Physical Therapy Expert Forum
Periformis muscle?
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Periformis muscle?

Have you ever heard of something called the piriformis muscle? I have had continued problems with this muscle over the years. I have degenerative joint/disk disease and had all the treatments and physical therapy. At one time, I did Pilates which helped before my condition got worse. Recently I had a nerve block (RFO radio frequency obliteration) and it did not take. I have had this procedure in the past and it did work but not recently. I am in too much pain to do physical therapy exercises at present. What can I do about this muscle?
There is much debate in the medical community about the piriformis muscle, why is that?
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For true piriformis muscle syndrome the recommended protocol would be stretching and soft tissue massage/release performed manually.  If it is not a true piriformis syndrome these alone will note help rid you of pain so further diagnostics would have to be performed as to the cause of your pain.  Without a proper evaluation I cannot recommend any further intervention however if you would like the name of a specialist in your region I would be happy to refer one for you.

Best in Health,

JAG
2 Comments
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Let me see what I can explain here. I have a history of degenerative joint/disk disease since 2001. Had about 5 operations on my back and neck. Had metal implanted and had it removed 5 years later due to an impingement of the nerve. The rest of the surgeries on my back were to scrape the bone spurs and related bone degeneration. Had epidurals to my spine, and then developed problems with my hip after 12 attempts at physical therapy. For the most part I was walking but with difficulty due to pain in my hip. Check with the doctor for sciatica and he gave me trigger point injections. At that time he mentioned piriformis muscle problems and I have had at least two nerve blocks in the hip area. One nerve block back in 2010 was mostly successful because I able to do more walking and was doing pretty good for the most part. In the middle of 2011, my hip started bothering me again but I had been through two pain management doctors already because the doctors had moved on to private practice and I cannot find them anymore. The last nerve block in Oct of 2012, did not take. My new PM doctor said she followed the same procedure as the previous doctor for my pain relief. She told me I had my limit of steroid injections for the year and she could not give me anymore until December. She prescribed morphine for a month until I could get a shot. After a conference with her to get her focused on my condition, she has agreed to trigger point injections on my next visit but I am being scheduled for a spinal cord stimulator.
I am really not sure this new doctor is focused on my condition that I have explained to her. Would like a second opinion. I live in Long Beach California and have Medi/Medi insurance. Can you advise? Would appreciate a second opinion. Thanks.
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