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Piriformis Syndrome Treatments

Over the course of the past five years of suffering with Piriformis Syndrome I underwent over a dozen different, non-surgical, failed treatments. I’m going to cut to the chase on this page by focusing on the surgical treatment because it has proven to be the answer I was looking for. Other Piriformis Syndrome sufferers have had success with other treatments, and I encourage them to share their successes on this page.

Piriformis Tendon Release

On July 5, 2012 I had two surgical procedures:

  • Endoscopic piriformis release and sciatic nerve neurolysis Learn More >>

Piriformis Tendon Release Post-Operative Report

The post-operative surgery report is available here.

Piriformis Tendon Release Surgery Results

Since the procedures my chronic sciatic nerve pain has not returned. I haven’t felt this good after any of the other treatments I’ve had. I’m am now claiming to be cured as of today, and recovery took me six months. I was told it may take five months to be fully healed.

Piriformis Tendon Release Photos

The surgeon provided these photos with annotations taken during the two simultaneous procedures mentioned above.

Disclaimer

The articles and content of this website may not be construed as personal medical advice and are provided for information only. No action should be taken based solely on the contents of this information. Readers should consult the appropriate health professionals on any matter relating to their health and well-being. The publisher of this website and its contents is not a licensed medical care provider. The information is provided with the understanding that the publisher is not engaged in the practice of medicine or any other health-care profession and does not enter into a health-care practitioner/patient relationship with its readers. The publisher is not responsible for errors or omissions.

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  1. Meredith
    August 22, 2017 at 2:01 am

    Shelley, it sounds like Jennifer has the help you need in CT, my other thought would be to try the Mayo Clinic. They finally figured out my issues after being treated unsuccessfully for 2 years while my life wasted away. They are excellent from making the first appointment to actually going, streamlining appointments so you don’t have to go and come back to see other drs. I can’t give them a bigger rating. I too, have been helped by pelvic floor PT. It’s amazing what they have done for me.
    Best wishes,
    Meredith

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  2. Shelley Mastroianni
    August 17, 2017 at 5:34 am

    My name is Shelley. I live in CT. I have been in excruciating pain for 19 months now. Ive had mri’s and CT scans. 2 diff physical therapists, 2 diff massage therapists, i tried accupunture and dozens of injections. Ive had steroids, bupivacaine, toradol (works great for 24 hours), botox twice ( 1st one helped for a couple months, 2nd nothing!) My last shot 1 week ago consisted of bupivacaine and clonodine. I read about great results with that but unfortunately not for me! I am at my wits end….ive been on lots of meds. Lyrica 375mg a day (doesnt help) , all forms of muscle relaxers (none helped except for the valium i was given in the ER, which my dr wont give me) prednisone (didnt help), vimovo (didnt help), advil in quantities that will probably kill me ( but maybe id be better off anyway), i was on a Butrans patch (started at 7.5mcg and went to 20mcg and hour, doesnt help) now she switched me to belbuca 300mcg 2 x a day (doesnt help)! She refuses to give me anything stronger that might help…..in the mean time i cant sleep cuz i cant lay down for longer than a couple hours, i am in so much pain i drag myself out of bed at 2am and walk my neighborhood in the dark while limping and crying for over an hour. I get in the shower w hot water and i then i try ice packs. Nothing works! I walk some more and am forced into work deliriously tired and sick with pain! I was out of work for 16 months but its suffer through work or live on the street!! I have a pain management dr who is of little value to me, whom i call so many timez a week she must wish i was dead too! She refuses to give me any kind of worthy pain medicine to give me even one normal semi decent day! I have searched all over the state for help and they either dont take my insurance or they have no idea what piriformus syndrome is!!! My primary care dr doesnt give a crap about me and i feel like im doing battle w the devil and im losing in a big way!! I need pain relief, i need sanity, i need sleep, I NEED HELP!!! If anyone knows of a DR in CT, please have a heart and rescue me….I’ve never needed help more than i do right now! Life is not worth living in this kind of hellacious torturous PAIN!!

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    • Robert Keller
      August 21, 2017 at 6:56 pm

      Shelley,
      Send me your contact info. I may be able to put you in touch with a surgeon on the west coast…


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    • Robert Keller
      August 21, 2017 at 6:57 pm

      I meant the East Coast.. Sorry.

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    • JD
      August 21, 2017 at 9:14 pm

      Shelley,
      I’ve been in your shoes. My advice is to make appointment with Dr. Hal Martin in Dallas.

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    • Jennifer Farnell
      August 21, 2017 at 9:32 pm

      Shelley, I am in CT also. I went through 2 1/2 years of hell before I found doctors willing to acknowledge that piriformis syndrome might be the problem, and that was after I have a L5/S1 laminectomy and facet widening (which I desperately needed at that point). They have been the only doctors who have listened to me and who have been open minded and supportive (and I have been to Danbury, Yale New Haven (who almost killed me), etc). ONS in Stamford / Greenwich. I’ve done all of it…PT, steroid injections, back surgery, etc. and it has all come down to piriformis syndrome, which was finally released by an open minded surgeon at ONS (after back surgery, at the same group, which WAS needed and after my ONS neurosurgeon decided that even though the back surgery had gone well, I probably had underlying piriformis syndrome which most likely created the need for back surgery.). My neurosurgeon for my back was Dr. Scott Simon. Dr. Tim Greene did the the piriformis release surgery after trying all conventional treatments. I am FAR better today than I was prior to surgery or even 3 years ago. I was one of those special cases that needed the surgery as I was was too far gone for non-invasive treatments to work. I also have a fabulous PT who treats pelvic floor issues, including piriformis, but I was too far gone to be treated prior to surgery (developed propriospinal myoclonus seizures which also occurred during treatment). I have been through hell and back with providers who refused to even consider piriformis syndrome (although my symptoms have suggested it from the very start). I cannot recommend ONS highly enough. They listened to me and saved me, without hyperbole, from a medical system which wanted to fuse my discs (after surgery and with no apparent reason, Yale New Haven, or who wanted to do more steroid treatments (won’t name the source…they were a 2nd opinion taking the safe way out, but ignored my medical records, 5 MRIs, CAT scan and EMT) , after 3 failed steroid injections, etc.). My life, after 3 years of hell, has turned around. There’s no way of knowing yet if the surgery was 100% successful, but my quality of life have turned 180 degrees. I can move without pain. I can take the garbage out. I’m down to 2 extra strength Advil / Tylenol one time per day, while i had been taking 2400 mg of Advil daily for two years (don’t ask what it did to my GI system.) Feel free to get in touch privately if you want more information. But if I could recommend a medical hero, ONS is it.

