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Ask Matt

Having had Piriformis Syndrome for five consecutive years I’ve learned a few things. I’ve created this page as a Q&A. So, if you have any questions for me please submit them below. If I don’t know the answer, or have a strong opinion, I will try to direct you to an answer.

Categories: Piriformis Syndrome
  1. Wesley
    September 27, 2021 at 1:41 pm

    Hi everyone. I’m scheduled for an open surgery with Dr. Starr. Tracy or Sharon, could I talk to you about your experience with Dr. Starr? Or anyone else?

  2. Barbara
    February 10, 2018 at 8:19 am

    Matt are you still viewing and answering questions?
    Would love to ask you questions before I take this new step if having the Piriformis muscle removed!


  3. Barbara
    February 10, 2018 at 7:20 am

    Matt are you still there to take questions?

    • February 10, 2018 at 10:01 am

      Yes Barbara. I still read and approve every single post to my blog.

  4. Christina Schmidt
    October 19, 2017 at 8:01 pm

    Hello- I have an old hamstring tear
    And one doc I recently went to questioned nerve involvement, and suggested Dr Hal Martin. I could see a clip of your comment her you were scheduled to see him. What did he do to diagnose nerve involvement? Have you had a MR Neirography? I actually googled
    That and that’s when your name/site popped up.
    Many thanks as I’m a competitive triathlete, sidelined, and lack of clear diagnosis and plan is greatly affecting my quality of life. Christina


    • Gina
      October 19, 2017 at 8:22 pm

      I had surgery 27th Thomas Ellis in Columbus Ohio. There are many things that can contribute to piriformis muscle pain. I have a piriformis muscle syndrome (with or without fibro) Facebook group I administer. You can join the Facebook group, read the pinned post and files section for information. There is lots of good information there. Gina


  5. Doug stanley
    September 26, 2017 at 4:50 pm

    I’ve had a l4 l5 s1 laminectomy done and after the surgery I fell and started getting immense pain in the middle of my right side from the lower back down to the foot ,I thought it was my hip but the doc said it is the si joint but I still can’t get anyone to fix it.This has taken my life from me aND I’m tired of not being able to do anything,I have a very hard time just walking most days ,who would you suggest I go see to have thus taken care of,thanks for any suggestion you can give me .


  6. Nolan
    July 18, 2017 at 11:47 am

    What does piriformis feel like? What are diagnostic tools available?.


    • L
      July 18, 2017 at 8:22 pm

      It is the muscle you sit on and HURTS BIG TIME – You will automatically shift your weight to the other hip and sometimes you are unable to sit in any position – depending on how advanced it is. When sitting or lying down the pressure squashes the Piriformis causing it to contract, thus pinching the sciatic —- which can lead to feeling like you are being ELECTROCUTED !!! Sometimes feeling tingle go down your leg – all the way to your big toe. Sometimes I have felt like a HOT POKER IRON was placed on the inside of my foot – yep, reflexes take over and I would jump out of bed or the chair SCREEMING. Many times I have not been able to even touch the floor with the ball of my foot lasting 15 – 45 seconds. That (I thought was the most pain I have ever felt) ….. until I felt like a nail was being driven into the top of my foot.
      When my pain was its worse I had to lie on my left side and NEVER pull my knees upward toward my chest — but lie STRAIGHT on my side with NO MOVEMENT AT ALL or I would be electrocuted again. The most sleep I would get would be 2-3 hours – and the moment I moved the electrocutions would zap me right out of bed.
      I have noticed that any squatting or letting PT do the Piriformis stretch — would cause me to SUFFER by evening.
      I did find that PT Ultrasound gives great relief. I’m not sure if chiropractors have the same type of unit. Also, letting the hot shower pulse beat on the low back and Piriformis area helps. Keeping up certain exercises helps keep from having muscle atrophy.
      Like my doctor said, the guided injections can help a lot, but sometimes it has to be done 3-4 times before you feel any relief. Last month was my 4th series of guided injections and I had no faith but to my surprise I did get great relief for a full week and able to sleep all night. A week later I returned to PT and they did the Piriformis stretch and woke up everything down there. Will not do that again. I am still able to sleep all night. Another thing that REALLY STARTED ELECTROCUTIONS IN A MOMENT is if ice is applied. No way ever again. Am scheduled for identical repeat injection on Aug. 1st.
      Hope I have been of some help.


      • Nolan
        July 18, 2017 at 9:08 pm

        Thanks so much. Seems like our symptoms are very close to each other. I have gone through a series of hip injections which have given some relief but don’t last very long. I have asked the doctor about periformis but, he seems that he doesn’t want to entertain the idea. He keeps telling me that it’s time for a hip replacement. I don’t want to even entertain that idea until I can’t stand it any longer.


      • L
        July 18, 2017 at 10:09 pm

        I hear you, the mini mini doctors I have gone to was not able to help me in anyway, they don’t know how to help you. They send you from one specialist to another, and I don’t know how to help you either. They just give you MRIs and x-rays and want to give you opioids or narcotics which do not work.
        I don’t know what part of the US you live in but I do hope you can find some relief somehow. From what I have googled if you get a hip replacement, it does not change the Piriformis if that is where the problem is coming from. I googled what causes pain in the butt, and it gave me about seven different reasons, and when I got down to the piriformis muscle syndrome it matched exactly .
        Sorry you are in so much pain and I do understand. Hope you will find some relief.


      • Nolan
        July 19, 2017 at 5:34 pm
      • L
        July 19, 2017 at 9:38 pm

        Anything to help. I know what the pain is.
        NONE of the opioids or narcotics worked after the first time unless I doubled up and I will NOT do that.
        Way back last year when going out to eat lunch, I was in so much pain and was getting ELECTROCUTED big time and I ordered a Margarita with a double shot as fast as she could get it there — ALL MY PAIN STOPPED almost immediately.
        So, I have been using this since — BUT NEVER MORE THAN TWICE A DAY. It will give you 2-3 hours relief and able to lie down and sleep.
        Gabapentin also helps, I also use Promethazine – neither of them are opioids. Promethazine is for upset stomach – all my doctors can’t understand why it helps because this drug has no pain properties in it . …. but for me it helps take off the edge.
        Moist heat also helps. NEVER ICE, it causes instant electrocutions.
        I have recently learned that pulling the garden hose around to water the garden and flowers. I did this Monday – later I suffered big time. Today, I watered again dragging the hose around — later I felt the same pain I felt MONDAY. — hummmm – I won’t do that again.
        Sometimes it is important to keep a daily log in order to figure out what things you do that hurts you later but at the time you feel no pain.
        At one point I went to Hobby Lobby and purchased a large foam square at about 4″ thick and trimmed it down to fit my car seat including cutting a whole in the area of my Piriformis.
        I hope this information will help you.


      • Nolan
        July 19, 2017 at 11:16 pm

        I was just given gabapenten by my GP.
        Hurting so bad. I’m afraid I’ll do something stupid.pain started in 1985 in the military and it’s just gotten worse




      • L
        July 20, 2017 at 8:09 am

        Gabapentin does help some. I took up to the Max, 3- Gabapentin 300 mg . 4-times daily. Keep in mind, whenever you are taking prescription medication, it will all probably cause constipation and/or Weight gain. It is very important to you something natural, such as magnesium in capsule form, aloe vera capsules, or licorice DGL. All of these you can find at the natural groceries or health food store.


      • L
        July 26, 2017 at 10:21 am

        If it’s “ok” with you and you do text on your phone, send me your phone number or email address and I will try to help you as much as possible or give you information that has helped me tremendously.
        I do understand and know the horrible pain you are experiencing.
        (254) 931-7190
        I look forward to hearing from you.



      • Gina Suppa
        July 19, 2017 at 7:26 am

        Hip structural issues can cause the piriformis muscle to over function and become hypertonic from trying to stabilize the femur. It’s a common symptom. You may want to join the Hip Awareness (FAI, PAO, THR) Facebook group. Cortisone and botox injections, when hip structural issues go unaddressed is a bandaid. The pirformis muscle can most likely be a symptom and not the roof cause. Of the hip issues go unaddressed for two long, it can make the piriformis muscle enlarged, shortened in length and become chronic. Then the piriformis muscle can pull on sacrum and cause sacroiliac joint dysfunction. The sacraoliac ligaments can get stretched out. Then all the instability in the pelvis can start causing s1, L5 spine instability. It can be a chain reaction. This is what I learned from going undiagnosed with Hip structural issues, getting surgery, then having a piriformis tendon release and sciatic nerve neurolysis surgery myself. I am not in the medical field, but a long time suffer and finally getting my life back after 9 years, lots of doctor ls, surgery, rehab, regenerative medicine and tons of other procedures……. Always consult with a doctor for medical advice. I can only provide you my opinions from experience.


      • Nolan
        July 19, 2017 at 12:58 pm

        THanks so much. Going to see a interventional pain doctor. Will see what he says


    • regina a brooks
      July 19, 2017 at 5:46 pm

      My son had an fai impingement. Finally after Dr after Dr, we found a Dr that properly diagnosed the issues. His leg could not rotate properly in the socket as the socket was overgrown.
      I found him from this site.
      I’m in Indianapolis


    • October 2, 2017 at 12:50 pm

      my husband had piriformis surgery Sept 2015. My postings and his story are embedded in this blog, dating back to 2015-16 or later timeframes. Not sure if you’ve been able to read his story. What I understand is that even those the symptoms can be similar, each case can be different. as in my husband’s case, the open surgery performed by Dr. Starr/UTSW/Parkland Dallas, revealed my husband piriformis muscle was adhered to his pelvic bone and his sciatic nerve was behind it being smashed…for 7 months it was smashed and caused him 24/7 nerve pain from his hip down to his foot…he couldn’t sneeze, cough, sit on the commode, without generating this shocking nerve pain. Pain pills were ineffective, gabapentin was ineffective. After surgery, it wasn’t “instant” relief, but he said 80%, so he was at least functional. He worked about a year with intense physical therapy in trying to get the nerves back to functioning and gliding. He went to Zale Lipshy at UTSW PT. He had herniated disc surgery in 2013; total knee in 2014 and piriformis in 2015, so this year was the first time in five years, that he’s been able to golf. Having the surgery was a Godsend…there is no way he could have continued living in the condition he was pre-surgical. I can tell you that Dr. Starr ordered an MRN, yes MR Neurography. Dr. Chhabra injected him, but could not use botox because he said the piriformis muscle appeared atrophied (surgery showed it to be plastered to his pelvic). I understand that the injection is “diagnostic” in that IF the patient gets any relief, it proves piriformis syndrome. BTW – we have Federal BCBS insurance and both Parkland and UTSW took our insurance. Dr. Starr is a hip trauma surgery at UTSW, officed at Parkland, and understands about the piriformis. Because of this blog, there have been people who have flown from around the US to consult with and have surgery. Bear in mind that his practice is hip trauma…I told his Fellow that appeared he may need to have a piriformis team. So, not sure if he is still accepting piriformis patients, or not. However, this year my husband saw Dr. Starr for another issue, and my husband is now on Medicare, and there was no issue accepting Medicare with our secondary of BCBS Fed. My husband having this debilitating issue was life changing…having the surgery gave him back his life. He has a foot long scar down the side of his hip area and he will tell you it was worth it… He has educated himself on this issue, has a chart of his muscles and nerves, and pin-pointed the areas for his PT to work on…she listened and has helped him regain everything he is today!! He will tell you that he understands why people would harm themselves. BTW – he self-diagnosed by listening to a youtube by Dr. Aaron Filler, neurosurgeon out of CA. I understand Dr. Filler is also the one who developed the MRN.


  7. Loren Summers
    April 9, 2017 at 10:14 pm

    Can anyone recommend a doctor in Seattle to get the ball rolling, specifically the Pro EMG test? I literally am at the end of my rope…

    • L
      April 10, 2017 at 9:21 am

      I cannot recommend a doctor in Seattle. However, I have had Piriformis muscle syndrome over a year now. I accidentally found out when I drink tequila, it relaxes the Piriformis muscle – Therefore it is not contract and pinch for sciatic nerves. Also, recently I have been using Young living essential oils orally. I went to the health food store and purchased empty gelatin capsules – I added Young Living Essential Oils:
      3-drops German Chamomile
      3-drops Sacred Frankincense
      2-drops Eucalyptus Globulus
      2-drops Helichrysum
      Finish filling capsule with Extra Virgin olive oil..
      I did not know this would work, but I have googled to see what other people did with oils, so I tried it. This is giving me much more relief than using the oils topically. I was also doing electrical stimulation and ultrasound. Together with the E-stimulation and ultrasound I did not even need my tequila.
      So sorry you have been in so much pain for so long. I do understand. I hope this works for you.
      Let me know ?

      • Jessica
        April 10, 2017 at 5:30 pm

        How long does it take to notice improvement w the oil regimen and how often to take it ? I have a friend that does doTerra oils and they have all the same types, think it matters the supplier ? I know nothing about oils but I’m willing to try for butt pain relief


      • L
        April 10, 2017 at 6:08 pm

        Jessica ,
        I noticed a big improvement in two days. I would take the capsules four or five times per day. Also, I was doing electrical stimulation and ultrasoun which is very good to give deep heat and reduce inflammation. If you have inflammation , you have more pain, thus more tightness against the Piriformis muscle causing it to contract. Also, using oils topically (Deep Relief, Frankincense, & Peppermint last because it drives the others in). Yes, it does matter what brand you use – it MUST be 100% pure. Young Living oils are 100% pure – from field to seal. I have noticed others at the Heath food store that said they were 100% pure – but I know Young Living says they are the ONLY essential oil that is 100% pure – however, just recently I have learned of another – don’t remember the name. I asked the health food store about their oils – they said some of the essential oils are 100% pure BUT the process was not pure. That can make a difference if you want the best. As I mentioned earlier, I would do the double shot tequila in a margarita and it would instantly relax the muscle so that it was not contracting in hurting or pressing against the sciatic causing it to run down my leg into my foot. I have quit doing the margaritas because of calories and will do one part fresh lime juice to two parts tequila – – and drink it down as fast as I can because it taste like floor cleaner. But within 10 minutes my muscle is relaxed and no longer hurts. This would last about 3-4 hours. A pain specialist that I go to also confirmed this would happen. Then I started e-stim and ultrasound and also did my oils orally and no longer needed the tequila.
        I hope it also works for you as I DO know the butt pain and I also got ELECTROCUTED from the Piriformis pinching the sciatic. I looked like I was touching a live wire !
        Please let me know if this works for you, I look forward to hearing from you. I pray for all with this problem.


      • Jessica
        April 10, 2017 at 6:54 pm

        doTerra might be the second brand of 100% oils ? I’d try it for a week for sure ! That’s amazing. Yes, I have pain to the foot like you describe. Sitting is my enemy.


      • L
        April 10, 2017 at 7:49 pm

        This is what I have learned about the doTerra oils:
        I wanted to share with you a link I found from someone who did a comparison of doTerra and YL. I thought since you’ve been in dialogue with the person on the piriformis blog, you may want to share with her as well:


      • L
        April 14, 2017 at 11:59 am

        We talked about essential oils and how they had REALLY helped me. I am not well, but MUCH better. How are you doing.

      • Jessica
        April 17, 2017 at 10:07 am

        Working on getting a supply through a friend. She recommends a different concoction but I’m afraid to deviate from your recommendation so need to decide.
        Idaho balsam fir, copaiba and frank. Any thoughts ?


      • L
        April 17, 2017 at 11:07 am

        You have made a good choice. When I run out of one oil for my capsules I will search and find out what one of the other main anti-inflammatory oil’s are and use it instead . I just showed you the combination that I used. Like this morning when I was working up some more capsules, I had run out of Rosemary, so I used Juniper instead. Another time when I ran out of one I would use Vitiver instead – – which is a very strong anti-inflammatory oil. – – The following is a website you can use for the main oils for pain and anti-inflammatory – – again, I get the most relief when I put it in capsules.
        Chamomile oil to reduce inflammation and pain. …
        Lavender oil for pain relief. …
        Sweet marjoram. …
        Eucalyptus essential oil. …
        Peppermint essential oil. …
        Rosemary essential oil. …
        Thyme. …
        Clary sage


      • April 17, 2017 at 11:08 am

        Jessica – I’m just starting to use YL oils, and to my knowledge, I don’t think the other oils suggested, added to the one “L” has recommended, would hurt at all…probably help. I understand Frankincense is the top oil, ever. I’m using it in my ningxia red drink, with other oils. I’m not a piriformis patient, my husband “was”. Thank the Lord he’s doing better. He’s 18 months post op this month and he is doing SUPER!! Dr. Starr did surgery in Sept 2015, long road of rehab of at least a year, but thankfully, he is finally back to a new normal. Mindful that all piriformis cases aren’t the same, as he has back issues and surgery, knee replacement, prior to his piriformis issues. Plus, he had a fractured foot on his good side, that resulted in plantar fasciitis, his rolling his foot to be able to walk, torn tendon, so he’s been complicated. Within the past month, he’s played two rounds of golf…first since 2012 (back surgery 2013), so blessed he is FINALLY able to get back to doing “life stuff” and not be consumed with all of his health challenges. So, back to the oils, I say use whatever “L” is saying and the others as well, you can’t over them!!


      • L
        April 17, 2017 at 11:10 am

        It would not let me post the website – – that you got the best information of what I put in my last post to you. – – Just Google Young living essential oils for inflammation and you will get all the information you need.
        I would love to hear back from you and how you were doing – – I take about five capsules a day.


      • L
        April 25, 2017 at 3:41 pm

        I have been thinking about you and praying for you. How have you been doing since we last chat ?
        If you purchased the oils I hope they’re working as well for you as they do me .
        If you are using the do Terra oils it should be fine. At least they are a therapeutic grade – you do not want to ingest anything otherwise.
        I look forward to hearing from you.

      • Jessica
        April 28, 2017 at 10:02 am

        Ordered oils. Waiting to arrive !


      • L
        May 5, 2017 at 9:22 pm

        Hi Jessica,
        Glad you have decided to order the oils – – if you need any information on them or further information on how are use them please feel free to ask – – I look forward to your reply and how you are doing once you start the oils. I still take my capsules 4 – 5 times daily — I recently cut back the amount I was putting into the capsules but still taking the capsules 4 to 5 times daily.


      • L
        June 17, 2017 at 2:49 pm

        I am concerned about how you are doing with your oils. The oils really help me, but also, I realized after my PT had met its limits with my insurance, the ULTRASOUND REALLY helped me also. Without the Ultrasound I am slipping back to having to be up again every night.
        I would love to hear from you.

      • L
        July 7, 2017 at 11:58 am

        Jessica and All other with the Piriformis Muscle Syndrome,
        What I have found for ‘temporary’ relief — I use Young Living Essential Oils: Deep Relief roll-on, followed by Peppermint and last DMSO roll-on which DRIVES anything else you have on your skin IN. You can get the DMSO at Walmart or Walmart website or order from Walgreens. Google DMSO roll-on to get the multiple uses.


      • April 10, 2017 at 7:04 pm

        Hi “L”!! I’ll send you a link that compares doTerra and Young Living oils, and agree with you that YL are superior.


      • gina
        April 10, 2017 at 6:57 pm

        I still think Dr. Brown would be a good first start locally. He is a physiatrist AND a chiropractor. He knows the body well, and can do a EMG. He is brilliant. He understands this part of the body well and I am sure, if you need surgery, he can help you find a doctor in your area. I would give anything to go to Dr. Brown. I had a piriformis tendon release and sciatic nerve neurylosis surgery. It was a horrible surgery. After, my pelvis was left unstable. If there is any way to do regenerative medicine, I would explore that first. If Brown says regenerative medicine is not the key, I am sure he will point you to someone to help you. As far as West Coast PS doctors, There is Jacque Lines in California and Tollstrup in Nevada. I know of no others. Adam Star in Dallas is supposed to be good too. He is a hip trauma surgeon and knows this part of the body well. I had surgery with a orthopedic hip surgeon and wish I would have went to a perephial nerve surgeon. I just think they understand this part of the body better.


    • gina
      April 10, 2017 at 1:34 pm

      I would start with Michael Brown. http://michaelnbrownmd.com/

      He is a Sports Medicine Doctor/Physiatrist/Pain Management and a Chiropractor. He is very knowledgeable in regenerative medicine and a good first conservative approach to help possibly resolve this issue naturally and without possibly surgery. He can ultrasound the sciatic nerve an muscles and see what is going on. He is one of the best regenerative medicine doctors in the country. Good luck to you. Gina

      • Loren Summers
        April 10, 2017 at 1:45 pm

        I guess I should have made this clear in my original question; I am looking for a doctor to begin exploring surgical options. I’ve been going the conservative route for 5 years and I am done with that now. I’ve done the chiro; massage therapy; accupunture; oils; cupping; MRI; CT; Fusion consult; PT; anti-inflammatories; pain killers etc. I’m looking for the name of a doctor in Seattle that can consult on the release surgery. Thanks.


      • April 10, 2017 at 1:53 pm

        Loren – after multiple physicians (internal med, physical medicine & rehab, neurosurgeons), we found, through this blog, a hip trauma orthopedic specialist who knew exactly what my husband was going through. Maybe you can search your area for a hip trauma orthopedic surgeon?


    • Robert Keller
      April 10, 2017 at 2:58 pm

      Dr. Tollestrup out of Las Vegas has done over 200 Piriformous /sciatic Neurolysis surgeries… I’d call or email.


    • Gina Suppa
      July 19, 2017 at 7:27 am

      Michael Brown is a physiatrist in Seattle. He also does regenerative medicine.


  8. L
    January 29, 2017 at 8:32 pm

    ANYBODY out there that has been diagnosed with “piriformis muscle syndrome” – and if a ONLY you have been receiving symptoms like you have been ELECTROCUTED which runs down your leg, or to your foot, perhaps make it feels like it has a hot iron on it, or that is been whacked with a crowbar ? Unable to sit or lie down at all without getting these sensations. I would love to hear from you and what your experience with Dr. Adam Starr. Please help.

    • Elizabeth
      January 29, 2017 at 9:39 pm

      I have had pain in my legs that I describe as electric shock for 15 years now. It hurts when laying down, so needless to say, for the last 15 years I get electrocuted throughout the night 2-12 times. It took 13 years, a Neurography scan, and provocative EMG before I had a clear diagnosis.
      My piriformis and obturator internus muscles are pinching my sciatic nerve in both legs. This diagnosis was confirmed with rounds of cortisone injections into the piriformis muscles followed by Botox into the piriformis weeks later when the cortisone had worn off. I also had the same injections done separately into the obturator internus muscles. These injections were done at Mayo in Florida. Each round of injections brought significant relief, but not total relief.
      Later I had a discogram that confirmed a grade 4 annular tear in my L5-S1 disc right by the sciatic nerve. My MRI only showed a “small annular tear” which was ignored as insignificant for years despite the provocative EMG showing problems with this disc.
      I know this is a lot of information, but it is relevant to your question about Dr. Starr, who I saw last year. During my consultation he was very hopeful surgery on the piriformis and obturator could help me. He said that he always has his patients go through rounds of diagnostic injections into the muscle first, as well as a neurography scan before surgery. We were both encouraged by the fact that I had already done those things with a good result. Just to be sure he had me send my neurography films to his partner who does these scans himself to see if he agrees with the diagnosis. Forgive me because I can’t remember his partner’s name.
      Anyway, when that doctor called to give me his opinion of my scans I was devistated because he said my scans didn’t show any issues whatsoever. I was devastated and confused because my diagnosis was not only seen on the neurography, but also the provocative EMG, and confirmed with MANY rounds of diagnostic injections (Botox and steroid). When I told him this he had absolutely nothing to say. In my confusion I tried contacting Dr. Starr’s office but had a very hard time getting a response. I liked Dr. Starr and am sure he is an excellent surgeon, but my only concern with the surgery I need is that there is a high risk of scar tissue forming after surgery. Then that scar tissue can start irritating the nerve and you are back to square one. I asked Dr. Starr during my appointment if there is anything you can do to minimize that risk like wrapping the nerve with something that could protect it. He said no, but I know I have read small studies that talk about this risk and wrapping the nerve to protect it. So long story short, between the scar tisssue risk (that my Mayo doc and many others warn me about) and the contradiction in my diagnosis, I decided not to have surgery at this point. In the mean time, I still get electrocuted every single night (Ultram and neurontin help take the edge off) and desperately wish I had confidence in what to do next. If anyone has experience with the whole scar tissue risk that comes along with his type of surgery please chime in!!!! I hope this long answer helped someone!!

      • Robert keller
        January 30, 2017 at 12:15 am

        Hi Elizabeth,

        Email Dr. Dellon. Go to Dellon.com

        He took my piriformis out 14 weeks ago.
        I still have pain but it’s sooooo much better.
        He preaches water walking after sutures are removed.

        He’ll explain how he does the surgery and answer your questions.

        Don’t continue to suffer!

