Home > Physicians, Piriformis Syndrome, Surgery > Piriformis Syndrome Surgical Release Challenges

Piriformis Syndrome Surgical Release Challenges

I’ve been meaning to write this post for many months, and I’m sorry it took me so long to do so. I want to share some general knowledge I learned from Dr. John Heinrich’s PA Adam. In one of my conversations with Adam I asked him why this surgery was so complicated. Adam replied that one of the reasons was because there wasn’t a surgical cutting tool specifically designed to clear/free the sciatic nerve of fascial adhesions or scar tissue. An ideal cutting tool would be specifically designed to get around the sciatic nerve in a 360 degree fashion. I’m proof that an idealistic cutting tool is not necessary to be cured surgically from Piriformis Syndrome. But, the surgeon’s skills and experience are that much more critical. Please do your homework before making a decision to allow a surgeon to perform this surgery on you. You may be asking yourself how things could possibly get any worse if you don’t have surgery. You are desperate, and I totally get that. My heart goes out to you; you are the reason I created and maintain this blog. But, please know that there are people (people I have communicated with personally) that have not been cured or are worse off as a result of Endoscopic Piriformis Release and Sciatic Nerve Neurolysis. Please note that none of these unfortunate people I have spoken with were treated by Dr. John Heinrich. There is risk and you have to weigh the reward. I felt the risk was acceptable after doing years of research and exhausting all other options. Dr. John Heinrich was the surgeon for the job, and I thank God nearly everyday for his abilities.

Best Regards,

Matt

  1. Khrissy
    September 22, 2016 at 11:42 am

    Hello all,
    I thought I would share my story since this site helped me to diagnose myself. I am now 3 days post endoscopic sciatic nerve neurolysis and feeling hopeful for the first time in a long time! I am only 33 and want to have children and get my life back. I have been unable to work or pretty much do anything except lay around and watch tv for the past year.

    My issues started when I got rear ended on the freeway. It didn’t seem like a big accident at the time, maybe 20 or 30mph, and only a small amount of damage. I was worried about getting to work and only quickly jotted down the other drivers info. Within a couple hours I was in the Er with first neck pain and then later what I thought was low back pain (radiating down leg). I had herniated a disc in my back 5 years before and thought it was a flare up. Over the next few months I realized It was much more than a flare. I had mris on lumber, cwrvical, and sacrum as well as a myelogram. The only thing the doctors found was an annular tear and bulge at l5-s1. They didn’t seem to understand why I had so much pain or numbness, probably thought I was faking it. I went through many weeks of unsuccessful pt . Any activity just made the pain worse. I started experiencing weakness in my left leg after about 6 months and my pain management doctor actually advised me to NOT go to a neurologist! If you have weakness definitely go to a neurologist! I finally went despite his advise and the neurologist confrmed multiple compressed “nerve roots” and told me to go to a neurosurgeon for decompression surgery in my spine. I finally went to see a ucla neurosurgeon and he told me he could do nothing for me and he didn’t think the spine was the cause of my symptoms. By this time I had the begining of foot drop and was worried I was going to end up in a wheelchair. The neurosurgeon was not very helpful and just suggested I go back to a neurologist and perhaps mine wasn’t good enough. I decided to take things into my hand and scoured the Internet looking for anything that might cause foot drop that would explain my symptoms. I stumbled upon a paper on the diagnosis and management of piriformis syndrome. I was shocked at how well it fit. In 10 months no doctor had suggested this. After that I found more info and made an appointment with Dr Timothy Jackson in Pasadena, Ca. He has been reviewed in a few places on this site. He examined me and agreed that I probably had piriformis syndrome aka deep gluteal syndrome. He did a cortisone injection diagnosticaly. This hurt more for about 2 days and then my pain was pretty much gone for a week! After almost a year of constant pain this was amazing! We scheduled surgery within a few weeks and now I am recovering. I havnt spoke with Dr Jackson yet myself as I was groggy after anesthesia but he told my husband he found a lot of scar tissue compressing the sciatic nerves. I hope to learn more at my post op appointment. What has really got me excited is that I can already move my left foot more than I could before surgery. I definitely have hope now that I will recover a good portion of my strength! So far the after surgery pain has been more like trauma pain as opposed to nerve pain. Does anyone have specific suggestions for pt? Helpful websites etc? I just wanted to share my story and will update.

    • September 22, 2016 at 11:58 am

      Im very happy for you Khrissy. My blog was created for you and others like us. Please be diligent with you PT. It was critical to my full recovery.

      Matt

      • September 22, 2016 at 12:34 pm

        How come I can’t find the comments I get in my e-mail to reply to?

        Dr. Jackson is the real deal and I have even posted his video of my 100% good (after a year and a half) outcome endoscopic surgery. I recommend him for the medically tourism inclined. I live in San Diego and my wife drove home after the surgery – a little longer as he sutured my hamstring back onto the sacral bone too. No problem – 140 miles. Only real pain afterwards was sitting on small holes in butt. After a month all GOOD! Just FYI to fellow suffers. dc

      • Khrissy
        September 22, 2016 at 2:55 pm

        Thanks Dick, I did read your info on Dr Jackson and it helped me feel confident about the surgery. I stayed the night at a hotel in Pasadena just to avoid traffic and I was glad I did because I was naseus from the anesthesia, lack of food, and tons of pain meds. The nurses, and staff were also super helpful. I have been in a fair amount of pain, now on day 3 post op, but more tenderness than nerve pain like I had before. I didn’t have a hamstring to reattach, just a lot of scar tissue squeezing the nerve to the point my leg and foot were no longer functioning correctly. I hope to see more improvement as I heal, one month would be a great recovery time for the pain!

  2. Nav
    September 15, 2016 at 7:02 am

    Hi, I am a 27 year old male from Sydney, Australia and just had Open Piriformis Decompression Surgery on my right Piriformis on 5th September 2016. Just like you all, Piriformis Syndrome has negatively impacted my quality of life for the past 3-4 years and I have been unable to focus at work, have had to stop sport and cannot even lie down properly.

    APOLOGIES IN ADVANCE FOR THE REALLY LONG POST, however I thought the details may help those that require any guidance.

    Previously, I have tried many conservative treatment options which only provided temporarily pain relief. My pain involved numbness at the back of my upper leg, burning at the sole of my heel and deep hip pain when bending the leg towards the chest. My pain got worse when sitting down, running, walking uphill, bending and squatting. As I have a desk job and sit all day, the nerve pain had become way too irritating and impacted my ability to focus at work.

    Initially, it took a whole year to figure out what was causing my pain, as many physios, chiros and a neurosurgeon could did not agree with me that I had piriformis syndrome, but rather other issues in my lower back. It was only till I saw a Neurologist a year later who got me to do an MRN of the Right Hip. It was then discovered that the nerve was irritated at the Piriformis, hence Piriformis Syndrome was finally diagnosed (as I had already diagnosed through my research through Google). Once diagnosed, I got a Cortisone Injection in the Piriformis and it relieved the pain for 3 months. I tried the Cortisone Injection another 2 times every 3 months until the Neurologist concluded I was taking them too often, so he finally referred me to a Neurosurgeon. Although I had a minor disc buldge at L5/S1, the Neurosurgeon said my pain is not coming from this region and told me to get a Botox injection in the Piriformis. This Botox injection worked wonders and took away all my pain for a good 9 months until it wore off in November last year. We tried another Botox injection which failed and then a Cortisone injection which had no impact. After seeing the neurosurgeon again, he wanted me to get updated scans of my back and hip to eliminate any other issues before considering Piriformis Decompression Surgery. My lower back MRI showed a L5/S1 disc bulge (which I already had from before) and my hip scan showed a CAM type FAI with a labral tear. The neurosurgeon wanted to eliminate each problem one by one and then got me to get a Cortisone injection in the L5/S1 nerve root, however no changes. I then got a cortisone injection in the Hip bursa, however this made no changes. I then also went to go see a Hip surgeon to get a second opinion on the FAI, and he said it was only minor and my main source of pain was the Piriformis Syndrome. He got me to get a Bone scan and a plain XRAY of the Hip and it showed no issues with the Hip. He then also got me to get an updated MRI of the Lumbar Plexus region to check the Sciatic notch and see what type of Piriformis Syndrome I have. This new MRI showed that the Piriformis had reduced in size by 60% (due to the Botox Injections and tightening from overload on the muscle). It also showed a split Piriformis, and the Hip Surgeon concluded that I should have Piriformis Decompression Surgery before any further nerve damage occurs. I may need surgery for the FAI and Labral tear in the future if it gets any worse.

    Before making the final decision on Piriformis Surgery, I undertook 7-8 weeks of Rehab with a Physio and Excersize physiologist. This program helped strengthen my core and reactive my glute muscles, however it made my nerve pain worse in the buttock and foot due to the tight piriformis muscle irritating the nerve.

    I went to go see my Neurosurgeon a month ago and we agreed to proceed with Open Piriformis Decompression surgery. The Neurosurgeon performs the surgery in combination with a Hip surgeon. This was performed on 5th September 2016 and I am now 11 days post surgery.

    According to the Neurosurgeon the surgery went well and there were no complications. The findings showed there was a Split Sciatic Nerve and fibrous bands/deep fibers of the piriformis encasing the CPN division of the Nerve. The incision was around 3 inches long.