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    • J
      August 25, 2017 at 3:52 am

      Hi Shelley I have some questions, can you send an email address?
      I’m a fellow suffer….depending on your exact symptoms I have some things you may want to try.

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    • Chelsea Brooks
      September 16, 2017 at 12:06 am

      Hi-
      I’m currently scheduled for piraformis release by my orthopedic surgeon next month. I also possibly have a gluteal tear. I also have trochantaric bursitis. The bursitis isn’t causing my pain. That I know.
      It’s expiremental, the release is. It’s a rare syndrome. Insurance may or may not over the release. But it may be worth it. For me, I ended up at a teaching hospital. But I took my report to my own ortho surgeon and he is going to release it. But I’ve been in pain for almost 2 years. Like you- I’ve tried piraformis injections (2 with 2-3 days relief), SI injection, a bursa injection, physical therapy, TENS, and most recently a PRP injection.
      Have you had an EMG done? Mine shoes severe gluteal atrophy in glute med and min.
      Find an ortho doctor. They may be able to help you.
      Keep searching, and pray for me too. I am hoping this is my answer.


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  3. Tracy
    August 13, 2017 at 4:42 pm

    You will start feeling better after about 4-6 weeks. Relax and give yourself some time to heal. You heal from the outside-in. 19 months later and I still ache sometimes laying on the scar.

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  4. JD
    August 13, 2017 at 9:46 am

    Just had open surgery to decompress sciatic nerve, it was tethered by a ton of scar tissue and blood vessels. Piriformis was not released because it was not compressing nerve. A few accessory nerve branches off sciatic where removed also. Incision is painfull, any insight on how long incision pain takes to get better.

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  5. Meredith
    August 3, 2017 at 9:31 am

    Some of you will remember my post in May that I was going to Mayo Clinic to find out what was causing all my pain. A nurse practitioner there reviewed all my MRIs and info that was sent in from all my doctors and talked with me at great length as well as giving me a thorough examination. She concluded that the pain was not coming from the piriformis but the Levator Ani, a pelvic floor muscle, and ordered pelvic floor PT and a doctor to give me an injection there.

    Since I’ve been back I did receive an injection that gave me a little relief on the 10th day, but the PT has really helped. I have been able to sit for periods of time without using an icepack for 4 days now, which is amazing since I hadn’t been able to sit without one for 2 years and a month. The skin on my bottom had broken down so much from the ice that I developed a staff infection in February and even MRCA.

    Needless to say I am thrilled beyond belief that this pelvic floor PT is helping, and I will get another injection at some point because I now know more specifically where the shot needs to be inserted — there are 4 Levator Ani muscles, 2 on each side.

    Just wanted to catch you all up just in case my story could help someone else and also to share that Mayo Clinic (Jacksonville, Fl) is amazing from making the appointment to the reception to the doctors and NP there.

    Blessings!
    Meredith

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  6. Frances from Gainesville
    July 29, 2017 at 2:59 am

    John Heinrich in Milwaukee, WI, is not the same person as John Heinrich in Dallas, TX. I believe the author of this post was healed with the surgeon in WI. Is that correct? Shopping surgeons as there is no one in FL who conducts this procedure.


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    • July 29, 2017 at 3:28 am

      John Heinrich in Mikwaukee, Wisconsin treated me.

  7. Tim
    July 7, 2017 at 5:56 pm

    I had the endoscopic sciatic neurolysis and some piriformis release done by Dr. Jackson in Pasadena about 3 months ago. Recovery was very quick and the pain was minimal. At first I was worried because I had more constant pain after the procedure, but physical therapy or maybe just time has reduced the pain. Sitting still will get uncomfortable after a couple of hours but I recover over-night, so that is a huge improvement. I am definitely not 100% but the surgery was clearly worth doing. My diagnosis was deep gluteal syndrome.


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    • Nancy Peregrine
      July 7, 2017 at 8:35 pm

      This is a general post. but it seems to be going to Tim. My diagnosis, at UCSF (San Francisco), after neuro MRI, nerve conduction & muscle-nerve test, was “severe foraminic stenosis. The channel through which the sciatic nerve passes had calcifications that were compressing & twisting the nerve – therefore 7 years of spinal & hip pain! Also, the L5-S1 disc was herniated. I had surgery for a synthetic disc placement & reaming out of the sciatic nerve channel & a “cage” of rods to stabilize the L5-S1 area. This included cadaver bone. I’m on week 4 of recovery, but from day 1 the hip & referred pain down the leg have been gone! I am on a protocol of no BLT – bending/lifting/twisting – for 6 weeks. The surgery is called ,minimally invasive spinal surgery. My surgeon was Aaron Clark. Hoping for the best!