      • regina
        January 30, 2017 at 9:43 am

        My son was being treated for Periformis, but really had a hip impingement. It has taken us 9 months after surgery with therapy twice per week to finally fix the issue. Just additional information. I found the surgeon in Indianapolis on this site.

      • L
        January 30, 2017 at 7:20 am

        Thank you for the information in the home detail regarding what happened. There are so many different reasons for the Piriformis muscle syndrome. I pray for you and hope you will find some relief.

      • L
        January 30, 2017 at 9:33 am

        I accidentally found out that a straight shot of Tequila (1-1/2 oz) helps BIG TIME – in 10-minutes stops the muscle from contracting which pinches the sciatic.
        I mix 1-1/2 oz clear Tequila with 1 oz pure lime juice and about 1-oz triple sec — put a little salt on your fist and lick it – – and then drink the stuff down fast . But I can’t do Tequila & drive. At least it is a better choice than kerosene.
        I wish you well.

      • L
        January 30, 2017 at 11:35 am

        I accidentally found out that a straight shot of Tequila (1-1/2 oz) helps BIG TIME – in 10-minutes stops the muscle from contracting which pinches the sciatic.
        I mix 1-1/2 oz clear Tequila with 1 oz pure lime juice and about 1-oz triple sec — put a little salt on your fist and lick it – – and then drink the stuff down fast . Many times it is the ONLY way I can get to the doctor – unless I car surf. But I can’t do Tequila & drive. At least it is a better choice than kerosene.
        I wish you well.

      • January 30, 2017 at 2:59 pm

        My opinion of this Starr is not high because as in an era of endoscopic surgery to cut your butt open with an 8 inch incision is barbaric. And if what you say is true about a provocative EMG and scans – (it took a GE 3.0 MRI to finally show my sciatic nerve edges shadowed under an enlarged P-muscle).

        After much research and getting jacked around with unneeded injections – within two months of a p-tear scar tissue will have formed so no amount of cortisone of Botox will have a permanent effect, found Dr. Jackson in Pasadena, endoscopic surgeon who had done 13 procedures at the time – all but one good outcomes. He did a sciatic neurolosis and found my hamstring was detached too so sewed that up.

        There is a video of the procedure on this site but I can’t find it. it’s been over a year and half now and I am still symptom and totally pain free.

        Maybe you could send your scans and EMG results to Dr. Jackson as after i mentioned my outcome on this site he started getting medical tourism to his practice. For a second opinon I believe he’s your man even if you had to pay for an electronic office visit for him to give you an opinion. dc

    • January 29, 2017 at 10:23 pm

      L – what you describe is exactly what my husband experienced; however, also add he could not sit on the commode, cough or sneeze without causing “electrocution”, shocking nerve sensations from his lower back to his foot. It looked like he was being struck by lightening!
      Dr. Starr is incredible…he does the open technique so that he can see and feel what is going on. Dr. Starr removed the piriformis muscle. In his 20+ years of putting hips back together, he had NEVER seen a piriformis muscle attached to the pelvis with the sciatic nerve being smashed behind it, so no wonder my husband could NEVER get relief. The surgeon Dr. Starr performed gave my husband his life back…he said 80% better right after surgery. He’s an avid rehab’er, and who knows if he will ever be 100% again…he’s having to teach his muscles how to glide. Zale Lipshy PT (Sprague) is great and still works with my husband. You won’t be disappointed with Dr. Starr and the entire team there!!

      • L
        January 30, 2017 at 7:23 am

        Thank you for your reply and for the incredible description. I pray that there will be a relief soon.

    • Ray Barrera
      April 17, 2017 at 6:54 pm

      Unfortunately i am going through the exact pain you are describing and it’s absolutely unbearable most of the time. I’ve had 2 back surgeries ,numerous injections ,three different types of scs trails and have been on pain meds for the last seven years. I think I will be making an appointment to see Dr Starr myself. I’m sorry for your pain.


      • L
        April 17, 2017 at 7:47 pm

        Hi Ray,
        Yes, Dr. Adam Starr is a trauma surgeon and I have been trying to get in there since September – – getting there it’s like getting into Fort Knox. Your doctor will have to receive a form to fill out, he must complete an outside referral form if you have not seen this doctor before, and it must be completed, it would be a good idea for your doctor to have in the diagnosis piriformis muscle syndrome also.. seriously, in the meantime I would recommend drinking one shot of lime to two shots of tequila, drink it down as fast as you can because it taste like floor cleaner. But in less than 10 minutes my pain is gone and I can sit or lie down for about 2 to 3 hours, until the tequila wares off. —- Now I have started putting Young Living Essential Oils into gelatin capsules. I would use some of the strongest Oils for pain and inflammation, German Chamomile, vetiver, sacred frankincense, eucalyptus globules and then finish filling the capsule with extra-virgin olive oil with a dropper . I take these and still take these five times a day. Keep the capsules in your freezer. Do not make up more than you need for two days because they will eat right through the gelatin capsules and you will lose your oils. I hope this will help you and I would love to hear back about your progress.


  9. Victor
    January 21, 2017 at 4:29 pm

    When this first started for you’d your glute/ affected area feel almost like a stabbing / tearing pain every time you bent forward or sat down? Also have you had an MRI done or anything ?

    • January 21, 2017 at 4:56 pm

      I felt a deep, achy pain when sitting.

  10. September 3, 2016 at 8:43 am

    I had my second cortisone shot oh August 22 and it helped slightly but pain is back. My doctor referred me to a pain clinic, didn’t offer me any other treatment options which I know are available (Botox and surgery). I feel like he is passing me off to another doctor to deal with and I don’t want to be put on meds just to cover it up.

    I have seen a chiropractor a couple of times and he uses a TENS unit on me which really helps but wears off after a couple of days. He called my insurance to see if they would pay for one and they told him only if I went through the hospital which is why I’m agreeing to see the pain clinic. Any experiences with pain clinics?

  11. melissa
    August 30, 2016 at 11:37 am

    I’m going on three years with bilateral piriformis syndrome. I’ve been undergoing trigger point injections since April with slight alleviation, but not much. I tried a botox injection, which actually made my sciatica worse. The sciatica went away for the most part after the botox wore off. I’ve done three rounds of physical therapy and am about to start another. I ice, heat, stretch, strengthen. My doctor is encouraging me to continue to make efforts to allow my body to heal itself. Has anyone ever actually healed completely from chronic piriformis after so many years? I am starting to consider the surgery. What was the down time?


    • Robert
      August 30, 2016 at 12:05 pm

      Email dr. Tollestrup in Las Vegas.

      He’s a nice dr. I think down time is 3-5 weeks.

  12. Merrilee Miller
    July 22, 2016 at 9:35 am

    Hi there, I’m hoping you can answer some questions for me. I’ve been going through a hard time lately and this possible injury is taking a toll on me mentally and physically. I am a division one collegiate athlete and at the end of last years season, I noticed my legs just weren’t mine anymore. It was getting hard to run for long periods of time without my legs getting extremely heavy and practically numb. I notice this sensation in my quads and I have periodic foot tingling. On my left upper hamstring/lower butt I have pain and it feels like it needs to be almost popped or just pulled apart to relieve the tension. I have knots so big in my gluteus that if I sit on the ground, I can roll around on them. I notice these symptoms get worse when I run on incline. It takes my led much longer to recover than my lungs. After I’m done running I have to manually move my legs around or else it is too hard to do it. I get frequent spams in my glutes that just go off when they want to and end when they want to. When I try to stretch out the piriformis, it either burns, sends a battery acid like feeling down my leg, or makes my feet tingle or all three. Please I need your help with this. Thank you very much.

  13. Angie
    June 20, 2016 at 1:12 am

    Hi Matt,
    I am doing some research on Piriformis syndrome and came across your blog. I really believe that’s what’s going on with me. I fell at work in Dec 2014 an immediately burning pain in my butt and back of thigh on the left side began to burn. Hip pain also set in. After 10 months of PT, injections and multiple MRI’s and CT scans it showed that I had damaged the femoral head in my hip. I had a core decompression surgery to repair the hip bur the burning in my butt and thigh has never stopped. for the past four months I have endured more injections and PT and still it remains hard to sit, stand or walk for more than 10 or 15 min before the pain increases.When the pain is at the highest level my groin area goes numb. During the night when I “try to sleep I have tingling in my calf down to my foot. This is a workers comp case would so getting doctors to listen to me is very hard. I want to go outside those doctors and get another opinion because I am sure I have piriformis syndrome. I have an excellent neurologist that performed my back surgery many years ago that I recovered from 100% percent, I don’t know if he has ever treated this before. This pain caused me to miss out on so many things as well as keep me from sitting through my graduation ceremony last year. Just thought I would share my story.

  14. Robert Keller
    February 21, 2016 at 10:28 am

    Matt, did you have the entire Piriformis muscle removed? Dr. Tollestrup in Las Vegas has done 200 Piriformis surgeries. He’s suggesting taking the muscle out all together. Your thoughts?

    • February 21, 2016 at 10:32 am

      I had the muscle tendon cut at the sciatic notch. I would have been fine with having it removed altogether.

    • Tom
      August 29, 2016 at 11:40 pm

      Hi Robert, I’m interested in this surgeon. Where did you get the number that he’s done 200 piriformis surgeries?

      • Robert
        August 30, 2016 at 7:35 am

        Hi Tom. I asked Dr. Tollestrup. He told me.

  15. Denise
    January 24, 2016 at 6:46 pm

    Hi all,

    I know there have been some questions here about having arthroscopic surgery with Dr. Jackson to address sciatica/piriformis syndrome. I had surgery with Dr. Jackson on December 21st. My surgery was two-part. First, he repaired a labral tear in my right hip (tear never showed up on any imaging, Dr. Jackson was the one to catch it and luckily he was right). The second part was sciatic neurolysis. During that part, he said that my nerve actually looked good and removed a small band that may or may not have been pushing on my nerve. He said it was hard to tell whether that is causing all the pain in my my butt. It’s been almost 5 weeks and unfortunately for me I think it’s too soon to know whether it helped, as I’m still in pain. According to Dr. Jackson, it can take 3-6 months for my hip to fully heal and a year for the sciatica/piriformis to heal. So I have a while to wait. I have days that I don’t feel hopeful as I’m in so much pain, but surgery really was the next logical choice for me after 1 1/2 years of absolutely recalcitrant piriformis pain and hip pain, and I’m only 31. I will try and keep everyone updated on how I feel down the road. I will say, I really like Dr. Jackson and felt that he and his gram were very supportive. He personally called me the day after surgery to see how I was, and his nurses also called. Heidi (his nurse) is fantastic and always got back to me immediately when I called her. I’m happy with my choice in surgeon, just no sure yet whether I will be one of the lucky ones who benefits from surgery.


    • Helaine
      April 16, 2016 at 11:50 am

      Hello Denise. I just happened to read your post and wanted to know if you’re doing any better now 3 months later? I too had arthroscopic hip surgery (11 months ago) to repair a labral tear and FAI but still suffer terribly from buttocks pain (which I suspect MAY relate to piriformis) as well as some hip and front of leg pain/numbness. Would love to hear any updates on your piriformis surgery. — Helaine

      • Debbie.
        May 16, 2016 at 8:57 am

        Good morning Helaine
        I would like to be more encouraging, but unfortunately I am not doing well. After the sciatic neurolysis I did extremely well for two months. I mean I felt like a normal person could sit for good periods of time and went days without significant amounts of pain. However it did not last. I was ordered physical therapy and after three or four sessions the muscles “woke up” and the muscle spasms returned. The same old buttocks pain has consistently increased and I am now at the same pain level as I was prior to surgery. I wish I could be more encouraging .

    • Jane Turner
      November 6, 2016 at 9:08 pm

      Hi Denise,

      I would also love to hear an update…have things gotten any better?


      • Robert keller
        November 7, 2016 at 5:04 pm

        Hi All,

        Had my left piriformis muscle removed by a dr Dellon 3 weeks ago.

        Recovery is going as planned.
        I start water walking in pool Wednesday.

  16. Denise
    November 25, 2015 at 1:58 am

    Hi Debbie,

    I am new to this page and would love to know how you’re doing. I have surgery scheduled with Dr. Jackson in a few weeks and am intrigued by your experiences so far. I hope you are feeling better!

    • Debbie
      May 16, 2016 at 9:01 am

      What procedure are you having done ?

  17. Robert Keller
    November 23, 2015 at 11:24 pm

    Debbie, I too would like to know how you’re doing. Robert

  18. Debbie Cardoza
    November 18, 2015 at 10:20 am

    Well on Monday I had a endoscopic sciatic nerve neurolysis. I had it done in Pasadena with Dr. Timothy Jackson. I actually started crying in the OR before they put me to sleep. 8 years is a long time to suffer. Way too early to tell if it made a difference. Will keep you all posted.

    • Athena Fremstad
      November 21, 2015 at 2:41 pm

      Debbie I was wondering if you could tell me how the surgery went? Also, what kind of testing did Dr Jackson require. I know someone else on the forum had the same surgery and it was successful. Please let me know, as I am considering coming from FL to see him!

      • November 23, 2015 at 1:37 am

        Right now I am struggling. I am six days post surgery. I am having trouble controlling my bladder and cannot put any weight on my leg without my pain level going skyhigh. I left a message for Dr. Jackson’s assistant Thursday and tried sending an email on Friday. I finally called the on-call surgeon today. The on call surgeon someone would schedule me an appointment on Monday but he called back 10 minutes later and said he spoke to Dr. Jackson and that dr. Jackson sent the email to Heidi accidentlt and that I would get an email. I really wish Dr. Jackson have taken just a few minutes to call me himself. I waited all day for an email but have not yet received anything. So at this point I’m not sure how to respond.

      • November 23, 2015 at 11:42 am

        Good morning Athena It is too early for me to say I could recommend him. I have been disappointed in the lack of communication since surgery. I have been struggling, severe pain when I put pressure on my leg and I have lost control of bladder function. As well staff callwd and had to move my week follow up appt. but didnt know when a normal follow up is. They referred me to Heidi and I left a message. Didn’t get a call back so I emailed Friday morning. Got nothing back and was in so much pain I called the on-call doc on Sunday. He was very nice ans said they would get me in on Monday. He called back 20 min. later, said he spoke with Dr. Jackson and that we didn’t need to come in. The on-call doc said Dr. Jackson accidentally sent a reply to Heidi and I would get an email. Well, it’s Monday and still no email or call. It would have been so nice to get a short call from him.

    • ashly
      November 24, 2015 at 8:33 pm

      How are you now? Are you better? Do you like Dr. Jackson?

      • DMC
        February 19, 2016 at 12:27 pm

        Ashley, I am doing much better. The constant burning pain has been reduced significantly. I can sit through a meal. My muscles are very weak and climbing a flight there still a significant challenge, but I am so much better than before the surgery. And yes I am very thankful, very very thankful for Dr. Jackson. I was initially worried because I had lost some trust in doctors. The surgery center was probably the best I experienced as far as cleanliness, following protocols, and compassion.

        I would recommend Dr. Jackson to anyone.

        Debbie Cardoza Consultant


  19. Ken
    November 5, 2015 at 11:28 pm

    I am at my wit’s end so I am hoping I can get some help here. I read a lot of materials and saw 7 different doctors/PTs/Acupunturists.

    I got left butt pain starting this March. At one point it was so painful that I couldn’t sit on my sofa but I could still walk as usual (running not a problem too). It was particularly painful when I rose from my seat. And now I am at a stage with minimal pain (thank God) and I can sit for two hours without any pain afterwards. However, I am still having minimal pain when I do certain stretches, namely when I try to touch my toes with my fingers when standing, and more so when I put my affected leg straight on a higher ground and my unaffected leg standing (slightly bent) and then I bend my upper body towards the front.

    I did x-ray and it’s OK. Didn’t do MRI cuz all PTs/MDs tested my movements and said no issue. Two PTs said it’s piriformis syndrome, and one PT said might be referred pain. I have been doing bridges, piriformis stretches, core exercises, clamshells, straight leg raise, squats (and lately, lunges), for about a month now.

    What could I do get rid of that last pain?

  20. November 2, 2015 at 3:25 am

    Just heard about this blog from a yoga teacher suffering with sciatica pain.
    Any time there is pain in the body, one must look globally at the entire body because forward head carriage, posterior pelvic tilt, collapsed arches etc can all be related to sciatica.I have been a bodyworker for many years and created YogAlign as a method to become balanced in posture and movement so that there is no pressure on nerves, joints and connective tissue. It works from the inside of the body out and is about balancing the forces of flexion, extension and expansion in the body by rewiring the nervous system.

    I work with many yogis who have over-stretched their joints and nerves and help them learn a style of yoga that actually balances the body, aligns the posture and does not advocate stretching or getting flexible as a goal.

    Clients I see with sciatica have done a lot of stretching of the gluteals, sacral platform and the spinal column. Many people have over-stretched and inflammed the sciatic nerve by pulling on it doing yoga poses that do not simulate natural function of the body. If you are doing pigeon and hip openers and forward bends. STOP all stretching and instead focus on strengthening and stabilizing the forces of the hip. Use yoga blocks to get your hips at least 3 to 4 inches higher than the knees when sitting and do not cross your legs or let your thighs externally rotate as well.
    See my website at http://www.yogalign.com for more information. Michaelle Edwards

  21. Jill
    October 6, 2015 at 3:31 pm

    If i plan to travel to Milwaukee should I try to contact Dr. Heinrich or Dr. Hardin first? Do they work together? Do they both do surgery or does only Heinrich do surgery? Can Heinrich diagnose and do surgery? I am confused after reading so many postings. I am trying to get a “Pelvic MRI” prior to going there which I am hoping is equiv to a MRN yet cannot find someone I feel confident to do a Prov. EMG in the Denver area. Thanks for any clarification and also can someone provide a contact email for Dr. Heinrich? THank you for this blog. If there is a place on this blog with Dr. contact info that would be sooooo helpful.

  22. Julie Cecchin
    September 27, 2015 at 8:32 am

    Hello Matt, I have piriformis syndrome and am booked in to have a Botox injection into my piriformis on Thursday. My doctor says he does not know anyone here in Australia who does the operation you are talking about. Where are you from?

  23. melissa
    September 9, 2015 at 2:08 pm

    I’m in tears after reading your story. I am a yoga teach and I’ve been suffering from piriformis syndrome for well over a year after tearing my semimembranosis (middle hamstring). I’ve been prescribed anti-inflammatories, pain medication, Lidoderm patches, three rounds of physical therapy, acupuncture, with little or no relief. I’m going in for a follow up on Tuesday and after reading your story I will ask to be referred to a specialist for proactive EMG. I’m in the San Francisco bay area, if anyone knows of any reputable specialists my way. Thank you.

    • September 10, 2015 at 9:26 pm

      Provocative EMG you mean Melissa. Good luck.

      • melissa
        September 11, 2015 at 11:28 am

        Thank you Matt. Gina, my PS was caused by a grade 2 tear in my inner hamstring. No structural issues, just a reaction. I’m a yoga instructor and unfortunately this condition is common in yoga practitioners. If you google “yoga butt” you will get more hits on piriformis syndrome than girls in lululemon.

    • Gina
      September 11, 2015 at 10:25 am

      In San Francisco their is a Line Jaques. She was mentioned in the Piriformis Syndrome Facebook group.

    • Gina
      September 11, 2015 at 10:27 am

      Line Jacques. Sorry – I spelled it wrong. Also, I recommend getting your hips checked by a qualified femoral acetabular impingement hip specialist. structural hip issues can cause weak hip muscles/glutes, etc and can cause piriformis muscle to over function.

    • Gina
      September 11, 2015 at 5:09 pm

      I am a former yoga instructor, gymnasts, dancer., runner, active lifestyle….. No more…. Mine was cause by femoral acetabular impingement and a labrum tear. I have had surgery for both the FAI /labrum tear in 2011 and pirformis muscle./sciatic nerve 3/2015. Still having issues……. Hoping once I get my hip muscles even stronger, this calms down……..

  24. September 7, 2015 at 9:50 pm

    I have piriformis syndrome, too, and am sick and tired of too many doctors, too many treatments and too little success. So I decided to set up a wiki and sub-reddit where people like us can exchange information about what we tried, what we learned, etc. Just went live today: http://openpiriformis.org/ Would love your stories!

  25. CarolSpondenceInk!
    August 26, 2015 at 10:38 am

    Hi. Carol from Texas here.
    Over the last two weeks my left side of leg hurt worse and worse culminating in horrible pain in knee. Saw an orthopedist this week who says I have ITBS. Illiotibial Band syndrome (know it is mispelled). I wonder now if this is related to my Piriformis or if I never had piriformis and had ITBS the entire time or if one caused the other.

    Only remedy he offered was anti-inflamatory pill meloxican, a strong pain pill Tylenol-3 and physical therapy.

    Looking for insight.

    Help. I am in Plano-Frisco-Richardson part of Texas.


    • Gina
      September 11, 2015 at 10:23 am

      I recommend getting your hips checked by a good femoral acetabular impingement, labral tear, hip trauma doctor. Structural hip issues can cause symptoms you describe.

      • November 2, 2015 at 10:10 pm

        How does one find such a specialist?

      • Gina
        November 6, 2015 at 8:41 am

        There is a hip awareness Facebook group and Best FAI Hip Surgeon Facebook group. You can also Google your city arcs femoral acetabular impingement doctor and see what comes up.

    • September 12, 2015 at 11:49 pm

      Carol – we are in the DFW area, to. My husband will have piriformis release surgery the end of this month. Dr. Adam Starr, UTSW @ Parkland, orthopedic hip trauma surgeon, is one of the best in his field and has much success with this procedure. He is an awesome, kind person and we highly recommend him!

      • ilyas
        December 7, 2016 at 4:05 pm

        How is he now? is he better after surgery? i am from Dallas , i had this pain since 2009.

  26. Lea
    August 25, 2015 at 10:54 pm

    Just had 6 month check up with surgeon after open piriformis surgery (see my entries need treatment section around d March 1). I am a new man and surgeon expects further healing. I am Mt biking, hiking, swimming. Very little symptoms and still getting g better. There is hope!//keep plugging away everyone. 4 years from start of pain to surgery and healing will take some time.

    • August 25, 2015 at 10:56 pm

      I’m genuinely happy for you Lea.

    • Gina
      August 26, 2015 at 8:32 am

      Great news Lea – Congratulations. I am five months post OPEN piriformis tendon release and sciatic nerve neurolysis surgery, where they lengthened the piriformis tendon, shaved the trochanter and removed the sciatic nerve that was embedded in the deep rotator muscles. I still have some weak glutes and finding my obturator internus muscle is picking up the slack. As a result, I still have difficulties standing for a long time and walking. I am doing isolated glute exercises and having them release the obturator internus muscle during active release therapy. I provides me relief. They believe once I build up my glutes and they stop fatiguing that the obterator won’t pick up the slack. I am also following up with a physical medicine doctor for an exam to get a proper evaluation on the subsequent pain source and to rule out sacroliaic joint issues. We are really hopeful that my pain is attributed to muscle weakness. But, it is taking so long to get strong that it is very frustrating. I am way way better and have no piriformis pain. YAY! Did you experience any subsequent type pain? How long did it take to feel no pain. What did you do to strengthen the glutes and what other muscles needed strenghtening? They said I suffered since 2008 with this and had a 2011 hip surgery, so it will take longer for me to heal. I am completely anxious to move past all this. I am getting better. I can sit now, but when the obturator internus flares, I get so frustrated. I welcome any thoughts on this! Thanks! Again, very very happy to hear you are doing well. Keep up the good work!

      • Lea
        August 28, 2015 at 1:06 pm

        Like you I am just doing glute strengthening. Due to pain it took about 3 months to start that aspect of the recovery. I still have pain at times so it can take a while for it to go away. My doc said it could take a year. I did have si joint issues. Prp healed the instability. A good pt is a must!

    • Carol Gill
      August 26, 2015 at 10:35 am

      so happy for you.
      so what state are you in?
      and what type of doctor did you finally end up with that did the diagnosis and treatment?

      Carol Gill in Texas

      • Lea
        August 28, 2015 at 1:10 pm

        I am in the nw and my doctor is a orthopedic spine surgeon. Please Reed my posts that go into more detail. They are in the treatment section of the blog. I posted them in late Feb or early march

  27. Carol Gill
    August 20, 2015 at 2:38 pm

    August 20 2015

    I have had Piriformis issues for about 5 years now… also been treated for SI and bursitis … and had lots of pain meds prescribed. heat, ice, stretches, cane, bed rest, some days good, some days bad.

    Realized there are flare ups…. and this time I was not going to wait for the flare up to end…cuz i never know how long that will be. Got busy researching and found something I have been looking for for months…..

    Yesterday I went to a new treatment …. trigger point myofacial treatment… and as much as it hurt (like hell)…. i have hope that this might work. I don’t want surgery — don’t want to be cut open, don’t want to recuperate, don’t want to pay for it….

    look up airrosti.com and see if there are any specialists in your area.

