cant close before xmas .. So I sched, an appt with him this time and I think its best I listen and ask questions,,,, In the meantime my Pain has been somewhat manageable... I stopped wearing any real heels as much as I kove them and upped my sketchers wardrobe.... I get very intense medical massages... 90 min of holding my breath as she digs into those knots.and she will break them up... No real heavy sciatica.. I need to start stretching before the treadmill.. The test will be can I walk in a grocery store without extreme pain after 2min,,,,,If I can avoid surgery for awhile i will. The reality is with scoliosis as it keeps moving what do I do when it starts to press into my only lung as well as my stomach and intestines ,which are already a mess from the kung cancer mets to the colon,,,, No DR talks about this..., I research everything.. And my neuro Dr, is a =n amazing DR and man ... he has been very helpful to me and my family,,, I have a list for him,.. I encourage everyone to do as much research as you can about your condition and make a list of questions for your DR... For me and others I know ,, bad backs do not respond to basic injections,, Best wishes all!!