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    • Jon
      July 19, 2017 at 9:58 pm

      Tim,
      I’m close to moving forward with surgery with Tim. Any way I can direct message or email you to chat further.
      Regards


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    • Jon Olson
      August 1, 2017 at 11:31 am

      Jolson23@yahoo.com

      Ping me an email if you get a chance.

      Thanks Tim.

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  8. Jenny
    May 30, 2017 at 3:24 am

    Hello, I had the open piriformis tendon release surgery 3 weeks ago at UCLA with Dr. Pouratian. He found the piriformis muscle itself was not impinging my sciatic nerve, but the tendon was very tight over the nerve so he snipped it at the greater trochanter and then ensured there was enough space for my sciatic nerve. I am not one to take pain pills so I currently feel both the “old familiar” piriformis pain, plus the discomfort from the surgery itself. The doctors are vague and say “time will tell.” For those of you who have had surgery, how long was it before you noticed the previous “old familiar” piriformis pain to lessen/decrease – especially when SITTING? I have no idea what a realistic timeframe is. Thank you! Jenny


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    • Jim
      May 31, 2017 at 10:11 am

      Hi Jenny, I had PR and neurolysis in August 2016. During the first 3wks, it was tough to tell if there were changes due to surgical pain/healing. At week 3 or 4, the pain temporarily increased–I believe this is due to fluids around the nerve dissipating during recovery. For the first 6mos, pain levels were up and down, but I wasn’t seeing much improvement. Then feb. I felt a cold icy feeling which I’ve felt before prior to improvement, and sure enough I started feeling better in early March. I am now probably 60-75% recovered, so that means sitting still comes with mild discomfort and is not something I enjoy doing for more than an hour or two, but the pain levels max at “4”s and “5”s and are manageable with an aleve once or twice a week. I don’t require heavy pain meds anymore. I would add that I have very aggressively pursued muscle strengthening, stretching and certain yoga stretches which may have contributed as much or more to my improvement as surgery. My surgeon told me that some patients don’t see much improvement for up to a year after surgery.


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    • June 13, 2017 at 2:17 am
  9. Chrissy Mason
    May 25, 2017 at 12:24 pm

    How does one find a doctor that performs the surgical procedures? My husband fell at work last fall. All treatment, shots, therapy, etc have failed. Doctors thought it was SI joint but it’s not and they won’t diagnose piriformis syndrome but they all mention it. He is waiting for work. comp. to approve a nerve block shot in the piriformis. However, he feels he needs to see a doctor to discuss surgical intervention. Any good doctors for this in Chicago or at UW-Madison? We are clueless about who would be best. Thanks.


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  10. Meredith
    May 6, 2017 at 2:36 pm

    Krissey, I haven’t had ps and given birth later but I have had a c-section and it was so much easier than my vaginal birth that I would definitely take your doctors advice to have a c-section. I had surgery last July and I’m still in so much pain, can’t sit, stand, drive, it’s just awful.
    I have an appointment at Mayo Clinic on may 15th. Wondering if anyone has been to Mayo with piriformis syndrome?


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    • Khrissy
      May 11, 2017 at 4:11 pm

      Meredith,
      Thanks for your response. I am hoping the c-section won’t be so bad. I was on crutches for over a month after my deep gluteal surgery and it was endoscopic, so I am not looking forward to another surgery. My surgery has not been completely successful either, although I have seen some improvement. The biggest improvement is not having nerve weakness and footdrop anymore. Also, before the surgery, I was pretty much always in pain and always had to take pain killers (every day). Now if I just sit around the house (pretty limited) I can avoid pain killers much more. I am still very limited and may seek further treatment after I give birth. I hope the Mayo Clinic can help you out and find a solution to your pain. It can be so hard.

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  11. Khrissy
    May 2, 2017 at 7:38 am

    Hello everyone. This is a question for any women who have had deep gluten syndrome/piriformis syndrome and then given birth after. I have (still have really) deep gluten syndrome. I had surgery last September (2016) and have since improved but deal with pain regularly and still very limited. I am 34 and 16 weeks pregnant. My obgyn (seen two now) are insisting on a csection. There is pretty much no literature on the effects of vaginal birth on dgs/ps and they believe the isk of making things worse is too high. Has anyone else here given birth after having dgs/ps? If so we’re you able to give birth vaginally or via csection? Any effects of the pregnancy or birth would be helpful. The only thing I can find is that giving birth can cause ps but nothing about it as a pre-existing condition. My surgeon and obgyns really don’t know anymore either. Thanks!


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    • Khrissy
      May 2, 2017 at 7:41 am

      My phone wants to autocorrect gluteal to gluten. Deep gluteal syndrome is what it is supposed to say.


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    • Elise Harden
      May 6, 2017 at 6:04 pm

      Hey Khrissy. I think your surgeon would be most qualified to address that. I’m sure pregnancy exacerbated my condition. I did not have children after ps/dgs surgery.( I’m 10+ months post op. And really pleased).
      Chat with your surgeon. I’m sure the c section is to accommodate the doctor, not you and your baby.
      Personally, I would not do the c section unless there is immediate danger to mother and/or child. Muscles being cut is going to take longer to heal than a vaginal delivery. I had a tubal reversal thru a c section type incision- took 6 months before the incision area felt right and fully healed. Of course, an episidomy is no fun either. I don’t think the birth process will harm the nerves… But your surgeon can probably answer your questions and concerns.
      Good luck and Congratulations!