    I will keep you posted.

    One visit down…. and something is happening…. hope it is good. Still sore…
    Carol in Texas

  28. Spring Fernandez
    August 18, 2015 at 6:11 pm

    We have an appt with Hal Martin, MD in Dallas but the reviews on the net are scaring me. Can anyone help?

    • Gina
      August 19, 2015 at 6:12 am

      If, you have piriformis, I would consider looking at open surgery as an option. There are many issues that can also occur in that area. I have heard good things of Adam Star in Dallas. Actually, I have heard any bad reviews about him….. Listen to your gut.

    • August 20, 2015 at 4:13 pm

      My husband saw Dr. Adam Starr this week and the ball is rolling. Dr. Chhabra will do the MR Neurography (MRN) this coming Wednesday; the following Tuesday, Dr. Chhabra will inject the piriformis muscle with botox; and the following Tuesday, we follow up with Dr. Starr for “what’s next”. We finally feel excited about being in a group who recognizes the pain and who take the measures for getting relief, even if that means surgery. Dr. Starr does the invasive technique, so that he can SEE everything that is going on in the area and can make repairs. We understand the incision is a foot long. I would highly recommend Dr. Starr…he is a highly recognized traumatologist (suggest you google), so putting hips back together is routine.

      • August 20, 2015 at 4:45 pm

        Dr. Adam Starr, UTSW (Parkland), Dallas, TX. His Dad happens to have been our allergist in Temple, TX. Small world!!

      • Brian Hobbs
        August 20, 2015 at 4:53 pm

        Sharon- That is awesome! You are in the hands of one of the best surgeons in the world! He did my surgery last Nov and your husband will be glad he does the open surgery. There are TOO many other issues that can be going on there and while Adam can see everything he can fix any other issues. After hearing a lot of people with ortho it’s really a completely different surgery and risk to not get it done right. Just my opinion. My surgery was 3 hours and compared to the other which is 15 min and a quick tendon release. I know it has worked for some but I have talked to so many who also had other issues that were taken care of while doing the open. Again just my opinion from research and personally going through all this for 8 years and now on the other side!! Good luck and let me know if he needs to talk about the recovery. Dr Chaabra will confirm it for certain for you all first as well. You are in great hands, I am glad you got in to see him!

      • Brian Hobbs
        August 20, 2015 at 5:22 pm

        That is a small world! I just saw your post about that a month ago. Not sure why I didn’t get an alert from your post. Adam grew up in that area.

      • August 21, 2015 at 11:16 am

        the p-blog yet! dc


        This is way long, but bear with me.

        Is the MRN (‘Neurography’ vs. I imaging) you mention being done with Dr. Filler’s proprietary scan software licensed to Dr. Chhabra? Just a heads up – if you sign something saying you will be personally responsible for the cost of scans or procedures, and even if the office personnel says your insurance is okay – often scan is $5K or more! – according to negative reviews on yelp, http://www.yelp.com/biz/filler-aaron-g-md-phd-santa-monica – you will be hounded to death by staff to pay! I have no idea if Chhabra IS affiliated with Filler’s procedures, but Filler’s website shows Dallas, TX as a satellite radiology clinic location – so just proceed with caution!

        And from what I’ve read about Botox injections for p-syndrome they can paralyze muscles for months (usually relieves pain as p does not contract) but when it wears off – if it does – you still have p-syndrome, as the CAUSE has not been treated, just symptoms.

        The usual protocol (‘exploratory’ surgery is crazy when you can know ahead of time exactly what is wrong and where) is an EMG and often there are no results as without p muscle contracting no data. Then up to three piriformis pain injections to see if cortisol/lidocaine stop the pain by reducing inflammation. Sometimes that can work permanently as p-inflammation goes down and stops compressing sciatic nerve, but often only works for a few days or weeks.

        BTW and if you have torn your p and it has formed a lot of scar tissue over time – thus enlarged in MRI – was in my case – no amount of injecting will make that scar tissue shrink! Botox and cortisol just keep p from contracting thus no pain – for awhile.

        Sharon, I would really rethink the open ‘foot long’ incision to ‘explore’ all areas of possible entrapments’, etc. (hospital stay post op and cannot sit on wound stitches for months!!)?

        Seems barbaric as a good T 3.0 GE MRI (DTI capable) should show exactly what the problem(s) is/are and where the surgical (endoscopic) techniques should be employed. See below if embedded photo of MRI of pelvic nerves will even show up …

        And that means that a surgeon skilled in endoscopic technique should be able to do MIS and fix the problems without any foot long incision!!

        Please scroll down and see the video of Dr. Jackson’s sciatic neurolysis and p-ablation (so belly of p no longer sits on top of sciatic nerve compressing it).

        My result was some pain sitting of course from two holes of endo surgery for a month post op and now 2 months later NO PAIN ALL! Medicare covered it – less than an hour and half in surgery – and it was done in the brand new surgical suit in Dr. Jackson’s building! Sharon I hope this helps.

        If you have any questions e-mail me tfcr@cox.net – The key to my diagnosis was a regular MRI but with a GE Tesla 3.0 unit (DTI enabled) at Moore’s Cancer Center here in San Diego and read by excellent MSK specialist.

        It showed ‘…obliterated fat plane around sciatic nerve’ confirming (Dr. Jackson said immediately) that indeed surgery was now recommended – no more screwing around with injections! And he knew exactly where and what he needed to do from the MRI!

        He has done 12 or so p-compression releases (doesn’t snip tendon – says is unnecessary) combined with sciatic nerve neurolysis.

        Let me know if I can be of any help as I was a fellow sufferer like your husband – and now I AM NOT! dc

        From reviews of Filler: “…So, that led to surgery a month ago – revealed a notably enlarged piriformis that was entrapping both my superior gluteal nerve and sciatic nerve. Dr. Filler spent 6 hours “fiddling and straightening things out.” … So, what did it cost? I am fighting with the insurance company over the injections and MRI since they think it is ‘investigational’…(and) they don’t want to pay for it.

        My cost for that is about $11,000…(and) then there is the hospital charge of $65,000 for about a 24 hour stay for observation, not even admitted for overnight … and the cost to fly to LA and stay there for 5 days…”

      • Spring Fernandez
        August 21, 2015 at 3:16 pm

        Sharon I am so excited for you and your husband. I have contacted Dr. Starr’s office and they are going to give us an appt. We already have an appt with Dr. Martin and an authorization from our insurance company to see him. It would be very hard to get an authorization to see someone else so we are sort of stuck. I plan on getting an appt with Dr. Starr and seeking his opinion out of pocket. Not sure what that office visit will cost but I feel it is worth it to get an opinion. We have an appt with Dr. Martin in December if my poor husband can just hold out.

      • August 23, 2015 at 2:07 pm

        Brian – so good to hear back from you. Between Matt starting the blog, sharing his experience, your finding the blog and sharing yours, WE CREDIT BOTH OF YOU to our finally being on the right path and can see the tunnel…heading toward the light?!! In my husband’s current state, there is no way he could go months or years like this. Even the PT at Zale Lipshy, after 12 weeks of various modalities of PT, even pelvic PT, felt my husband has an entrapment. So, Brian, I would really like to contact you via e-mail; however, I have no idea how to do so via this blog?

      • Brian
        August 26, 2015 at 3:41 pm

        Hello Sharon
        You can contact me via email at. Bkhobby@yahoo.com

        Thanks! And hope your husband is doing ok.

      • December 14, 2015 at 11:36 pm

        Update on my husband since I don’t see updates that I thought I had posted. Dr. Adam Starr, UTSW Dallas (@ Parkland), performed hip surgery on my husband on 09-28-15. Dr. Starr does invasive surgery, a foot long incision down the hip/leg (you don’t “sit” on it), so that he can see and feel what’s in there. Thank goodness as no definitive testing showed that my husband’s piriformis muscle was attached to his pelvic bone and the sciatic nerve was being smashed behind it. Seven months of it being smashed, so no wonder he got no relief from all of the injections and therapy. Dr. Starr is a hip trauma surgeon (UTSW) at the Dallas county hospital, the trauma hospital of the county, so he has “done” lots of hips in his 20+ years of practice, and he said he had NEVER seen a piriformis muscle attached to a pelvic bone. My husband said if he had a list of five things, he could mark four of them off; however, he is now dealing with sciatic issues. His problems are a pain level of #12 in the mornings, having to exercise, stretch, just to get moving, and the afternoon pain level of #4 or less.
        At six weeks, Dr. Starr referred him back to Dr. Chhabra, who ordered another MRN and CT guided injections. He’s back with the PT he had before surgery, and they are working on his balance and getting things lined back up from I suppose from the compromise of what the PS realigned. He said this afternoon was a better day, it was like he was OK. So, things are looking better and better. Being that the sciatic nerve was being smashed for seven months, who knows how long it’s going to take to get “him” back to happy or if it could have permanent damage. We meet with Dr. Chhabra in two weeks to go over the MRN of the lower si area he had this past Saturday. It’s like my husband and I discussed, he got the PS resolved and now he’s dealing with a new diagnosis and treatment plan. HOWEVER, he would do the surgery over again, as he’s is no longer having 24/7 (chronic) nerve pain. He told his PT that he wished he could get up in the morning like he went to bed, that it would be a good day if that would happen. Small progress tells us things are heading that way. We are blessed. Blessed by Matt who has shared his story and continues to pour his heart into this blog; and we were blessed by finding the post by Brian H here in Dallas, who lead us to Dr. Starr. Without this blog, we’d still be on this horrid journey!!

      • Brian
        January 28, 2016 at 8:19 pm

        Did you have a PT in DFW that you recommend for PS?

      • January 31, 2016 at 7:26 pm

        Brian – my husband goes to Zale Lipshy PT (believe it’s Sprague) UTSW on Harry Hines, Dallas, TX

    • Jim
      August 20, 2015 at 11:20 pm

      Hopefully you will have a good experience. I was unable to get anywhere with him.

      • Spring Fernandez
        August 21, 2015 at 3:12 pm

        Jim – did you see him? and if you don’t mind why was he unable to help?

  29. carol gill
    August 18, 2015 at 2:16 pm

    Pretty please people.
    When you find a doctor. . Tell us entire name and what type and where he or she is.

    It helps us find the right type in our towns.


    • August 18, 2015 at 4:01 pm

      If you are up for medical tourism Carol the young sports medicine ortho surgeon that looked at my 3.0 T (GE) DTI MRI and said you have obliterated fat plane around a part of your sciatic nerve which almost always your piriformis muscle is compressing it when contracted.

      And I asked if he thought I should have yet one more pain injection which my neurosurgeon was recommending (more money for his medical group in my opinion) and he said no lets schedule and I’ll do an endo neurolysis of the sciatic nerve, ablate the p muscle where it is compressing the nerve, cut off the fibrous bands that are probably constricting the nerve too ” (painfully BTW).

      ‘I will also look at your hamstring which appears to be detached from the bone too.” It was and He reattached it with four sutures,

      I have put up the YouTube of the endoscopic surgery on this blog if you want to see it but you will need to scroll down a few posts.

      Here is the link to the surgeon in Pasadena, CA Dr. Tim Jackson Congress Medical Group.

      I am completely pain free now and recommend him and the surgery very highly!

      http://www.timothyjacksonmd.com/patient-info/conditions-procedures/hip-conditions/piriformis-syndrome/ dc

  30. Michelle
    August 9, 2015 at 1:19 pm

    Dick –

    For some reason there isn’t a reply option under your post. What is GE TDI? Could you please advise how I can go about finding a facility that does these?

    Thanks again very much for your advice!!


    • Michelle
      August 9, 2015 at 1:28 pm

      Dick – I found information about the GE 3.0 TDI. Any advice on finding the right doctor to prescribe it?

      • August 9, 2015 at 1:57 pm

        Any primary care or any doctor really, but you have to work with your insurance to make sure they will cover. Ask the radiology department where ever the 3.0 is if they need to do any special ‘protocalls’ to be sure the pelvic peripheral nerves (sciatic especially but sub and superior gluts too!) will image well and fibrous bands around sciatic nerve too, if possible

        My guy says they don’t image well but he suspected they were too tight around the inflamed nerve and the surgery proved him right dc.

  31. Michelle
    August 8, 2015 at 11:59 am

    Hi Matt. Thank you for sharing all that you have on your website! I have had chronic pain since 2005. Two years in I was finally diagnosed with a label tear in my right hip. I had a hip arthroscopy and I guess it repaired the tear but following surgery I developed severe burning in both of my outer thighs when using an elliptical. At first I thought that would be the extent of it. Unfortunately it has only gotten worse. I’ve tried everything. Most recently I tried myofascial release and neat every single time I went for an appointment my right piriformis was in a spasm and I had no control to release it. Finally after the MFR therapist would apply a specific gentle pressure to my piriformis for about 7 minutes all of a sudden it would release as if I had purposely tensed up and released the muscle myself. Apparently this isn’t the norm because it caught all of the therapists by surprise. One had just went to a conference about the parasympathetic and sympathetic nervous system and she said it was involuntary (I knew this but it was good to have someone recognize it).

    I haven’t been to MFR in a couple of months because it was over an hour from home and I had to go 3 to 4 times a week for an hour or two at a time and it became overwhelming. It helped some but did not relieve my pain. My symptoms are sharp, deep pain in my right buttock, severe burning along both of my outer thighs, a dull ache in my right groin. I’m going through a terrible flare up right now and can’t seem to do much else because of the intensity. I’ve read through parts of your site and have come across a couple of doctor’s names. Who would you recommend for me? I am willing to travel to get out of this pain even though dirtying for very long is very uncomfortable.

    Any help you can give would be greatly appreciated!!

    • August 8, 2015 at 1:50 pm

      Look at Dr. Jackson’s website and click ‘Piriformis Syndrome’.

      See my longer comments and the video of surgery jsut below.

      My ice pick pain is gone! I don’t know where you are but perhaps a call to his office to see if he will review any MRIs you have for a diagnosis would be helpful!


      See my comment and Youtube video just below this thread. dc

      • Michelle
        August 8, 2015 at 2:38 pm

        Thank you, Dick! I really appreciate you taking the time to reply! And thank you for deciphering my post in spite of all of the typos (silly autocorrect…I’m typing this from my phone). I’m in Oklahoma but I’m willing to travel wherever necessary if I can get out of pain. This has been going on for so long I just can’t stand it anymore. I don’t do well on most medications and the few I can take have resulted in lots of side effects (many normal that most people experience but others due to my body’s poor ability to process many medications). They keep the pain tolerable usually but when I have a flare up I’m lucky for the medications to just take the edge off. Plus the medications make feel different from my normal self. Less ambitious, more depressed, etc. but if I didn’t have them I don’t know what I’d do. It’s a tough position to be in!

        From what I posted about my symptoms do you think it is piriformis syndrome? I have come across information about Greater Trochanteric Pain Syndrome that matches the burning I have in my outer thighs. I know my piriformis spasms constantly (when I have had a therapist that was able to get it to relax it was such a relief!!). But I don’t have the sciatic pain down the back of my leg…but as I mentioned I have severe burning in my outer thighs from my hips to my knees.

        Thanks again for you help!!

      • August 8, 2015 at 6:24 pm

        I would suggest you get a T 3.0 GE TDI capable pelvic MRI in your area. Call GE and leave message asking for installtioins in your area! They will get back to you!

        he key to my situation (after 22 months of screwing around EMGs, pain injections, useless PT etc. my eitiology was injury) was the last read of the T 3.0 as radiologist finally able to image that the fat plane of my sciatic nerve (no radiating pain down leg either, jsut sitting, walking up hills etc.) was missing meaning it was squished by priiformis. And it was. All good from surgery now. My radiologist is a great guy and will read you MRI 3.0 if you want. Let me know and I will give you his number and the scheduler. dc

      • August 9, 2015 at 1:40 pm


        Call the number and leave message with GE T 3.0 TDI capable – and where in your area would be the closest site with an installation. TDI is Tensor Diffused Imagaing and has something to do with still water imaging, and I am not positive that this is the key to a diagnosis but jsut what my radiologist recommened me getting at the Moore’s Cancer Center here.

        he was able to see the sciatic nerves and the enlarged p with this which an earlier (two months) scan with a GE 1.5 was not able to show. Hope this helps and if you can get a 3.0 scan and read is inconclusive, my guy says he will gladly help with a second opinion read if you will call his department and make arrangements. Then send the DVD!

        Here is an e-mail from my radiologist friend at UCSD REsearch. Another blogger contacted me and we found a T 3.0 GE at a hospital in Des Moines for him. However Dr. Bill Bradely says to be careful of ‘protocalling’ which can be a problem and recommended that Gary jsut come to San Diego for a vacation and get it done here. The phone numbers are in the e-mail too. dc


        Gary can always get an MRI in Iowa and have Brady render a second opinion, however, you should know that he will not be protocoling it and it may therefore be suboptimal and have to be repeated. Most insurance companies do not pay for repeat interpretations and certainly not for repeat scans of the same body part.


        William G. Bradley, Jr, MD, PhD, FACR
        Professor and Chair
        Department of Radiology,
        University of California San Diego Health System
        402 Dickinson St #454, San Diego, CA 92103-8224
        619-543 2890 (W); 619 543 2889 (F)

    • August 17, 2015 at 5:48 pm

      Hi Michelle and all the others. Thanks to Matt who began this blog, and for Brian Hobbs who recommended a doctor here at UTSW/Dallas, TX. My husband has an appointment tomorrow morning with the hip trauma surgeon here and we are hoping and praying that the evaluation will confirm PS and he has the piriformis release surgery. It cannot be too soon, and his has only been going on for the last six months. He would not have made “years” as so many of you have!! We are thankful my husband watched a youtube video, found the doctor in California who was describing my husband’s symptoms to a “T”, and we approached the PM&R doctor with what my husband felt was causing his problems, PS. She listened, referred him to PT in hopes to get relief. Doesn’t matter how much stretching and “needling” they do, it goes back to square one, with constant, nerve pain from his butt to his foot. He cannot cough, sneeze, tilt his head the slightest, walk on uneven surfaces, sit on the commode, without it generating grabbing nerve pain. He is so ready to have the piriformis release surgery and get back to “life”. Good luck to eacn and everyone of you and we are so blessed and thankful we stumbled upon this blog. It has been a Godsend for us!!

      • August 17, 2015 at 6:12 pm

        I wish you both the very best. Please remember, if he has the surgery, to do the physical therapy afterwards. It was critical to my success.

      • Brian
        August 18, 2015 at 11:08 am

        Good luck to you and your husband with Adam! He is great and will be able to help if he does have PS.. keep us in the loop!

      • August 18, 2015 at 11:54 am

        I’m having torble replying – this blog goes way to bottom and i have scroll up to find comments. Anyway I am no after 2 months completely free of pain! Now i jsut have to get endo surgery to decompress L3 exiting as the MRI and CT Mylo show indentation at foramin ‘severe’ which is why my left leg is still dead but not having to do with p-syndrome any more.

        When I press in where I did before in butt, no excruciating sciatic nerve pain and no pain sitting or walking fast up hill with dog now ALL GOOD

        If you can afford to do any medical tourism I recommend Dr. Jackson in Pasadena, CA as he is not far for me to drive but might be worth a plane ticket!

        Super highly recommend him as he does not snip the p tendon as he feels what he does obviates the need. I think what he did when ablating (cutting some away) of the p muscle belly where it was compressing the nerve is sort like a tongue and groove idea like in carpentry. He also took out the fibrous band that where constricting the mashed and swollen nerve too!

        Anyway – all good here now – how I have given hope others on this blog! dc

      • Spring Fernandez
        August 18, 2015 at 6:17 pm

        What doctor is he doing in Dallas and how did it go?

    • CarolSpondenceInk!
      August 26, 2015 at 10:42 am

      Look up airrosti.com for MF release… see if one is anywhere near you.

      Carol in Texas.

      • Michelle
        August 26, 2015 at 2:19 pm

        Thanks, Carol!! I actually have tried Arrosti. Unfortunately it didn’t work for me. I truly gave it a go and endured the pain. It would have been worth it if it would have worked. I’m glad I tried it though!! And I’m ALWAYS open for for advice!! Thanks again!! Did you have luck with Arrosti?

      • November 2, 2015 at 10:11 pm

        Arosti didn’t work for me either. .all I got was a bruise for 2 weeks. Then I tried medical massages… hurt worse too.

  32. Joyce Snyder
    July 29, 2015 at 8:45 am

    Hi, I’m in Manhattan. Diagnosed with PS, did not have MRN. Just plain MRI and EMG (not proactive EMG). EMG showed muscle weakness. My sciatica goes from hip to toe. It is elicited when I do hip abduction and adduction. From reading medical papers online, I’ve concluded I have a problem not with my piriformis, but in my gluteus minimus (consistent with this pain pattern). I am doing Graston Technique with chiropractor and also seeing physical therapist. When Graston was done on the gluteus minimus part of my butt, as opposed to where the piriformis would be, it was very painful. The entire right butt cheek was full of Trigger Points. Anyone investigate problems with gluteus minimus? This muscle elicits a pseudo-sciatica that is just like sciatica.–Joyce

    • Lowell
      August 6, 2015 at 11:49 am

      Yes. I tried it all. Piriformis causes compensatory changes in your glute elicited as trigger points and tight muscles. I treated the symptoms for 3 years before surgery. All the trigger points are now gone and I am 80 percent 5 months post surgery.

      • Dick Cummins
        August 6, 2015 at 1:25 pm


        About a month and a half ago I finally had surgery. This after 22 months with p syndrome that none of the orthos I was assigned to knew anything about evidently.

        One said he would not order a GE 3.0 T with TDI capablility due to cost and the fact that I probably was just suffering from post L4/5 fusion swelling of L5 (2cm’s). I got rig of him and the Medicare HMO and went with AARP United Plan N – so can go to any Doc that takes Medicare and they pick up the rest which so far has not been nearly the $134 a month I pay BTW! (N has $20 copay.)

        So finally after two MRIs and one read the next day as an MRN – not really but they shined me on about that -said they turned down ‘fat sat’ – which said – enlarged left piriformis and a 2cm edema of the exiting L5 nerve root. Thus began the pain injections which just treat the symptoms but as the orthro group i was seeing in San Diego evidently did not have a p man with experience in endoscopic decompression and sciatic neurolysis they finally said maybe I could use some Botox. I told them to take a long walk off of the short ocean bridge in Ocean Beach and found a radiologist here who said he would reread my old MRI/N. Great guy – e-mail back and forth all the time!

        He said indeed the left p is enlarged, gold standard for p syndrome and recommended me to Moore’s Caner Center at UCSD Hospitals for a scan with their T 3.0 GE MRI with TDI (tensor diffused imaging – don’t ask) and the result was!!! Tah dahh! – missing fat plane around left sciatic nerve as well as hamstring torn loose from bone (eitiology of all this was stumbling injury playing out field running and when got up could not even run to first base!)

        Radiologist said may have tight fibrous bands around swollen sciatic nerve (where p is pressing down on it when contracting) do not expand and thus a lot of pain possibly. Not possibly either!

        So I Googled around for a surgeon who does endo p syndrome release and he looked at the MRI/N (3.0) and said I did not need yet another pain injection – that the nerve was very compressed and mashed had been probably for long time. He would recommend an endo sciatic neurolysis ablating the the p belly where it was squishing the nerve as well as reattaching my hamstring where it had come loose from the sacral bone. I asked if he detached the p tendon and he said no did not seem to do any better with that!! Experience counts fellow suffers!

        I agreed immediately because he said he had done 12 -15 of these procedures (says he doesn’t see p syndrome all that often but enough!) and that his surgeries had good out comes so far.

        I had the surgery a month and a half ago and am nearly pain free now!! I was sore sitting on that bun of course due to dime sized holes and a nerve that was scraped clean etc.

        However I still have a road killed dead left leg as the 3.0 MRI and a CT Mylo shows severe lateral recess stenosis L3/4 as well as marked impingement L3 left exiting nerve (foraminoplasty probably in future as well as facet arthrosis reduction to release LRS pressure).

        Also L4/5 (had recent fusion) with L5 now showing marked / severe impingement too!

        So at least I seem to have gotten rid of one pain in the ass (ice pick p syndorome) but still have a ways to go to get rid of weakness and foot pain that I have had for much longer than the p pain.

        For anyone reading this that may want to do some medical tourism to California see my YouTube of surgery that Dr. Tim Jackson (sports medicine ortho surgeon) kindly edited for length and sent to me.

        Not sure if it will open from here but you could copy/paste into URL!

