General Discussion Triathlon Talk » Piriformis syndrome Rss Feed  
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2016-01-02 6:07 PM

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Subject: Piriformis syndrome
Holy carp does this hurt. I've had a cortisone injection and deep tissue therapy so far. So far, no luck. Monday I'm seeing a chiro/acupuncture guy to see if he can help me. I get these deep searing waves of pain from my hip socket and it rolls down to the front of my shin where it flares and then returns deep in my lower spine. If I sit for more than 20 minutes, I get floored with pain upon standing. The pain stays with me for a few steps and then it fades. Tylenol 3 barely scratches the surface and ibuprofen fares no better. Ice and heat help a little.

Any tips, therapy or ideas anyone can share with me on this? I gotta go, I spent too much time sitting and the pain is starting up again. Thanks in advance for any ideas.



2016-01-04 9:58 PM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
I suffered from this from almost 12 years (really, though not often as severe as you describe) as a result of a hamstring injury and possibly a muscle imbalance from an earlier injury to my SI joint on the same side. (Neither of which were actually training-related.) What really helped in my case was deep tissue massage/ ART to break up the scar tissue from the original injury, which was somehow causing the piriformis to go into spasm as well as irritating the sciatic nerve. Guessing based on your description of pain that sciatic nerve may also be involved. Piriformis in itself is just basically a pain in the butt, but all that stuff is pretty close together in the same area. I tried a lot of things, including chiropractic, but nothing really had a lasting effect except for the massage (which was excruciatingly painful, and I have pretty good pain tolerance) and also seeing a PT and doing a lot of stretching/strengthening of hamstrings, glutes, and core muscles. It still acts up sometimes if I don't stretch consistently after running, after a hard race, or prolonged sitting (mainly transcontinental flights in my case--I'm kind of hyperactive and my job keeps me on my feet so it's pretty rare I actually sit too long to aggravate things!) but has generally been a non-issue for the past few years.

I'd suggest you consult a PT who has experience in dealing with athletes, ideally someone who can do deep tissue/ART as well or who can recommend someone who can. Ibuprofen/heat/ice may help a bit with an acute injury, but this stuff easily becomes chronic unless you address the root causes, which may or may not be something that chiro or acupuncture could help.
2016-01-06 3:03 PM
in reply to: Hot Runner

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Subject: RE: Piriformis syndrome
New dx is that it isn't priformis. Xray shows some L4/5 deterioration and slippage. Did a bunch of adjustments and inversion today. I hope he's right because this pain really sucks. Need vicodin, but you practically need to have bone protruding from skin before they will prescribe it these days.
2016-01-11 3:07 PM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
I have been dealing with a bad SI joint and pyriformis spasms since a race in Nov. I thought I had a slipped disc when I went to the doc in early Dec, but everything looked OK in XRay, they didn't do an MRI. With PT it's getting better, but slow to heal, I have never been laid up for 2 months. I feel what base i had quickly slipping into the dark night.
2016-01-24 8:45 PM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
I hope what you have IS related to your back and not something else. Reason why I say this is I had the same type of pain as you. Nothing helped - rest, therapy, ART. Xray didn't show anything out of the ordinary. Finally got an MRI and found out I have a hip labral tear.

See if you can get in for some PT and have them evaluate you. Then maybe go for a second opinion…many things are missed in evaluations and until you have "proof", you 'll get all sorts of misdiagnosis.

I wish what I had was Piriformis syndrome. Now just dealing with therapy and HOPING that I can maybe run again!

Best of luck!
2016-01-25 8:50 AM
in reply to: runspingirl

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Subject: RE: Piriformis syndrome
Two days after my last post I reached down in the shower to was my left foot and I nearly went down. Emer clinic visit for a shot and he says sciatica…. left the other chiro and went to a guy my wife has seen for years. The pain was over the top incredible. I couldn't sit upright and lying down was bad. I had every nerve in my right leg lit up like a Christmas tree. I couldn't lie on one side with a pillow between my legs because the pressure of the weight sent spasms and increased the pain.

