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  Periformis Sciatic Pain (deep butt & thigh)

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Author Topic:   Periformis Sciatic Pain (deep butt & thigh) | Page views:
hwakeunhan
Junior Member
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Posts: 18
From:
Registered: Jan 2003

posted 02-06-2003 02:32 PM     Click Here to See the Profile for hwakeunhan     Edit/Delete Message   Reply w/Quote
Has anyone ever suffered from periformis sciatic pain? I went to the chiropractor and we were able to confirm on this diagnosis which an orthopedist & osteopath failed to (they kept insisting it's my disc and prescribed anti-inflammatory & neurontin which did not help). My periformis muscle is too tight and it's toucing the nerve causing a nasty radiating pain through my butt and thigh all the way to my ankle.

My chiropractor gave acupuncture, ultra sound massage & performed some intense stretching. I'm still in great pain but feeling confident that I'll improve soon.

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ScarS
Senior Member
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Posts: 83
From:South Texas
Registered: May 2001

posted 02-10-2003 11:16 AM     Click Here to See the Profile for ScarS     Edit/Delete Message   Reply w/Quote
Hi. I noticed you haven't gotten any replies so I thought I'd suggest going to the SEARCH option here with the word PIRIFORMIS. I found 24 previous messages and maybe you can get some info about it. I have had Piriformis Syndrome in the past and it's a butt muscle that can irritate the sciatic nerve. Massage, heat, mild stretches can help some and if it's really serious, doctors can cut the muscle, but that's a last resort. Good luck.

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Had posterior lumbar interbody fusion at L4/L5/S1 on Jan. 30,'01 with 6 pedicle screws, 2 Steffe plates, 4 Brantigan carbon fiber cages and my own hip graft for spondylolisthesis. Wear leg braces (afo's on both legs)for drop foot from nerve damage.

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hwakeunhan
Junior Member
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Posts: 18
From:
Registered: Jan 2003

posted 02-10-2003 11:34 AM     Click Here to See the Profile for hwakeunhan     Edit/Delete Message   Reply w/Quote
Thanks for your post. My pain is getting worse by the moment. I've had nasty back and sciatic pain before but this is the certainly the worst.

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BAXTER
Senior Veteran
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Posts: 812
From:New York, USA
Registered: Dec 2000

posted 02-10-2003 02:02 PM     Click Here to See the Profile for BAXTER     Edit/Delete Message   Reply w/Quote
Hi Hwakeunhan,

I don't have any advice, I just wanted to say hello, and that I hope that you feel better really soon

Be Well,
Baxter

------------------
Two level laminectomy fusion L5-S1 & L2-3 done on 12/6/02.
Fifteen inch scar from the very top of butt crack (sorry), to the bra line.
BAK cages, rods & screws.(Titanium)
My pelvic bone was used for grafting.
Praying that the other two discs in between, won't have to be fused later, as I was told it was a possibility, due to the other two discs in between, not being in that great of shape.
Doc didn't want to fuse four levels, unless it is really necessary.
I would hate to repeat the surgery, as the recovery period, is so very painful.
I also have a free fragment in my T11-12 area, that I'm still refusing surgery for, at this point in time.
That surgery is way too dangerous for me to consider, until if affects my being able to walk.

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successtory
Veteran
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Posts: 290
From:Concord, CA, USA
Registered: Dec 2002

posted 02-10-2003 05:00 PM     Click Here to See the Profile for successtory     Edit/Delete Message   Reply w/Quote
Hi Hwakeunhan,

The doctors at Kaiser said I had piriformis syndrome before my current doctor put me through tests and an MRI (which only showed a slight bulge). My chiro (primary physician) told me that if the piriformis muscle gets inflamed or damaged, it lays directly above the sciatic nerve which runs up and down while the piriformis runs length-ways across the top of the butt (so if you were to picture it...it would look like a 'T'...where the top part of the 'T' is the piriformis muscle and the trunk of the 'T' is the sciatic nerve.

Your doctor is doing the right things for this syndrome (if that IS what you have). I'm sure he gave you the 'twist' test. That's where you turn your hips to the right and then to the left (instead of top of trunk twisting...your hips are twisting). If there is pain caused by this action...it is 'definitely' the piriformis, if not....you need to search further. Have you had an MRI? It is the first test doctors will "normally" give you when they need to see what is going on.

Another thought.....water therapy. Ask you doctor if that is for you. Just make sure you have a good water therapist before you jump into the water (so don't just get a YMCA membership....go through a therapist). You also need to make sure your ab muscles are good so you can get in and out of the pool....but your therapist will know to make sure you are OK in that arena.

I hope this helps. I just hope you are staying off your rump. No driving. No sitting (for longer than you can stand). No bending. No vacuuming (one of the WORST for piriformis/sciatic pain)....same with laundry. If you are on rest (per your doctor)...please REST. Do NOT take that time to do all those errands you just haven't had time for. This time off should be just that....your muscle and sciatic nerve need relief. So slow down....and rest. It takes double the time for back injuries to heal (at least) because (1) there is no blood supply going to our disks and (2) we are working with our central nervous system....we all must be careful there.

