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Molly
5-31-11, 10:48am
Has anyone had piriformis syndrome? If so, how did you fix it? How long did it take?

Piriformis syndrome is a type of sciatica. The piriformis muscle spasms around the sciatic nerve, choking it and causing pain in the butt and down the back of the leg.

I have had it for two months and it isn't budging. I am in physical therapy and am told that everyone's recovery is different. It is literally a pain in the butt. It hurts to sit and walk. It is impossible to run.

Anyone else who has had this?

Rosemary
5-31-11, 11:00am
I had that last summer. It took about 6 months of every-other week physical therapy plus exercises at home for it to go away. I found some stretches online that helped me a lot. After a number of months I also went to a chiropractor once - it seemed to help, but I personally don't like to do that type of sharp movement that often.

Tradd
5-31-11, 11:16am
Try massage. It's helped me a TON!

I have piriformis syndrome. It's also known as "false" sciatica, since it's the muscle, not the nerve. My mom had real sciatica - nerve involvment.

Lots of stretches. I found when it really hurts, ibroprofen doesn't touch it. Soaking in a very hot bath for an hour with a book, adding more hot water as necessary is really the only thing that seems to work.

Mine wasn't from exercise. I was stuck in rush hour traffic for 1.5-2 hours EVERY night coming home from work, the winter of 2007-2008. Only 25 miles commute. I would be stuck in gridlocked traffic crying from the pain and unable to move in traffic. If I got off the highway, it would take me even longer to get home. The movement back and forth between the gas and brake pedals was what did it to me. Burning, searing pain up the inside of my thigh and on the back. I'd get home, limp upstairs, get something quick for dinner, and eat and read while sitting in the tub, in a very hot bath. It seems like I spent that entire winter in the bathtub.

I started massage and it got better. That was the catalyst for me to move out to be suburbs to be closer to work. Commute is much, much better.

poetry_writer
5-31-11, 11:26am
Yes. I have it. The most important thing , at least for me, has been finding a chair that fits my butt. I am currently sitting on one that does NOT and I've had a flare up. It can take some experimenting. I have more pain on the left side and I cant sit on anything that puts pressure on that particular painful spot in my hiney. I also had some success one time with sitting on thin ice packs. Xanax helps. It sucks for sure. Hoping you feel better soon.

herbgeek
5-31-11, 2:26pm
I don't know if I have the syndrome, but I have pulled my piriformis muscle doing some vinyasa yoga. Too many fast transitions. It took way too long to feel better again like > 6 months.

CathyA
5-31-11, 2:35pm
I supposedly had it (according to my ortho doc). I had PT on it, but it didn't seem to help. It finally just went away. I wonder if acupuncture might help?

Gardenarian
5-31-11, 2:51pm
I also had it for a while, along with other lower back pain. A combination of yoga and massage works very well to keep my back in order. I also try to sit in chairs as little as possible. I have a stand-up desk at work and at home I generally sit on the floor. I use a lumbar support pillow in the car.

SiouzQ.
5-31-11, 3:55pm
I have had it, as well as other various pelvic, hip and lower back pain in my adulthood. I have been in physical therapy many, many times in the past, which did help some. It did finally go away for the most part...

But now I have a getting-severe-at-times very, very sore tensor fasciae latae muscle, which is the fancy name for the muscle on the outside of your hip. I think it seems to be due to all the increased walking and physical activity I started around the first of the year. Laying off activity doesn't seem to be helping it unfortunately. I have a lot of imbalances in my musculature that the chiropractor used to take care of when I had insurance; now I don't and it is $50 a visit. I am trying to take care of it myself by icing, doing stretches and all that so I don't have to spend money on it. We'll see...

Nella
5-31-11, 4:02pm
The piriformis muscle originates on the anterior (front) side of the sacrum (tail bone), crosses the sciatic nerve under the gluteal muscles, and inserts (ends) at the greater trochanter which is the "hip bone" or femur ("thigh bone") where it inserts at your pelvis. [It's not the "hip" by your waist where Mom used to place her hands when she was angry.] When the piriformis is contracted it rotates the leg laterally (out to the side) causing your toes to point out rather than straight ahead. Besides finding a good massage therapist who knows how to correctly work the piriformis (highly recommended), you can: 1) make sure that when you walk you are walking with your toes/feet pointed straight ahead not out to the side; and 2) when you drive make sure the heel of your foot is directly under your toes when pushing on the gas pedal (which at the beginning will feel very weird if you've been driving with your toes pointing to the right instead of absolutely straight up and down); and 3) every once in a while rotate your whole leg inward, as if you were going to walk pigeon toed, for a nice slow stretch of the piriformis. A little self-massage tip: Once you really know where your piriformis is located, you can get a tennis ball and roll it under your bum on the floor back and forth across the muscle. Most people have some tenderness in the piriformis muscle, and if you've strained it, or if it's in spasm, it can be quite painful.