        Here is Dr. Jackson’s link too.. http://www.timothyjacksonmd.com/

        Dick Cummins tfcr@cox.net

      • Lowell
        August 18, 2015 at 9:35 pm

        By the way..I am also Lea on this blog. Sorry for the confusion

      • Gina
        August 19, 2015 at 6:20 am

        Lea/Lowell – I am very interested in hearing more about the compensation issues. I had a piriformis tendon release and sciatic nerve neuroloysis surgery on 3/31/2015. I am having difficulties getting glutes to fire and having sacroiliac pain. I think… Going to the doctor to find out. Either way, I have difficulties still. I previously had hip surgery, and the doctor says it will take a while to build up my muscles. But, I am really interested in learning more about your rehabilitation. Any incite you can provide would be absolutely wonderful and I would be most gracious!!!!

      • Gina
        August 19, 2015 at 6:26 am

        Oh – on the positive side, the horrific piriformis pain and sciatic nerve pain that was terrible is gone. Now I seem to have swelling in si joint that causes some sciatic nerve pain in ankle. Ankle only and pain about 1″ from top of butt crack. If I take Naproxin, it goes away. I am sure it is muscular, but I need to figure out which muscles are not firing and I need to get my core stable. Happy to loose the terrible PS pain, but anxious to get to be 100% better.

  33. Elaine
    July 6, 2015 at 6:41 pm

    Hi Matt,
    I’ve left a message here in the past, but not sure how I read your suggestions?? I have been getting emails where you’re answering other’s questions. I’m now being told with intense physical therapy I can stretch and loose the life stopping pain.. Is this true??
    I’ve had 2 major back surgery’s. L 4 -5 fusion along with S 1- L 5 ALIF fusion.. Praying that’s what it takes as I don’t want any more surgery. Also had a Rhizotomy. 3 surgery’s in 9 months and pains worse than before surgery..
    Thank you,

  34. Jim Judski
    June 30, 2015 at 5:33 pm

    Hello Lori Miller,
    – You can contact me for a personal response with …telljim@yahoo.com
    – Maybe I can put you in touch with a person or two

    Jim Judski

  35. Lori Miller
    June 29, 2015 at 11:18 am

    Matt are you still active on this website? If you are, I know you had some contact information from some folks from Albany NY of where we could get some help. It was a conversation with jim judski and a Tom gentlemen. I would appreciate any help you may be able to provide

    • June 29, 2015 at 11:55 am

      Lori, I suggest searching through the posts. I recall the conversation, but not any specifics.

  36. Sherry W.
    June 23, 2015 at 4:48 pm

    Hello, I have been suffering with right buttock, right hip, thigh, calf and foot pain for two and a half years. It started when I began a very intense workout routine of running, stairs and zumba. Ive had back surgery, but no relief. Ive had many different opinions but only recently piriformis syndrome. I have had a steroid injection in my piriformis muscle and it helped a lot. It’s worn off now. I’ve been in PT for about eight weeks now with no improvement. If fact, I would say it’s worse. I talked to a woman on facebook that says most piriformis is a result of FAI (Femoroacetabular Impingement). I read through the information about FAI and it says pain in the groin, which I don’t have. I know that true piriformis is rare and usually in mega athletes. My question is: Does anyone have anything to add about FAI being the cause of PS? And, what should I do next? I am seeing a pain Dr. What kind of specialist should I see…ortho…or ????
    I am absolutely beside myself. I have got to have relief! I am close to Indianapolis Indiana.

    • Gina
      June 29, 2015 at 1:54 pm

      Sherry – I am pretty certain that you are speaking about me as the person you talked to on Facebook. If you would like to talk to people about femoral acetabular impingement and labral tears, there is a Hip Awareness (FAI, PAO) group on Facebook too. You can contact them and discuss posterior piriformis pain and how it relates to FAI if you need others to set your mind clear about how things work in the hips. For a true diagnosis of PS, you need to rule out hips and spine. If you have no hip issues and no spine issues and you have a tight PS with sciatic nerve issues, a doctor then will confirm PS. Too diagnosis PS only, they can do a MRN, or a similar type MRI with high resolution. You can also get a provocative EMG. However, I had PS and my provocative EMG was negative, so EMGs are confusing. It depends on what branch of the sciatic nerve is being affected. I posted some articles in the Facebook Piriformis groups about testing for EMG. You can check that out. A good type of doctor to start with is a doctor who specializes in hips and femoral acetabular impingement and labral tears. Dr. Henrich, which Matt has his surgery done by is that kind of doctor. You can google Indianapolis, doctor and femoral acetabular impingement and some doctors come up. Dr. Byrd is very well known hip doctor. This doctor studied under Byrd. https://www.methodistsports.com/physicians/dr-peter-maiers/. You can always call his office and talk to his nurse or nursing/physician assistant and interview the doctor too.

      • CAROL
        July 5, 2015 at 12:22 pm

        Gina thsnks for your info. Some good ideas on how to find a doctor. I went to a well known back specialist who ran a CT Scan and xrays with dye and told me I just had sciatica and sent me to pain specialist for injections in my SI areas.
        helped a little bUT when I wenter for follow up I still had pain in hip.. so he sent me to orthopedist who xrays and said I had trocsnteric bursits.. and he gave me injection. BUT my butt and hip still hurts… I still have original problem. Which a chiropractor told me years ago was PS. I will continue searching for trearment. Tired of living on pain medicine.
        anyone in DALLAS know of help…please please let me know.

    • Annette
      September 27, 2015 at 8:17 pm

      There are definitely cases of Piriformis entrapping the sciatic nerve. I had a bad fall and scar tissue formed around my sciatic nerve in three places adhering it to my Piriformis and inferior gluteal artery. I don’t have FAI or other hip issue. So yes it’s definitely possible to not have hop involvement especyif there was an injury to the area or an injury while exercising. Best things to do is to have provocative EMG testing to determine if you have it. Good luck.

    • regina B
      February 20, 2016 at 2:19 am

      I have 20 year old son with terrible Sciatic issues. Which Dr in Indianapolis have you found? I have given up on the Ortho Indy group, and we are seeing Dr Meiers listed below. We do not know yet if he can help.

      • Amy H.
        March 7, 2016 at 6:13 pm

        Regina – I am in Indianapolis too in need of doc that will understand the piriformis/sciatic issue. I had considered OrthIndy as a starting point, but thought I might go whole hog and try to find a neurologist instead. I had an incredible sports medicine/chiro in Evansville that could nip flare ups in the bud, but am years beyond an initial flare up now. Can you please post what you find with Dr Meiers or any further care providers that seem to get the issue?

      • regina B
        March 7, 2016 at 6:54 pm

        Amy, my son has an FAI impingement on his left hip. Dr Meiers believes it is causing the sciatic issue due to poor walking. Today, we just scheduled surgery for May. He did say if we needed periformis surgery, he would to to Dr. Byrd in Nashville and he would go also. He said there is no one in Indianapolis who does not do open. Your other option is
        Neurologist Dr. Nicholas Barbaro at Campbell Brian and Spine – IU downtown.
        Of all of the hip people I have seen in Indianapolis Dr Meiers , he seems to be the best.
        We saw the best hip at OrthoIndy and his gave us 15 minutes of time. Meiers has an excellent PA and athletic trainer that also work with him. So far, so good.

  37. BK
    June 23, 2015 at 3:59 pm

    For those who saw Dr. Heinrich, I’m scheduled to see Dr. Heinrich in 3 weeks. I live in Seattle and obviously would like to make as little trip as possible leading into surgery (of course if necessary). So my question is what exams/tests did Dr. Heinrich had you to go through before scheduling your surgery? I read Matt’s posts and it sounds like Provocative EMG was the only thing he ordered. Did he ever suggest a Botox injection or some kind of injection to confirm your have P.S.? Other question is, did you call directly to Dr. Hardin’s office to schedule a P.EMG or Dr. Heinrich’s office did it for you? I reached out to Dr. Hardin’s office a couple times but no one called me back. Thank you for you help!

    • Gina
      June 29, 2015 at 2:00 pm

      I went there and Cindy from his office new I was out of town and scheduled everything. They set up appointments with Dr. Hardin and Dr. Henrich, as well as set up a test a groin injection to make sure I did not have a hip labral tear or femoral acetabular impingement. I did not have Dr. Henrich do my piriformis release as he only does scope surgery. After researching this, I learned that open surgery would be a better option for me. As it turned out, I am glad I did. My pifiormis muscle was so tight it rubberbanded the sciatic nerve to the deep rotator muscles, the sciatic nerve was growing and attached to the trochanter and I had to have bone shaved off my trochanter so the sciatic nerve would no longer rub. If I did scope, they could not have moved my leg around to see that the nerve was rubbing on the trochanter and I could have had additional issues with sciatic nerve pain, even though I had the release.

  38. Dick Cummins
    June 21, 2015 at 11:42 am

    Okay – have had ice pick in butt since 2103 Sept. Stumbled forward playing senior softball running in outfield, got up with ice pick in left buttock. 21 months now and a fusion of L4/5 not related we knew but had spondo and ‘indented L4’ ,etc. so opted for surgery. Surgeon said we could deal with ice pick later as it looked like piriformis syndrome to him.

    Now have confirmed PS with Tesla 3.0 GE MRN scan at Cancer center UCSD hospital in San Diego. My (former) neurosurgeon says flat sciatic nerve left side with no white fatty outline thus probably PS as it looks compressed. He wanted me to have yet a third injection but I opted for finding another surgeon with experience in PS – as this one didn’t believe it was real until seeing the MRI/N

    Goggleing I found Dr. Tim Jackson, Congress Medical Center, Pasadena who has done 13 -15 endoscopic piriformis decompressions. As he says this is not a common syndrome but definitely exists! And as I am retired (72) and have time on my hands I did a lot of reading and this doctor is totally comfortable talking me through all possibile outcomes and phases of treatment unlike some other doctors who do not like it that I have read many peer-reviewed paper on the subject.

    I will be having an endoscopic sciatic neurolosis and piriformis decompression tomorrow (not tendon snip as he doesn’t think this is all that helpful if you can ablate the area of the pirifomis that is compressing on the nerve – if indeed that is it.

    I will report back soon. Dr. Jackson points out it can take some time to see if the procedure is successful. This from his site:


    The diagnosis of piriformis syndrome involves a combination of physical examination employing different movements of the hip and the leg which may trigger characteristic pain in the buttock and leg. Imaging studies such as MRI may be useful in ruling out other causes of sciatic nerve compression such as degenerative disc disease, spondylolisthesis, spinal stenosis or arthritis of the spine.


    Dr. Jackson specializes in a minimally invasive, endoscopic sciatic nerve decompression. With this technique, two small, less than 1 cm, incisions are placed in the gluteal crease and all areas of possible sciatic nerve impingement are released.

    ‘In patients with severe pain, corticosteroid or anesthetic injections can also be used.
    In a few cases, botulism toxin injections and electrotherapy can also be considered. These help reduce the muscle tightness. In patients not responding to the conservative approach, surgery may be considered. This involves the endoscopic surgical release of the piriformis muscle and decompression of the sciatic nerve.

    If you go to the link below Dr. Jackson has a video of him doing this procedure while narrating the techniques and progress. Excellent and very helpful to me!


    dick cummins 6-21-15

  39. Elaine
    June 17, 2015 at 11:01 pm

    After 2 major surgery’s with complications in Tucson, AZ my surgeon says I’m healing fine and shouldn’t be in pain.. Ahhhhh,, I am in severe pain.. Do you know of Dr.s in Tucson I could be referred too??? HELP…
    Thank You,

  40. sherie
    June 4, 2015 at 6:03 pm

    I had a botox shot 3 weeks of heaven then it wore off I want to find a surgeon in albany ny for piriformis anyone

    • Lori Miller
      June 6, 2015 at 9:17 pm

      Hi sherie, I too am struggling to find a good doc in Albany area to help with this whole periformis issue. Have asked a few times on this site but have not gotten any answers back yet. I have also been trying to find out where to go for the mrn scan. I hope we can get some answers from some kind folks.

    • Lori Miller
      June 29, 2015 at 11:05 am

      Hi Sheri. Did you have any luck locating any doctors close to you?

  41. May 26, 2015 at 12:40 pm

    Hi Matt, Jerry Hesch is an amazing practitioner who has helped a lot of people diagnose true cause when they have had little luck with Drs. He asked me to direct you to him since he has moved to Aurora, COLO. Here is his website page on facebook. https://www.facebook.com/heschinstitute?pnref=lhc
    and his website page http://www.heschinstitute.com/

    Hope all is well with you !

    Kat Bunker

  42. May 19, 2015 at 12:18 pm

    Sorry Debbie can you please retry your question?

    • Debbie
      May 20, 2015 at 10:55 am

      Yes, I’m sorry Matt. I have been struggling with what appears to be piriformis syndrome for 8 years. I have been misdiagnosed, operated on (before finding sites like yours with valuable information), injected, “ablated”, PT’d,… I finally gave up trying to find a cure, and after 6 years my doctor talked me into an intrathecal pain pump. But it’s not a good solution because the muscle just continues to spasm. Before the pump I monitored your site, seeking resources. I was also a member of another group Long story short I am looking for a list doctors in or near California who know what they’re doing.

      • Gina
        May 21, 2015 at 5:22 am

        Line Jaques in San Francisco mentioned in one of the Facebook Piriformis Groups.

  43. carol gill
    April 6, 2015 at 6:30 pm

    I live in richardson tx
    I need a local doctor to treat my piriformis syndrom… I dont want pain pills.. I want to be mobile again. To be able to do a complete grocery shopping trip without having to sit down. Couldn’t climb the stairs at symphony last week ..had to pull myself up on the rails…so embarrassing.
    Daughter having big wedding in june. I don’t want to sit on sidelines.

    I want a shot or surgery or magic. …

    Any recommendations?

    • Gina
      April 6, 2015 at 8:39 pm

      Adam Star in Dallas Texas gets it. There are few doctors that really understand piriformis muscle syndrome. He is one of them. He will examine you, require MR Neurograpy, a provocative EMG, two botox injections and be able to make a proper diagnosis.

      • Spring Fernandez
        July 14, 2015 at 3:20 pm

        Tried to get this physicians number and it proved difficult. My husband has PS and it is wearing him down he is very depressed. Pain doctor can’t find a “back problem”? No help there. Referred to Dallas drove three hours from Abilene for the physician to say he doesn’t take care of that. This has just been a very frustrating ordeal. Otho surgeon says PS and second opinion and pain dr say they don’t believe that is a “real disgnosis”. As a nurse my heart is breaking for my husband as constant pain is affecting him emotionally!

    • Sue
      April 7, 2015 at 8:04 am

      I’ve had piriformis for 8 years and finally had a shot and was greatly relieved immediately. I asked the pain doc to put in the same shot that Dr. Filler would use. About 20% of patients have success with this injection. I’m getting a second one in 5 weeks to make sure. I also would do the stretching exercises, but be careful as I stretched too much and partially tore some hamstrings. Good luck

      • Kelly
        June 11, 2015 at 6:10 pm

        Can I ask what shot you had? I got piriformis syndrome after my l5s1 fusion in January. I’m going to try trigger point injections in 2 weeks

      • June 15, 2015 at 1:05 pm

        Kelly read my treatment history page. Thanks.

      • sue
        June 15, 2015 at 1:21 pm

        If you google Dr. Aaron Filler he mentions an injection on his website, with the ingredients. I took that to my pain management people and literally after the injection the pain was gone. You may have to have another one in 5 weeks, but I didn’t.

    • May 3, 2015 at 9:30 am

      Carol, here is my email. Please feel free to contact me. I just had surgery three weeks ago.

  44. Sonya Anderson
    April 1, 2015 at 6:06 am

    I have some exciting news for people in the Denver area. I have suffered from this undiagnosed condition, Piriformis Syndrome, for three years. Last month I was bed ridden and told there was nothing else that could be done except pain management. I was searching for a doctor in Colorado to order an Neuropathy test ($4,000 out of pocket) to confirm I have Piriformis Syndrome so I could seek help in another state, possibly surgery. A friend of mine suggested I go and see Dr. Maya Gonzales of Evergreen Spine and Sports Medicine. I went and discovered that unless the sciatic nerve goes through the piriformis, this condition is treatable through active release. I am on my forth treatment and I am walking. The pain is greatly reduced. I am getting better. I am so excited to be getting my life back and without the need for surgery. I highly recommend Maya to anyone who wish to get an accurate diagnosis. She is also willing to order any imaging that might need to be done. Finally, a piriformis expert in the Denver metro area!

    • Jill Farris
      October 5, 2015 at 4:42 pm

      Sonya – I live in the Denver area and have been suffering from “undiagnosed” Piriformis syndrome since having my 2 level spinal fusion in 2009. I would like to talk directly but do not have your email. Mine is jill4rockymts@gmail.com I am interested in hearing how you are doing and may visit Maya to see if she can help diagnose me.

  45. March 29, 2015 at 10:47 pm

    Does/has experienced PS with glute Max atrophy and not have issues with piriformis release? Dr Heinrich says he’s not worked with anyone with glute atrophy so couldn’t answer my specific questions. Does anyone know of a closer, endoscopic PS surgeon in southern IL or St Louis area? I’m near Barnes Jewish/Washington University St Louis but my physiatrist says no one there does PS release. pretty sad considering it’s a top 5 in the US and the Ortho team are the Drs to the local pro sports teams. Does anyone know, from personal/medical experience how that would affect me having bum? My plan was to get into the gym before this happened to work on it, too late😪 I don’t know how much more I can take, especially with the added no bum issue and wondering if anyone would touch me. I got the fat that looks like a have a nice bum. (FYI: glute atrophy started somewhere along the line of my back problems and was not activating them, then an illness that kept me bedridden and not eating well, and I’m sure being bedridden now is probably making it worse😩

  46. James
    March 29, 2015 at 8:50 pm

    Can anyone in the southeast direct me to what they believe is the closest provocative emg testing location? I live in Columbia SC. Thanks in advance.

  47. Ace
    March 25, 2015 at 3:21 pm

    have you heard about dr dieter mortier from Belgium ?

    • March 31, 2015 at 9:50 pm

      I have heard of him, but have no opinion of his work.

  48. Mike
    March 20, 2015 at 9:00 pm

    Has anyone ever experience pain points instead of full blown sciatica down your left leg, mine are 1)below my left buttock, 2) in my thigh, right above the knee in the back, 3)on my calf(outside center ), 4)on my foot(top, behind big toe)? I am not sure I have a piriformis issue, no experts here, but I did have a lower back injury with surf board and recently tripped on steps and fell down hard on my buttocks.

    • March 29, 2015 at 10:32 pm

      I have nerve pain in places I’ve never known exsisted or expected! I get pain from L4-S2. Side of thigh, behind, both sides of calf muscles, sometimes center, all toes, genital pain that varies (some I know is coming from pudendal and some possible from S2-3?), front upper thigh, shoots up the back…it’s crazy! My life is spent in bed and PT for manual therapy; since I wasn’t taken seriously it’s so bad I can no longer do simple glute raises without nerve pain, assuming adhesions have taken great hold. My left side, the nerve comes over the P and splits after that. Going to do botox. Hoping if I get relief from the injections (bilateral PS) and stretching and strengthening doesn’t help, I may beg my PM Dr to keep injecting to permanently shut it down vs surgery.

    • Annette
      September 27, 2015 at 8:40 pm

      The pain points you describe could be from your sciatic nerve. If you had a direct trauma to your buttock and your Piriformis is tight or if scar tissue has formed then your sciatic old possibly be compressed. Go online and follow the diagram of the sciatic nerve and its branches down the leg. You can experience pain in any number of ways when your nerve is involved. Sciatic pain is tricky. Some people can be compressed in their lumbar or buttock and may only feel pain in the back or side of your calf, or ankle, or toe but not feel pain anywhere else. I have these painful points down the track of my nerve. I had a bad fall directly on buttock then thick fibrous bands of scar tissue formed around my sciatic nerve in three places compressing it to my Piriformis and inferior gluteal artery. I recommend you get a provocatyEMG test to rule out Piriformis/sciatica. Check out LOREN FISHMAN in NYC. HE WROTE A BOOK SCIATICA solutions. It’s on Amazon. Buy it and you will find info on provocative EMG testy which he created. If you can’t go to see him for the testing then try looking for a physiatrist in your area who knows about it and knows how to do it. Regular EMG testing doesn’t show for this you have to do this specific test. Good luck.

      • Mike
        October 3, 2015 at 8:50 am

        Thank you Annette, I do believe a provocative EMG is needed, but have no real knowledge of anyone in central PA with reputation, will continue to look around on this site for closest contact.

  49. Tania
    March 19, 2015 at 8:08 am

    Matt–Currently gathering my past records/attempts at treating my 2 1/2 year battle with PS to send to Dr. Heinrich to see if he will take on my case. Wondering if you are still pain free after having surgery with him? Thanks in advance!

  50. Jim
    March 9, 2015 at 6:27 am

    I am scheduled for the same surgery and was wondering if you or anyone has had trouble with insurance paying for the procedure?

  51. Sue
    March 5, 2015 at 8:55 am

    I have been reading your blog and have suffered from Piriformis Syndrome for years. I too have gone to numerous doctors that all had a different diagnosis and treatment. I’m unable to fine a doctor in my area that can perform this surgery (Jacksonville, FL) and wondered if you had any contacts in my area. I have talked to Dr. Filler’s office in CA about the MR Neurography Scan but it would be out of pocket. Any suggestions? I’m desperate.

    • Kandace Compton
      March 20, 2015 at 12:40 pm

      I’m so happy you guys are all here. Knowing you have done your due diligence and still ended up no where like I makes me feel not so alone. Would be better if they would not do this. I’m looking for a doctor in the Washington DC area. I called Dr. Heinrich’s office to see if he might refer me to someone here. Beware the reception is rude and will say “Have we seen you? Well then no we can’t refer you.” First, of course you haven’t seen me, I’m in DC and you’re in the midwest. Second, I would prefer to have the Dr. not the receptionist tell me “No or Yes”. Not belittling her position but I must have been right as I submitted a complaint on Dr. Heinrich’s website and got back a nice reply that said they were sorry and the receptionist would be talked to. It may take a while but at least I’ve started with the source. I’d try calling too to see if he knows anyone in the Florida area.

  52. Sonya Anderson
    February 16, 2015 at 2:00 pm

    Hi Matt,
    I live in the Denver area and need to find a doctor who specializes in piriformis syndrome. It has been speculated that the sciatic nerve goes through my piriformis. I have spent three excruciating years having everything ruled out and now the solution is a pain management clinic. I need a doctor that might refer me to an MR Neuropathy scan so we can see what is going on. This seems to be a family condition as my younger sister just started having symptoms. Neither of us has been in any kind of accident. Who did you find to get the ball rolling here?

    • Pam B
      February 21, 2015 at 1:50 pm

      Dear Sonya,
      I live in the Denver area as well and believe that I may have piriformis syndrome. I am looking for a doctor who does the provocative EMG and who might do the release surgery closer than Milwaukee. Have you have any luck finding doctors in Denver to help you? I have been to many doctors here without much help yet. Still searching!

      • Sonya
        February 21, 2015 at 4:45 pm

        Pam as of today I have not. Most doctors in this area want to refer you to a pain clinic. I told him I’ve been suffering for three years and opiates are not the answer. Currently I’m getting all my records together to send to Dr. Heinrich in Wisconsin. I am hoping that he will refer me to do one of the tests that can confirm piriformis syndrome but out here. There is a facility that does these tests but you need a doctors referral and they admit that they haven’t done many in the Denver area. If you want to email me directly or reply so that we can talk more. I will let you know as soon as some something materializes.

      • Pam B
        February 21, 2015 at 5:13 pm

        Hi Sonya, I would really like to email you directly but I don’t have your email address. Mine is pbrody2@gmail.com. Look forward to sharing some info about where to go (or not go as the case may be) in the Denver area…Pam

    • Gina
      February 21, 2015 at 2:11 pm

      I don’t know if this will help you, but Hal Martin in Baylor Texas, taught Henrick how to do the release surgery. There is also a doctor, Adam Star in Dallas that does the “open” version of the surgery. Hope your all having a less painful day…..

      • Pam B
        February 21, 2015 at 6:02 pm

        Hi Gina,
        Thank your for the info! Has anyone had the surgery with Hal Martin or Adam Star? I am wondering what kind of experiences people with PS have had with these docs. Hope you are having a good day! Pam

      • Brian
        March 14, 2015 at 9:27 am

        @Pam B- I am the one here who used Adam Starr in Dallas. I know him personally as well. He is one of the best hip surgeons in the world and well known. For him to do open PS release is very easy for him as it is a procedure he does in all his normal trauma surgeries for shattered hips. He will put you through all the diagnostics to make sure you have PS but I cant speak highly enough about Adam, he is amazing!! I suffered with this for 8 years, tried everything, and saw everyone! He did my open procedure Nov 17th 2014 and I have been pain FREE ever since!! I cant recommend him enough. My story is all through this blog as well. For some reason I stopped getting notifications when people post so I am way behind …. Let me know how I can help you!