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      • Khrissy
        May 11, 2017 at 4:06 pm

        Hi Elise,
        thanks for responding. My surgeon really has no idea unfortunately. I have tried to do the research myself and there is nothing out there. I had an open appendectomy about 4 years ago where they did cut my abdominal muscles and recovery was awful so I did ask the obgyn and apparently they do not cut the abdominal muscles for csection (just move them apart). Since we are all in the dark, I will probably go with my obgyn’s recommendation. Although I would much rather try to give birth naturally, there is some chance I will make my condition worse in the process. I do not want to end up with nerve weakness again or increased pain. I am just hoping the c-section wont be so bad. Wish there was more research on the topic.

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  12. Bev
    April 17, 2017 at 4:27 pm

    Matt… can you send me a email so I can ask you a couple of questions about your surgery for piriformis syndrome and your recovery program?
    I am considering making an appointment with Dr. John Heinrich also.


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  13. Patti
    April 10, 2017 at 8:32 pm

    I’ve had doctors tell me that I have piriformis syndrome and other doctors tell me I have Sijd. I recently saw yet another doctor who performed a discogram and several blocks. He believes my leg nerve pain is caused by an annular tear at L5. How can we ever be sure before we go under the knife. It’s so so hard.

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    • Laura Bracken
      May 25, 2017 at 3:11 pm

      Diagnostic tests can be helpful. I just had a MR Neuogram, an EMG and neurological study, and a dynamic ultrasound done at UC San Francisco. None of my local doctors suggested these tests, I went to UCSF for a second opinion (Dr. Line Jacques, neurosurgeon) when Dr. Filler (Santa Monica, neurosurgeon, does a lot of piriformis release surgeries) suggested that I need a third surgery. I haven’t seen Dr. Jacques yet to discuss the tests but the reports from all three say that my sciatic nerve is fine, no evidence of scar tissue from previous surgeries etc. However, the neurogram detected a cyst at L2. Sigh. It seems improbable that it is responsible for this pain but who knows. At any rate, you may need to get a referral to a neurosurgeon who works with peripheral nerves at a major medical center.


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  14. April 10, 2017 at 6:55 pm

    Although I thoroughly believe in finding the cause of the pain & rectifying it, as much as possible, I hear of many people managing pain nowadays with CBD oil – even mainstream docs are writing about it now….I have begun collecting sources…one well-known source is Simpson Oil.
    For my own issue, which I thought might be PS, due to deep L buttock pain & cramping, it turns out it is a herniated L5/S1 disc that is compressing the sciatic nerve, radiating out to the buttock & down the leg. The diagnosis is severe foraminic stenosis. At least this is what the docs think now, and I’m scheduled for minimally invasive microsurgery surgery in June (The doctor, Aaron Clark at UCSF, has written extensively on this).. I’ve had many tests, including a PS test where the leg is moving while ultrasound watches the piriformis & sciatic nerve either slide on one another or not – mine were quite loose & not bound up together.
    Best wishes to everyone!
    Nancy


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  15. Veronica
    February 14, 2017 at 6:01 pm

    Of interest to anyone in uncontrolled pain and/or or having difficulty obtaining needed medication:
    https://www.petition2congress.com/5202/first-do-no-harm-dea-targets-physicians-who-treat-their-patients

  16. Meredith
    February 14, 2017 at 5:02 pm

    Dotyoureyesblog,
    Where do you live and who did your surgery?
    Your outcome is fantastic!!

  17. Elise Harden
    February 14, 2017 at 2:38 pm

    Hey Mark,

    I’m on cymbalta and it does fine for me. I keep the dose low. Once acclimated, im fine on it. I don’t do narcotics. I don’t tolerate them well and my husband is a recovering addict. I also have adult children that believe they are recreational. I’d talk to someone in pain management for ideas. I also have an NSAID gel for topical use. Works OK, but my GI system is done with NSAID’s.

    Have you done PT?

    Best of luck to you. Surgery isn’t a magic fix, but if you’re lucky, it helps.

  18. February 14, 2017 at 12:16 pm

    Hi everyone,
    I finally had the release surgery on February 6. Here’s an update. I’m 27/female.

    If you hadn’t seen any of my previous posts here’s the short version. Bad car wreck nov 2007 and been complaining about hip problems since. Nov 2014 started getting sciatic pain real bad, conservative treatment didn’t help got a cortisone shot in April 2015 and lead to me having labrum repair surgery plus FAI for both cam and pincer in July 2015. MRI also showed swollen piriformis. 6 months rehab all was well, July 2016 piriformis pain returned.

    Aug-dec 2016 did more PT and had 6 more cortisone shots, all failed.

    Feb 6: surgery went well, only 45 mins, if you get sick smfrom anesthesia ask for a patch it helps. Surgery was at 12 I was out by 4 or 5. Got home and slept most of the night. Incision is 4-5 inches and have 17 staples.

    Feb 7 & 8: very difficult I was in a ton of pain, I couldn’t move any part of my body without pain going down my leg. Everything hurt, the pain meds (Tylenol 3) weren’t helping so I called my surgeon and he prescribed me torodol to take with the Tylenol 3 and it really helped, I was moving around by the end of the day Wednesday. I made it from my bed to the living room too.

    Friday/Saturday/Sunday: lots lots better. By Friday I was even bearing weight a little and Sunday I went to he grocery store with my husband and didn’t use crutches, I was pretty sore by the time I got back home but I was dying to get out of the house.

    Monday: only thing that hurts is the incuson site, I’m not using crutches at all, worked from home a little too.

    Tuesday: back to work for a half day, post op follow up is today and hopefully get my staples out. They look neat and all but the incision hurts.