    I stayed in hospital overnight, however was able to walk immediately. I did use crutches for the first couple days as safety. I am still taking OxyCodone for Pain and Celecoxib for Inflammation.

    I note that the nerve pain had slightly reduced immediately after surgery for a week, and for the last couple days I have not felt it much, unless I lie on back for a long period of time or move the leg around a bit too much. This is probably due to the inflammation around the Piriformis. There is still alot of pain around the wound/upper leg area, however this will obviously take time to go away as the wound heals. So far, I have not had any extremely rough days after surgery and recovery seems to be going well, however I am weary of the risks of Scar Tissue growing back and irritating the nerve. I have a month off work and will gradually go back to work as I do not want to aggravate anything especially since I sit down all day.

    I start Hydrotherapy next week and will then start Physio at 6 weeks. I am feeling optimistic and relieved after surgery knowing that I have tried everything in my power to get my life back on track.

    Happy to answer any questions. I will continue to provide updates on my recovery.

    Thanks.

    • L
      September 17, 2016 at 2:16 pm

      My reply to Nav,
      Bless your heart – – I DO understand exactly where you’re coming from. ( this is a long post also, but I hope it will help others). My issue started on February 22, 2016 with a simple bio identical hormone pellet inserted barely under the scan into the fatty tissue of the hip. — However, the nurse practitioner inserted a little bit lower than usual. Same afternoon when the numbness wore off, I was in SCREEMING PAIN — she obviously blunt jammed into the gluteus muscle — Which was trauma and aggravated everything else that was silently going on – – and would probably have remain dormant had this not happened) — it felt like someone had taken a knife and did serveral slices across my gluteus. I did call the doctor to let him know, of course, nobody answered, nobody returned my call after a week. I am a person who NEVER GETS SICK – NEVER CATCH ANYTHING & over 60 – – NEVER HAS PAIN — I have always had an exuberant amount of energy – – just like my dad of 92 and still building. After seeing my primary physician – – does not understand – – put me on narcotics – – serveral of different ones, including Valium, Flexeril, another muscle relaxer, Percocet, etc. and others. – – With absolutely no relief. I was set to the neurologist for a nerve conduction study – – of which they could find NOTHING wrong with me – – DAH ! — I had to x-rays – – 2-MRI’s of which showed a lot of stuff going on – – help me understand how a whole lot is going on and I am never feeling any pain. The MRI did also indicate L5 – S1 — I also saw an orthopedic surgeon which told me my x-rays look so near perfect he could put them in the book of the perfect beside the bad x-ray. – – I was sent back to him again after my MRI – – he asked me WHAT was I doing there ? I reminded him that I had an MRI and asked him if he had read it – – he responded with hesitation – – yes, but many things show up on the MRI that are not there – – so, I asked him about my situation and how long I would be this way – – he responded, – – you will have to live with this for the rest of your life – – He cannot even do injections. – – Guess what, I fired him – – I do not accept that. – – So I found another orthopedic surgeon in Austin – – he told me I did NOT have piriformis muscle syndrome – – he sent me to Texas physical therapist specialist. – – Which there are 12 in the central Texas location ranging from Plano, to San Marcus, TX. – – So, I went to them for seven weeks, twice daily – – they did help me – – a lot – – As they gently touched my hip and moving down my thigh – – so barely touching me – – that sent me into electrocutions, BIG TIME — this is not fun, and it is not merely spasms – – but like touching a cattle hot wire fence – – and being electrocuted. I left the office being electrocuted and jerking big time – – and trying to buckle up in my seatbelt while I am being electrocuted – – VERY DIFFICULT — we stopped at a nearby sports bar – – I was afraid they would call 911 because of the way I was acting – – I was not acting, cannot help it, in excruciating pain – – I asked him to bring me a margarita with a double shot ASAP — ( The first time I had ever ordered this). they did – – I drink half of it as fast as I could – – and within 10 seconds all of my electrocutions and spasms STOPPED — thank you God, I do not have to drink kerosene !!! — I can drink tequila instead. I did continue with Texas physical therapy specialist, and today I still do the exercises they gave me – – they dismissed me saying, my related problems are nerve related. – – I went back to my orthopedic surgeon, – – he did not want to do injections, because they only work maybe half the time – – since then, I went to pain specialist of Austin, which have several locations including, Austin, Waco, Killeen and various other locations – – The Killeen Office is wonderful – – I saw Dr. Pankaj Mehta M. D. – – He was trained at Cleveland medical, Ohio – – He treats you with the upmost respect – – He gave me an injection of Cortizone into the piriformis muscle — apparently, because it only works half the time – I am scheduled for October 17 to have a nerve block into the L5 – S1 — I do believe in prayer – – however I had this done on Friday, September 2, 2016 – – this is a week later and I really feel no different – – the first two or three days was much worse than prior.
      I continue to pray that the nerve block scheduled will work and I will have no future problems, I do not run – – however, I am very active, I instruct ballroom dancing – – as Long as I am on my feet, I am doing really good – – but major problems lying down at night or trying to sit down to watch a movie in the evening. – – I get electrocuted again. So, I do laundry, cook, bake, mop, anything that will keep me busy on my feet – – Time goes much faster if you throw yourself into a project instead of literally trying to pace – – then I will have a double shot margarita and I can go back to bed and perhaps get 5 to 6 hours sleep. – – – being on my feet, allows that muscle to relax – – when I am sitting or lying down, it is pressing against that muscle which causes the electrocutions – – I am puzzled by these doctors – – even specialist – – they sweep it under the carpet and does not know what is going on – – and send you to someone else – – yes, you got it, I still drink my Doubleshot margarita to relax the muscle – – as per the doctor that gave me the injection told me, the narcotics will NOT help relax the NERVES BUT ALCOHOL WILL RELAX THE MUSCLE WHICH CONTRACTS AND PINCHES THE NERVE –– – I am not an alcoholic – – I do my exercises – – but seem to require at least one margarita daily with a double shot — I have read several other post that also say they were giving a nerve block – or Botox – which help them for maybe nine months but had further problems from the Botox — mine will not be Botox, but I hope it works.
      – – Bottom line, the trauma from gouging the gluteus muscle brought everything else to surface. I am open and eagerly look forward to read other blogs posted. I also pray for many others out there with this problem that doctors say is RARE – – But from what I have read, the problem is not rare, but doctors that know how to treat it are rare.

      • Nav
        September 18, 2016 at 8:40 am

        Hi L,
        So sorry to hear about all the pain you are going through. It is the most frustrating and dissappointing thing when doctors, physios and specialists cannot figure out what is going on and conclude “why cant u live with it the rest of your life”. If only they were in a patients shoes. It makes our life so much harder when we cannot figure out the answers.
        I hope your L5/S1 nerve block works. If it doesn’t work, i suggest requesting your specialist to have you do an MRN scan (instead of an MRI) of your lower back and hip. An MRN spefically scans your nerves and can potentially help identify any irritations of the nerve, hence if you have a piriformis syndrome or any other nerve irritation. I previously had MRI scans of my hip which did not pick up any nerve irritation in the hip and my nerve conduction studies also did not show any signs of nerve irritation. It was only once i saw my neurologist did he recommend an MRN scan which showed my piriformis syndrome.
        Sometimes cortisone injections may not work and botox is another alternative before considering any surgical intervation. Both of these worked for me however botox worked much more effectively for me. Everyones case is different though.

        Maybe go see a neurosurgeon in your area for a second opinion.

        I really hope you can get to the bottom of your pain and get some relief asap.

        All the best with it.
        Cheers

      • L
        September 18, 2016 at 11:30 am

        Nev,
        Thank you for your reply and your update information – – presently I’m crying as I have in the past — I have always tried to live a very healthy life, – – exercise – – eating very healthy — trying to do the right thing in all aspects – – and keeping a relationship with God asking Him to lead me in the way He sees fit – – I do not understand why this could happen to me – – hopefully, I will be at influence and help others in anyway I can – – I try ask God to help me anyway he chooses me to help others. – – But to please, please release me from this pain. And to please lead me to Wherever he wants me. — as mentioned before, my entire life I have been very blessed with no pain what so ever cash – and I look around and see many many others but younger than me crippled, and many other kinds of pain that has perhaps left them with no memory – – thank you again God that I am not there and please help me to be where I should be.
        L

  3. Staci
    September 10, 2016 at 7:34 pm

    I hope all of the above commenters get to read this. I have had the piriformis/sciatic pain for over 20 years. I always got the same answer each orthopaedic I went to….”its sciatic, nothing we can do”. Finally, I did my homework and knew there were options if someone could tell me exactly what is was that was causing me so much pain in my butt and down my leg. I am a female and it even affected my menstrual cycle…..totally painful!!!! I found a spine specialist at an orthopaedic clinic in Knoxville, TN(I live nearby) Long story short, hetold me most doctors do not believe this type of pain exists, but thankfully he did. I had an MRI, showed nothing. I had a Nerve Conduction Study(very painful, but worth it)and BAM…..he found that this was indeed a piriformis/tendon issue, causing my sciatic pain as well. I had 2 injections of which neither one worked. I am having surgery Monday, Sept 12, 2016 to hopefully cure this pain. I have great faith in my dr’s capabilities. This a rare surgery and no one else in the area will do it. He has been in practice for 25 yrs and has seen only 20 cases. He has had 90% success rate and the unsuccessful surgeries were due to other issues in conjuction with the piriformis. I hope that if you are having this type of terrible pain, that you keep lookink until you find a dr that believes your pain is real. I wanted to share my story for support and know you are not alone in this! Prayers for my successful surgery are very much appreciated:) Good luck to you all!!!!