      • Sue
        March 16, 2015 at 8:12 am

        Thank you for the information. I wonder if Dr. Adam Starr would know of anyone in Florida that could to this same surgery I’m just like you in this regard, suffering for 8 years and can’t take much more. I’m at my wits end. Could you find out if Dr. Starr knows of anyone and get back to me. I would be forever grateful. srobertsimco@hotmail.com

      • Trina
        April 1, 2015 at 4:17 pm

        Hi Brian, I was wondering if you would mind privately emailing me. I had surgery with Dr. Heinrich but am still having some problems. I have a few other doctors written down that I might try to contact, and am curious about how things are conducted when someone meets with Dr. Adam Starr. For example, do you need a referral to see him and if he will ask for a MR Neurograph before scheduling surgery?

  53. Lori Miller
    February 2, 2015 at 11:39 pm

    Hi Matt, I too am having sciatic issues after L5/S1 discectomy/laminectomy. My surgeon said he did not know what was causing it. Suggested to go to pain management. I have been trying to figure out what is wrong by my symptoms which have gotten progressively worse. I am 8 weeks post op and now have symptoms which exhibit the periformis syndrome and are now going into groin area. I have appt. with pain doc in two days for back injection but feel I need the injection for periformis syndrome. I only have till March to figure this out due to having to return to work. I too live near Albany, NY and would love to know the doctors that Jim may know of. This is so painful and no one seems to be able to help.
    Thank you for this site!

    • Trina
      March 27, 2015 at 10:45 am

      Hi Brian, I was wondering if you would mind privately emailing me. I had surgery with Dr. Heinrich but am still having some problems. I have a few other doctors written down that I might try to contact, and am curious about how things are conducted when someone meets with Dr. Adam Starr. For example, do you need a referral to see him and if he will ask for a MR Neurograph before scheduling surgery?

  54. Megan
    February 2, 2015 at 8:43 pm


    I have been reading this and wow. My story is that I was a swimmer my whole life, ending it being a ncaa division 1 swimmer. Right before I graduated college I fell on by lumbar/butt hard. That night I had slight tingling in my feet butt didn’t think anything of it. That has been my main symptom until recently. I saw a slew of doctors and got a mri from my brain to my butt (since I was so young(22) to rule out everything) came back negative. Got all the blood work, muscle emg testing, everything came back perfect. I’ve had so many doctors sign me off. I’ve seen multiple chiropractors, massage, acupuncture trying to be holistic as possible. It’s been 3 years since the fall and my symptoms are the most terrible they’ve ever been! Tingling/burning down my whole legs/feet/butt. I also have some slight tingling in my hands and that has been relieved by massage around my clavicle area because all of those muscles are clumped up too! Anyways, now I’m starting to get random shooting pain around my hip area and sciatica pain down my legs. I am a nurse and work for a surgeon who is the one suggested I had piriformis syndrome but I live in Columbia, SC. Any suggestions on what to do next or a reliable surgeon to see in the southeast? I need to start going to see a pt/try injections next but I know my piriformis is wrecked and just getting worse with everything I do . The tingling is unbearable these days! Help!!! I’m miserable and only 24!

    • Athena
      July 19, 2015 at 7:35 am

      I have seen Vicki Sims and Dr Weiss in Gainsville GA. I had SI joint dysfunction and had their fixation surgery. I have now developed PS and am going back for the release surgery. I have buttock pain and sciatic pain in both legs but the tingling drives me crazy! I live in Orlando and couldn’t find any doctors locally that treat this here

  55. beverley
    January 12, 2015 at 8:28 am

    i don’t have piriformis syndrome although I do have issues there but my primary pain is coming from my PSOAS — which is shorter on one side (found in a special MRI). I would like to try and botox it — does anyone know who does botox in NYC?

  56. December 4, 2014 at 8:07 pm

    Thanks Scott M. I am glad you explained to me. I keep thinking I should see Martin cuz my hip doctor said so. But am very happy with Henrich and besides he is closer. Just wanted to make sure you didn’t have an odd experience or knew something I didn’t. Glad to hear it was more of a scheduling situation. Please keep me posted on your progress.

  57. December 4, 2014 at 8:01 pm

    Trplhluvr I am extremely grateful for your post and to hear how well your doing. I saw both Dr. Henrich and Dr. Hardin and am very pleased their knowledge and patience. They took a lot of time with me. Your symptoms sound more similar to mine. I only have buttock and ankle pain. The ankle pain is horrible too. I would love to chat. If you would not mind? My personal email is Harleywg22001@yahoo.com.

    Last week I went to spine doctor and had that ruled out. Monday I go to a neuro muscular doctor. I really want a MRN before surgery. My EMG did not test positive, but I to am hyper mobile and dr. Henrich didn’t seem to concerned.

    I hope to hear from you. Gina

    Thanks for your post!

    • Trplhluvr
      December 4, 2014 at 9:53 pm

      Hi Gina, I would love to chat! I have not spoken to anyone else who has ever had this or these symptoms. I am going to shoot an email to you tonight and you can respond whenever you have time. It sounds like you had the same provocative EMG experience that I did and Dr. Heinrich did not seem too concerned about mine either. I think because I had a positive response from the injections, that helped him with his diagnosis. I also wanted a MRN first, but I could not get any doctor to refer me and it is out of my network so I would have to pay the full cost. I still hope that I don’t need to go that route, only time will tell.

      I hope to hear from you soon!


  58. Scott Morse
    December 4, 2014 at 7:47 pm

    Hello all just got home from 3rd Botox and steroid w/ lidocaine in my prior forms muscle the Doc shot my a** in two spots ( think bee sting only with a 5″ stinger into the butt it feels like the shot goes deep enough to touch your pelvic bone. I am sitting in my overstuffed chair drinking a glass of my favorite red wine ( it relaxes my muscles). After the injection I Christmas shopped with my wife all afternoon, so shot at 11:30 am got home at 6 pm and I hurt so bad but I know the payoff will two days from now ( hopefully). Dr Hardin emailed me back and told me that if Botox gives relief he believes I should stay the course. And my Dr. Arora confirmed that with each Botox injection into the Piriformis that it causes some atrophy and sooner or later the Piriformis will shrink enough to stop the pressure on the sciatica. That’s if I’m in the 80% that has the sciatica go underneath the Piriformis. So will you all pray that I am in that group and not the Group that has a split sciatica or one that weaves through the Piriformis fibers? Will keep you all posted when the Botox takes effect

    Happy Holidays y’all

  59. Trplhluvr
    December 4, 2014 at 5:03 pm

    I would like to make a few comments on this website. First of all, I am so thankful to have found this website, there isn’t a lot of information out there regarding piriformis syndrome. And it mimics so many other things that doctors tend to rule out those other things first and by then, the pain from this syndrome only seems to get worse.

    Mine started out as a mild ache in the hips, which I ignored because I was a runner and was used to feeling aches and pains. Then I started having problems with the bottom of my feet. The pain eventually moved into my lower back and then my backside. It just kept progressing even though I had stopped all sorts of exercise. It got to the point where I couldn’t stand to go to work and I had absolutely no social life. I couldn’t drive in a car anywhere. My lower back hurt, my hips and backside burned and hurt, and my feet were intolerable, they burned and ached so bad I couldn’t stand on them for very long and when I did sit, that made my hips/backside and feet worse. I realized that any kind of bending at the hip made my feet worse and that sitting brought intolerable pain from the hips on down.

    I went to 8 different doctors who all didn’t listen and dismissed me, even after I told them that I knew something wasn’t right in the hip/backside area that affected my feet. They kept ordering blood tests, X-rays of my feet and back, MRI’s of my back. Everything kept coming back normal and doctors kept telling me I was fine and it was in my head. Every doctor kept prescribing me medications…3 NSAIDs, gabapentin, prednisone, and none of it touched my pain. I could take the hip/backside pain if I had to, but I couldn’t take the foot pain. And it was on both sides.

    I found this website and traveled to Milwaukee to see Dr. Heinrich. He listened to me and didn’t make me feel like I was crazy. He actually did a hip MRI, which I had asked for from other doctors. He also sent me to Dr. Hardin for the provocative EMG. I also had injections in both of my piriformis muscles.

    Again, I am grateful to have found this website. But please, learn to trust yourself and fight for your health. Everyone is different and I think that people with this syndrome all have different symptoms. I see similar stories, but none are exactly alike with symptoms and pain. I also have realized that some people have multiple issues and some only have one, so that affects your symptoms and your treatment and how you respond to treatment.

    I wanted to share my story because I can’t say that anyone else will have the same symptoms as me or the same results as my treatments.

    My hip MRI was pretty normal and healthy except that it showed I had tendinitis and bursitis. No tears or rips or anything like that.

    I had the provocative EMG and it came back normal, just like my regular EMG. Dr. Hardin told me that I was super flexible and more females “pass” this test than males, so this result didn’t mean that there was nothing wrong with me. It was still very possible that my nerve was being pinched, especially from me explaining my pain symptoms. I kept reading on this website that I had to have a provocative EMG and that once it showed my nerve was pinched by my piriformis, I would have proof and that someone could finally help me. So when my provocative EMG came back normal, I was devastated.

    I did have relief from the injections for about a week, but the injections only gave me relief from the muscle pain in my hip/backside/back area. The foot burning and pain was still there. Dr. Heinrich explained that there was muscle pain, so the injections helped with that…and there was nerve pain. The muscle was probably still pinching my sciatic nerve, and that was nerve pain I was feeling in my feet. The injection couldn’t help with the nerve pain, only muscle pain.

    I can take the hip/backside pain, but I cannot tolerate the foot pain and burning. That is the worst part of this. And medications do help with the muscle pain in my hip/backside area, but they do not touch my foot pain/burning.

    I then scheduled surgery with Dr. Heinrich for the left side. I had the same 3 things done as Matt. I am now 8 weeks out today. I am hoping that the left side heals so that I can get the right side done. I am one of a few of his patients that has had foot problems with this syndrome. I guess most people have pain that travels only to the thigh or the knee, but mine goes further. I was also told that 2 other patients had relief in their feet pretty much right away, but I haven’t. Mine comes and goes. I am still hopeful that will get better though, because right now I feel better than I have before surgery.

    I shared my story because I do not have anyone else to talk to about this. None of my friends or family know what this is…if you ask someone about their plantar fascitiis or back pain, they can all relate to that, but no one understands this. Not even the doctors in my area. I found what information I could find on the internet and had to take my health into my own hands. One doctor wanted to do foot surgery on me and another sent me to a chiropractor which I stopped going to after a few visits. Trust your gut and fight for your health.

    Dr. Heinrich and everyone else at his office has always treated me with absolute respect and courtesy. They are honest with you and will try their best to find out what is wrong. I have no guarantees that my surgery worked yet. My hip/backside pain is different after surgery, but I feel that is only going to get better. No one can tell me if the foot pain will go away completely yet. But their office was willing to take a chance on me and I trust them. I believe they know what they are talking about and I have ruled out everything else with my back and my feet.

    The one thing that I can say Matt is absolutely correct about is going to physical therapy. I tried that before my surgery and it only aggravated everything. Now that I am going after surgery, I always feel better after I go to PT.

    I apologize that this is so long, but wanted to share. Other stories have helped me on this website, so hopefully mine can help someone too.

  60. Ted
    December 3, 2014 at 6:37 pm

    Thanks for helping others with this tremendous resource, Matt. I greatly appreciate any input you or anyone else might have on my sad story.

    My basic deal:
    -Early 40’s male, previously very active with jogging, cycling, skiing, weights.

    -October 2013: Onset of severe right side gluteal pain that made sitting for a few minutes a painful challenge. Followed lumbar pain that resolved in a few weeks.

    -March 2014: Provocative EMG with Dr. Fishman in Manhattan. Findings included “prolongation of the right peroneal H-reflex of more than 5.2 ms when compared to the left.” Fishman’s impression: “electrophysiological evidence of a significant right piriformis and at the posterior tibial branch of the sciatic nerve as it leaves the buttock in relation to the piriformis muscle.”

    -March 2014: Botox injection into right piriformis by Fishman. Relieved glute pain by about 75%, but was left with proximal hamstring / ischial tunnel area pain that onset immediately upon sitting. Not as bad as glute pain, but still problematic.

    -June 2014: MR Neurography study of the Pelvis with attention to the right side. Filler’s impression: “Significant broadening and flattening and hyperintensity change affecting the sciatic nerve from the sciatic notch to below the level of the ischial tunnel; findings consistent with pelvic nerve entrapment such as piriformis and ischial tunnel syndrome.”

    -August 2014: Convinced by Columbia educated Neurosurgeon in Denver area (where I live) that piriformis syndrome could not be the generator of my nerve oriented pain now extending below the knee and into my right foot. Got an ortho opinion consistent with his and then had him perform a “minimally invasive” L4-L5 laminotomy + L4-L5 & L5-S1 foraminotomies to address mild/moderate neural foraminal narrowing shown on multiple regular MRI’s. Big mistake.

    -Current (almost 4 mo. post op): Nerve pain into my foot much worse than before surgery – really bad. Glute and upper hamstring pain about the same.

    My questions:
    1.) Can the piriformis and/or ischial tunnel be responsible for burning, pins/needles, numbness symptoms into the foot?
    2.) Could lumbar decompression surgery aggravate those symptoms and make them more intense? Or do symptoms worsened by surgery give me a smoking gun that they were messing around in the right area?
    3.) Can MR Neurography provide findings consistent with PS, but the pain generator still be the spine?
    4.) Does any know of a physician capable of performing a provocative EMG in the Denver area?
    5.) Any opinions on whether Filler’s MRI guided injections in the piriformis are worth the travel / hassle / expense? Or would an ultrasound guided injection probably accomplish about the same?

    Thanks again for any input on the above and/or advice on where I go from here. The glute and hamstring pain are annoying and limiting, but the foot pain is nearly intractable. I think my next step is to try to figure out whether the foot pain is coming from the spine or piriformis by injecting each and seeing what changes, if anything. Peace, Ted

  61. Scott morse
    December 3, 2014 at 4:24 pm

    You were right about Dr. Hardin wow I sent him an email and I got a response within a few hours , what a doc very knowledgeable about Piriformis. He suggested that if I get relief from Botox that it would be reasonable to stay the course and each subsequent Botox injection can cause atrophy in the muscle and relieve the nerve pain a little longer until the the muscle atrophies small enough to relieve the pressure. Of course that is if I’m one of the 20% that has the nerve interweaving through the muscle fibers and with my luck I believe the later.
    He mentioned he does not do the nerve entrapment surgery and he has a different surgeon do that Scott Mitchell do you know he has to do that endoscopic procedure?
    Also how long did it take you to recover from the surgery? And was there the extreme pain with the surgery as us piriformis (syndromees) go through every day all day?

  62. December 3, 2014 at 8:54 am

    Scott, . May I ask why you decided to go to Dr. Martin, over Dr. Henrich? I am in the process of getting my insurance approved to have surgery with Dr. Henrich in January. My hip doctor recommend Dr. Martin, but he is in Texas and Milwaukee is closer to me. I met wirh Dr. Henrich and he is very thorough and knowledgeable. He rechecked my FAI hip surgery to rule that out, recommended going to spine surgeon and that was ruled out. Monday, I am meeting with Dr. Shook at Cleveland Clinic, he is a neuro muscular doctor to see what he says and make sure. I am hoping he will order a MR Neurograpy to make sure too. My provocative EMG with Hardin came back negative, so it is not clear 100% piriformis muscle pinching on sciatic nerve, so taking extra caution to rule everything else out before surgery. Dr. Henrich says sometimes EMG doesn’t test positive and the release is still the answer. I am hyper mobile, so a stretch for most, feels like nothing to me, so the EMG isn’t always accurate. I am in horrific nerve pain and the spasm seem to be getting worse and worse.

    • Scott Mitchell
      December 3, 2014 at 11:27 pm

      HI GINA, I tried DR Heinrich at first.His office told me that he had a back log of at least 10 patients waiting for the surgery .This was in April of this year.They also told me there was a “shortage” of the tubing that he preferred for the camera and instruments.After consulting with DR HARDIN(still the best doc i’ve ever met) he suggested DR.MARTIN.And he also mentored Dr H in this procedure.Still took me this long yo her here.Surgery is on the 11th and i am praying for relief,and i’m pretty much agnostic,LOL…,TO my knowledge regarding DR H,i even offered to hunt the tubing down but they wanted nothing to do with that.I have my own opinions/hunches,but that’s all they are .Best of luck to you Gina and don’t give up. I will be reporting on this blog as soon as it;’s possible.,Scott M

  63. Scott Mitchell
    November 27, 2014 at 7:14 pm

    @Scott Morse DR. SCOTT HARDIN EMAIL IS Scott.Hardin@Aurora.org i e-mailed him back in april and he responded within 24 hours.My own DOCS aren’t even close to that. Not only that but he read every word of a very lengthy letter with my complete history.And after a pelvis/sacrum shattering paragliding accident in 2006 ,16 operations later (8 back) it was very complicated to say the least.DR. HARDIN is by far the most compassionate DR i’ve ever had.I am still communicating with him,step by step….hope this helps,Scott M. man ,a lot of Scotts going on here,lol

  64. Scott Mitchell
    November 27, 2014 at 6:58 pm

    OK,Scott Mitchell here.I originally posted to this site in may or april of this year.To much to repeat,but it’s still there.After spending 6 weeks with DR HAL MARTIN,may – july i was sent home with a knee brace locking my knee at 30 degrees.This stopped 90 % of foot pain and redness.But i had a SCS implanted and this was holding DR M from doing proper MRI s.SO i went home to FL and had it removed.PM syndrome worse then ever,can not sit 20 seconds.Went back to DR HAL MARTIN 11 /17 and did MRIs he needed.Surgery for piriformis and sciatica release is set for 12/11 ,IN ABOUT 15 DAYS…..Just to have a chance of getting out of this disabling pain is giving me hope,which i had almost lost.I will try to post every few weeks starting 2-3 weeks post surgery.Thank you MATT for your blog,would have never found DR HARDIN or DR MARTIN without it.HAPPY THANKSGIVING EVERYBODY!

    • JoAnn
      December 3, 2014 at 12:01 am

      Hi – My name is JoAnn Kenton I am an Athletic Trainer. I would like to share some information I have with you concerning this procedure. I do thick I should speak with you ASAP!

      • December 3, 2014 at 6:06 am

        Jo-Ann, please contact me. I am contemplating this procedure. Harleywg22001@yahoo.com. Thank you.

      • December 3, 2014 at 11:38 pm

        Jo Ann Scott Mitchell here,my e- mail is surfgringo@aol.com please feel free to contact me.I suspect you having something not positive to say on this procedure.I am an open minded person,but please understandi’ve had sciatica 24/7 for 7 years now,been diagnosed with CRPS. But from my research i’d be the only person i know ,with CRPS,who can get my foot normal looking with laying down and pain medication. I will listen to whatever you have to say.Thank you Scott M

      • JoAnn
        December 4, 2014 at 7:50 pm

        I just wrote you an email.

  65. November 26, 2014 at 11:02 pm

    Hey people thanks Matt for your hard work in getting this done. I have HF botox injections to relieve my piriformis and it has given relief for about 2-3 months only to come back (it seems worse each time) I want to consider piriformis release surgery. Any doctors in the twin city area or mayo clinic ? Can you post dr Hardin in Milwaukee numbers or emails as it might be worth the trip
    I am suffering so bad right now I can only think bd thoughts as I can’t get in for another botox until December 4th
    Best regards Scott

    • Scott
      November 29, 2014 at 12:04 pm

      Thanks for the info I am going to start the process but as of the past two weeks my insurance reopen a bunch of claims and they say I owe thousands after I paid my deductible so who knows maybe Obamacare will bail me out. But insurance or not I gotta do something because laying around with a pain in my a** is not living.

  66. Lini
    November 24, 2014 at 2:19 pm

    I am looking for treatment of Piriformis Syndrome in Tucson, AZ.I appreciate any and all suggestions, recommendations and referrals.

    • November 25, 2014 at 9:39 pm

      I live in Tucson Az since 14 years and with the help of Matts Website I chose the proper way where to go.
      First there is nobody in Tucson which performs the Arthroscopic Sciatic Nerve Release in Arizona.
      The best Surgeon is in Milwaukee Wisconsin (read Matts Website) I chose a surgeon in Carson City Nevada the closest one to our location. his name is Robert Rupp in Carson City Nevada and he did a great Job.
      He actually has a Video on YOU TUBE about the procedure.
      I had pain from the lower end of the sacrum across the buttock and down all the way to the foot.
      After the procedure the pain down the leg was gone after about 4-6 weeks healing

      • idahom7
        December 21, 2015 at 8:20 pm

        I live in Boise ID and think I have piriformis syndrome. I cannot find a surgeon in Boise. I am interested in Dr. Rupp . What tests or imaging did you do prior to seeing Dr Rupp? Has anyone else had positive results from Dr. Rupp?

    • Charlie
      April 24, 2015 at 4:26 pm

      Just came across this website looking for piriformis syndrome relief in Tucson. Noticed you were looking for help back in November. Were you able to fine anyone in the Tucson area that would at least give Botox injections? Or any knowledge of where to go for help? I’ve been suffering for 3 years with no success fron PT and steroid shots. Thanks for any help you can provide.

  67. Ian
    November 6, 2014 at 7:06 pm

    can anyone recommend the closest/best place to get a provocative EMG done in the MD area?

    • November 6, 2014 at 8:06 pm

      Be careful where you go. I went to a place and they did it wrong. They only tested for sciatic nerve, they didn’t check to see where it was compressed. Even though the whole point was to check the piriformis to see if it was impingement there. Duh hhhhhhh! I go next week to see Dr. Henrich and have another one done.

  68. meaghan
    October 25, 2014 at 11:37 pm

    Hi I am new to this blog, can anyone recommend the closest/best place to get a provocative EMG done in the Boston area? Thank you

  69. Shelly
    October 10, 2014 at 11:31 pm

    Hi All.
    I too have been dealing with this pain in the butt for around 6+ years. Spent more than 5 of those years with a terrible pain management doctor that could never get my shots in the right place. Not only that, but I am pretty sure the last time I allowed him to do shots he actually shot me in my sciatic NeRVe!! I woke up screaming in pain during the procedure while I was sedated!! I got worse and increased my pain meds by probably 200% while I was with him. It was a neuro surgeon that found that my SN passed through my piriformis around 2010. At that time, there was almost no one that could help me. I finally found Dr. Hal Martin in Dallas, TX this year. I live in San Antonio, TX. I have seen him a few times and we are trying to find a path. I am hoping for surgery SOON! He tells me I also need my SI joint fused, which A–he doesn’t do, and B–insurance doesn’t cover it. I have two small children and a husband that would like their mom/wife back! This pain sucks so badly!!

  70. October 1, 2014 at 7:14 pm

    Hi Matt!
    I read your EMG and noticed they mentioned how flexible you were. I too believe to be suffering from bilateral PS due to having surgery which required me to sit/sleep upright for a week. I had an EMG but they only checked spinal when Dr wanted everything. My EMG showed bilateral S1 ridulopathy, though I only have a disc bulge with no nerve impingement. My Dr thinks I may have both issues going on. I have sciatic nerve pain in all dermatomes (l4-s1 and pudendal) and my left foot feels weak (during PT I thought they had a heavier weight on my left foot when in fact it was the same as the right), feet will vibrate, etc. My piriformis spasm pain seems to be primarily from ischium to tendon (though I can palate it further toward sacrum-my glutes atrophied due to back injury and didn’t know it for years so I can easily feel all hip muscles), and I have been able to stretch out my hips but only to a certain point and then pain gets bad. My question to you is: when you had your EMG, did you even feel a stretch when they/you did the FAIR position? Left side I feel a bit, but my right not (unless it’s a bad day). Are they still able to get a diagnosis in those that have flexibility? I’m afraid of getting a false negative. That’s one thing that frustrates me is Drs and PT’s saying I “pass” their FAIR test, yet if I stretch with knee over thigh (lying or sitting figure 4) and stretch too much, which as I’m sure you know is a fine line between enough and too much, I’m even more miserable for hours.

    I’m so miserable and I’m aggravated by my previous Dr who dismissed my pain as FM because I had strained both calves a few months prior and then this bilateral pain. He says no one gets bilateral pain. Anyway, I can’t get comfortable lying, sitting, standing for more more than 30-60 min, walking for the same. I’m due to go to PM for injections. I pray for relief!

  71. September 10, 2014 at 11:01 pm

    KB – study Matts website and you come to the conclusion that this Dr Heinrich is the best doctor to help you.
    There is only a hand full doctors in this country that understand and do this procedure safe and right.
    I live in Tucson Arizona and was lucky that there is a orthopedist that does the procedure in Carson City Nevada ind he did a good job and I came out well. The issue is to establish first if you have a entrapped sciatic nerve in the piriformis muscle and if you do, the procedure that Matt describes is the only answer to free the sciatic nerve.
    Besides Dr Heinrich in Milwaukee, there is a Doctor in Chicago that does the procedure but you have to read the reviews about him.
    There are other doctors that offer the procedure but I would be careful.


