I have had a type sciatica for the last 6 years. It seems to originate from my buttock and so, 18 months ago I was diagnosed from my symptoms only and a consultation with an Ortho specialist as having piriformis syndrome. I had some physio treatment which really helped but the problem didn't really go away, I just got to the point where I could live with it.
Last April, it flared up again, big time. I went back to physio and relief was very temporary (minutes) and also had acupuncture etc. I was considering seeing another consultant (reasons as to why I did not go back to see the original one) and the symptoms eased, again not really going away) Two weeks ago I saw another consultant who sent me for an mri on my lower back as he said that the most common place for the nerve to be irritated is there. He said that the reason I have no back pain is because the pain is referred to my buttock and then down my leg. I was amazed to find that he had not asked for a scan of my piriformis as this was in the equation. The scan showed that one of my vertebra was mis-aligned and could be the reason I am having problems. He now wants to do an injection into the spine and I am aware that I asked his opinion but I still think the problem is with the piriformis muscle and think what he wants to do is by injecting is to rule it in or out. However, I am not sure that is necessarily going to prove anything unless my symptoms improve as I am aware that these injections do not always work first time.
Moreover, if you look at my buttocks and compare one to the other, the affected one, around the site of the pain has a large dimple, as if there is no padding under the flesh. The other one is very rounded. Does anyone think this suggests that there is a problem with the muscle underneath that area?? To be honest, I haven't brought this to his attention but thought he should have noticed himself. I think this is quite a serious measure to just rule something in our out.
No, I do not have any other problems apart from the fact that my back is achy. I have always had this problem and other problems with muscles being tight in my back due to sitting and have had chiro sessions for some years before I had the sciatica
Yes I have the cd with the scan on. I have viewed them with the specialist.
I am really having problems with walking over a long period. More problems with hills, stairs and shoes with a heel.
Reading your post has my interest. You mention piriformis muscle and I have a lot to say about that.
To start, read my bio and some of my journals. That will explain some of my medical history. There is a lot there. I have DJD/DDD for years. I have had all the injections, nerve blocks, surgeries, metal implants and removal, pain pills, patches and every treatment till the present.
I have had continuous problems with my hip pain. Finally a doctor mentioned the piriformis muscle WHICH IS DEBATED IN THE MEDICAL COMMUNITY. I was told, it they can't see it or touch it, there is no treatment for it. I finally had a doctor check into this with my medical history and my pain management doctor suggested a Botox injection which seemed to work on the piriformis muscle. I am walking for the first time in years and relatively pain free for the moment. I had the injections done in late November and so far so good. Read up on this and see if you can get a doctor to treat the muscle with Botox. It seemed to work for me so keep me updated on what you have learned. The medical community has a problem recognizing this muscle issue.
I have raised HELL about this piriformis muscle issue on Pain management couch. Trying to get doctors to treat this issue has been rough but I got someone to treat it even though I had to fight with her to treat it. Let me know the results of your research. Good luck.
So far, so good, I had the injection in late November and I am walking using muscles that were 'asleep' for many a year. They hurt but they are working now. Pain level down to a tolerable level, off the pain medication and walking almost every day. When I take a day off, my muscles want to tighten up so I try and keep they active almost every day. Thanks for passing this on.
This is the information I received about the Botox injection..(from a doctor ? on a web site). Hope it helps.
The Botox injection works by preventing the motor nerve and the muscle communicating so the nerve does not send any pain signals to the brain.
Botox should only be use as secondary treatment, where the condition does not respond well to conventional treatment. This is not because it is unsafe, but a lesser known fact about the use of Botox to treat piriformis syndrome, is that the muscle will never fully regain all its strength. Usually patients will find that it is around 90% as strong as it was prior to the treatment, after a year or so, but it will never be fully restored.
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