FYI: I'm a medical massage therapist in practice now for 10 years. Annecdotally, it seems like it's the right piriformis that's always tight and painful, especially with folks who drive a lot. IMHO the problem often stems from the way these folks hold their foot on the accelerator.

pony mom
5-31-11, 7:43pm
Another massage therapist here. Find an MT that uses a technique known as 'pin and stretch'. Since the piriformis muscle is contracted and fat, it is squeezing the nerve in the small notch they pass through. Pinning the muscle, thus shortening it, while stretching it will help lengthen it. The way I learned it is having the client lay prone, stand on the side you're working on between the thigh and glutes. Place leg towards edge of table and bend leg at the knee and hold the ankle. Push the ankle away from you, towards the other leg (while lower leg is vertical), with other hand press and hold a spot on the piriformis muscle (I can explain where it is but just poke around---it'll be tender). While pressing that spot, pull the ankle towards you, release the spot, then repeat. It's much easier to do than it sounds. It'll be such a 'good' pain. Doing this will stretch the muscle, releasing the contraction and ease up on the nerve.

kenh
5-31-11, 10:06pm
It's great to have some massage professionals commenting! We should get their comments on other problems, too, before they get overloaded!

mm1970
6-2-11, 8:55pm
Uh, yes. But you're not gonna like the answer.

I did PT. It helped. But only as long as I went to PT. I stopped running (which probably caused it). Right before my 2nd half marathon is when it flared up (about last April).

But it's been a year, and I still have it. It's not constant, daily pain (like it was last summer), but it still flares up once a week or so. Like today. Sitting on a tennis ball helps. I've been walking, doing yoga, lifting, swimming, and biking. I think maybe yoga and the foam roller help. Today I had a flare up, and it's the second day in a row that I skipped my 15 mins of yoga in the morning.

I have also purchased orthotics for my running/walking shoes. I have toyed with running barefoot. I noticed in particular that ANY running (like 1/2 block to chase my kid) will cause a flare up. But in Hawaii on vacay, I chased him a lot in flip flops, and no flare ups. I also have a knee issue though, so I've only tried to run here and there for a few minutes.

My pain is in my left leg. Apparently, I pronate AND I run with my toes pointing inward and my legs also go inward, particularly the left leg (crosses way over the center). My doc and PT said that my running style causes my piriformis to be too stretched taut, making it constantly try to contract.

Good luck. It really really sucks.

CathyA
6-3-11, 4:48am
And I would make sure its not your feet. Feet that aren't properly supported can really affect your entire leg/hip/back.
My sciatica/piriformis syndrome really flared up when I was using an exercise bike. I think some of us just have our nerves in more vulnerable places.
I think alot of people have problems with foot pronation. I've had many custom orthotics in my life. Most of them helped alot. But this last time, I spent $450 on them, and they didn't help. What ended up helping the most were Walkfit orthotics I bought at Target for $20.00.

How are your knees doing?

citrine
6-8-11, 10:43am
Another MT here....the entire gluteal region, thighs, and feet need to be worked out to ensure that all the muscles are nice and loose. There are a lot of great stretches you can get on the internet for free. Another thing that would help is to place a tennis ball under your glutes and roll around gently over it. If you cannot lie on the floor to do it, you can also do it against a wall. A few sessions with a good MT will definitely help you out :)

ke3
6-16-11, 10:37am
Another massage therapist here. Find an MT that uses a technique known as 'pin and stretch'. Since the piriformis muscle is contracted and fat, it is squeezing the nerve in the small notch they pass through. Pinning the muscle, thus shortening it, while stretching it will help lengthen it. The way I learned it is having the client lay prone, stand on the side you're working on between the thigh and glutes. Place leg towards edge of table and bend leg at the knee and hold the ankle. Push the ankle away from you, towards the other leg (while lower leg is vertical), with other hand press and hold a spot on the piriformis muscle (I can explain where it is but just poke around---it'll be tender). While pressing that spot, pull the ankle towards you, release the spot, then repeat. It's much easier to do than it sounds. It'll be such a 'good' pain. Doing this will stretch the muscle, releasing the contraction and ease up on the nerve.

Pony mom, can you rewrite your answer from the point of view of the patient? Can I do this by myself? I've tried to figure this out, and I can't get past "while lower leg is vertical". I've been living with piriformis syndrome for two years now, and whatever you're describing sounds good, but I just can't get it. Thanks!

pony mom
6-18-11, 5:28pm
I don't know if it can be done on your own. You're basically lying on your stomach, with leg on affected side placed out to the side a bit (away from other leg) with leg bent, so your lower leg and foot is vertical and pointing to the ceiling. You need another person to press on your piriformis muscle in your glute while your bent leg is moving. It's not anatomically impossible to reach your glute but pressing down firmly enough with your arm at that angle is difficult.

The movement done by the person performing this was described as 'pulling a pint', since the technique was developed by a British man. Holding your ankle, they hold your bent leg, then press on the muscle, then pull the ankle/lower leg towards them (like pulling a giant lever). Release the muscle, push the leg back to vertical (or slightly more towards other leg), push muscle, pull leg towards them. The knee stays on the table while the lower leg moves back and forth. The lower leg should stay bent at 90 degress during the movement so you don't strain the knee.

Hope this makes it a bit clearer. When it's done correctly it'll be a delicious pain. The kind that hurts but feels good.