    I have NO piriformis or sciatic pain! I can feel the muscle is tight but and will take some work to get the strength back and everything but I’m very excited that I have no pain!! Let me know if y’all have any questions

    • Elise Harden
      February 14, 2017 at 9:30 pm

      Yeah! I hope it gets better each day!!!

    • Jon
      February 27, 2017 at 1:15 pm

      Who performed the surgery?

      • February 27, 2017 at 2:47 pm

        Dr. John Heinrich in Milwaukee, WI.

  19. Mark
    February 13, 2017 at 8:25 pm

    I’ve had this problem for 23 years. It’s exhausting. My whole life is forced to revolve around it. My problem is that the politicians keep making it harder to get pain medication. It’s been a struggle to get 4 lortab 7.5’s and 4 Tramadol to keep it reasonable so that I can work for my family. It’s ridiculous, I’ve ended a lot of pain just by switching to an organic diet , foundation training exercises help a lot more than I would have thought. Had a steroid shot in both Piriformis that worked for a month. I probably could’ve gotten by on just Tramadol during that month but my portion of the shots was $1600. I can’t afford that every month.
    Regardless of all my efforts, I have barely been able to make the lortab Tramadol combination work throughout the whole day but I can suffer through and it has been a reliable combo. Now that I’m “stable”, the doctor wants to take me off the lortab and only have Tramadol. It’s a problem because I haven’t reduced my pain to where I can physically make it work. If I felt like I did when I had the shots I would be fine with it. Over all these years I can count the pain free days on one hand. Stretches give some relief but I would have to stretch every 30 minutes and it wouldn’t do that much.

    What is the correct amount of medicine for someone with PS? It is way worse than any doctor that I’ve been to thinks it is. I’ve never been on anything stronger than the lortab 7.5 and Tramadol combination. It’s hard but I can make it work even though I’m still in a lot of pain. I’m going to push the doctor to send me for PR Surgery so I don’t have to bother with the meds anymore. This is a pain problem and is not an addiction issue at all. I had to fight that stereotype for a very long time. I can stand in one spot for about 10 minutes before I feel the muscles start to tighten all the way up my body. Anyone who has this knows the hell I live with.
    What are the common pain meds prescribed for it? Are people normally prescribed something stronger? I’m fine with the old school meds, I’m not taking any more crazy stuff like lyrica or the new stuff that has 10,000 side effects.

    • February 13, 2017 at 8:45 pm

      Mark, I personally never found a medication that could effectively manage my PS pain. That’s probably why I kept searching for a cure. My opinion, based on my experience, is that there isn’t a medication that can help for the long term. My gut tells me that your post will likely result in many many others sharing their opinions and experiences as well. For those that have had this condition for one or more years it’s likely they’ve tried the gambit of medications ranging from NSAID to Norco.

      • Tom
        February 20, 2017 at 12:00 am

        I took Motrin for 10 years and it gave me liver disease. I can’t take any painkillers or anti inflammatories or muscle relaxers as a result.

        Never take NSAIDS long term, they can destroy your immune system. Forever.

    • Jim #2
      February 13, 2017 at 9:22 pm

      I was prescribed tramadol by my neurologist A couple years ago and I used it daily for about two or three months. However I developed a tolerance so that it no longer had the needed painkilling affect. When I discontinued using it I noticed two things: fairly unpleasant flu-like withdrawal and that my nerves were much more sensitive than prior to starting the medication. This is the underlying problem with most pain relievers even though they block the signal to the brain, your body starts trying to overcome that by becoming much much more sensitive. The only thing that has provided reliable relief has been a program of strengthening and reactivating my Glute muscles. One supplement I can suggest is benfotiamine – I take a 250 mg capsule twice a day with a B complex and it dulls the pain. I had release surgery six months ago and in my case it has not yet resulted in a meaningful improvement. If you’re interested in a copy of my exercise protocol more than happy to email it to you.

      • Mark
        February 14, 2017 at 3:38 am

        I will order the Benfotiamine and will give that a try for sure. I take turmeric also to keep from forming a tolerance. Also if I’m on both medicines then I will take an extra when needed and purposely run myself short one week. This seems to keep my tolerance down also. Then the next month I will short myself on the other. Tramadol is great for muscle and nerve pain but has the most wicked side effects. I found that buying Kratom (Mitragyna Speciosa) which is a relative of the coffee plant gets rid of all withdrawal symptoms from this. It doesn’t make you feel any different really other than it helps with pain somehow and keeps you from overtaking your meds. It’s an amazing plant. Check your state to see if it’s been banned, Big Pharma doesn’t want it to be legal. It doesn’t look like many people have had much relief from the surgery. The real answer may be just strengthening the glutes like you said. I’ll check back in the morning, my battery is dying. Thanks

  20. Jim
    February 6, 2017 at 11:41 am

    Nancy, that is actually a very important and informative post. PS is a very complex issue which varies greatly from person to person. It is far too easy to self-diagnose and be completely wrong. Most people want a quick fix — either a pill or an operation to resolve the problem; but I suspect it is a minority whose PS can be successfully treated this way.