Well, I'm not sure if I answered anything here or not for you (hehe)-sorry. But I sure hope you get some pain-free moments!

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successtory
Oct 2000: Repetitive Stress Injury-Inverted Hernia
Feb 2001: MRI. Shows only slight bulge at L4-L5
Dec 2001: Discogram/CT scan shows Inverted Hernia at L5-S1. L4-L5 & L5-S1 ruptured in all 4 quadrants. Unable to walk.
Feb 2002: IDET, Nucleoplasty, Intra-Discal Injections
Sept 2002: Rated in the top 10% for successful patients. Retraining for new career.

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hwakeunhan
Junior Member
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Posts: 18
From:
Registered: Jan 2003

posted 02-11-2003 10:33 AM     Click Here to See the Profile for hwakeunhan     Edit/Delete Message   Reply w/Quote
Hello to you too Bax!

Thanks, Successtory for your post. I've only had MRI for my lower back not around piriformis. My doc says he's order me a MRI should I not feel better within this month. Right now I feel like tying my left leg tight with a rope and get dragged by a truck to relieve the pain. No vacuuming you say? I gotta show your post to my wife!

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dutch400
Member
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Posts: 35
From:Plant City
Registered: Dec 2002

posted 02-11-2003 10:46 AM     Click Here to See the Profile for dutch400     Edit/Delete Message   Reply w/Quote
Hi there
I would stop and take it easy for a while. Use ice if you feel a hot spote on your lower back. Get the MRI to rule out a disc rupture before doing the things that make it worse. I seen a chiroprator when I was young and was told about the same thing. Landed in the hospital soon afterward to remove a ruptured disc.
Nico

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painisgone
Newbie
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Posts: 2
From:Kapaa ,Hawaii ,USA
Registered: Feb 2003

posted 02-12-2003 03:16 AM     Click Here to See the Profile for painisgone     Edit/Delete Message   Reply w/Quote
you must go see a physical therapist trained in the mckenzie techniques.I had the same pains you decribed and this cured me.I'm not kidding -check it out -
It is just a few simple spine extentsion exercises and the pain is gone.

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hwakeunhan
Junior Member
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Posts: 18
From:
Registered: Jan 2003

posted 02-12-2003 11:28 AM     Click Here to See the Profile for hwakeunhan     Edit/Delete Message   Reply w/Quote
What exactly are McKenzie Techniques? I can't seem to find any detailed information on the net.

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Merrida
Senior Veteran
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Posts: 1126
From:Nashua, NH
Registered: Dec 2002

posted 02-12-2003 06:01 PM     Click Here to See the Profile for Merrida     Edit/Delete Message   Reply w/Quote
As long as you do not have ANY ANTERIOR disk involvement, MacKenzie might be very useful. But please do not assume the method is great for "all" back conditions. Hyper extensions are totally contraindicated for anterior disk herniations or spondylolisthesis.

Again, we don't know what's up because thus far, the diagnostics are pointing to muscular involvement,...

Generally (barring the above), I have heard great things about MacKenzie.

It's a type of manipulation/movement/therapy that involves movements similar to,...think of doing a back bend (except you're supported and they sometimes use a "chair" type table for support). It's similar to,...how you'd stretch your hip flexors out by leaning back, hands on your hips, as if to open up the area in front of your hips and stretch back, extending backwards.

(I'm trying to just explain position, not tell you about what the experience will be like for you -- but the philosophy, I believe, is similar to stuffing the herniated part of a disk back into position by traction of the opposing vertebrae,...again this is all trying to explain, in a way, what's accomplished).

I *think* this is how/what is done, but I certainly defer to those who know more.

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Telzey
Veteran
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Posts: 392
From:San Francisco Bay Area, CA, USA
Registered: Oct 2002

posted 02-12-2003 07:03 PM     Click Here to See the Profile for Telzey     Edit/Delete Message   Reply w/Quote
Hi hwakeunhan
There are some excellent stretches for the piriformis muscle which a physical therapist should be able to show you. It's not a bad idea to stretch that muscle regardless of the type of problem in your back.

However... the problem may not be solely a tight piriformis. I would like to caution you here because I had low back pain for 4 years, and my chiropractor kept insisting it was scar tissue in my quadratus lumborum, and that if I only went through a few more treatments it was bound to get better

Well, I finally went to a spine specialist who ordered an MRI and immediately diagnosed it as an annular tear in my L5/S1 disk.

Of course, knowing what it was and being able to fix it were two different things. Disk trouble is VERY slow to heal because there is no circulation to the disks. I tried a lot of different techniques with not much success.

One thing that did help me is the McKenzie exercises, mentioned earlier in this thread. I actually credit the McKenzie exercises with keeping me from developing leg pain and sciatica as a result of my torn disk. I didn't go to a physical therapist to learn them... I just learned them out of a book, "7 Steps to a Pain-Free Life" by Robin McKenzie.

