Hi, mss515. I can totally relate to your pain in the piriformis muscles. I was struck (as a pedestrian) by a speeding car. It hit me, threw me into a spin in the air where I was struck a second time. The first hit was directly in my SI joint, leaving an extensive, prominent hematoma from the SI to the top of the back of my thigh (covered the entire buttock). There was a hairline fx in that same side of my pelvis. I have had repeated physical therapy courses whereby they give me stretching, strengthening exercises and attempt to 'release' the piriformis muscles (being so taut). I don't believe they have ever been 100% successful. I have also had the US and hot packs/massage to help. My leg is different in length and it was explained to me that when I was hit (and I took a full body whiplash), that I sustained a sacral torsion, which, in effect constantly twists my pelvis out of alignment, externally rotating it from th force of that impact. It was explained to me that I would require manipulation to manually re-align my pelvis from time to time. I live with the SI and buttock pain every minute of every day since being struck nearly 6 years ago. When the pain in the SI gets so bothersome that I need the SI injected, (which is a few times/year), it is always a sign that I've learned that my pelvis needs re-aligned. But since these maneuvers have always been just temporary, considering the time and cost and more pain being exacerbated by the therapy sessions three times/week, I really drag my heels to opt for more therapy. I do use a TENS with very large bow shaped pads that are perfect size to cover the SI joint but it still only reduces the pain somewhat. I settle for somewhat over 'not at all'. Another way that the therapists/doctors determine my pelvis is our of alignment is not only by measuring, but by having me stand and bend forward as far as I can, where they can also observe/examine if one side of the back (over the SI/buttock area) is raised higher than the other side, being asymetrical. I am glad that you are able to achieve complete dissipation of your pain with pelvic realignment. I am certain that the sacral torsion is the culprit for keeping my pelvis disaligned. I recall that the orthodontist once explained to me that teeth (bone) have memory, so that unless I wear a retainer at night, the teeth could gradually return to their 'pre-braces' state. The sacral torsion twisted the lower spine so that it constantly pulls the pelivs out. My pain (compounded with fibromyalgia( has been debilitating to me. In addition to physical therapy and pelvic floor physical therapy, I have also tried 2 different PM doctors, a rheumatologist (also osteoarthritis), a neurologist and orthopedic surgeon to try to find effective pain management, but I also have multiple drug allergies. I hate the sensation of being 'detached' or feeling groggy o foggy or drowsy or have my sleep cycle interrupted even more (two sleep studies show that I do not achieve the deep phase of sleep and medications can add to that problem). About the only 'measures' left for my relief are the ointments, the heating pad or ice (I usually favor heat), heat wraps for the back, the TENS. My physicians have been very comfortable in prescribing narcotics for me I suppose as I so very seldom call for refill, they know I cannot be taking them very frequently nor with regularity. The biggest aggrevators for me (aside from poor sleep) is sitting for any length of time, riding any distance in a car, and especially sitting on the hard wooden pews at church (which is a real downer to me as I want to be participating fully in the celebration and prayer at church but am so distracted). It is usually after I have attended church that I need to take a pain pill. Once the pain gets to that level, I am out of commision for at least a few days. Thanks for sharing your experience. That just goes to show how differently we all respond. I am glad I happened to find this forum. Wishing you longstanding relief.
Very important subject that many are unaware of.
Question. Was your leg length corrected when the pelvic twists was manually realigned by the chiro (a fuctional LL discrepancy).
Or ........, was the LL anatomical (a short leg bone and corrected by heal lift in shoe?)
People can also have both as I do. Problem is if you are older when an anatomical length is discovered, the body might not like a shoe lift. All one can do is try it.
Docs are clueless about this, what a shame.