  72. KB
    September 10, 2014 at 3:30 pm

    Can someone recommend the BEST doctor in Atlanta to treat piriformis syndrome? I’ve had this condition for four years now and it’s TERRIBLE. My first set of injections did absolutely NOTHING except cost a LOT of money. Thank you in advance – I’m desperate for help!

    • Cheryl Scott
      October 30, 2014 at 10:38 am

      Did you find a doctor in Atlanta to treat your piriformis? I live in Gwinnett County and am looking for one also. Cheryl

      • November 6, 2014 at 7:45 pm

        I went to a pain clinic who sent me directly to physical therapy and told me not to bother with the injections..keep in mind I have also been going through this for four years. I am now going to an awesome phy. therapist named Susan at Physiotherapy of Atlanta located in Buckhead. After way too many DR visits and opinions, she finally informed me that while I have p iriformis syndrome, the bigger issue are my chronic tight glutes and hips!! She is the only one who has detected this and I am finally getting relief! In fact, my piriformis is pretty much gone because she has performed ART massage (active release technique) and are now conquering the glutes. It will take some time but I finally feel like I just may have a solution. I have learned that everything truly is intertwined so one issue can impact everything and it’s important to find someone who can think of the bigger picture. In other words, the glutes could have essentially led to piriformis, etc. Hope that helps and best of luck to all. I am hoping to start 2015 with a run….it has been waaaaay too long! 🙂

      • December 4, 2014 at 8:20 pm

        Hi Cheryl, I am still in PT at Buckhead Physiotherapy of Atlanta, but slowly getting results with ART massage and dry needling….and serious stretching. I highly recommend PT before any injections but that is only based on my experience. I also have a herniated disc in my lower back that impacts my glutes, hips and legs. Any doc can refer you to PT but I suggest that one. I hope that helps, bed of luck.

  73. August 16, 2014 at 1:07 pm

    I’ve done many cases of direct injection of the piriformis muscle under CT guidance. I inject the medial third and the lateral third with Steroids and Lidocaine. If the pain goes away, then you have your diagnosis. If the pain comes back I can inject it again. If the pain comes back, I inject Botox. The procedure is safe and simple and takes 15 minutes as an outpatient procedure.

  74. Fran
    June 10, 2014 at 12:52 am

    Hello Matt,
    It’s refreshing, yet scary, to see that piriformis syndrome is so common that people such as yourself have dedicated blogs for it. I just came across your blog before bed while trying to get in a comfortable position that is not on my backside. (I imagine you know what that feels like.) Long story short, I’m a female in my twenties and have had PS for at least a year now. It’s already gotten to the point where I can’t lay on my left side and I can’t sit down with out instant pain in my butt/legs.
    So far, I have jumped through the standard PS/sciatica treatment hoops: 5 weeks of physical therapy (maybe helped a bit, but came back with a vengeance). 1 steroid injection (no help at all). Rest (God no!). 2 MRIs and 1 ultrasound (showed nothing). Chiropractic/message therapy (been doing both for around 3 months now and even though my body mechanics may be better, my pain while sitting/laying down is not better!). I stretch at least twice a day for at least 15 minutes and use a foam roller and tennis ball every night (I even bring a tennis ball in the car to sit on because that somehow helps). I’ve taken so many OTC pain meds and they do nothing. Even gabapentin has no effect on the pain.
    At this point, I’ve been looking into either Botox injections or surgery to get rid of this pain. It is debilitating every aspect of my life. Because of it, I hardly socialize, I can’t get a better job, can’t sleep without the assistance of sleep aids. There has to be some way out of this . I’m actually scared of surgery because it’s permanent; I don’t have any problems with being active now, but I want to keep it that way. Botox seems like the next best step. What do you think? Also, I’m in the Atlanta area reading about these amazing doctors in Belgium and Milwaukee. Would you happen to know of any doctors closer to here, or anywhere on the east coast? Any help would be much appreciated.

    • Cheryl
      September 27, 2014 at 3:31 pm

      Did you find a dr. in the Atlanta area to help with your PS problems?

  75. Gina
    April 29, 2014 at 10:55 pm

    Matt – I called your Doctor in Milwaukee and he did not call me back, so I am here in Cleveland still trying to figure this whole thing out. I have two pain management doctors, one at Lake West Hospitals and one at the Cleveland Clinic, and it is me continually asking for EMG’s and things to try and figure this out. Finally my physical therapist recommended an EMG test and my pain managmeent doctor recormmended it. Then the Clevealnd Clinc machne was down, so I had a second doctor at Lake West do the EMG test. I had the EMG test done and I tested positive for L5 sciatic nerve pain. Consequently, I am being sent for another MRI on my back…… They zapped me with electrical currents and pricked me with needles and listened to my muscles. Apparently the muscles that run from the sciatic nerve are in constant engage motion, even while I am resting. Therefore, the nerve is sending signals to my muscles when it is not supposed to.
    My concern is that when I had the EMG done, how come the doctor did not go up to my back and around my buttocks to see if the sciatic nerve was compressed in my back, around my femur, or in my piriformis muscle????? I am confused….. DId he do it right?
    So tomorrow, I will have an MRI on my back. I will be TOTALLY surprised if I have anything wrong with my back, like the L5. (I do have to small bulging L3&L4 discs, but the doctors say that it is no more than anyone at my age.) The NEW pain management doctor said that after we get an MRI on my back, he would like to do a nerve block. Shoot, if you can give me a nerve block to stop this, I will be happy! However, I get really confused because I still do NOT feel like the sciatic nerve is coming from my back, but coming from something connected to the FAI surgery.
    Since I have absolutely no back pain, it prompted me to do a google search for femoral acetabular impingement(FAI) and sciatic nerve pain. I had FAI surgeryin 2011, and have been struggeling with sciatic nerve pain before and after surgery. Well low and behold it seems to be a common problem. Time after time, it said that trauma to the nerve can occur during traction from the FAI surgery. Here it is verbatim:
    Nerve Damage: Trauma to nerves may be temporary or permanent and can cause numbness, tingling, pain, and weakness. The nerves most at risk for damage include lateral femoral cutaneous from portal insertion and pudendal and sciatic nerve from traction.
    Since I had sciatic nerve pain even before surgery, that caused me to do more searches. Here is another intersting blurb about this:
    FIA is a However, osteonccrosis of the femoral head, sciatic nerve injury, greater trochanter osteotomy nonunion, and heterotopic bone formation may occur. The medial femoral circumflex artery is the primary source of blood flow to the adult femoral head. It must be protected to preserve the blood supply to the femoral head to prevent osteonecrosis of the femoral head. The sciatic nerve runs in close proximity to the piriformis muscle and is at risk when the capsular exposure is erroneously performed distal to the piriformis muscle. In patients who have had previous hip surgery, the sciatic nerve may be entrapped within scar tissue. This places the nerve at higher risk for traction injury during dislocation. In such a patient, the nerve should be preferably identified and released from any scar tissue before the procedure beings. Sharp dissection of the glutes miniums from the capsule and gentle retraction of the soft tissue around the hip can decrease the risk of heteropic bone formation. ….. http://books.google.com/books?id=Roy4xpcvQLsC&pg=PA53&lpg=PA53&dq=femoral+acetabular+impingement+and+sciatic+nerve+pain&source=bl&ots=qiHlhxF0VB&sig=KvrTIgVZjaLsAjH3Adk11w_GEpU&hl=en&sa=X&ei=22ZgU9X0GOio2gWs94DABQ&ved=0CGgQ6AEwCTgU#v=onepage&q=femoral%20acetabular%20impingement%20and%20sciatic%20nerve%20pain&f=false
    Then I started to think. Here are my thoughts. I welcome yours.
    Prior to surgery, I had sciatic nerve pain caused from the tear in the labrum from the FAI, and compensating. The piriformis muscle was compressing on the sciatic nerve. Possibly I internally rotated, and caused the piriformis muscle tendon to shorten. Now after surgery, either I am continuing to compensate, or my sciatic nerve is entrapped in scar tissue. Or, I have “true” piriformis muscle syndrome. Which could have been caused from the compensation before surgery and the piriformis muscle tendon being short. I really believe that tomorrows MRI is going to show no back problems and then I am going to baffle the doctors.
    Hopefully, even if I have no L5 back issues, I hope they still give be the sciatic nerve block. I really need to get out of pain!!!!
    Any thoughts?????????????

  76. Patti
    April 27, 2014 at 6:08 pm

    Hi Matt, I’ve been suffering for three years. In February I had an MRN which showed that I have sciatic nerve entrapment at the level of the piriformis tendon and possibly also involving the obturitur internis. I live in Ottawa, Ontario, Canada and I’m having problems even getting either a cortisone or botox injection. Can you please tell me the surgeons name in Milwalkie and if you know of a good place in New York State where I could have a piriformis muscle injection. Thank-Zhou so much!

    • April 29, 2014 at 8:24 pm

      The surgeon’s name is Dr. John Heinrich. Sorry, but I don’t have any referrals for New York State. Best of luck.


  77. Scott Mitchell
    April 10, 2014 at 6:44 pm

    FOUND IT! today i had a provocative EMG test done by DR SCOTT HARDIN in Milwaukee! I’ve had 8 back operations with the last one being a L5-S1 FUSION,only to get worse..AND when i googled can’t sit,can’t climb stairs PIRIFORMIS MUSCLE SYNDROME kept popping up till i found this incredible,informative blog about Matts journey…i was convinced i had it and started looking for a PROVOCATIVE EMG test. I live in FL. and could not find anybody who knew about this test,even the Cleveland Clinic in FL. (where my fusion was done). And so i decided to follow MATT and go to Milwaukee and have it performed by DR. SCOTT HARDIN. Now i’ve been to a LOT of doctors since my horrible paragliding crash in 2006. Some good,others not. I knew i had the right DR. with DR HARDIN when he responded to my e-mail within 18 hours.And he responded to every single question,which told me he actually read every word of a very lengthy letter of my 8 years dealing with unbelievable,unrelenting pain….if your reading this,you know what i mean. Now i have not been able to sit for 5 YEARS,and flying to Milwaukee was extremely difficult to say the least. But it was one of the best decisions of my life.HANDS DOWN DR HARDIN is the most compassionate,caring and intelligent doc i have ever met. SPENT ALMOST 2 HOURS WITH ME.and performed the ever so important PROVOCATIVE EMG TEST which confirmed that my sciatica nerve is impinged at the piriformis level .He recommended that i have an endoscopic release surgery of the piriformis muscle and the sciatica nerve.This was today and to finally have an answer for my pain is still sinking in……the surgeon that MATT used and works with, DR HARDIN, can not do surgery due to shortage of special tubing that he uses for the camera,I probably will be going to DALLAS to meet DR. MARTIN,who Matt told me actually mentored DR. HARDIN on this procedure….MATT thank you for caring and especially for all your homework…most of all thank you for leading me to DR. HARDIN. I will be writing more on this blog after i have the surgery and will try to be as helpful as MATT was. MATT 1 year from now i will fly back to Milwaukee and play a round of golf with you….you can put it on your schedule! sincerely,Scott Mitchell

    • April 10, 2014 at 7:30 pm

      You’re welcome Scott. Love the attitude. Good luck on your next step and keep me posted. A round of golf is one giant leap nearer now in your future, and you can now go to bed and wake up each day having the answer you’ve been searching for for so long. I remember exactly what that felt like immediately after Dr. Hardin tested me. Great ass feeling (pun intended).


      • Patti
        May 12, 2014 at 10:59 pm

        Any news from Scott?

      • May 13, 2014 at 3:38 pm


  78. March 24, 2014 at 8:57 pm

    I have fibromyalgia I was diagnosed with that about 2 years ago. Before that I was a very faithful runner running 5 miles a day 6 times a week but the fibro stopped that in it’s tracks or so I thought due to pain so I started doing hot yoga and that was helping all my fibro symptoms. I’ve had what I thought to be sciatic issues on and off for years but always got better with rest. Ever since November, so about 4 months now I can’t do anything without debilitating pain of a level 8 or 9 in the hip and radiating down my leg. I’ve been going to the pain clinic for pain and I’m on Skelaxin so if I do nothing physical I’m ok but if I do anything walk, hot yoga, run, or stretch it comes right back. I’m scheduled for an injection next week but have my doubts as bad as it is. I was doing the yoga poses great till it kicked into full bora pain and now some of the poses I had no problem with I can’t do. My question is what type of surgeon does this procedure?

    • March 25, 2014 at 7:20 pm

      Orthopedic Surgeon performs this procedure.

  79. Michelle
    January 2, 2014 at 12:50 am

    I am curious about what you mean by a long recovery? Did you still have the pain after the surgery and it took a while to calm down? I have gone through 6 mos of drs, many tests, PT, acupuncture, massage, ART, diagnostic injections in piriformis, SI joint, and spine, you name it for my pain, but I have had no relief and received no true diagnosis. I have not had a EMG as you did. One of my MRI’s showed a benign bone tumor in my proximal femur close to where my pain is so 6 weeks ago I had surgery to have that removed as it was possibly a cause for my pain. The surgeon also released my piriformis by cutting the tendon as he noticed it was tight. My pain went away (other than surgery pain) but 6 weeks later the pain came back in full force. Now I am wondering if the pain was not piriformis all along and if the diagnostic injection I had just didn’t work. I understand that scar tissue can build up from piriformis release surgery. I am wondering if you still had the pain 6 weeks after your surgery or if you had no pain immediately after? Because of the bone tumor surgery, I have not been able to do any physical therapy.


    • Scott Mitchell
      April 10, 2014 at 10:47 pm

      MICHELLE i remember reading someplace that when a surgeon cuts the tendon bot does not remove piriformis muscle,there can be a danger of the muscle “sucking”the nerve into the part that is still attached to the sacrum.Also keep in mind the sciatica nerve goes UNDER 80% of the population,the other 20 percent the nerve can split and go around the muscle or even thru it…..maybe ask your surgeon if he removed the muscle or just cut tendon….best of luck to you.I know and feel your pain

  80. Debbie
    December 15, 2013 at 4:43 pm

    Matt, I just want to say thank you for your compassion and kindness for taking the time to maintain this site and to answer questions. I know that it takes time. I have been suffering for 6 years and share common experiences with others here,….. There are no doctors here locally in CA that treat or are even familiar with PS) I was an active school principal but finally had to retire because of this. I’ve been asked to do consulting work but cannot at this point. I’ve also been through all the treaments as well. I have had some success on and off with botox injections(finally had to go to New York) but the last one was not. I am not sure if it was because it was missed or because the botox no longer works. The spasm has just gotten worse and worse. I don’t want to give up on the botox yet. But I am also considering surgery. But I need a compassionate doctor, one who will be persistent and not try to fit me into their “interest”. I know about Dr. Martin and Dr.Heinrich. Very difficult for me to get to these places but I can if I must. A Dr. Kliot at UCSF? Anyone else in CA? Is there someone in New York or at John Hopkins? Difficult but a little easier to get to. Is there a list somewhere of doctors who specialize as I know that there are not many. I also know that is is a challenge to discuss online. Any help would be GREATLY APPRECIATED. Desperate…..and in so much pain.
    Debbie C.

    • December 15, 2013 at 9:50 pm

      if you want to take the safe route, Dr. Heinrich is the best one in the country and you are not taking any chances there. He requests a Provocative EMG as proof that the sciatic nerve is impinged.
      My personal advise is dont go to Texas.
      I had the procedure done in Lake Tahoe with a DR Rupp and I came out ok, but if you dont want to take any chances see if Dr Heinrich takes you, he is absolutely the best.
      I know Dr Martin in Texas was one of the doctors that contributed to the development of the procedure but he has too many negative feed backs.
      A note to Matt: I know this is your website Matt and if you dont want me to post these comments I will certainly respect your wishes

  81. December 3, 2013 at 9:18 pm

    would you share where you had the operation done

    • Heather
      December 5, 2013 at 11:15 am

      I had the surgery done in NYC at Mount Sinai Hospital.

  82. Heather
    December 1, 2013 at 7:06 am

    Hi Matt,

    Thanks for your reply regarding nerve pain after surgery. How often did you go for massage? I feel like all of a sudden all of my muscles in my hip/buttock don’t know what to do and tighten up as soon as I am up and moving around, causing more pain. I also have pain into the si joint area, and believe between these two areas the nerve is being irritated greatly. Waiting for doctors to give me their opinion. I went to massage once and saw improvement, but next is scheduled two weeks from first. I am wondering if once a week is needed. Also, did you ever experience si pain, specifically near point of piriformis muscle attachment? It is helpful to speak with you, as you ave gone through this. The experience I have had with my doctors is that they don’t really seem to know why I experience what I do, which doesn’t give me much direction as to how to get better. Thanks so much for your continued thoughts and sharing!

  83. Heather Bivins
    November 3, 2013 at 6:33 pm

    Hi Matt,

    I wrote earlier this year and underwent surgery for piriformis whereby they removed a benign tumor but left the muscle intact. Unfortunately, after a period of 6-12 weeks, I started to have further difficulty and the doctors decided I needed to go back to surgery to remove the piriformis muscle as they feared scar tissue had reformed between the muscle and the sciatic nerve. I have since had surgery #2 where they removed the muscle and scar tissue. It seems my ability to recover depends upon healing and whether more scar tissue forms where it shouldn’t. Despite trying to get answers from doctors as to activities, etc. to promote the best chance for proper healing, they don’t seem to provide much. My question to you is whether your doctor discussed this with you following your surgery and if they gave you any suggestions for stretching, walking, or maybe even resting for the first month or two after surgery to try to prevent scar tissue reformation where one would not want it?

    Thanks for any thoughts!

    • November 3, 2013 at 9:08 pm

      Heather it sounds like you’ve been through a lot. Hang in there. Here’s what I can tell you based on what I was told and experienced:

      There is always a chance for scar tissue. My wife (who is a Physician Assistant for Orthopedic surgeons) feels (as well as I) that I greatly mitigated the risk of forming scar tissue by:

      1. Lots of rest for the first two months. Take it easy. Do not sit on the treated area if it hurts.
      2. I had regular deep tissue and myofascial massages. Especially targeted the hip and IT band (all the way down to my knee).
      3. I also wore my ice compression machine every night for several hours for the first month or so. (Now, this probably didn’t factor into not suffering complications from scar tissue, but I thought I would share because it felt so good to do.)
      4. Stretching, but nothing too vigorous. Just did piriformis muscle release stretches you can find online easily.

      Good luck and keep me posted.


      • Heather
        November 4, 2013 at 9:59 am

        Thank-you, Matt, for our response! I really appreciate it!

      • Heather
        November 20, 2013 at 6:47 am

        Hey, Matt,

        Since I wrote to you last, I have had a steady increase in sciatic nerve pain. I’ve asked the doctors about it, but they seem to think it is just irritation from the surgery and maybe my activity level. I really have tried to do less this time around, which mostly has meant walking in the house and rotating between standing and laying down. I had a few days last week where I had to walk and stand for a few hours at a time, and since then the pain has become almost nonstop. It hurts whether I lay down, stand, or walk. What worries me most is that this has increased with time after surgery (now 4 weeks out). Did you have problems with your nerve for a period of time after surgery or did your nerve pain stop? I have had 2 surgeries in the past 5 months, which I am sure doesn’t help, but I am concerned that there is something wrong to be causing this type of pain at increasing levels. Again, I know we are all different, but it would help to know if this is something others experience and I just need to wait it out or if this is unusual. Thanks!

      • November 22, 2013 at 10:03 pm


        Yeah I had nerve pain for several months after surgery. It is a slow recovery process. Get massages and go to physical therapy. For me, these two things made a huge impact, for the better, in my recovery.


      • August 20, 2015 at 4:33 pm

        Matt – just curious, what type surgery did you have, open or arthroscopic?

      • August 20, 2015 at 4:43 pm

        Sharon please read my Treatments page.

  84. October 26, 2013 at 6:23 pm

    Hi Matt,
    when you had your buttock massages did you have a myofacial massage or just a standard
    massage, and did you have pain after the massages?

    • October 26, 2013 at 6:40 pm

      I had my IT Band massaged at physical therapy. It hurt like heck during but not after. It was a deep tissue massage.

      • October 26, 2013 at 6:53 pm

        Many thanks for your reply Matt, did you have Buttock massage or did you have any pain issues with the buttocks?

  85. Gina
    October 23, 2013 at 11:17 am

    Hello Matt – You may be the right person I have been searching for. I hope you can help.

    To make a long story short, I have had issues with my piriformis muscle and sciatic nerve since October 2008. After a while my predundal nerve had pain, and I had groin pain. From 2008-2011, I was trying to get diagnosed and doctors blamed my back. In September 2011 I was finaly diagnosed with Femoral Acetabular Impingement (FAI). I had surgery to repair my torn labrum, reshape my femur, and lengthen my psoas. My surgery was a success, except I am left with piriformis muscle pain and sciantic nerve pain.

    I had an injection in February 2013, I went to therapy and immediately after the injection I was back to normal. The pain started again in August 2012. I went for another injection last month and did not get the results I hoped for. If I am in flat shoes, I have piriformis muscle tightness and sciatic nerve pain. If I wear high heals, the pain goes away. The problem is I cannot wear heals all the time. They are going to try botox in the piriformis muscle to see if that gives me some relief.

    My FAI doctor said if the injections don’t work, he would send me to see Hal Martin at the Baylor Medical Center in Texas for a piriformis release. I have been battling this pain in the butt for years. Do you have any suggestions?

    Note: I have flat feet, and pronate. I went to a orthopedic doctor and they said I don’t need inserts. I was wondering if my internal rotation of my feet could cause the problem. Also, I do not have anterior cruciate ligaments in my knees. My muscles around my knees are strong, but I am wondering if these two factors, along with weak muscles around the hip & psoas could cause me to internally rotate more than I should.

    I am also thinking that when I had the impingement that I externally rotated more and now that I don’t have it, I am internally rotating and having problems because my piriformis muscle is too short. I can stretch the piriformis muscle and get rid of the pain. If I exercise, I can get rid of the pain. The only problem is that when I relax, the muscle tightens and pinches on the nerve. I cannot physically exercise and stretch the muscle all the time to get out of pain. I am ready for permanent relief. I welcome any suggestions and or comments.

    SOS…. I am tired of this pain in the butt! There is no way I can live the rest of my life having piriformis muscle injections, every 6 months.

    • October 26, 2013 at 4:30 pm


      Sorry for not replying sooner. I think you need to get a provocative EMG, You can read all about it on my blog. It will tell you for sure if you have compression of your sciatic nerve at the piriformis level. This is the single most important diagnostic test in my opinion. Super simple to do. Do the test and let me know what the results are.


  86. October 11, 2013 at 6:28 pm

    Hi Matt,
    when you had your buttock massages did you have a myofacial massage or just a standard
    massage, and did you have pain after the massages?


  87. September 30, 2013 at 10:37 pm

    can you tell me when you stared exercises after the procedure and also when did you start
    massages of the buttock after the procedure.
    Thank you

    • October 1, 2013 at 8:08 pm

      I started massages as soon as a started physical therapy. I started this approximately a couple months after surgery.

      I also started exercising physical therapy.

      • October 1, 2013 at 9:31 pm

        many thanks for the info

  88. September 22, 2013 at 9:59 pm



  89. September 21, 2013 at 9:25 pm

    Jessica :
    Dr. Hal Martin Baylor hip preservation center.
    I agree with Matt on getting some pain control. Glad you are seeing pain management soon. I had a provocative disco-gram to rule out lumbar radiculopathy for my sciatic pain as I have some disc pathology myself. It was negative of course. She could also have a diagnostic injection to SI joint which would narrow the source. Give me your personal email if you decide to pursue consult with Dr. Martin and we can chat by phone regarding my experience. I did not have PS per his evaluation but rather a very unstable, loose and torn hip which has been repaired. My sciatic issue has not yet been addressed. I need an EMG once I recover from hip fully.

    • September 21, 2013 at 9:27 pm

      Sorry, don’t know what I am doing. . .Jessica, I’m in the Dallas area and have the same problems. .. 10+ Doctors and 5 years later, the pain continues to get worse and no-one can resolve. Can you provide me the information for Dr. Martin?

      • September 21, 2013 at 10:28 pm


        Please consider getting a Provocative EMG, which is also known as a FAIR-test (Flexed, Adducted and Internal Rotation position). Here’s an image of the position you would be in during a Provocative EMG. This is not a traditional EMG. You can read all about it on my Piriformis Syndrome Diagnosis page.

        You are also welcome to print my Provocative EMG test results to take with you. Keep me posted.

      • jessica
        September 22, 2013 at 9:54 am


        Follow what Matt has suggested with the provacative EMG, if you can find someone to order and do it in the Dallas area. Dr. Martin is at Baylor and you can find his info if you google Dr. Hal Martin. I did not have the diagnosis of PS when he saw me (my Florida doctor thought I might and sent me to him for that reason) so I cannot comment on his abilities specific to that althought I know he has worked closely with Dr. Heinrich who Matt had surgery with. He only fixed my hip which included labral tear, FAI, and ligament/joint laxity.
        Good luck and keep us posted ! We all understand your pain and distress !!! I’m 3 months out from the hip repair and it’s really like 2 steps forward, 1 step back but I’m definitely better.