New chiro and his therapist were able to determine that my l-4 and 5 were locked! To unlock this, his therapist knuckled up both fists in my crotch at what you could call the bikini line. She pushed down and the chiro pulled my bent leg from a low angle. It took three visits to get things back where they belong. Now I just need to get rehabbed. Pain still there, but it can sit up and drive again. I have an hour deep tissue scheduled today and hopefully she can unlock the muscles that are holding things in the 'pizzed off' position.

I think it is possible that I might have a hip labral tear, but need wait a few more days and see if pain remains. Runspingirl, what are they doing to rehab the tear?


2016-01-31 9:41 PM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
Glad you are feeling better. My back locks up usually every couple weeks (and usually from strength training in the gym the day before), and same as you, takes the therapist a little bit to get it moving again, but my SI joint is completely out of whack so that causes things to be unstable in the first place.

Regarding rehab…
Lots and lots and lots (did I say lots?) of hip strengthening exercises. That and core work too. Bridges in every form, monster walks with a band, using machines, on a table, on the floor, back extensions, clams and lately a lot of agility drills to assess the movement in that area. So far I can do almost everything they ask me…except run. I haven't tried to run yet, still a bit paranoid and want to give PT a good chance to strengthen the area.

The hip labrum doesn't heal on it's own. If things get bad, I'll have to opt for surgery, but trying to avoid that - not keen on a 6-12 month recovery - eek!
I really hope yours isn't a tear! Keep us updated!!!
2016-02-01 9:33 AM
in reply to: runspingirl

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Subject: RE: Piriformis syndrome
Thanks for the input. I hope you get back to 'fighting form' soon as well. Cheers!
2016-02-16 7:11 AM
in reply to: #5158775


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Subject: RE: Piriformis syndrome
Wow - I feel for you!! Re your back, is it the facet joints or the discs? If the former, facet joint injections work a treat! They give you a decent pain free window in which to rehab effectively. Let's face it, a good PT will tell you rehab in pain is ineffective!!! If the injections don't work after 2 or 3 rounds or if the pain window given is very small, you could try nerve a ration. Sounds ghastly but they essentially put a needle in, send an electric current through it to heat it up and burn away the neves. The result is a longer pain free window.

I had inflammation to facets l4/l5 and l5/s1. Once diagnosed with labral tear and impingement I the hip I had a vicious cycle between back pain and hip pain. The combination of hip injections and nerve ablation has given me a (relatively) pain free window. Surgeon gave me his blessing to ski (his prescription is gentle cruising from restaurant to restaurant and sticking to gentle slopes). So it is hardly the ski trip I hoped for but I am just grateful that I can!! Surgery planned for summer then back on a mountain next February or Easter at the latest!!

Get yourself a hood orthopaedic surgeon who can get the X-rays and MRI to confirm the problem. Pt and chiropractors are great, but they are working blind and would be more effective if they knew the diagnosis.
My surgeon is working with my PT to develop a pre op strengthening programme and post op rehab programme too.

Good luck!
2016-02-19 6:14 PM
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Subject: RE: Piriformis syndrome
MRI results show disc bulging 12 mm at L3/4. Also some narrowing at L4/5. I guess I was in denial and postponed getting proper imaging done sooner. Now I'm waiting to hear from surgeon to see how extensive the surgery will be. The Doc I was referred to supposedly pioneered a laparoscopic micro discectomy procedure that is minimally invasive and reduces the pain and down time normally associated with back operations. Hopefully I'm a candidate for this procedure and not a more extensive one. *Sigh*

Edited by mdg2003 2016-02-19 6:15 PM
2016-02-24 9:19 AM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
I herniated L 4/5 and it ruptured inward in the spine, on Christmas eve 2013. I never cried so hard. I ended up getting two epidural cortisone shots three weeks apart from each other. the first one was all I really needed, the relief was instant but the Dr said I should do the second shot and pass on the third one. All is good now.