    • mea ellen
      September 12, 2016 at 3:49 pm

      I see that your surgery is today and I am keeping you in my thoughts and sending positive vibes. Please do post the results… I am having many of the same problems.. 70 yr old very active female with chronic pain in right hip down to foot due to short leg and ski injury… I recently started undergoing intensive fascia release therapy which was providing some relief… but then one morning BAM a snap in the piriformis area followed by excruciating acute pain from waist to heel… after suffering 2 days (unable to stand – literally crawling on hands and knees) finally found a pain/acupuncture doctor and got instant relief from combo lidocaine injections in piri area and acupuncture all down the leg. I continued the fascia release therapy and then a month later (last Friday) BAM it happened again… today after 75 agonizing hours, I finally got the pain med injection/acupuncture treatment again, but this time it has not brought much relief… And today I got the diagnosis “SI Instability” – so my question is this: Is it possible the fascia release, while helping in other areas, led to the hypermobility/instability in the SI which causes the extreme sciatic pain? I’ve never heard of this, but it does seem coincidental – the first episode occurring within weeks after starting the fascia release program? Anyway please do let us know the results of your pirifomis surgery and tell more about it. thanks for posting.

    • September 16, 2016 at 1:23 pm

      Staci, how are you doing from your PM release surgery? I too had a EMG test many years ago that said I had Piroformis Syndrome. But when I finally went to a surgeon, he said no it was just SI joint pain. My ins wouldn’t approve SI joint fusion. So I went to another ortho dr and got PRP therapy. This seems to be starting to help the SI joint but my pain has changed a little, not much but enough to think maybe I had both conditions and now I need a PM release. just reached my 7th year in the battle with this horrid pain. And yes, did PT, Chiropractor, injections, I have tried almost everything.

    • L
      September 25, 2016 at 1:07 pm

      Hi Staci,
      I have been praying for you and many others with this problem – – how are you doing since your surgery – – is the progress good or are you still having pain.
      I have been to multiple doctors, two different orthopedic surgeons, a neurologist which gave me a nerve conduction study, two MRIs, two x-rays, PT for seven weeks, twice-weekly, chiropractic, electrical stimulation for ONE solid week 8 to 10 hours a day – – none of the above has helped or even showed my problem – – PT did release me saying they could no longer help me because my problem WAS nerve related. On September 13, I had a Cortizone injection into my piriformis muscle, at which time my doctor immediately scheduled me for a nerve block on October 17 – – because it is seldom that the Cortizone injection will help. He was right, I was only WORSE for about a week afterwards – – now I am back to where I was before the Cortizone injection. I do understand the pain many of you must be going through, as I am unable to sit more than about 15 minutes at one time – – even with my doughnut pillow – –, so I am on my feet the entire day doing numerous projects – – lucky for me I like to cook and bake and dance – – and you all know what the pain is when you get electrocuted when you sit or lie down – – it feels like a bolt of lightning hit your foot – – or a hot iron is placed on it – – and you do what is normal – – you jump and scream – – I am supposed to have a nerve block in my S1 — Who out there has had this nerve block to the S1 ??? – – Did it work at all – – how long did it last – – what I am really concerned about is: since this nerve block is supposed to block the pain that tells my brain ouch, what further damage am I doing when I sit or lie down ??? My entire life, I have been extremely healthy and never get ill – – I can count on one hand the number of times I have been ill in my entire life and still have room left – – I am over 60. That says a lot – – I have always been able to do anything without thought of not being able to. Now, I feel like my life has been robbed along with my career. – – I am still very fortunate in many ways, I have a wonderful loving husband and a wonderful daughter who help out. I can’t drive far because I am sitting when I drive – – and when that electric bolt hits my foot I am afraid what would happen – – it has happened before as I was leaving my home with my husband and drove Two Houses past ours and I started getting electrocuted.
      ( I know this is long, and I am sorry but I do understand what you guys are going through)
      Another thing, after the nerve block, if it only is temporary, how long can they keep doing this and what future problems will it cause – – so I am also eagerly trying to find doctors that have performed the Piriformis release surgery on a normal basis with good outcome. So far the only one I have found by googling is in the UK. Unfortunately, many doctors simply do the process of illumination. I learned from somebody on one of the blogs that had an MRN which is a different type of MRI and it shows all the nerves. Unfortunately, they only place you can get them are at the MRN institutes, which are three in Texas, and others in other states. But, they do not except Medicare. The cost is $4020.
      I even checked further with the mayo clinic’s — there are three in the United States – – Arizona, Florida, Rochester Minnesota. Rochester is the only one that does MRN — I was unable to get a price because they need a code from the provider – – you would think it would be mandatory for doctors to do an MRN when the problem is nerve related, so they can zero in on the real problem without the process of elimination. Mayo was very pleasant and easy to talk to and did tell me they would bill Medicare but the payment is sent to the patient and patient would then have to send it to Mayo — I have never heard of this before — I am just trying to see some of my future options if necessary. I found out WHAT I had by a long search of googling, BUT when I mentioned to the doctors “Piriformis Muscle Syndrome” .. They told me “NO, you don’t have that, it is very rare ” — Hey, just because it is rare does not mean I don’t have it. After reading so many blogs from people that do have it, I see that it is not so very rare – – BUT finding a doctor to treat it is RARE.
      The last time I posted I became very emotional – – this happens when the pain is just so bad and it will also affect my stomach and I feel helpless – – that is when I have to have a stiff margarita – – it takes about 20 minutes for me to feel all better. I try to limit this to once a day. Thank God for my strength to stay on my feet.
      I continue to pray for you all out there that share this miserable pain and hope you’ll find the right solution to help you.

  4. Lillian Nash
    August 30, 2016 at 6:37 pm

    Hi Matt,
    I HEAR you. Where are you, better yet, where is Dr. Heinrich that performed your surgery. I have been in constant pain since Feb. 2016 (pushing 7-months). I have been to my primary physician, sent to a Neurologist for a nerve conduction study, to and Orthopedic Surgeon for X-rays and MRI’s to only have him tell me (without examining me or even touching me) my x-rays were near perfect and he didn’t believe everything the MRI’s said and that I would just have to live this way for the rest of my life. He said he could not help me in any way, not even injections. I quickly found another recommended Orthopedic Surgeon – he sent me to Physical Therapy for about 7-weeks and they also did dry needling which did help to relieve a very tight contracted spot on my gluteus muscle from being punctured. PT did finally dismiss me saying my remaining problems were nerve related advising me to return to my Orthopedic Surgeon. I did, and he said he can’t help me and that HE doesn’t perform the Piriformis Muscle Syndrome Surgery and he recommended I find a doctor that does them often. I found one by google search in the Dallas area and his office gal said he did the Piriformis Muscle Syndrome Surgeries all the time. However, when I called her again today, she denies telling me this and that the doctor has NEVER done this type of surgery and earlier, the first time, she also said he didn’t accept Medicare. (So why are they advertising through google that they do ?) After hours and hours of searching to try and figure out what was wrong with me I discovered that I have the EXACT symptoms in every detail of ‘Piriformis Muscle Syndrome” ….. where am I going to find a doctor to help in the Central Texas area. I am a Ballroom Dance Instructor and I feel my life has ended. ( I pray that Dr Heinrich is not far away) Thank you for your time and I look forward to your reply. Meanwhile, have a great day.
    Lillian

    • Shelly
      September 11, 2016 at 7:32 pm

      Lillian,
      Who is the Dallas Doctor? I see Dr. Hal Martin at the Hip Preservation Center at Baylor UNIV hospital. He is in the process of helping me with my piriformis/hip/back issues. Call him! Some others here have mentioned a Dr. Starr in the Dallas area. Have you heard of him?

      • Lillian
        September 11, 2016 at 7:51 pm

        Shelly,
        The doctor I found online with his website is Dr. Donald Mackenzie in Plano. His website talks about the Piriformis muscle syndrome. I talked to his office girl “Lena” and I understood that this doctor did the Piriformis muscle syndrome release surgery all the time. However, I called her about a week ago and she denied that he did that surgery and that he was a spine surgeon. Now I thought that was strange because of what his website said. I am currently visiting with pain specialties of Austin. They have offices in many different locations including Georgetown, Austin, Killeen, copperas Cove. I am supposed to get some injections – – I think they will be Cortizone, – I am hoping these injections will work for me and hopefully I will not have to have surgery.