  90. September 18, 2013 at 11:28 am

    Dear Matt,

    I am an orthopaedic surgeon that has performed over 500 of these surgeries in my practice in Veurne,Belgium, Europe.

    My website is quite helpful: http://www.piriformissyndrome.eu

    My results of the first 100 patients were, well actually 100 percent full relief after 3-4 months. Since I have performed a lot, statistics do annoy me a bit. Till now chances of success still are as high as 95-98%. Just one patient has no relief after surgery, now one year further.

    If you do have questions regarding this, you can find me through mail : dieter.mortier@gmail.com


    Dieter Mortier, MD

  91. Mike
    August 14, 2013 at 8:37 pm

    Yeah, as this journey has been going, hit another bump in the road, the Pain Management apt, was pushed until next Monday. Do you think a SI joint injection can happen that day, or does it require a general anesthesia?

    • August 14, 2013 at 8:43 pm

      My SI Joint injections were not under anesthesia. I was numbed up and then injected. Walked out of the hospital less than an hour later.

  92. August 11, 2013 at 9:23 pm

    1)does Dr Heinrich set you up with a physical Therapist or is it left up to you to find one?
    2)Did you stay in Milwaukee ofter the procedure for PT?
    3)How long did Dr Heinrich want you to stay there after the procedure before you go back home.
    4)May I ask how you found Dr Heinrich?

    • August 11, 2013 at 9:40 pm

      See my answers in bold:

      1)does Dr Heinrich set you up with a physical Therapist or is it left up to you to find one?
      He recommends several that he feels are best equipped to handle his surgical patients.

      2)Did you stay in Milwaukee after the procedure for PT?
      I live in Milwaukee. And, I didn’t start physical therapy for several months after the surgery.

      3)How long did Dr Heinrich want you to stay there after the procedure before you go back home.
      I went home that very day on crutches. You cant put ANY pressure on the operated hip/leg for a week at a minimum.

      4)May I ask how you found Dr Heinrich?
      I was referred to Dr. Heinrich by Dr. Clay Frank (a spine surgeon in Milwaukee/Racine, WI). My wife works with Dr. Frank in Racine, WI. Dr. Frank also referred me to Dr. Scott Hardin for the Provocative EMG. He told me to get that done BEFORE going to Dr. Heinrich, and to take my test results to Dr. Heinrich.

      • August 11, 2013 at 10:16 pm

        Thank you for these informative answers, it helps a lot to do my planning for this visit ( I live in Tucson AZ). I will call tomorrow to find out how long it takes to get in to see him

      • August 11, 2013 at 10:30 pm


        I strongly encourage you to get a Provocative EMG before going to Dr. Heinrich, and to send your test results to him as soon as you have them. Diagnostic evidence proving that your sciatic nerve is being compressed at the Piriformis level is of great importance if you wish to be candidate for a surgical release. I would also get a CT-Guided Piriformis injection before going to see him. If you don’t get any relief from the injection (even for a couple of days) you may very well not have Piriformis Syndrome. So, first get the Provocative EMG, then the injection, then go see Dr. Heinrich. He will take great interest in your test and injection results, and if you haven’t done these things before seeing him he may want you to do them before considering you a candidate for surgery. I can also tell you that your insurance company may also want to see these results before approving a surgical release.

        FYI: I had about a month long wait to get in to see him.

      • August 12, 2013 at 10:49 pm

        after having sent up some records, today I talked to Dr Heinrichs scheduler. She said that Dr Heinrich is in surgery all day and it will be tomorrow until I get some answers.I told her that I will get the Provocativ EMG and a CT guided piriformis injection. Than I called here back as I forgot to tell her I have Medicare Insurance with Blue Cross supplement insurance and that I dont need any referrals or approval for the procedure according to medicare guide lines (Dr Heinrichs office does accept medicare insurance together with a supplement).
        Then suddenly 15 minutes later I got a call from her and she told me that Dr Heinrich does not want to see me and since we have been in Dallas a few month ago, he suggests I see Dr Hal Martin because it is closer to us and because “DR.HAL MARTIN IS THE BEST SURGEON IN THE COUNTRY FOR PIRIFORMIS RELEASE SURGERY.”
        Don’t let anybody fool you.
        I sent them back a nice e-mail saying I was sorry about that but I dont have Dr Martin work on my Sciatic nerve to be insured like so many others.
        I dont know where Dr. Heinrich gets his information, but behind those reviews are real people with real problems. There are just complainers out there but Dr Martin has to many
        real complaints.
        Its too bad because Dr Heinrich is one of the best.

  93. jessica
    August 10, 2013 at 9:23 pm


    I have an anular tear L4-5 as well and it was not of significance to anyone I saw, including the ortho spine specialist. Even with bulge, I was not expected to have anything surgical. I would guess that Pain Management is going to want to try lumbar epidurals. That was the route I was taken down initially with no improvement x 3, but….I had spine changes too and they wanted to try that first. I think getting a diagnostic SI joint injection is smart to really rule out the SI (I was told I had this by a chiro and was adjusted with no improvement). Then, you can have the provocative EMG as Matt suggests and go from there on the Piriformis.

    • Mike
      August 11, 2013 at 7:50 am

      Thanks for the confirmation Jessica, then I think we have our plan, it just will be another month of waiting. Fortunately, we did get a med(amitriptyline) from the Neuro last week for nerve pain that seems to be helping with my wife’s pain and, especially, sleep, which is making a big difference in battling the pain during the day. We bought a recliner on Monday for sleeping, as well, this seems to be helping, too.

      I hope all is going well with your recovery!

    • Mike
      August 22, 2013 at 8:24 pm

      Well, my wife is scheduled for the SI joint injection next Wednesday, and my wife has to stop her NSAID’s after tonight. She has already tirated down with increasing PAIN, truly don’t know how we will make Wednesday, a lot of tears tonight, and comments of not being able to do this much longer, a little scary.. Jessica, just curious about your symptoms before Dr. Martin, what did they all include, and what did Dr. Martin do exactly to diagnose your condition. By the way, we I asked the pain management doc about a Provacative EMG, he had no clue, and he also made comment about Piriformis Syndrome being very rare, I guess as you say, we can at least find out if the SI is playing a part in this journey.

  94. Mike
    August 8, 2013 at 6:32 am

    After Ortho review of my wife’s Spine MRI, which showed numerous bulging disks, but “nothing of concern”, and normal EMG/Nerve Conduction tests, with Pelvic MRI showing narrowing of Left SI joint, which is side that is most pronounced with pain/sciactica, and after Rheumo and Neuro appointments showed nothing, we are at wits end, and think we need to see someone in Central PA that is more knowledgeable about the SI/Piriformis connection. When I asked the neuro doctor if we should have a provacative EMG done to check the piriformis, she asked me “why would we want to do that”, that would not change the diagnosis and treatment using “Physical Therapy”, but the problem is, no one doctor has given us a true diagnosis, in fact the Rheumo was the one that sent her to PT based on the Pelvic MRI, which stated nothing about the Piriformis. My wife has been in 5 to 8 scale daily pain with Sciactica down left side since April, she is worn out, and is telling me as such, and I am extremely worried. We need help fast.

    • August 9, 2013 at 5:55 pm

      First and foremost you need to knock down your wife’s pain. I’ve listed some tools and techniques in my blog posts that helped me breakthrough at times. Do not underestimate the effectiveness of the TENS Unit. It will buy her some time and only costs around $100.

      Second, consider going to pain management in order to get pain medication for short term relief (and sanity). Chances are your wife will need some heavy-duty medication to put a dent in her suffering. However, this is not going to last long and she will need more and more of it to keep the pain abated; this is not a permanent solution to the problem. Be very careful here.

      Third, get the Provocative EMG (I can only recommend Dr. Scott Hardin in Milwaukee, WI).

      Fourth, go see Dr. John Heinrich after Dr. Hardin proves she has sciatic compression at the piriformis level (a.k.a. Piriformis Syndrome). Make the appointment now so it gets on his calendar. If you time if right you can see Dr. Hardin and Dr. Heinrich in the same day or within two days of one another. Dr. Hardin will give you your test results at your visit and send them to Dr. Heinrich immediately.

      • August 9, 2013 at 6:43 pm

        Good recommendations Matt. I had numerous PT sessions for my pirifirmis entrapment
        and all the did is cause more pain because a therapist can hardly ever free the entrapped nerve, therefore once the EMG doctor confirmes radicolapaty involving the sciatic nerve, then in my opinion PT is a waste.

    • August 9, 2013 at 6:57 pm

      Jessica, would you mind giving us the first name of this Dr Martin in Dallas, since there are quite a few Martins even on Orthopedic surgery

      • Jessica
        August 9, 2013 at 10:35 pm

        Dr. Hal Martin Baylor hip preservation center.
        I agree with Matt on getting some pain control. Glad you are seeing pain management soon. I had a provocative disco-gram to rule out lumbar radiculopathy for my sciatic pain as I have some disc pathology myself. It was negative of course. She could also have a diagnostic injection to SI joint which would narrow the source. Give me your personal email if you decide to pursue consult with Dr. Martin and we can chat by phone regarding my experience. I did not have PS per his evaluation but rather a very unstable, loose and torn hip which has been repaired. My sciatic issue has not yet been addressed. I need an EMG once I recover from hip fully.

    • August 9, 2013 at 7:28 pm


      One more thought for you…my wife a physician assistant for Orthopedic Surgeons and wants to know if you saw a Neurosurgeon or Orthopedic surgeon for your wife’s back? It is difficult to discern exactly who you went to based on your post?


      • Mike
        August 9, 2013 at 8:55 pm

        Matt and ALL,

        Thank you for your comments.

        In regards to your question, we saw an Orthopedic Surgeon for the LUMBAR/Thoracic MRI opinion, and a Neourologist who has scheduled a 2nd EMG/Nerve conduction study, I am going to try an influence this 2nd chance and have the Provacative EMG done, but some doctors are not very receptive. The first study, a standard EMG, was done and stated to be “normal”. We see pain management on Wednesday, hoping they will act on the left SI/Piriformis connection. My wife wants to give the PT some more time, hoping the Pain Management will give us some relief and allow for some real work at stretching the piriformis. We are doing 800mg DUEXIS twice a day, TENS, ICE/HEAT, and Oxycodone as needed. She is a brave soul, and is fighting the temptation to take anything else. I am just trying to research and be proactive if we need to punt on the PT, and am so glad I found this site.

      • August 9, 2013 at 9:57 pm

        You really need to get your wife a Provocative EMG. It was the only test that proved without a doubt that I didn’t have any radiculopathy (back problems), but I did have extreme sciatic compression at the piriformis level. Had I not had that test I would still be suffering AND still searching for answers.

        I’m so happy that you found my blog as well. I want to help as many people like me as possible find the answer to their pain.

        How did you find my blog?

      • August 9, 2013 at 10:08 pm

        One more comment…I also had a Standard EMG and it was NORMAL. You can read the actual test results on my Diagnosis blog page.

        The Standard EMG is a waste of time and money. Physicians who are not receptive to a Provocative EMG for people suffering with this type of pain are IGNORANT. I get very emotional about this particular issue so please forgive me if I’m coming across as too abrasive. Please trust me. You need to have her get a Provocative EMG, even if you don’t get a referral. Just call your insurance company and tell them you need one and see what they say. I didnt require pre-authorization or a referral.

        If possible you should come see Dr. Scott Hardin in Milwaukee, WI for this test. He is renowned for diagnosing Piriformis Syndrome. It’s a simple 30 minute test, and it isn’t expensive.

        – Matt

      • Mike
        August 10, 2013 at 8:54 am

        Hi Matt,

        Yes, from your site I have become very aware of the importance of the provocative MRI, if we run into anther roadblock and Pain Management fails, we will definitely check with insurance. My research for local medical professionals with any real experience in this area, close to us is in NYC, Dr. Loren Fishman.

      • August 10, 2013 at 3:14 pm


        I did not say Provocative MRI. I said Provocative EMG. I have heard and read very good things about Dr. Fishman. He will understand what test your wife needs. I encourage you to meet with him soon.

        Take Care


      • Mike
        August 10, 2013 at 6:41 pm

        Matt, thanks for the feedback….and sorry, my bad, yes, Provocative EMG…..so the game plan is to see if Pain Management will inject her left SI joint, but I really do not know what to expect at our appt. Wednesday, to be honest, since the only real evidence there is with the SI joint is my wife’s pain in that area, and the Pelvic MRI, which was ordered to target the SI area, showing the left SI to be “narrowed” compared to the right, though the report stated that the marrow signal of the left appears to be in normal limits. I just don’t know if this evidence will be enough to get PM to act. I hope so, we need to rule this in or out. The Rheumo actually discounted the Piriformis interaction at first, but changed her mind after talking to the PT who my wife was seeing, so it will be interesting to find out what the marching orders are that were sent to Pain Management. The biggest problem with this journey has been the time it has taken to see all these specialist. Now we are waiting for another month for the 2nd EMG test(late Sept.) I still am not 100% certain the lumbar MRI is completely clear, so I am thinking of a 2nd opinion on this, too. The worse offender is the L4-L5 classified as a diffused disc bulge with small central annular tear, with mild hypertrophy of the flavum and facet joints, but all disc where somewhat bulged in one manner or another, with the Ortho saying this is pretty normal for someone our age(50). I still think I will get this looked at by another Ortho in the area.

  95. July 30, 2013 at 9:05 pm

    How do I leave a message that it gets to you………Helmut

  96. July 29, 2013 at 10:29 pm

    My name is Helmut, my medical history is almost identical to yours concerning the amount of years in pain plus all the tests performed over the years,until I too found I have a entrapped sciatic nerve in the piriformis muscle.
    I found two Orthopedic surgeons that do the Arthroscopic sciatic nerve decompression or release .
    The first is a DR. RUPP in Carson City Nevada, he has a Video on YOU TUBE showing the actual procedure.
    The second is Dr. DOMB in Chicago, doing the same procedure and he too has a video on YOU TUBE showing the procedure
    If you know them or locate their websites, I would be grateful if you could post your comments

  97. jessica
    June 10, 2013 at 10:41 am

    I’m seeing Dr. Martin tomorrow June 11th in Dallas, they have me tentatively on the surgery schedule for Thursday June 13th pending his evaluation and any additional testing. I am hearing that insurance coverage could be an issue….BCBS has been taking up to 30 days to approve ???? I am nearly in tears thinking about the prospect of a trip to Dallas with no surgery and all of the time/effort/$ that I have put into arranging for this (full time job, 3 kids, help at home, 2 plane tixs, hotel costs, rental car etc….). Do you know what CPT codes were used for your surgery and if you had any issues with immediate approval once Dr. Heinrich diagnosed ? I have been on the phone with god and county but still no guarantees and I’m very frightened that this won’t happen as planned. Any help would be greatly appreciated at this late hour !!!

    • June 10, 2013 at 8:06 pm


      I know too well the anticipation of having a 2 hour procedure which should start you on the road to recovery from chronic pain. I have United Healthcare, and to make matters worse Dr. Heinrich was out-of-network. Getting approval for the surgery was not quick. I’m so sorry to tell you that, but it is true. In the end, after a couple months of battling the insurance agency the surgery was approved. Hang in there. And, to answer your question about codes, it was coded as “Uncategorized”.


    • Val
      June 10, 2013 at 9:35 pm

      Jessica it took about 3 weeks for my approval with no code. I finally go approval but they made me sign a paper that said if they did NOT pay for some reason that I was responsible. It was weird but I signed it because they said that’s what they do when there is no code. Good luck

    • jessica
      June 14, 2013 at 9:56 pm


      Saw Dr. Martin Tuesday (he is awesome by the way !) but I don’t have piriformis syndrome, I actually have a hamstring avulsion (tendon is partial off bone) and lots of scarring around my sciatic (like a bird’s nest). My pain was also suspicious for femoral hip impingement and when he did the hip scope, I had a large tear in the labrum. After 2 hours in the hip, he was unable to even address the hamstring and sciatic release because I was swelling and the nerve was getting angry. He stopped and I have to go back for the hamstring and sciatic release in 12 weeks.
      What an ordeal….but I am thrilled that I traveled to see him and he expects some of my leg pain is going to be better due to the tear repar in the hip, as well as, smoothing off the acetabulum where it was impinging.
      Pray for the best !! I highly recommend Dr. Martin for anyone with the constalletion of symptoms.

      • thynes2013
        June 17, 2013 at 6:11 am

        Hi Jessica, so glad to hear you liked Dr. Martin. I’ve heard he’s really nice. Funny, my ortho doc here doesn’t think I truly have piriformis syndrome. He’s pretty confinced I have a femoral ischial impingement. Which from what I’ve read from your most recent post, is what you have. Good Luck and keep us posted. Once I figure our what will be done, ( surgically wise ) I will keep posting too. Tina

      • Jessica
        June 17, 2013 at 9:17 am

        Tina, who are you seeing and where ?

      • thynes2013
        June 18, 2013 at 6:18 am

        Hi Jessica, I really want to see Dr. Martin. My husband is kinda against it being he’s out of state and concerned if I have complications. I’m still working on my husband. Also, I have bilateral issues. It first started on my left which is worst but now I’m getting bad on my right. I’m currently seeing Dr. Joyce here in CT. He’s an ortho doc who does arthroscopic surgeries but if it’s PF or anything like that, he does open surgery. How are you doing? Did you have to stay in Texas for a week? I really, really want to go to Dr. Martin. I’m just nervous myself having to go so far away…. I’m glad you were able to go and you liked him. I’m praying that you feel better and better every day. It’s awful this pain. I’ve had this for 20 months and I’m so sick of it…. take care of yourself… tina

      • Iris
        June 26, 2013 at 6:26 am

        Jessica, where do you live? Would you please post your phone number or email where I/others may reach out to you this week to hear about your experiences and share ours?

      • Jessica
        June 26, 2013 at 12:23 pm

        I live in south Florida.

      • Val
        June 26, 2013 at 8:46 pm

        Jessica, do you have any nerve or burning pain since surgery? I am only 3 weeks out but have some going on and hope in time it calms down. Original pain seems better but replaced by this now. Hope your feeling better.

  98. Mattie
    June 9, 2013 at 9:50 pm

    Last summer I was finally diagnosed as having SI joint dysfunction and a borderline piriformis syndrome on the right (dx by provocative EMG; H wave .44 below criteria). I had to fly across the country (Atlanta) to get this diagnosis and learn a conservative PT program targeted for SI joints and piriformis muscles. After 12 weeks of doing this at home (my husband helped me do corrections for the mobile joints 3x daily), it didn’t work and I still couldn’t stand very long without pain. I went back across country to have a bilateral SIJ fusion (minimally invasive type). At the time, my Dr. did not address the PS since it was borderline. Now, fast forward a year, months of PT, numerous piriformis injections, stretching every day, etc…..still have a right side PS. It just plain got worse after the SIJ’s got stabilized and the pelvis was straightened out. I am scheduled to go back across the country and have the minimally invasive PR release in July. All that said, I would like to understand some details on how it feels post-operatively. I will be getting back on the airplane the next day. I am in my fifties, in graduate school and start an internship and a job on my feet in August. I am hoping this is nothing compared to the MVA I endured in ’98 followed by multiple spinal fusions and last year’s SIJ fusion. I have a high pain tolerance and my musculature has been weak for a decade now. Please help me with reasonable expectations for the recovery period. I have almost 3 weeks off. I cannot sit long right now without the pain hitting 7-8/10 daily. I don’t take anything for it because nothing pharmacological helps, but the stretching and hot tub knock it back down. Thanks, Mattie

    • June 9, 2013 at 10:25 pm


      Sorry to read about all your suffering. There’s a lot of us out there who truly understand what you’re going through. I’m thrilled for you that you’re having surgery.Are you having the same procedure I did? You can read about it on my treatment page. I can only speak to recovery from endoscopic piriformis release and sciatic nerve neurolysis. It’s not a difficult recovery, but it took me 4-6 months.

    • tina
      June 23, 2013 at 8:04 am

      Hi Kate, I’m going to look up Dr. Joyce right now at Caregully. What great advice- thank you!
      How are you feeling? You had a PF release recently – right!? I hope you’re doing much better…. tina

      • thynes2013
        June 24, 2013 at 2:27 pm

        Kat, You had your surgery at Dellon. We’re you happy with them? Also, they are very expensive- right? Do you know if you can make a pymt plan with them…
        thank you – Tina

  99. Val
    June 8, 2013 at 8:44 am

    Hey Matt, did Dr. Heinrich also go through the side of your hip for your surgery with 3 small holes? Just wandering. I go for my post op on Monday and I am hoping he says I can go crutch less soon. Pain has not been horrible and it does not hurt to sit at all. But I have been just trying to lay down mostly. I am excited for physical therapy. I have some weird nerve sensation on the back of my thigh and butt occasionally, but am thinking everything probably needs to calm down. One day at a time…….

    • June 9, 2013 at 10:14 pm

      Hi Val,

      Yeah I have the same three small holes. Isn’t it amazing to not hurt when sitting? Did Dr. Heinrich tell you that you had bursitis as well, and if so, did he remove it? Please keep us posted on your PT progress.

      • Val
        June 10, 2013 at 9:41 pm

        Yes I had bursitis as well. Adam gave me a few more stretches to do and said we will hold off on pt. Dr Heinrich seemed to think I was doing pretty good. No crutches in 2 days!!!!!! So excited but gonna take this slow. I don’t want to mess anything up. So far so good!

      • Val
        June 18, 2013 at 4:39 pm

        Hi Matt,
        I go see dr Heinrich on Monday for my 2 week appt. hoping he puts me in pt soon. My sitting is better but I am getting some numbness on my upper front thigh that comes and goes and some weird nerve sensation around the butt area going down my leg. It is not painful but more nagging than anything. Hoping this is just the nerves needing to calm down. Did you experience anything like that? Just wondering. I think it can take a while for every thing to get back to normal. Thx, Val.

  100. June 7, 2013 at 4:44 am

    Thanks, Matt, for your comments. If there is more you’d be more comfortable putting in an an email, please feel free ( I think I gave you my address but cab give it again if needed). I understand possibly longer recovery, just wondered why they felt the procedure might be less affective if done openly. And as it turned out, I had a tumor which they didn’t expect to find, and I am not sure yet how much that was responsible for my pain. I only get concerned at the thought of not getting better in the long haul, as you and I both know how horribly life altering this problem can be. I appreciate your time to share your experiences… This is definitely a health problem that needs a place for open discussion among those who are suffering. I will keep you posted with my progress, perhaps it will offer a second option for those suffering if my recovery proves successful. I hope you continue to feel better every day! Heather

  101. June 6, 2013 at 8:43 am

    Matt- I am wondering why you feel the open surgery for this problem is not good? I was looking but didn’t find a specific reason… Just longer recovery because of the incision? My doctor seemed quite hopeful this treatment would be effective, although I won’t speak directly to him Until follow-up next week. From my research on the topic, it does seem there are different approaches to conducting the surgery, and Dr. filler seems to be cutting edge to try to minimalize recovery, but seems to have mixed results depending upon the individual case.
    Please explain further your concerns with the open surgery for this problem. Thanks!

    • June 6, 2013 at 9:36 pm


      It’s tough to have an in depth conversation about this via blog posting. I will try my best to be very clear and concise. Everything I’m about to say is based on my experiences, not my opinion.

      I was referred by Dr. Clay Frank, an orthopaedic surgeon, to Dr. John Heinrich, also an orthopaedic surgeon after Dr. Frank diagnosed me with piriformis syndrome. He did this primarily because Dr. Heinrich performed arthroscopic piriformis release unlike Dr. Frank who performed it via open surgery. I recall Dr. Frank telling me that the recovery would be much faster.

      Upon seeing Dr. Heinrich at my initial consultation he informed me that exact procedure he was planning to perform can not be performed by open surgery. This is why I’m careful to be clear that I cant recommend open surgery to someone that is hoping to have the exact same procedure as myself.

      That is the only reason why I don’t recommend open surgery to anyone. I really don’t have an opinion one way or the other. I hope I didn’t cause you to be too concerned that open surgery wasn’t the proper choice. I sincerely hope it was.

      With High Regard,


  102. Val
    June 4, 2013 at 12:39 pm

    Matt, day one after my surgery with dr Heinrich. When he was doing surgery he discovered that my sciatic split around my piraformis. He also removed allot of scar tissue around the area since miine was due to a fall. My surgery ended up taking about 2 hours because of my unexpected anatomy. I see him next Monday so I am interested in talking to him about my surgery. Will keep you posted on my recovery.excited to start my pt.