  21. February 6, 2017 at 10:51 am

    I Here’s a report from Nancy Peregrine who wrote in some time ago, not knowing what was going on in my L hip, but since local practitioners were just focused on pain relief Meloxicam – which gave me a severe GI bleed!) & I wanted to know what was going on, I researched MRN & was able to get a referral for one at UCSF, as well as connect with a neurosurgeon there (Line Jacques MD) who ordered a few other tests (nerve conduction, muscle contraction). These determined that my condition is not PS. Dr. Jacques determined that the L5 disc is herniated, causing pinching of sciatic nerve, radiating out to hip & travelling down leg. I was referred to Dr. Aaron Clark at UCSF, who specializes in minimally invasive surgery. I saw him last week & he said, if we can confirm that the hip pain is related to the L5 disc via steroid injection in back relieving hip pain, then we can go ahead & schedule disc removal with synthetic disc placement, taking stress off nerve. The original MRI I did was focused on the hip area, as that is where the pain is, so it didn’t include enough of the spine…for this reason he has ordered a more comprehensive regular MRI.
    I had signed up with this list, when I had self-diagnosed with possible PS, but that is evidently not my problem, so I shouldn’t continue posting. However, I thought people might be interested in my situation somewhat mimicking PS. None of the treatments I have done have helped more than a few hours or days – yoga, massage, acupuncture, prolotherapy, hip steroid injection, physical therapy.
    Nancy Peregrine

  22. Meredith
    January 16, 2017 at 10:27 pm

    Hi Tim,
    I’m responding to your question about the bigger surgery, bigger incision and going through the gluteal muscle. My incision was about 3.5 inches long, went through the gluteal muscle and cut the piriformis so that when I sit down the piriformis spreads open and doesn’t touch the sciatic nerve. After surgery, I walked out of the hospital, no crutches and was pain free for two days until the block wore off. After that the pain was back, and truthfully the surgery site was pretty painful for about 2 weeks. At three weeks I was in PT and he was massaging it out twice a week.

    But my piriformis pain never let up. I am doing a little better now. I can’t work, haven’t been able to drive since last February until last week when I did a little driving. I can’t sit down, standing hurts, most comfortable is laying on my left side. I sit on an ice pack (or really I lay on an ice pack all day everyday). Oh and my surgery was July 5, 2016. My doctor was very surprised that I was still hurting at 6 weeks out of surgery. Maybe it was because I had PS for over a year and it wasn’t diagnosed. Apparently my outcome wasn’t the norm.

    If you are in a place where you are hurting all day everyday, and you don’t have much of a life anyway (don’t know if you are able to work or drive?) I probably would consider having the surgery. That’s just my opinion.

    I’d probably ask the surgeon how many he does a year and how many are successful and at what point will you be pain free.

  23. Tim gallison
    January 16, 2017 at 6:53 pm

    Glad I have found this blog. I am 7 years into PS. Tried everything that has been discussed. I had my 1st of 2 surgeries about 1 year ago. Pain free for about 4 weeks pain came back, 2nd surgery about 6 months later with pledgets surrounding the nerve. Woke up pain was still there and only goes away with laying on right side, standing, etc. cannot exercise, sit for long periods of time, etc.. having an MRI in a week or so with a new surgeon, last one was good and the surgeries were very easy, home the same day small incisions both times. This MRI will have contrast and the new surgeon would use a much bigger incision into the gluteal muscle so nothing like the small incision. I was wondering if anyone can tell me how that surgery went. incision pain? Recovery time? Crutches? Sleeping is ok but on right side only, sleeping on back is gone, sleeping on left side is almost on my stomach so that is not comfy. Numbness in my left foot only came after 2nd surgery and the surgeon just thinks that is a Surat nerve issue and thinks that is fixable. I just am not sure I can do a 3rd surgery. It means 1 day in hospital which is no biggie, I have spent 30 straight days in the hospital when I was 13 years old but if I have surgery and the recovery is misery and still it does. To work I just do not see the point. I am starting to,resolve myself that I will,live the rest of my days like this and I am only 40. Not being able to exercise or sit very long is just killing me. Thanks for any help and I hope all,of you find s solution to this miserable condition known as PS.
    TIM

    • Jane
      February 11, 2017 at 6:45 pm

      Hi Tim, thanks for the post but sorry for your pain and long struggle. You mentioned 2 surgeries with small incisions. I’d love to know who you got surgery from and who might do the 3rd surgery. Three, ugh!

      You could email me if that’s easier at janeturn22@hotmail.com.

      Take care…

  24. Bev
    January 12, 2017 at 1:53 pm

    So thankful to find this group.

    This pain is so debilitating. I can no longer go anywhere because it is too painful to sit!

    I live in central Illinois. It seems the best surgeons are in Texas and Jacksonville FL. Anyone that has had good or bad experiences with doctors in Indianapolis or Milwaukee, would you be so kind to share those with me? ready2go2@frontier.com

    • Levi Cleveland
      April 10, 2017 at 4:47 pm

      Hello I live in jax fl. And I am going through the worst pain I have ever felt in my life in my left leg which I believe is ps. I am 3 months p/o from a 2 tier tlif and this pain started about a month ago. This was never a problem before my spinal fusion and I’m in need of serious help. Can you please tell me the drs. you have found here so I can try to set something up it would be greatly appreciated. Tyia.

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  25. Patti
    January 9, 2017 at 7:32 pm

    Did anyone consider that you might have sacroiliac joint dysfunction with secondary piriformis syndrome? They say the piriformis tightens as it tries to stabilize the si joint. I’m saying this because you haven’t gotten enough relief from your pirirformis surgeries.

    • January 17, 2017 at 8:04 pm

      I’ve just read your post and looked up sacroiliac joint dysfunction. The symptoms to this are all to familiar! (Or I’m a hypochondriac) I think I need to go back and discuss this with my consultant once I’ve recovered from my recent surgery.
      I’m so glad I found this site.