      • September 11, 2016 at 8:34 pm

        Dr. Adam Starr at UTSW (office at Parkland), Dallas, TX is incredible. He is a hip trauma surgeon, and he does the open release so that he can see what all is going on in the hip. He’s also been voted several years, as one of the top traumatologists in the USA. When he opened my husband up, he found that the piriformis muscle had adhered to his pelvic bone and the sciatic nerve was being smashed behind it (sept 2015). In his 20+ years, he had NEVER seen this. He refers you to Dr. Chhabra for an MRN, then botox injection, which is diagnostic, as if it helps for a day, it confirms piriformis syndrome. I would highly recommend Dr. Starr…people have flown from all over the US to see him and have surgery. He is kind, he listens, he understands, and he is there to help you be pain free. You cannot go wrong with Dr. Starr, Dr. Chhabra and their teams!!http://profiles.utsouthwestern.edu/profile/19574/adam-starr.html

      • Risa Hillard
        September 11, 2016 at 9:05 pm

        I, too, have had the open surgery with Dr. Starr. He is awesome and very responsive…a truly wonderful, caring, sincere Doctor. He is everything Sharon said…and more!!!

      • Lillian
        September 11, 2016 at 9:44 pm

        Risa,
        What happened to cause your pain to begin in the first place.

      • Risa Hillard
        September 12, 2016 at 5:56 am

        No trauma or injury occurred, but the MRN showed I had a bifurcated piriformis muscle that was compressing the sciatic nerve. Probably years of sitting too much at work. I now have a sit/stand workstation.

  5. Tamily Butterton
    July 17, 2016 at 6:16 pm

    I am so glad I have come across your page. I need some support, feel so alone in this agonising pain. I have suffered for over ten years now, Dr’s never believed me and I was left for a long time with no treatment. I eventually got a diagnosis via a pelvic mri. I had the left leg piriformis muscle released and over time I’ve deteriorated, I’m convinced I have scar tissue that’s formed and catching the sciatic nerve but the hip area is sore too, it’s agony. My left leg is bad too and the sciatic nerve is trapped their too. I hate my pain and not sure how much more of this crippling pain I can cope with.
    My local NHS trust treat me terribly and when in agony it’s awful, luckily got a great gp.

  6. Susan
    May 19, 2016 at 1:54 pm

    Hi Everyone,

    I am getting Botox injections in my right and left piriformis, and am also considering piriformis surgery as a future option. My understanding with both the injections and surgery is that afterwards, it is important to do physical therapy. In regards to PT, do I need to find a PT with experience in piriformis issues? I live in the Bay Area, and PT’s are a dime a dozen. Probably lots of mediocre ones – I just don’t know how to begin looking for a competent PT and the criteria I would use in my search. The doc doing my injection is not local, so I couldn’t get any local referrals from her. Any input would be much appreciated!

    • May 19, 2016 at 3:47 pm

      Susan – after different PT modalities (dry needling, cupping, pelvic, etc., etc.) my husband had piriformis release surgery last September. You may be able to find more history in my previous posts. However, his piriformis muscle was adhered to his pelvic bone and the sciatic nerve was being smashed behind it. Post surgery, he said he was 80% better, but he still had lingering issues. He went back for another MRN and the hip trauma specialist and orthopedic radiologist in Dallas TX, referred him back to the neurosurgeon. The neurosurgeon was “miffed” that he had gone through the surgery and still pain was high. He definitely had a closed mind and would not listen or hear anything my husband was telling him, i.e. he was 80% better and not 24/7 pain. After discussing spinal fusion, and no guarantee if it would or would not work, the game plan was more PT. He is finally seeing small results and continues to work it hard. Back to dry needling and waking up muscles in the back of his leg that continue to spasm. He has to stretch and exercise every day just to get going and get everything warmed up. In saying all of this, I would recommend you ask if the PT does dry needling, cupping, etc. My husband can tell the difference and he’s only had three sessions. In fact, he cancelled his last appointment for needling (aka as Chinese/Korean/Japanese acupuncture, but Western medicine here doesn’t call it that). This is a “syndrome” and I don’t think textbook cases are the norm with this monster! Good luck to you!! And I still cannot thank Matt for starting and continuing this blog…and for Brian who shared his story…resulting in our story!! Even though my husband is not 100%, and not sure if he ever will be, he is making some progress and that is a huge blessing!! Going back to the months he suffered, he will take anything over that journey.

  7. Elizabeth
    April 27, 2016 at 4:09 pm

    Hi Everyone,

    I have been struggling with nerve pain in both legs for 14 years. I initially had debilitating SI joint pain which has now been resolved with stem cell injections, where my doctor got my own stem cells from my bone marrow. Unfortunately, despite the fact that these injections eliminated my back pain, the leg nerve pain continues. My MRN, provocative EMG, and diagnostic Botox injections all point to pain coming from my pirfirmis as well as obturator internus muscles. I have seen a few physicians who have recommended a piriformis release, but had not found a physician who has experience with the obturator as a pain generator until I read a post on this site by a woman named Sharon whose husband had surgery with Dr. Adam Starr in Dallas where he removed the piriformis muscle completely and clipped/released the obturator tendon. As you all know, years of debilitating pain is a huge motivator, so my husband and I traveled to Dallas for an appointment with Dr. Starr. Based on all my studies, and success with Botox we talked about the potential for surgery where he would probably do the same thing to me….remove the piriformis muscle and clip/release the obturator tendon. My problem is that I am scared of potential negative impacts of surgery, and scared to do nothing. Do any of you have any experience or knowledge regarding removing the entire pitiformis muscle and/or any experience/knowledge of the obturator internus also contributing to nerve pain, or any other doctors who do? I can’t say enough good things about Dr. Starr. He seemed to have so much knowledge of the sciatic nerve and surrounding area. He spent so much time with me and was extremely thorough. The problem is that I have seen so many different doctors who all have their opinions on surgery techniques as well as their opinions on whether surgery is even worth the risk. I look forward to hearing from anyone. It is clear that experience has taught all of us so much about this issue.

    • Risa Hillard
      April 27, 2016 at 8:23 pm

      Elizabeth,

      Dr Starr removed my right piriformis muscle 4.5 mo ago. It was a very easy surgery for me and easy recovery. My pain is much better, but I am not without pain but didn’t expect to be yet. It takes time for the sciatic nerve to heal as it is scarred. I’ve gone from not being able to sit at all prior to surgery to being able to sit for a couple of hrs at a time pretty comfortably and travel in the car and fly without much pain. I’m very glad I had the surgery, sleep without pain (wasn’t sleeping well at all prior to surgery), take no pain meds (was prior to surgery), and believe i will continue to improve even more in the months ahead. I do not have problems with the obturator tendon. I’m happy to answer any other questions you might have.

      • Elizabeth
        April 27, 2016 at 8:59 pm

        Hi Risa,

        I am so glad to hear you are doing better. Thank you so much for your reply and being willing to answer my questions. It helps to know we are all in this together. I read a post earlier today from someone who had open piriformis surgery with Dr. Ellis in Ohio. In the post the person mentions that Dr. Ellis moved the leg around after the release to see how the nerve and other muscles responded. My question to you is, do you know if Dr. Starr does this? I hate that I did not ask him this questions because it seems like an excellent way to see what other problems might exist. Also, what has your recovery been like? I am curious since I will have to have both hips operated on separately as none of the doctors I have seen think operating on both at the same time is wise. One more question, have you had any issues with scar tissue building up post surgery? Thank you again for taking the time to respond.

      • Risa Hillard
        April 27, 2016 at 9:34 pm

        To answer your questions: No, he did not move my leg around post surgery as you described and I have not had any issues with scar tissue to date.

  8. Ellen
    April 17, 2016 at 7:53 pm

    I have had similar symptoms to everyone on this blog. My orthopedic surgeon told me about this procedure Friday. I finally feel like there is hope! Hearing your story and those of others here on this blog has given me even more hope! Thank you!! I have to get my back checked one more time. If nothing surgical shows up there, I will be having this procedure. Bursectomy, piriformis release, and gluteus medius tear repair.

    I also have a ruptured disk in my neck.
    I’m scheduled for surgery to repair it soon, but I have more pain in my hip than my neck.
    So, I’m wondering if you were on crutches after your surgery. My arms are weak from the ruptured disk in my neck. I don’t know if I can use crutches???

    • Risa Hillard
      April 17, 2016 at 8:01 pm

      Most people are on crutches or a walker for a few days post-op, but I didn’t need them and didn’t use them. I walked unassisted the evening of my surgery (same day) with very little pain. But I only had the piriformis release surgery and not the other issues/repairs you are also having done.

    • Shelly Vickers
      June 3, 2016 at 6:47 pm

      Ellen–
      Have your doctor check for Ischiofemoral impingement. It is a simple test where you lie on your side and he bends your leg and moves your hip. I have terrible neck pain, but never really mentioned it because I was seeing a hip specialist. Well, it’s all related! It’s even related to my recurrent hernia above my belly button. CRAZY!!

  9. melissa
    February 1, 2016 at 12:56 pm

    I am curious if anyone has had any success with botox injections? I’m one and a half years in with chronic bilateral piriformis syndrome as a result of a torn hamstring. I am scheduled for lumbar and pelvis MRIs in a couple of weeks and possible injections under fluoroscopy. Any comments from people who have undergone botox or even steroid injections would be very welcomed. Thank you.

    • February 1, 2016 at 1:48 pm

      Melissa, please see my Treatments page for my experiences with both types of injections.