    • June 4, 2013 at 9:46 pm


      This is great news. I’m so happy for you. I know the decision to have surgery is not easy, but I also know how desperate you probably were leading up to that decision. I will pray for you that it provides the relief you deserve. Please consider going to Beth for physical therapy. She’s on the east side of Milwaukee; Adam (Heinrich’s PA) can write the referral/script for you. PLEASE keep me posted, and don’t get too down if you’re not healing as quick as you would like. It can be a long time (6 months or more) to have a FULL recovery. However, I will state that I knew the surgery was going to be life-changing (in a good way) the very first week after surgery.

    • jessica
      June 5, 2013 at 10:52 pm

      Hi Val,
      How are you doing post-surgery ? I am scheduled for June 13th with Dr. Martin in Dallas and I can’t wait !!
      Any words of wisdom ? The nurse told me that I would be weight-bearing as tolerated and driving once off narcotics, what do you think ?

      • Val
        June 10, 2013 at 9:25 pm

        I am one week out and doing pretty good. Went for my postoperative appt. today and it went well. 2 more days on crutches. Pain has not been to bad this last week. Didn’t use much of the prescription medication prescribed. I can’t do basement stairs or drive for 2 weeks yet. My surgery was on the right side so that is the reason behind no driving. I can tell the difference on sitting already and I think it will only get better. Only had to do the cpm machine for a week but will continue to ice. Hope your surgery goes well!

  103. June 3, 2013 at 8:01 pm

    Hi Matt! I have just had surgery for piriformis release and sciatic neurolysis. The surgeon actually found a benign lipoma tumor impinging the muscle and nerve, so he didn’t remove the piriformis but rather cut and stretched it and removed the tumor, and felt it would do well. My question for you with recovery… For day 1 after surgery I felt no leg pain or nerve pain, however in days 2 and 3 I have felt pain down through my foot. My swelling has increased greatly, and I am guessing that is responsible for the pain increase I am experiencing. Do you recall going through anything similar during your recovery? It seems quite easy to aggravate it. Thanks for your thoughts! Heather

    • June 4, 2013 at 9:55 pm


      I don’t recall having pain down to my foot, but I was taking strong pain medication for the first week immediately following surgery, as well as:

      1. Using crutches
      2. Wearing an ice machine 24×7 for 10-14 days
      3. Using a CPM machine 2x per day (which was not necessary)
      4. Laying down 24×7 for the first week

      I do recall that it was easy to aggravate it. And, that this was the case for many months following the procedure. Even to this day I cant lay on my hip for too long until I feel some mild discomfort. I had a ton of dense bursitis that had to be removed in my hip. Did you have a scope or was it an open surgery? I hope it wasn’t open. Which surgeon did the surgery? Where is the surgeon located?

      • June 5, 2013 at 4:41 am

        I had my surgery with Dr. Qureshi, Mount Sinai Hospital in NYC. I believe mine was with scope, but not 100% sure. what would open entail? I have a 4in. Incision along my right hip. I wasn’t given any restrictions except to stop when I felt pain- no crutches,etc. my problem seems to be the nerve pain- quite intense and not sure what aggravated it. I have some pretty strong pain medicine, too. I go from feeling pretty good to being in extreme pain. Thanks for your feedback! Heather

      • June 5, 2013 at 9:12 pm

        You had an open surgery, not a scope. A scope would entail three small incisions the size of a shirt button. The surgery I had and recommend can not be accomplished with an open method. I don’t want to discourage you. I am an optimistic person so please don’t fret. If, by chance, the surgery you had doesn’t meet your expectations then there is still hope. You always have the option of having a scope like mine from a surgeon like Dr. John Heinrich. I truly wish you the best. Please go to physical therapy.

        Best Regards,


    • tina
      June 14, 2013 at 8:47 am

      Hi Heather,
      How are u doing? Do you feel like you’re getting better each day. Remember, open surgery takes longer healing, they cut more muscles etc… So, please give yourself some time and take care… please keep us posted. Tina

      • June 15, 2013 at 4:40 am

        All things considered, I am doing quite well. They actually removed a very large benign lipoma tumor that had developed between my piriformis and sciatic nerve, which they believed was the major problem. I am walking around the house, and short trips outside. I will start PT next week. I get tired after being on my feet for awhile, still cannot sit too well, but saw a major change after day 12 post-op. I have along way to go, though, as muscles need major strengthening and surgery area needs to settle down much more. I can definitely see a difference in the pain, however, and I have restored hope that I will soon be rid of this horrible experience. My doctor comes highly recommended, too…. He’s been great, and actually said for my own situation the open surgery was best. I will continue to check in as I progress.

      • thynes2013
        June 17, 2013 at 9:16 am

        Great to hear you’re doing better Heather! take it easy and keep us updated…. where was your incision? my surgery most likely will be open also… thanks’ tina

      • jessica
        June 20, 2013 at 7:19 am

        Give me your personal email, let’s communicate about your symptoms and I can tell you about my experience with travel to Dallas and such. I was able to fly home the next day after surgery. I’m going to look up the name of doctor you are seeing in CT too.

      • tina
        June 30, 2013 at 7:03 am

        Hi Heather, how are u feeling and doing now? i hope you’re getting better each day…. i’m curious if you had a MRN or Provocative EMG prior to your surgery…. take care, tina

    • thynes2013
      June 14, 2013 at 8:53 am

      Hi Heather, how are you doing? Are you starting to feel better? Remember, this surgery takes a long time to heal from and plus yours was open so it will take longer…. hang in there and take it easy… pls. keep us updated. I live in CT so your doctor in NY wouldn’t be too far for me… thanks, tina

      • tina
        June 23, 2013 at 8:00 am

        Hi Jessica, I just sent you a email. My email is hynes_steve1@hotmail.com I also sent a friends request via FB. Thank you so much for being so nice and willing to give me some advice…. It’s so hard knowing who is the best doc to treat these hip issues….. take care and I hope you’re feeling better…. tina

      • July 1, 2013 at 7:47 pm

        Tina- I hope this replies back to you correctly… I did not have an MRN image done, however, I did have the provocative EMG/ nerve conduction which was the only way to definitively determine that I had piriformis syndrome and would be considered for surgery. As for how I am doing, I am not where I hoped to be at this point. I am an unusual case, as they found a large lipoma tumor under my piriformis muscle and removed it. They did not, however, detach my piriformis muscle, and I am having similar pain as before surgery because, I believe, the muscle is quite tight and easily aggravated. I am not sure what is next for me… I have a follow up again in a week. I started PT but think I was pushed beyond what I was ready for and the muscle over-reacted. But please remember, I am an unusual case and did not have the “usual” surgical procedure.

      • James JUDSKI
        July 6, 2013 at 11:20 am

        Hello Matt, – Havent spoke to you recently but have been following everyones progress (as best that I can concentrate to do with all of the pain) – Here’s the question;  …. per my own injury scenario – How frequently have you hear of other individuals having some sort of tumor (presenting as an injury – as I believe would be the case with I think either Heather or Tina (???) that mentioned this in their post).  –  I sure would like to hear from them, or anyone where the docs are having this suspicion; because in numerous Mri’s that I’ve had; you have to really look for this; and once you suspect an area – You must then re-adjust the window-setttings when interpreting the Images on the Study (or you will miss this entity altogether; which is the common denominator in > 90% of the cases). – If Anyone Presents with a “suspected tumor (benign or otherwise)” PLEASE send me a “Private Note” and I will share more details.   Jim   *********************************************

      • July 7, 2013 at 11:13 pm

        James I have only heard of two cases that involved a tumor. So, this is not a common condition among the people that post on my blog so far.

    • Val
      July 4, 2013 at 6:22 am

      Hi heather,
      I hope your feeling better with each day. I had my release surgery about a month ago. He also had to remove a lot of scar tissue in the area due to a fall. I feel like the initial spot may feel better but my nerves in that general area and down my leg into my foot are a bit fired up.some days more than others. I am beginning to see a small change in the leg area that it may be calming down a bit. But the hip area is still irritated. Tried to work very part time for the last couple days and it just aggravated everything. My doctor has not put me in pt at this point yet. I was told to do mild stretching and work if I want and my body will tell me if I am over doing it. Well it sure did!!! I go back to Dr Heinrich on the 23rd of July for another appt. I am such an active person so this has been a difficult transition “laying low”. My doctor says it could be months or a year to see if this worked. Good luck with your recovery!!

  104. Jim Meyers
    June 1, 2013 at 12:55 pm

    Hello Matt,
    I have an appointment with Dr Heinrich next week…a follow up for successful cam impingement surgery last December. However, I am going up to discuss rear hip compartment problems I’ve had that were not addressed by the surgery. Greater Trochanteric pain syndrome and piriformis problems that started immediately after some injections from Dr. Filler.

    That said, I might discuss piriformis release with Dr Heinrich and I had some questions for you.

    1. How did the piriformis release surgery affect your leg strength? Particularly with squats? I am an avid mountain biker which requires lots of leg strenght and endurance and I’m wondering how piriformis release might affect that activity. It seems like the more in shape I get the more the piriformis symptoms flare up.
    2. How does piriformis release affect hip stability? Thanks…I’m running out of space…

    • June 2, 2013 at 1:23 pm

      My leg was very weak due to having piriformis syndrome for five years. The surgery did not make it any weaker. I don’ do squats so I cant provide insight on that topic. I also haven’t noticed any issues with hip stability. The muscle is a pretty small muscle, and there are other muscles that will make up for the loss of it.

    • tina
      July 5, 2013 at 6:00 am

      hi Heather, remember, you’re still early in the game… how many weeks has it been since your surgery? I wonder if maybe the doc should have released your piriformis at the same time…. when do you have a follow up with your doctor? I’m actually looking into Dr. Kelly in NYC. I also have a labral tear that needs to get repaired soon. I’m not sure if that will be fixed before the PF/Ischial impingement issue. Please keep us updated and stay positive…. If i recall, your surgery was open which probably will take a year to be healed if not longer… tina

      • July 6, 2013 at 6:02 am

        Val :
        Hi heather,
        I hope your feeling better with each day. I had my release surgery about a month ago. He also had to remove a lot of scar tissue in the area due to a fall. I feel like the initial spot may feel better but my nerves in that general area and down my leg into my foot are a bit fired up.some days more than others. I am beginning to see a small change in the leg area that it may be calming down a bit. But the hip area is still irritated. Tried to work very part time for the last couple days and it just aggravated everything. My doctor has not put me in pt at this point yet. I was told to do mild stretching and work if I want and my body will tell me if I am over doing it. Well it sure did!!! I go back to Dr Heinrich on the 23rd of July for another appt. I am such an active person so this has been a difficult transition “laying low”. My doctor says it could be months or a year to see if this worked. Good luck with your recovery!!

        Val- Thanks for your post- it sounds like we both are experiencing similar pain post-op, and we had our surgery about the same time. The only thing additional I have experienced is what I believe to be some spasming I. The piriformis muscle, as the doctor elongated mine but left it attached. I, too, get tired and sore if I am on my feet for more than a couple of hours, or if I try to walk more than short distances at a time. I have been able to sit more, but only 15-20 minutes at a time. The trick is figuring how much is OK to do without irritating it. I am also very active and hate to “sit still” so this is a struggle! My PT is only electric stim and gentle massage right now- he sent me on a machine a week ago and that was a big mistake! I wish you the best and hope you continue to find less pain and more joyful moments! Heather

      • July 6, 2013 at 6:07 am

        Thanks, Tina! Good luck with your surgery! I am 5 weeks post-op. I have wondered about the piriformis muscle, too, but I know the doctor thought mine looked healthy and felt the tumor was the main issue. However, it is a lot of trauma for the piriformis, so I don’t know if it can recuperate and function correctly again or not. It is something I plan to ask in my next follow-up! Yes, patience is definitely needed with this type of problem!! :). Best of luck to you!

  105. Jim Meyers
    May 6, 2013 at 11:37 am

    Hello Matt,
    I have just started Graston/ART therapy with an experienced practitioner. So far the results are very promising. I have a tight and bothersome piriformis as well as symptoms of hip bursitis and gluteal tendinosis. Just wondering if you had any opinion about this form of treatment. I also had ART alone about a year ago which seemed to help. Thanks….Jim

    • May 9, 2013 at 8:18 pm

      I had something similar to Graston. It relieved my pain for a couple weeks, and then it was back to the usual agonizing daily pain. It was not a cure. I wish you all the best.

    • jessica
      May 11, 2013 at 10:34 pm

      Unfortunately, I tried ART and Graston for my hamstring and piriformis with no relief. On to surgery…..

  106. April 26, 2013 at 9:37 am

    Hello Matt,
    Your description of the H wave Fair wave testing is great. https://piriformissyndrome.me/piriformis-syndrome-diagnosis/
    Would you give your permission for us to reprint that on a non-profit website for SacroIliac Joint Dysfunction? PS is very often one of the co-conditions.

    Could you give me a short author’s byline about you? Maybe a photo to put by it? My email is supplied below.

    Thank you so much Matt. We are looking to spread the knowledge to help others get out of pain.

    P.S. a few months ago I had a sciatic neurolysis done, cutting away the piriformis muscle that was adhered all along the sciatic nerve, squashing it. Most docs who did EMGs had not heard of the provocative testing. I think it is important to get that info out there so others can ask their docs about it. ~ Thank You !

    • April 26, 2013 at 8:06 pm


      Your email address is being removed automatically by WordPress. You can email me at piriformissyndromehelp gmail.com (hopefully WordPress wont strip the email address if I write it this way).

      • tina
        May 18, 2013 at 5:24 pm

        Hi kat, did you have surgery bilateral or just on one side? Also, was your surgery open or arthroscopic? I hope you’re doing welland feel better and better each day…. take care – tina

  107. Val
    March 18, 2013 at 7:23 am

    Having Piriformis release surgery on June 3rd with Dr Heinrich. I fell in a Target store 2 years ago and have had every type of therapy there is. He says I will be on crutches for 3-4 weeks. Can I sit at a desk during that time? Also I own a tanning salon. Will I be able to go back to work after a month and bend over and clean tanning beds? I am excited/nervous to have this done but I really need to feel better!!!

    • March 18, 2013 at 3:56 pm

      Val, that’s great news. Let me know how it goes. I was only on crutches for 7-10 days at most. There was no way I could sit at a desk any sooner than four weeks. Forget about it!!!
      I was home, on the couch with my ice machine 24×7 for about a month. Admittedly I was being extra cautious, but why risk it?! After a month you should be able to return to work and do some activities that aren’t too rigorous. Your body will let you know if you’re aggravating things.

      Please make sure you go to physical therapy. If you don’t there is a chance you will feel like the surgery wasn’t as effective as you’d hoped. I hit a ceiling without the physical therapy and bust through it with it. I am 95% back to feeling normal (before PS), and within the next couple months I foresee 100% recovery.

      • Val
        March 18, 2013 at 9:30 pm

        I am so glad to hear that this procedure worked for you. Wow, one month huh? I am like the little energizer bunny, but hey, what ever it takes. Where did you go for pt? Was it a place reccomended by Dr Heinrich? I have a fairly large tanning salon in Brookfield and several clients have told me what a great doctor he is!!

      • March 19, 2013 at 9:47 pm

        I forget the name of the place, but it was recommended by Dr. Heinrich. It is located in Downtown Milwaukee at the East Point Plaza next to Noodles.

      • Val
        March 20, 2013 at 7:29 am

        Mat, I do have another question. Before you had your surgery, did the opposite side ever hurt from ovecompensating? My surgery will be on the right side yet my left sacrum area is starting to have more and more pain because I think I am leaning more to the left to take pressure off the right. Just wondering…

      • March 20, 2013 at 8:58 pm

        I did not have pain anywhere else other than my right “cheek” and back of right leg from cheek to just above the knee (along the sciatic nerve).

      • jessica
        May 11, 2013 at 10:36 pm

        So my question is what to expect in the first few days after surgery…I have 3 small children ? I plan to be out of work as long as necessary as I have a job that requires air travel and/or sitting at a desk for long periods of time.
        Thoughts here on what I will expect so that I can prepare my famiyl ?

      • May 11, 2013 at 10:47 pm

        Jessica, you will not be walking other than to use the bathroom for the first 2 to 3 days. You will most likely be on crutches for a week or two and hooked up to an ice machine (hopefully) 24×7 for the first 7-10 days. Don’t plan on sitting at your desk for about 30 calendar days, and then in small increments for the first couple weeks after you return to the office. TAKE IT SLOW, go to physical therapy, do some light stretching and get some rest. If you have a lot of bursitis like me you will not be able to lay on the treated hip area for at least a 1-2 months for more than 5-20 minutes at a time.

        Good luck and please let me know how it goes. I remember the surgery and recovery really well.

        Take Care,


  108. March 9, 2013 at 1:11 pm

    Hello Matt, new to following your blog and thank you so much for the surgical details. May I encourage anyone on the east side of country to consider Dr. Howard(specifically) of Rehabilitation Physicians of Georgia, Atlanta for a thorough EMG provocative test of piriformis. I had one in November and finally found my pain generator after several previous ones had been done showing no nerve issues whatsoever out of lumbar, yet I have burning pain down legs now for sure aggravated by piriformis. It was the most thorough EMG/NCV ever done for me. My piriformis syndrome is related to my years of SI instability for which I now am post-op 7 weeks of a percutaneous bi-lateral fixation surgery done by the SI experts in Gainesville, Ga. Dr. Howard works with the team of Vicki Sims, PT and orthopedic surgeron Dr. Weiss in Gainesville, Dr. Weiss also does piriformis release but not necessarily in the manner of yours Matt. Thank you Matt for the detail so I can compare procedures in my future consideration of most likely needing the release surgery as part two to my recent surgery. I actually live in Idaho and Wisconsin would be closer than going back to Atlanta.
    Looking forward to receiving your blog updates. Thanks

    • March 18, 2013 at 3:59 pm

      I’m happy you found my blog, and now know about Dr. Heinrich in Milwaukee, WI. Thank you for sharing the information about your EMG.

  109. February 20, 2013 at 6:57 pm

    Matt or Jim- could you please share with me the name of the physicians you were treated by in the Albany, NY area with me? I am currently seeking a doctor to provide me with a second opinion regarding my own injury in this hip area. I will gladly provide my email address if you direct me where to send it. Thanks! Heather

    • February 21, 2013 at 2:26 am


      I dont know of any physicians in Albany. I’m so sorry. Tom (one of my followers) knows of a couple. Send me your email address at piriformissyndromehelp@gmail.com and I can forward it to Tom on your behalf. Or, maybe Tom can add the physicians name in a reply to your post. Please hang in there.


  110. Jim Meyers
    December 19, 2012 at 6:59 pm

    Hi Matt, Just wondering how your rehab is progressing. I had surgery with Dr Heinrich on Dec 4 for FAI/cam….so far I’ve felt great…but I’m still on crutches for another week.

    • January 2, 2013 at 8:46 pm

      I’m doing very well. Recently took a trip to Disney World for five days, and I had no complications. Absolutely no regrets with my choice to have surgery to release my piriformis muscle from the sciatic notch.

  111. Jim Judski
    October 6, 2012 at 12:06 pm

    Hi Matt,
    – Memeber of Laura’s Piriformis Group > 3 yrs and followed you from there
    – Heard of your positive experiences with Dr. Heinrich; and was seriously thinking of going there ….. Need Advisement with gluteus medius/tfl tears
    – Please contact me ASAP @ telljim@ yahoo.com
    – Thank You
    – Jim Judski

    • October 7, 2012 at 4:36 pm


      My advice is to go see Dr. Heinrich. He has made the hip area his life’s work.

  112. Judy Toth
    October 1, 2012 at 9:48 am

    I need help. Sciatic nerve compressed by piriformis and obtorator internus. cannot walk, sit.
    i have contacted dr. martin and heinrich’s office. please anyone who has had this surgery. call or email me. i live in california.

    • October 7, 2012 at 4:32 pm


      I can tell how desperate you are to get some relief. Please hang in there. I’ve removed your personal info (email address and phone numbers) from your post to protect you. I don’t want the “wrong” person to get your information and abuse it. Here’s my email address: piriformissyndromehelp@gmail.com. Feel free to email me there and I can advise you on the next steps. I’m glad to see you called Dr. Heinrich’s office. He is a truly gifted surgeon, which I have had others in the medical field validate. As you may know by now, he performed my surgery.

      Take Care,


  113. Jim Meyers
    September 28, 2012 at 9:08 am

    Hello Matt…..I learned about you on the yahoo group….I wanted to ask you if you thought you benefited from the GT bursectomy you had?….I might be having that……I’ve had trouble sleeping on the affected side for about 5 years now……I also have trouble sitting….I’m wondering if I could benefit from the GT bursectomy. Thanks.

    • September 28, 2012 at 8:40 pm

      Its hard to say if I have benefited from the bursectomy because I need more time to heel. I had a “ton” of bursitis. I still can lay on that side for very long without feeling some discomfort. It may be months before I’m fully healed. This is a common problem. You should be able to find out if its an effective surgery if you do a little more research. Good luck.

  114. j
    September 22, 2012 at 6:52 pm

    Can I e-mail you? I don’t see a Contact.

  115. Jean
    September 20, 2012 at 8:05 am

    Hi I have reason to beleive that I have ps~~had laminectomy and spinal fusion and esi like a mile long~I have the butt pain and the hip issues~I am being set up for an emg on the 25th of this month~WHO HOW CAN I find out if he does the proactive test>>I am soooo desperate and had the pt~esi~done excersises galore ~I live near Albany Ny~so far I think my surgeon is on board becasue he set up the emg and pt for the PHS~Any info would be greatly received!

    • September 20, 2012 at 6:56 pm


      If you’re not having any luck doing keyword searches I would start by calling around. I had my test with a sports rehab physician, Dr. Scott Hardin in Milwaukee, WI. Good Luck.

    • November 26, 2012 at 9:26 pm

      Jean- have you found any surgeons near Albany, NY that deal with piriformis syndrome and offer the surgery if needed? I also live near Albany and have similar symptoms of piriformis syndrome. I haven’t found any doctor close that deals with this and would like to in case my situation requires such. Thanks for any information you may be able to provide!

      • judy toth
        November 28, 2012 at 9:30 am

        Did your fusion help you. I HAD piriformis release surgery first because my foot was paralyzed from dented sciatic nerve. now i am facing alif fusion. EMG with FAIR would best be done by a neurologist experienced with it. my neurosurgeon thought an experienced emg person could certainly do it if they educated themselves first. unbelievable that we have to tell the Dr’s what tests to do. i had a regular one that was normal with a paralyzed foot. what a joke.

      • Tom
        February 17, 2013 at 4:46 pm

        I too have the symptoms of piriformis. I fell hard on a solid rock ledge 2years ago. I have been to 3 chiro, 3 pt, 3 accupuncture, 2 neurosurgeons, orthopedic, neurologist and rheumatologist. I have a torn L4/L5 disk, however had 3 injections for disk and did not help. Also had emg which did not show pain was coming from disk. Was also told my disk was not operable. I also live in albany NY and i am frustrated with the care i have received. Does anyone know any good doctors in Albany that treat piriformis syndrome. Any info you may have will be greatly appreciated. I don’t where to turn. All the other treatments for disk and alignment problems only made me worse

      • February 20, 2013 at 10:32 am

        Sorry to hear about your suffering Tom. When reading your post, it reminded me of what an ortho surgeon told me after I explained my symptoms and failed treatments. He told me that the injury I had to the piriformis/groin area could very well have caused internal bleeding, which then led to scar tissue forming about 6 months after the injury. At this point is when the piriformis syndrome pain became chronic.

        I recommend that you get a Provocative EMG, not a standard EMG. You can read about it on my site and see what makes it different from a standard EMG. It will give you hard data that shows sciatic nerve compression at the piriformis level. I too passed my standard EMG with flying colors, and had an epic fail of the Provocative EMG. This is the evidence you need to be taken very seriously as a candidate for surgical treatment of Piriformis Syndrome, and as a chronic pain sufferer by most of other doctors based on my personal experience. MRI’s, Cat Scans, Ultra Sounds were not helpful other than diagnosing Piriformis Syndrome by Exclusion.

        I don’t know of any surgeons in the Albany area. I can only recommend Dr. John Heinrich in Milwaukee, WI because he successfully treated me. I am free of the chronic pain and living a normal active life again.

        Best of Luck to You. Let me know if you have any other questions. I’m happy to help.

      • Jim Judski
        February 20, 2013 at 5:32 pm

        -Please tell Tom to get ahold of me via private E-mail; as I have been treated by Physicians in the Albany, New York Region … and I may be able to assist.
        Later …… Jim Judski

  116. September 18, 2012 at 1:51 pm

    boas matt gostava de falar melhor consigo sobre o sindrome do piriforme preciso de ter essa cirurgia

    • September 20, 2012 at 9:23 pm

      The Dr. that operated on me was Dr. John Heinrich in Milwaukee, Wisconsin. He has performed a lot of these surgeries and has gotten very good at it.

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