2016-04-03 6:21 PM
in reply to: midessa7

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Subject: RE: Piriformis syndrome
Getting chopped on Thursday and I can't wait to get this chunk of blown disc off of my nerve!
2016-04-04 9:24 AM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
Originally posted by mdg2003

Getting chopped on Thursday and I can't wait to get this chunk of blown disc off of my nerve!


Sorry to hear about all of the pain and troubles. I had a micro discectomy at L5/S1 back in May of '14, with many of the same symptoms you described. The initial surgery wasn't too bad, but it has taken a while to get back into real form.

Good luck!
2016-04-09 10:33 AM
in reply to: jcnipper

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Subject: RE: Piriformis syndrome
Day 2 post op. Yesterday I was feeling great until around 2 PM and the pain set in. I was able to get on top of it with hydrocodone, except it took so much of it I was a bit loopy. I had a big bowl of pho for dinner and was zonked out by 930! Today... this thing hurts even more than yesterday. An added bonus is all the muscles in my neck and jaw are aching too. Anesthesiologist warned me of this because they place you on your stomach and arch your chin forward during the operation. Kind of like riding aero and holding your head full up for 1.5 hours. I'm through whining now...
2016-04-09 3:44 PM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
Best wishes for a complete and speedy recovery

2016-04-11 2:57 PM
in reply to: triosaurus

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Subject: RE: Piriformis syndrome
Thanks for the positive vibes.


2016-06-20 4:38 AM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome

How are you know, this far down the road from surgery? Hopefully much improved!!  Would be good to have your views after such a major intervention.

(Read your journey and cringed at the  prescription of the cortisone injections - haven't heard of a long term positive outcome from anyone who's had them yet).

2016-06-28 8:42 PM
in reply to: Konabound

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Subject: RE: Piriformis syndrome
Things appear to be all good. Still a bit of nerve pain flaring up. Doc says I'm looking at around a 90% chance that I won't have any more trouble, just to be careful lifting heavy things for a year. I still haven't been on the bike, but am planning to ease into that this weekend. I loaded a light backpack and did a little 6 mile hike yesterday. We're hiking the high Sierras next month and I needed to be certain I can haul some weight. Thanks for asking!
2016-07-09 2:54 PM
in reply to: mdg2003

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Subject: RE: Piriformis syndrome
This is not too relevant anymore, but I had sent your initial question to our advisory board of sports med docs, and this was their input:
http://www.beginnertriathlete.com/cms/article-detail.asp?articleid=...
2016-07-15 9:52 AM
in reply to: alicefoeller

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Subject: RE: Piriformis syndrome
Alice, thanks for checking! Even after surgery, my only real complaint is a pain in my tailbone when I sit down after a long day. PT tells me it is tightness in my piriformis causing it. He has me working on seated figure 4 stretches, which seems to be helping. So it looks like Ive come full circle and back to working on my piriformis again! Hamstring on left leg is also significantly tighter than my right; that's an imbalance I'm working out too. I tried riding last week and found that I'm still not quite ready to jump back into my old routine yet. I plan to work getting things loosened up and start on the trainer in mid/late August; just light spinning to begin and eventually gear up and add some load as tolerated. Thanks again for the article.
2016-08-19 12:44 AM
in reply to: mdg2003


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Subject: RE: Piriformis syndrome
In the event that torment is brought on by sitting or certain exercises, attempt to maintain a strategic distance from positions that trigger torment. Rest, ice, and warmth may calm side effects. A specialist or physical advisor can recommend a system of activities and extends to lessen sciatic nerve pressure. Osteopathic manipulative treatment has been utilized to alleviate agony and expansion scope of movement. Some social insurance suppliers may suggest calming pharmaceuticals, muscle relaxants, or infusions with a corticosteroid or analgesic. Different treatments, for example, iontophoresis, which utilizes a mellow electric current, and infusion with botulinum poison (botox) have been attempted by a few specialists. Utilizing the crippled properties of the botulinum poison, botox infusions is thought by some to alleviate muscle snugness and sciatic nerve pressure to minimize torment.

Surgery might be suggested if all else fails.


2016-11-17 11:10 PM
in reply to: mdg2003


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Subject: RE: Piriformis syndrome
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