    • Angie
      April 10, 2017 at 6:03 pm

      Exactly, Patty!!!!!!!!!!!!!!!!! Folks — before surgery, please have your Dr rule out SI joint problems and or bulging discs at either L4 or L5. Those who have had unsuccessful surgeries should be asking their Doc for low back MRIs. Still means your sciatic is being compromised but potentially not at the piriformis junction.

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  26. Laura Bracken
    January 9, 2017 at 2:07 pm

    I’ve had PS for 4 years, started out feeling like a muscle cramp while walking, progressed really rapidly to not being able to climb stairs and severe pain. My PT and primary both thought it was PS but my pain clinic dr ruled it out because a freehand cortisone shot didn’t work. I then developed pain down the side of my hip and thigh. I never have had any sciatica. Spinal cord stimulator trial failed. Put on Lyrica, which helped. I live in an underserved town of about 60,000 people. None of my doctors knew anything about severe PS or neurograms or any surgical alternatives. Long story short, a physiatrist tried massage therapy and IMS (dry needling), then an EMG guided Botox injection that didn’t help but did reveal gluteal nerve abnormalities, then a neurogram at UWash showed a split piriformis, then referred to Dr Filler. Surgery revealed a contracted piriformis but also the fibrous bands all over the sciatic nerve. The pain in my hip and thigh gradually resolved (6 months) and the pain in my butt got some better and moved down some. Second surgery on obdurator nerve revealed significant scar tissue at previous surgery and more fibrous bands. Some better but still can’t do my job, pain has moved again. Increased Lyrica which decreases pain but now have cognitive issues, especially memory. I’ve now burned through 25 years of sick leave and lost my job, approved for disability. Saw Dr Filler on Dec 19, he thinks one more surgery. He says I am a very rare case who has had terrible luck. He rarely reoperates now. I find him compassionate and he does a thorough exam, listens carefully. He is almost always late, even hours late, because he takes whatever time he thinks necessary on surgeries and with patients. He is a coinventor of the neurogram MRI protocol. Brilliant guy but his office staff are overworked? but without doubt don’t follow through or answer messages. He is out of network so that means the patient pays whatever insurance doesn’t pay which can be thousands of dollars. I am going to get a second opinion on the proposed surgery from Dr Jacques at UCSF. I know now that there are three surgical approaches for PS: 1. The traditional slice the gluteus Maximus which is very painful and often results in long term gait issues 2. The neurosurgeon minimally invasive approach e.g. Dr Filler and 3. The orthopedic surgeon using an endoscope going through the hip e.g. Dr Jackson in LA . The orthopedic surgeons call PS Deep Gluteal Syndrome which is good I think because the fibrous bands can involve more than the piriformis and the sciatic nerve.

  27. Gigi Duley
    January 9, 2017 at 1:42 am

    I have never commented here but they are talking about doing a piroformis reconstruction if this last set of 8 shots they gave me provides no help, I have struggled with piroformis syndrome for about 5 year and am now bedridden. I also have a spinal cord stimulator for chronic sciatic nerve pain on both sides that has been a god send. I have very bad fibromyalgia and and the wonderful friends that it brings with it, also chronic fatigue syndrome as well as migraines I’m not sure how I’m sane but I would like some input on your opinions on weather the surgery would be a good thing for me.
    Thank you for 👂
    Gigi

  28. December 19, 2016 at 9:09 pm

    Alright I have had 5 or 6 shots since August to try and tackle this thing. The shots have been in my SI joint and different parts of my piriformis. My doctor had me do an MRI last week and I had a follow up today. Results:

    Relative asymmetrical enlargement of the piriformis compared to the right. Doctor said it is true piriformis syndrome and not just inflammation, and muscle is actually bigger than the other and trapping the sciatic nerve root. She spoke with my surgeon who performed my FAI/torn labrum surgery last year and gave me a final shot in the body of the muscle (hurt more than all the previous ones combined)

    I will follow up with my surgeon January 10 and if I am still in pain they want to release it.

    I’m going to PT tomorrow to get some home excericises I can do in the meantime.

    I’m concerned about having another surgery just because they suck and I just had surgery on that side in July 2015, but I’m also sick of this pain.

  29. Meredith
    December 18, 2016 at 10:38 pm

    Maritza, what part of the country do you live in?
    Meredith

    • Maritza
      December 20, 2016 at 9:15 am

      North Carolina

  30. Jim
    December 18, 2016 at 4:57 pm

    Feel free to email me (libfrom22@yahoo.com) and I’ll send you a copy of my PT for PS protocol, which also has some other tips on battling PS.

  31. Elise Harden
    December 18, 2016 at 7:58 am

    I had surgery with Dr Martin 6 months ago. I’m not 100% but I’m a whole lot better! He’s not hard to get in to see. I’d recommend making the trip to see him.

    The pain is agonizing. Having no help is agonizing.

    Least phone them and see what can be done over the phone. The day I had surgery he had a patient from Ohio(?) And the day before from out of the states, like Ireland. So you’re not the first.

    Dr Hal Martin at the hip preservation center in Dallas at Baylor. Google the number. (Not sure to post it here).

  32. Maritza
    December 17, 2016 at 7:24 pm

    I live in North Carolina, yes I have heard by all doctors (7) that I have seen that it’s a very complicated surgery and that is why they will not do it. But I have been told that I need the surgery. 😞

    • Jim
      December 17, 2016 at 9:09 pm

      It’s actually not a highly complicated surgery for a doctor with experience doing it. The operation takes about 60-90 minutes and can be done on an outpatient basis. The bigger question is whether it will actually help you. My guess is that fewer than 25% of those have PR get a greater than 90% reduction in symptoms. That’s a guess. There are a variety of things that can cause PS/sciatica and while there may not be a lot of downside to PR (other than surgical complications, thrombosis, etc.) you are well advised to exhaust non-invasive efforts, in particular strengthening and reactivating the glutes, hip and core muscles — which in many cases can offer a significant reduction in symptoms.