Merrida is correct in her description. Essentially they are a series of back bends (extension or arching of the lumbar spine) performed in a number of different positions. If you have a posterior tear (like I do) or bulge they can work wonders. I can almost feel the disk sliding back into position as I do the series of back bends.

But, since you don't know if you have a posterior tear or herniation of your disk, you can't know if the McKenzie exercises will work for you.

I will try to look up the piriformis stretch I used to do, that felt really good... and I'll post it if I find it.

Good luck with your diagnosis, and eventual healing!
Telzey

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4 years of back pain
Annular tear L5-S1 diagnosed 3/02 via MRI
IDET 12/2/02
Still worse pain than pre-op, am told to wait 3-6 months for improvement

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Walt_2
Member
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Posts: 23
From:
Registered: Feb 2003

posted 02-16-2003 04:32 PM     Click Here to See the Profile for Walt_2     Edit/Delete Message   Reply w/Quote
They tried Lidocaine injections on me til they got tired of them now after a discogram they say its my disk and that shooting lidocaine is too close to the big nerve. I'm having a round of epidurals Tuesday so I can go back to work for the last time in my life. I was there 36 years and I'mm 55.

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bounce
Member
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Posts: 68
From:new zealand
Registered: Dec 2001

posted 02-16-2003 05:38 PM     Click Here to See the Profile for bounce     Edit/Delete Message   Reply w/Quote
Hi Everybody,

just read through these posts and im excited as since having thorasic surgey last year i have increased pain in my neck/shoulders
and in my hips butt and legs i have looked a couple of web sites on periformis syndrome and seem to have what they describe but one question id like a answer two if anyone has it can it affect the knee joint as i have bee experencing alot of knee problems mostley on my right knee walking is sore and if i kneel well ouch im printing stuff off to take to my ostepath and see what he thinks
thanks to hwak for starting this post i might get to the bottom (no pun intended) of my problems
cheers
takecare one and all Bounce

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Angelene
Senior Member
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Posts: 207
From:Edison, NJ
Registered: Nov 2001

posted 02-24-2003 06:36 PM     Click Here to See the Profile for Angelene     Edit/Delete Message   Reply w/Quote
I have severe sciatica pain, related to piriformis syndrome. But I truly doubt my doctor's medical expertise. I went to him to describe this pain I've been having for over a year (the pain in the butt that travels down my right leg, and is worse when I sit for long periods of time...etc) and when I described it to him, he simply said, "Oh, that's very common, many people have that, it's sciatica," and I was like, "I was reading about that, I thought it was more like piriformis syndrome,". He replied, "Well, it radiates down your leg, how could it be the muscle if it's radiating down through your lower thigh?" and in my head I'm thinking, he's the doctor, he knows what he's talking about. But then I came home and searched online, and found that the primary cause of sciatica IS piriformis syndrome! My doctor is officially a quack!
So anyway, he gave me a referral to a chiropractor, so I'm going to go soon and see what happens. What's funny is my doctor didn't do any tests, he didn't do the twist test, he didn't even ask exactly where it hurt. He just told me to take ibuprofin! So...what do you all think about this guy?

I find that what helps the pain is resting on an ice pack. I try not to remain sedentary--I exercise often and stretch my muscles often. One great stretch is this :

Lie on your back. Don't put your legs straight out, but bend them, like you're going to do sit ups. Lift up the leg on the side that is hurting (for me it's the right side) an cross it over the good leg. Grab the good leg with your hands and pull it towards your chest, bringing the bad leg up with it. It will burn in your butt cheek, and you'll feel the tense muscle stretching. Hold it for 5 seconds. Then for 10 seconds, eventually holding it for 30 seconds. You should try to do it 3 times a day to keep the muscle from tensing up.

You can search for this stretch online if you put into the engine "piriformis syndrome"...many hits come up.

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"Never give up, never surrender!"

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alimar123
Junior Member
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Posts: 16
From:White Bear Lake, MN, USA
Registered: Jan 2003

posted 02-24-2003 10:54 PM     Click Here to See the Profile for alimar123     Edit/Delete Message   Reply w/Quote
Oh my gosh! I am so excited to read all of these posts, because I feel like I might finally have an answer to what's causing my pain. Or hoping at least.

I had a fusion surgery last June, and a couple months after that, i started having butt, leg and ankle pain (outside of the ankle, and back of leg). None of the doctors that i've seen can figure out what's causing it, as my MRIs and CTs are normal. Also, i've had three epidural injections since my surgery, none of which have helped. I've got a couple more appointments coming up, one to another pain clinic, and one to a neurosurgeon, but i'm not holding my breath. My pain seems to stump my doctors because it doesn't respond to treatments and medications that should be working, i.e. neurontin, nonsteroidals, antiinflammatories, etc.

So now, my question is who do i go to to find out if this could be the problem causing my pain. Do I go to my orthopedic surgeon, my family doc, the neurosurgeon or chiropractor?????? My back surgeon is offering to go in and take out the hardware just to see if that is what's causing my pain, but he made it very clear that he has no idea if that would help. If this is indeed the piriformis muscle, and it can be handled conservatively, that would be so great!

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