  10. Mark S
    December 30, 2015 at 8:32 pm

    Any guys who do piraformis surgery in AZ or SOCAL.

    • Steve Francis
      April 13, 2016 at 6:30 pm

      Did you find any Doctors? I have been looking also with no luck

    • Alan
      May 4, 2016 at 12:35 pm

      try Dr. carlos guanche in van nuys california

  11. Mark S
    December 30, 2015 at 8:30 pm

    Any guys in AZ or SOCAL who do piraformis surgery?

  12. wendy
    December 28, 2015 at 7:45 am

    Hello Matt –

    I have been following your blog and wanted to thank you for creating it.

    I have the exact same 3 problems (except mine are on the left) that you have (had) and wanted to reach out for a couple of answers.

    If I am understanding correctly, you are pretty sports minded. I am wondering if you played any sports prior and if so, if you found ease in getting back to them post surgery? What kind of recovery time did you see?

    I was an avid downhill mountain biker and competitive downhill skier, as well as a basic outdoorsy person. This has sidelined me so much that I have only skied a handful of times over the past 3 years and don’t remember the last time I got on my bike. I spend a great deal of my time now inside, researching. I am wondering if I go through with a surgery if I will be able to get back to my old sporty self?

    Any advice and comments would be greatly appreciated.

    • January 7, 2016 at 8:36 am

      I have fully recovered and am back to my pre-PS self. My opinion is that the more active you are after surgery the more likely you are to make a full recovery. That being said, pay close attention to what your body and gut are telling you. Seek advice from a physical therapist that has experience treating PS.

    • Lea
      January 8, 2016 at 9:35 pm

      I am cured as well 10 months out from surgery. The mental side was the hardest. Just got back from an hour in the gym. It was hard to realize the activity would not hurt.

      • Nina chandler
        March 24, 2016 at 12:43 pm

        I am 3 weeks post surgery. I am in agony after any activity, the sciatic nerve is just so sent icon right it makes my whole leg burn. Does anyone have any insight they could give me?

      • March 26, 2016 at 8:14 pm

        Nina, I used a lot of ice for weeks, and took it real easy. Have you started physical therapy yet?

  13. eric brun
    November 13, 2015 at 10:44 am

    ive suffered sciatic pain for 20 years. I used to run…a lot. I started a factory job that involved turning to the right about every 10 seconds in a circle all day. that’s when the pain started. I stopped that job but the pain stayed. a few months later after jumping down from 4 feet I dislocated my back l4 l5. had surgery bout a year later fusion l4 l5 s1 which helped with the obvious back pain but not the sciatic. after 10 years of searching for answers I had a second surgery. removal of hardware, reinstalling fusion l4 l5 s1 and further rods from l2,3,4. now my entire lower back is screwed and I still suffer from sciatic pain. ive tried everything most more than once. nothing works. from online videos ive seen I think I have piriformis syndrome but my gp has nothing to offer me.
    $20000 medical bill for surgery in the us is not an option for me.
    I find it hard to believe no surgeon can do the piriformis release in Canada where I have full medical coverage.
    any advise would be greatly appreciated.

    • November 14, 2015 at 3:15 pm

      Eric – I posted this on June 27, 2015 at 1:03 pm Reply It has been five months since my surgery and all is good with the outcome! No more ice pick pain.
      See below:
      ‘I had sciatic neurolysis and hamstring reattachment endoscopic surgery last week. Dr. Timothy Jackson Congress Medical Group (in their surgical suite – very good, brand new!).
      Dr Jackson (has done 13-15 of these surgeries) said he found much scar tissue and some fibrous bands where sciatic nerve was being compressed by piriformis (after 21 months since injury), which finally an MRN (Tesla 3.0 GE Moore’s Cancer Center UCSD Hospitals San Diego), diagnosed.

      No more injections or just treating symptoms! He does not believe in snipping the piriformis tendon as he has had good outcomes without doing so. I haven’t started PT yet but will soon. Still tender and quite stiff where the holes were made to get endoscope and debridement tools in for MIS worki. Took about an hour under full anesthesia and not too long for recovery. All good. My wife drove me home from Pasadena to San Diego same day.

      I would recommend Dr. Jackson to anyone who suspects PS. I will update blog when have had a month’s PT! dick cummins – feel free to e-mail tfcr@cox.net – don’t think medical tourism to Pasadena would be that expensive. Here is is his website: http://www.timothyjacksonmd.com/my-practice/timothy-j-jackson-m-d/

      • Denise
        November 25, 2015 at 2:01 am

        I’m so glad to hear you are doing well! I have surgery scheduled with Dr. Jackson in a couple weeks and I’m so nervous! He will be fixing a hip impingement and trying to figure out what is pressing on my sciatic nerve, whether it’s the piriformis or hamstring, etc. Any advice you could give me would be great!

  14. Carlye Azzolina
    November 6, 2015 at 11:08 pm

    Matt, i am a patient of Dr. Heinrich, we have done several treatments for my piriformis issues and he believes I would be a benefit greatly from this surgery. I am glad to hear you had success. What was the recovery like?

  15. September 27, 2015 at 8:28 pm

    I had a bone marrow transplant in 1997 for acute leukemia, my sister was the donor. I have numerous health issues from all the chemo and GVHD which is my new immune system attacking my body. I was 38 when I was diagnosed with leukemia, I am now 56. One of my chief complaints is muscle pain, I get Botox for my neck, it really helps. I’ve had lower back pain since my transplant,the many bone marrow biopsies didn’t help. I have gotten steroid injections in my SI joints for years. I did get relief in the beginning but very little now. One week before Easter I could barely walk, the pain in my buttock going down my leg was excruciating. Long story short,I’ve had 2 steroids injections in my pirafomis muscle, one epidural with steroids put in spine, two injections in my SI, physical therapy, muscle relaxers, and pain meds. My son is getting married in Nov and I really want to dance the Mother/Son dance. I think Botox is the next thing they can try, my SED rate in my blood is high which indicates inflammation in my body. I was put on prednisone for this before but I won’t go on it again, to many side effects. I also had shingles 4 times and other difficulties. I can’t take anti inflammatories because severe reflux and esophageal spasms. I had a MRI to rule out spine problems. I’m at the point that OxyContin is not helping. I have conquered a lot the last 18 years and I am one of the fortunate ones to be alive. Most everyone agrees that my piraformus muscle is very inflamed and goes into spasms. I live in a rural area of Pa. I had my Bone marrow transplant in Philadelphia. Any help would be appreciated. Thank you, Ruthann

    • September 27, 2015 at 8:39 pm

      Ruthann I encourage you to do your research, including reviewing my blog’s articles, posts, and pages.

  16. Abi
    September 17, 2015 at 8:57 pm

    Honestly, this just helped me so much! I just, and by just I mean today, had a 3 part MRI to make sure there is nothing else going on. I was diagnosed with piriformis syndrome in 2013 and I have been through test after test, physical therapy, injections (including botox) and it seems like every Ortho doc here in Indiana is to scared to do this surgery. Now don’t get me wrong I 100% agree that I do not want a doctor doing the surgery if they are not comfortable, but I need some kind of help. This syndrome has taken over my life more in the last 9 months (after a fall on ice) then it has since I was diagnosed.

    • September 17, 2015 at 9:45 pm

      Indiana isn’t too far from Milwaukee, WI, where Dr. Heinrich is located.

    • regina B
      February 22, 2016 at 12:25 pm

      Abi,
      Have you had any luck? I am also in Indianapolis looking for solutions for my son.
      Regina

  17. Rosann Z
    September 13, 2015 at 9:32 am

    I had pirformis tendon release surgery by Dr. Henrich about 2 yrs ago. Unfortunately, I am not one of the lucky ones. Just recently I started having excruciating piriformis tendon pain at night. When I get up I can not put weight on this leg. Ice stretches over the last month have given me no relief. I am unable to find anything that talks about any long range problems that may occur. I had 2 back surgeries prior to his procedure. I am 57 yrs old and scared. What does 10 yrs promise to my quality of life.

    • Debbie
      October 3, 2015 at 1:31 am

      I’m so sorry. I have been struggling for 9 years too. It’s so scary. Wish I had some answers. Have you tried Botox after the surgery?

    • Trina
      October 15, 2015 at 4:42 pm

      Please get your hips checked for FAI. I also had a piriformis release by Dr. Heinrich and it was the incorrect surgery and should have never been done. I never found relief after the piriformis release because I actually had FAI. Hip joint problems can cause piriformis syndrome and if these are left unchecked, the piriformis pain will not go away.

      • October 15, 2015 at 4:46 pm

        Trina, I’m sorry you’re still in pain. Can you provide more detail, or are you simply implying that you were misdiagnosed?

      • Trina
        October 15, 2015 at 5:49 pm

        Thanks Mitch. I was misdiagnosed when in all actuality I had hip joint issues that were missed. Very disappointed that this happened, especially when Dr. Heinrich is a FAI specialist. I urge u to please explain to people on this website that they should have their hips and back ruled out first before agreeing to any piriformis surgery.

      • October 15, 2015 at 6:03 pm

        Trina, can you please email me your pre-op and post-op report? I will not post them. I need to be careful about negative claims against physicians in our free market litigious world.

      • Trina
        October 15, 2015 at 6:49 pm

        Matt, how can I private message u?

      • October 15, 2015 at 7:04 pm

        Trina, please email me at piriformissyndromehelp@gmail. com. Thank you.

      • Shelly Vickers
        June 3, 2016 at 6:58 pm

        AGREE to get your hips checked! I sought out Dr. Hal Martin in Dallas, TX, for a piriformis release never having any clue I even had hip problems. All my pain was in my low back, left buttocks, and left leg. He insisted on fixing my hip first. Femoroacetabluar impingement surgery last March 2015 took my piriformis/SI joint/sciatic pain away at least 50%. Now we are working on Ischiofemoral impingement. Hoping to avoid a piriformis release if at all possible.

      • Susan
        June 3, 2016 at 7:15 pm

        Hi Shelly,
        Just curious why Dr. Martin suspects ischiofemoral impingement. What symptoms do you have? What is his solution for this? Is it another surgery? I was diagnosed with piriformis syndrome 6 years ago, and had the piriformis release surgery. The surgery did not relieve the pain. Just recently, I went to a hip Doctor who thinks I may have been misdiagnosed and suspects IFI, though he didn’t officially give me a diagnosis. He said the surgery for IFI and piriformis is very similar – both need to release the sciatic nerve. The only difference is for IFI, the lesser trochanter needs to be shaved down. He actually referred me to Dr. Martin as well, but since I live in the San Francisco Bay Area, getting over to Texas will not be easy for me since sitting is a problem. Please let me know how Dr. Martin diagnosed your IFI and what his solution is. Thanks!

  18. Jim
    September 5, 2015 at 12:12 am

    Thank you mstehling for taking down my post today in regards to curing this awful affliction. Here is a non surgical way of healing the piriformis muscle and you don’t want to share it.

    Thanks Jim

    PS. It really does work and I’ve shared this with other suffers and they are now fully healed.

    • September 7, 2015 at 9:57 pm

      Dear Jim, you jumped to conclusion that I didn’t want to publicize your post on my blog. I usually do a weekly mass approval because I do take the time to read every single post.

      Matt

  19. August 24, 2015 at 5:25 pm

    The hip trauma surgeon in Dallas (Dr. Adam Starr – thanks to Brian) referred my husband to a specialized Radiologist/Orthopedist, Dr. Chhabra, who will perform a magnetic resonance neurography (MRN) this week. Next week, Dr. Chhabra will do a CT guided botox injection directly into the piriformis muscle. We understand that if it helps even a day, it confirms PS. We, of course, would hope for some long-term relief. However, if my husband has any relief and then the PS comes back, it confirms he needs a piriformis release. This hip trauma surgeon is used to putting people’s hips and pelvic areas back together so it is routine for him to perform the piriformis release surgery. This is an open, invasive surgery, with a foot long or so incision. However, they really don’t know exactly what is going on until they get in there, so it makes sense to us to have an open procedure. This hip trauma surgeon was rated as one of the top 29 traumatologists in the USA in 2012. So he is known in his field. My husband has been to the ER, an Internal Medicine Doctor, three neurosurgeons (thank God they were conservative and did NOT do unnecessary surgery), two PM&R doctors and has been receiving extensive PT for almost 12 weeks (feels good and by the time he’s in the car to come home, the monster is back). They even sent him to a special PT who specializes in pelvic therapy…she confirmed his muscles were “really tight up there”. My husband was over-the-top in doing his home PT…and did even more by what he found on the internet… The PT knows how diligent he has worked to try and get this worked out…she told him his last session that she felt he was the 3% who had an entrapment. Had my husband not found the youtube video by Dr. Filler in California, who described my husband’s condition/symptoms to a “T” (BTW, Dr. Filler is the one who developed/designed the MR Neurography), and I had not found this PS blog that Matt so graciously started and has continued to follow, as long as Brian who shared he was in the DFW area and Dr. Adam Starr performed his surgery, I’m not sure where we’d be right now. Thank each and everyone one of you who share on this blog, share the doctor’s names, etc., as it is helping those of us seeking some resolution of this monster. Since seeing Dr. Starr, we have a different attitude and can now see the tunnel that we’re about to embark on!! Thanks again for everyone. You have changed so many of us and we cannot be more thankful and grateful!!

    • August 24, 2015 at 5:59 pm

      Sharon, that’s exactly why I created this blog and screen every single post.

    • Crystal
      August 25, 2015 at 12:31 pm

      I had the open incision. Pain 70 to 80 percent better but had multiple complications w the incisiob because you are basically sitting or mating on it unless you are in your side. I has Ringo back in for them to noon it up and irrigate it and sew it back up better and I was in b the hospital 4 days and the incision formed a nasty keloid scar with lots of a car tiaaue. I am still glad I did it bx most of the sciatic pain is gone but in just wanted to warn you about that.

    • December 12, 2015 at 12:46 am

      Just wondering if your husband had surgery with Dr Starr and if so, how is he doing as I am having the release on Monday. Went thru all the same work up and injections with Chambra st UTSW.

      • December 14, 2015 at 11:01 pm

        Risa – not to be disrespectful; however, instead of repeating myself, I have provided comments along the way, including his surgery and findings. Please read and click on more posts and you should find our history. I can tell you that Dr. Starr removed my husband’s piriformis muscle as it was attached to his pelvic bone and the sciatic nerve was being smashed behind it. In his 20+ years of doing hips, he had never seen this. Good luck on your journey, you are in the very best hands…and heart!!

      • December 14, 2015 at 11:11 pm

        Risa – there are lots of posts that I’m not seeing, I’m sure they are embedded in other messages. I hope you find them. I don’t see Brian Hobbs posts either, I think you may just need to start “click’ing”!!

  20. dick cummins
    June 27, 2015 at 1:03 pm

    I had sciatic neurolysis and hamstring reattachment endoscopic surgery last week. Dr. Timothy Jackson Congress Medical Group (in their surgical suite – very good, brand new!).

    Dr Jackson (has done 13-15 of these surgeries) said he found much scar tissue and some fibrous bands where sciatic nerve was being compressed by piriformis (after 21 months since injury), which finally an MRN (Tesla 3.0 GE Moore’s Cancer Center UCSD Hospitals San Diego), diagnosed. No more injections or just treating symptoms!

    That MRN showed my left hamstring was detached some too so he tacked up the breaks with surgical super glue as he put it. He does not believe in snipping the piriformis tendon as he has had good outcomes without doing so.

    I haven’t started PT yet but will soon. Still tender and quite stiff where the three holes were made to get endoscope and debridement tools in for MIS worki. Took about an hour under full anesthesia and not too long for recovery. All good. My wife drove me home from Pasadena to San Diego same day and we stopped at TAco Smell as I was quite hungry.

    I would recommend Dr. Jackson to anyone who suspects PS. I will update blog when have had a month’s PT! dick cummins – feel free to e-mail tfcr@cox.net

  21. June 14, 2015 at 6:28 pm

    Matt,

    Couple questions for you. I have scheduled with Dr. Heinrich in July based on your website – I have very similar symptoms. When I spoke with him, he mentioned that the pain is with sitting and that the surgery could correct the butt but not necessarily the leg pain. Did you have lower butt (sit bones) and upper hamstring pain with sitting? Did you have hamstring pain on the outside of your knee? And lastly, I also start the day 2/3 and end up 8/9 – no position helps really except laying down. Does that sound familiar?

    Stacy

    • Lowell
      June 16, 2015 at 7:50 pm

      I had pain in all locations you mentioned and increasing pain through the day as you describe. I was also cured by surgery.

  22. June 14, 2015 at 6:26 pm

    Hi Matt,

    I have an appointment scheduled with Dr. Heinrich in July – based on similar symptoms. When I spoke with him, he mentioned that this is a sitting problem (which I have) and that the surgery could correct the butt but not necessarily the leg symptoms. Did you have pain in your sit bones and upper hamstrings when sitting? Did you have pain above the knee on the outer side? And lastly did the pain also exist when standing? Once my pain kicks in (wake up 2/3 and end of day 9/10) – no position really improves it except laying down.

    Thanks, Stacy

    • June 15, 2015 at 1:07 pm

      Yes I did have pain in both areas. Dr. Scherling fixed my leg without surgery. Dr. Heinrich fixed my piriformis pain.

  23. John
    May 27, 2015 at 6:08 pm

    I take it this type of surgery is impossible in the UK?

    • May 27, 2015 at 6:36 pm

      John I truly have no idea. If I were in the UK I would start calling renowned orthopedic surgeons that have devoted themselves to repairing/replacing hips.

  24. surveyor1953
    March 31, 2015 at 12:12 pm

    Matt,
    My burning is on both left and right side of the buttocks. Worse on the left though. Do you think the left side carries over to the other side? 21 days till I see Dr. Heinrich then Dr. Hardin the next. I read your posts almost every day praying I can be even half as lucky as you.
    It been about 2 years. Don’t know how people can emotionally stand longer. I’ll give you an update when I get back.

    • March 31, 2015 at 9:46 pm

      You should consider seeing Hardin first. He will send the results to Heinrich before you them meet with Heinrich.

  25. March 26, 2015 at 8:00 pm

    Just google Dr John Heinrich, Milwaukee and he’s easy to find.

  26. Kandace Compton
    March 18, 2015 at 8:30 pm

    Do you have contact information for Dr. John Heinrich. I’ve had it with this pain. I had surgery for a torn labrum in Fall 2012 and was told by yet another medical professional (this time an ART) that I had been misdiagnosed and that I was really suffering from a torn labrum. He sent me to a Dr. who did show me xrays showing a torn labrum. It might have worked in that I don’t have groin pain anymore. I used to have groin pain and pirioformis/sciatic nerve pain. Now I just have piriformis. I have already tried injections, physical therapy. Everytime I get back to trying to do something it acts up again despite me stretching. I just started a Crossfit Foundations and after the first class, my piriformis is acting up yet again so I just cancelled this. I did some research and found one website that said that the piriformis was needed and that cutting the piriformis would result in hip fractures. If you have had it and there’s a 90% success rate, that sounds good to me. I’d like to get Dr. Heinrich’s contact info to see if he can recommend someone in the DC area or I’ll fly to him.

  27. January 19, 2015 at 8:09 am

    Matt,
    I commented on the ” An Unimaginable Weekend” post asking for help. Are you going to respond and if so where? Anxious to hear from you and other with this awful problem.

    • January 19, 2015 at 1:25 pm

      I will respond as soon as Im able.

      • surveyor1953
        January 19, 2015 at 2:38 pm

        Thanks!!

        God Bless

        >

  28. Ed Browne
    January 17, 2015 at 9:11 pm

    Matt,
    Almost 2 years of intense buttock pain, failed back surgery, every injection known to man and an electric trial stimulator which was worthless and I made them remove. I went back to my surgeon and told him I was not going away. He has now referred me to an orthopeditic guy who does the release surgery. I’m am tired of being frantic in pain and probably would let a Vet do the surgery. I am a Professional Land Surveyor and I have operated a small firm for 31 years. I can only last about 3-4 hours at work and my quality of life is not good. I feel I know more about piriformis syndrome than most my doctors I talk too. How do I know who to trust. I feel my back surgery was because of a missed diagnosis and strongly feel this procedure is my answer. I have done countless hours of PT and exercise but my hamstring seems locked up and I’m in as much or more pain following exercise. I am at wits end. I’ve tried exercising through it, resting, you name it. It still burns non stop. I’m 61 and want to retire and enjoy the rest of my life without lying on my side. Any surgeons in Ohio you can recommend. Your dr. Heinrich would have to be a cash deal and pretty far away. Suggestions?
    Ed Browne

    • Gina
      May 6, 2015 at 4:49 pm

      Ed Browne – I had surgery with Dr. Thomas Ellis, Orthapedic One in Dublin Ohio 3/31/2015 – I have had good results so far. Nerve pain is gone, just tingeling and twitching left and some surgical pain. I am hoping this is it for me. I start physical therapy next week.

  29. May 25, 2014 at 6:38 pm

    –+
    Hi my name is Fran. i have parkinsons disease and believe i have ps. I had a long spell of dyskensia(uncontrolled upper torso control. My back has hurt me 4 years, Recently my pain has bevome unbearable. in 2010, i was in er due to my sciatica nerve. and it took 6 wks. of bed rest. it started 2 bother me again in 2013. i starting going to pain mgmt. the dr. was an anestihioligist.. He let me hurt from oct. 2013 till pres. due to the fact he couldn’t find a drug to help me. After morphine, butrans patch and oxycotin,which none helped my pain, i went back to Percocet, at least i had a little short time of relief.. I also havr a dbs inplanted in by brain. what kind of surgeon wood i need.Oh and my pain mgmt. dr. had ordered pt.@home 4 6 weeks. She did touch touch therapy on my pirformis and myofascia area and i had some relief 4 about 2hrs. after our session. she said that’s what was going on w/me. I’d like ur opinion, thanx fran

  30. Scott Mitchell
    April 6, 2014 at 12:31 pm

    Matt are you still active on this blog?

    • April 6, 2014 at 12:57 pm

      Yes I am still active. I dont check it every day though.

      Best Regards,

      Matt

  31. crystal
    March 26, 2014 at 3:03 am

    Scott: I had what I would consider a successful surgery 15 months ago w Dr. Barbarra in Indianapolis. I’m a 48 year old singe mom of 2 teens. Dr. Barbarro was a great surgeon and did the open incision. I have great relief from the constant sciatica and buttock pain. However I had moderate nerve damage already and positive EMG findings so getting the nerve to “calm down” and heal has been a long process. I still get some sciatica but it is 70 percent better. I was nearly bedridden too before the surgery and lost a lot of money and was unable to work as an attorney for over a year. If you want to email me you can. CsbauerJd@hotmail.com. I did have some post op complications that have not been pleasant which stem from the incision’s location which is up and down from under my leg to the top of the hip and the long length of the incision. Has been very hard to heal and I’ve had numerous infections with a very nasty scar and lots of scar tissue which is what I think continues to cause some of my symptoms. I still take some pain meds but I am back to work and able to function. Good luck.

    • Sherry W.
      June 24, 2015 at 1:15 pm

      Crystal, I just read your post. I am looking for someone to help me in the Indianapolis area. I have been suffering for nearly three years with PS. What kind of tests did Dr. Barbarro do to definitively diagnose your PS? Are you still pain free? How long were you home from work? Thanks so much!

      • Crystal
        October 4, 2015 at 9:08 pm

        Sherry W did I ever respond to this. Not sure but Dr, Barbarro did a steroid shot into the piriformis muscle and I was literally almost immediately relieved of symptoms so he knew that is what it was. He did a different kind of MRI too which didn’t show anything. But they knew it wasn’t coming from my back bc my MRI was find there and I pinpointed the start of the pain radiating from my buttocks NOT the back, I am down to taking maybe an average of one pain pill of 750 mg a day, NORC0 a day but it does rev up but no where near where it was before. That incision caused me so many problems and I had to go back in to have it irrigated and cleaned out so I worked at home for a year and decided to just keep working from here because with two teens it was easier to keep my eye on them.I have had other things that have caused problems with me meiically since the surgery but I am the same and functioning again. I am careful when walking because I am so scared of falling down on my butt and aggravating it so I am careful but It was a success and he is a great dr. You can email me directly at csbauerjd@hotmail.com

  32. Scott Mitchell
    March 19, 2014 at 2:05 pm

    MATT,i am a 56 year old male who has been thru hell since a paragliding accident in 2006.If you saw all the surgeries i’ve had,the drugs i am on you might have a stroke just looking at it.I have calked your DOCTORS office and CINDY was so nice,and said someone will call me in a day or so.THANK YOU for your blog .I AM 90% sure that i have the Piriformis Muscle Syndrome. My question to you is would you call me if i leave my number? It seems like you want to help people and in fact you have already helped me .My name is Scott 561 718 2635.,please if you would call me collect or whatever as i would like to “pick” your brain a little bit.If you don’t want to ,i understand completely.Again your blog has been so helpful and you helped me NOT to rush into a surgery with the wrong Doc. I am not a whack,just someone who has not been able to sit for 5years and living basically in bed. Sincerely,Scott Mitchell

    • March 20, 2014 at 8:01 pm

      Scott, thanks for your kind words. I’m sorry to hear you’re basically bedridden. I know the feeling all too well. I invite you to email me directly at piriformissyndromehelp@gmail.com, and then we’ll see if I can answer your questions.

      Best of luck to you,

      Matt

      • Scott Mitchell
        March 21, 2014 at 9:16 pm

        HEY MATT,how you doing ?sounding good thats for sure.Found a neurologist who’s gonna do PROVOCATIVE EKG done monday….talked withCindy again(i called back),she promised that note was on DR H s desk…i figured i need to know anyway…..i think the only other way to pinpoint is that nervemri ,which i can’t do due to spinal cord stim. is implanted in my back. Now question for you ..is how did this start for you?..Myself i had paragliding accident in 2006…..3fractures of pelvis Lside,fractured sacrum,broken shoulder,compound fracture of elbow,rib,and broken left foot…good recovery but could not due toe raises….hmm wonder why…6 months later can’t sit…oh last part of accident was 18 foot fall landing on left butt side,,set 07 L5 LAMINECTOMY,dura tear,6 weeks later can’t stand…jan -april 08 6 different laser at L4,L5 S1 bilateral…09 now CLEVELAND CLINIC L5 S1 fusion….AND YOU KNOW WHAT?i think it was PS all along….i haven’t been able to sit for 6 long years..ok thats my story and believe it or not ,thats truly shortened…glad i found your site…talk again after test

      • Scott Mitchell
        March 24, 2014 at 1:30 pm

        MATT could you please send me name and phone number of DR who did your provocative test….might just go straight to them.Scottie

      • Scott Mitchell
        March 29, 2014 at 1:44 pm

        HEY MATT, it’s a weekend again and i hope your golfing!.I have been in touch with DR HARDIN…what a nice guy! He responded to my email in less then 18 hours.Sure wish i had responses that quick from my own docs….long story short i am flying up on 16th of april and will have proper emg test done by him…this was all set up late afternoon fri,so don’t have appointment yet with DR. HEINRICH…but hoping when i talk to their office i’ll be able to see him too. IF i can’t get in with him then i’ll have to come back.But to me it is more important to find out if i even have PS..DR. HARDIN seems to think there is a good chance i do just based on my history and pain relief from lidocaine injection.SO GLAD ,because i was getting ready to have BOTOX injected. DR HARDIN said this COULD make condition worse,depending on where BOTOX settled in piriformis muscle in relation to sciatica nerve.When i’m up there i’d like to at least give you a call and say hello,think about it please. Had to fly first class, but was lucky to find tickets and 3 nights at Intercontinental hotel for less then a grand. I know you know the felling,can’t fly coach.BUT first class ,alone with a lot of walking during flight and meds i’ll get there. MATT can’t thank you enough. I TRIED the provocative test with a neurologist down here but he did NOT know what he was doing…was asking me what position i wanted and was looking up test on computer at same time…needless to say was a big waste of tome and taxpayer dollars (Medicare). My psychologist suggested 2 other guys who he told me would be honest,which they were.NEITHER one of them did it ,one suggested CLEVELAND CLINIC. That’s where i had my L5-S1 fusion done. AFTER all that i decided DR HARDIN would be best route for me.Ok MATT,hope you have a great weekend and i will keep you posted

      • Scott Mitchell
        April 6, 2014 at 12:29 pm

        Hey Matt..latest update.I am meeting DR HARDIN 4/10…..DR HEINRICH had no openings till may.His office also told me he may not do any more PMS surgeries this year,something about a shortage of tubing used during operation??? Don’t quite know what that’s all about ,but i hope DR HARDIN will be able to a little more light on that…i could not find anybody in S FL. who had any know how about provocative EMG test,even the Cleveland Clinic. So i bit the bullet and bought first class ticket to Milwaukee.Not looking forward to travel since i can’t sit.But i will take extra meds and get thru it…..couple questions…have you heard about this shortage of equipment or whatever and have you heard of another QUALIFIED surgeon,in TEXAS i think,who does this surgery? OK THANKS AGAIN FOR YOUR TIME,Scott Mitchell

      • April 6, 2014 at 5:40 pm

        Scott,

        I havent heard about any tubing shortage. You’re the first to mention it. As for Texas surgeon, I think this may be Hal Martin. Dr. Heinrich was mentored by Dr. Martin with respect to the procedure I had.

      • Scott Mitchell
        April 6, 2014 at 9:23 pm

        OK Thanks Matt,getting tested wen by Dr. Hardin…keep you posted,Really thanks for paving a path which made things easier for me ! sincerely ,Scottie

    • Scott A Morse
      December 3, 2014 at 4:45 pm

      Hi Scott Mitchell I was going through some of these posts and I saw you asked Matt to call you. I would like to ask if you would be willing to call me or if I could call you to pick your brain I have free long distance with my phone or its free for me to call from my cell to anyones cell so either way I can be reached at 612-414-6280 Best Regards Scott Morse and your right there are a lot of scotts going on this blog

  33. laurel
    February 12, 2014 at 5:37 pm

    Hi Matt,

    For some reason I can’t find the comments/posts I made in the past. Annette gave me some helpful info, but can’t access it. Any suggestions? The last post I see is from Nov 2013. Thank you so much!
    Laurel

    • March 20, 2014 at 8:06 pm

      Laurel,

      I actually have no idea what is causing that issue for you. I recommend that you open a page that is causing you trouble and hold down the shift key and select F5. Hope this helps.

  34. gordon
    November 29, 2013 at 8:01 pm

    Hi Matt,
    You mentioned in one of your posts that you were going to develop a list of doctors performing the arthroscopic piriformis release surgery. I live in south Florida and I find impossible to find any in my state. I only know of two your surgeon and dr. Hal Martin in Dallas. Do you know of any more, preferably closer to my home?
    Thanks Gordon

    • November 29, 2013 at 9:02 pm

      Gordon,

      I did mention that I wanted to feature a list of surgeons that perform the procedure. I started with a small list of three that I knew of. Shortly after I posted the list of surgeons I was contacted by some patients of one of the physicians I had posted. These patients were extremely upset and disturbed that I was “advertising” a surgeon that had “ruined their life” because they had not been cured (or made worse) by the surgery they had. They further insisted that I was in the wrong to “advertise” physicians that I didn’t have personal experience with.

      I struggled with whether to take down the post of physicians or just leave it. I have the right to freedom of speech, and no one has the right to stifle it. However, I also know that I couldn’t bear the thought of leading someone to a surgeon that could do more harm than good. In the end, I felt that taking the post down (for now) was the right choice. I did leave the name and address of the surgeon that cured me.

      I encourage others to post the name of surgeons that have helped them on my Surgeon Directory page. Furthermore, I will not approve a post that speaks ill of a surgeon for fear of being sued (trust me this has happened to bloggers and patients alike). I know that my blog can offer help to many, many others, and I don’t want to risk the good it can do by distracting my readers from the core of my message by letting the blog become a surgeon rating site. I hope you can understand why I’ve made the choices I have. I feel that they’re all for the greater good.

      • Ed Browne
        January 17, 2015 at 9:18 pm

        How do I find the surgeon referral page? Know or recommend any in Ohio?

      • Ed Browne
        January 17, 2015 at 9:23 pm

        Where’s the surgeon directory page?bany in Ohio?

      • Gina
        May 6, 2015 at 4:44 pm

        Ed Browne – I knjow you were looking for a Ohio Doctor and I thought I would let you know I had piriformis tendon release, sciatic nerve neurolysis and shaving of my trhonchater surgery performed by Dr. Thomas Ellis in Dublin, Ohio. So far, I am out of nerve pain and have significant improvement. I had the surgery 3/31/2015. I start physical therapy next week.

    • November 29, 2013 at 9:03 pm

      Gordon,

      I forgot to tell you that I don’t know of any physicians near your home in Florida. Sorry.

  35. Lina
    November 26, 2013 at 8:18 pm

    can i have estimate for the cost to be free!!!

    • November 28, 2013 at 8:24 am

      Lina, the surgery cost around $20,000, but I only paid $5,000 after insurance coverage benefits. I have United Healthcare.

      • Lyne Rivard
        November 28, 2013 at 2:12 pm

        Thanks so much for your answer, I’m sure you understand how much it’s precious to have your life back. After 4 years, I’ve lost everything of me… I’m not this person, I want to be back…

        I found a place in Belgium… I try to have information about the surgeon. He seems to be a lot, of that kind of surgery and it’s cheap… 2000 euro, around 3000$.

        Please, If you could just look at the website and tell me your opinion, I’d appreciate. http://www.piriformissyndrome.eu/ in the section treatment options, you could see the video..

        He use a provocative EMG and say the standard EMG are always negative. What kind of questions can I ask? I know he did the procedure more than 100 time and have 2 cases with trouble. Rate 95-98% success.

        Thanks a lot for your answer, and if you don’t have time to answer, I understand too… thanks

      • November 28, 2013 at 10:19 pm

        I like the content of the site. However I don’t think it’s practical to get treated by an international physician when there are alternatives located here in the U.S.. Youre going to need follow-up visits at two weeks, 6 weeks and possibly more. What if you have complications? If you have Piriformis Syndrome you’re not going to fair well sitting on a plane for extended periods.

      • Lyne Rivard
        November 29, 2013 at 11:25 am

        Thanks your points are important. I’m from Canada, and no one do this procedure here. I have to go in USA , Belgium, maybe Thailand? I have to find a doctor here for the following.

        The Belgium’s guy told me I could take the plane 4 days after, with comfort ? I doubt. , But it could be done. You’re right, I’ve to consider complications!!!

        I have the choice to do nothing and live with, or take a chance??? And I know I cannot live with! I try to consider pros and cons and think about all possibilities.

        Thanks for your comments, I appreciate.

  36. Sara
    August 15, 2013 at 11:24 pm

    I have piriformis syndrome and had the surgery but I did not and still do not feel better. The pain directly in my butt is better but since I suffered over a year before anything was done to release my muscle I now have problems with my SI joint! It’s been over 2 years since my injury and still having to deal with this is excruciating! But because I live in such a small town there are not many options or doctors that have dealt with this so it’s all trial and error for us!😦

    • Scott A Morse
      December 3, 2014 at 4:54 pm

      Hi Sara, i read your post and my heart goes out to you. Have any doctor you have talked to discuss pedundal nerve there are quite a few symptoms the same but instead of pain down your leg it sweeps toward the sphincter and penis/vaginal area, This might be something to check out I just did a google search and went from there. I hope you well.
      Scott Morse

  37. Val
    July 23, 2013 at 2:47 pm

    You give me such hope that I am going to have a full recovery. Saw Dr Heinrich yesterday for my 7 week. I am slowly improving but definetly have those good and bad days. Told him I was stretching and walking. Was hoping he would say pt but said maybe we would hold off a bit so we don’t push it. I read your posts and feel like that is a big part of recovery. He did how ever write me a referral for pt for when I feel like I want to get started and to see him in another 6 weeks.
    So I made a call to Beth today and we talked about starting in the next couple weeks. It is a bit of a drive but like you said, she really seemed to know a lot on the subject. I am super excited to get started.
    So very encouraged by your posts!!!! Thank you

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