      • Maritza
        December 18, 2016 at 1:11 am

        Ugh, that is my problem I have seen so many doctors. I have had about or more than 13 procedures. I even tried Botox that was the worst procedure I have ever done out of all of them. I did physical therapy for a year and a half didn’t help long. I stretch all the time no help. I literally feel when it tightening up it is so painful. My current doctor told me that he can not do any more injections because of scare tissue. I have done different things and no progress, my doctor is more frustrated than I am because he is not able to help me. This is his 3rd time telling me that I really need the release. I just don’t know what to do anymore.

        To be honest I don’t want surgery but if that’s what I have to do to feel better or get some relief I will. This is why my doctor kept giving me the injections. And now saying he can’t do anymore.

      • Maritza
        December 18, 2016 at 1:12 am

        I have spent a lot of money for temporary relief. This really sucks.

    • Jim
      December 18, 2016 at 9:03 am

      Maritza, I understand, I have been through all of that as well and injections, pills etc. don’t really address the underlying problem which often involves hypotonic glute and hip muscles. Before considering surgery you should consider having a good PT evaluate your glutes–if they are hypotonic you will need to strengthen them and get them activating again. You will need to do this whether you have surgery or not. If you do it before, you’ll save yourself a lot of recovery time.

      • Maritza
        December 18, 2016 at 3:09 pm

        Thanks, for your help and information, I will talk to my doctor about this. I will also read up more about it since I had not hear about thas prior. Is their anything else I would need to know? It’s like i said before I rather do other stuff then surgery. My doc. had mentioned surgery other times and I kept wanting to do other things rather than surgery.

        As I sit hear I have to keep stretching because my foot keeps going numb (when that doesn’t work I just lay down till it goes away). This is very frustrating.

      • Maritza
        December 18, 2016 at 3:11 pm

        I guess what I am trying to say is if I can avoid surgery and something else I would in a heart beat. But I truly thank you for the information.

  33. Elise Harden
    December 17, 2016 at 11:34 am

    Hi everyone! Elise here, I had surgery in June of this year (2016) with dr Martin.

    I’m back to work after 6 months off. Ugh! The adjustment was incredibly hard and painful. I have a lot of swelling/inflammation again on the surgical side. Luckily, with the additional swelling, the pain has settled down some. But my back isn’t happy now.

    I can’t take NSAIDS (GI issues). So I’ve just relied on Tylenol and curamin.

    I’ve been doing once a week massages after my pt ended, and that’s helped with a lot of the night pain. I’m resigned to the real possibility that this is permanent, this is my life. I’m not going to beat this. I put the hopes of returning to running in the back burner and bought a violin. But DH isn’t interested in sharing space with it haha!.

    There’s a possibility of a second surgery, that I think will release the piriformis (I thought I understood the first surgery- but nah, I give up).. So I’m not sure how I feel about a second go at it. We’ll see when the time comes. Overall, I am doing better- but I’m also doing less.

    Hope everyone finds help and relief.

  34. Maritza
    December 15, 2016 at 3:56 pm

    I am so amazed that I have finally found a page that talks about what I am going through at this moment. I Have had 3 years of hell with this pain in my butt, numbness down my leg and foot, pinching and irritation. Lord knows that I have tried everything and have spent a lot of money trying to get it figured out.
    I have been diagnosed with piriformis syndrome about 3 years ago, I have had numerous procedures done and none have worked. My doctor says I have to have the piriformis release surgery but, there are no doctors in my area that will do the surgery (for that matter in my state) the doctor that was available for that in my area retired the month before I went to his office, it left me crushed. My doctor has told me that I am not to have any more injections. So I do not know what to do. This has been a terrible problem for me, I have lost my job, I have a hard time going up the stairs (not as bad going down them even though it does bother me), I can’t play around with my family, ride a bike, dance pretty much enjoy life as I use too.
    I am very unhappy, trying to figure out my next move all by myself. My doctor has tried everything he is able to do for me. Believe me when I tell you that at my last procedure he was the saddest person in the room (as if someone had died) because he is not able to help me. Can I please get information on the doctor that is providing the suregery? Maybe I can contact them and see what they are able to do if anything can be done.

    • Jane
      December 16, 2016 at 6:00 pm

      Hi Maritza,

      Where are you located?

      There are doctors in Texas (Dr. Starr and. Martin) Milwaukie (Dr. John Heinrich), and LA area (Dr. Filler and Dr. Jackson) who are known for these procedures. You want a specialist who does this a lot, it’s very complicated surgery.

      • Maritza
        December 17, 2016 at 7:28 pm

        I would like a doctor that has done this often. I have looked everywhere and can’t find one. And sorry that my other answer ended up in its own thread. I really don’t why, anyways I live in the east coast North Carolina.

  35. Veronica
    November 21, 2016 at 7:34 pm

    Friends, your stories and symptoms sound very familiar to me. In the past 6+ years, I have been extensively worked up and treated for crushing pain in the low back, hip, piriformis and SI joint areas, left greater than right side. The left piriformis irritation began in the first year of my first desk job, and erupted 18 years later in connection with a neck/shoulder/elbow injury 2 years prior. Interventions have included:L4-L5 facet joint injections, SI joint test injections and rhizolysis, quarterly trochanteric bursa injections, chiropractic, accupuncture, Sarapin injections, massage, multiple rounds of physical therapy, and many home remedies and gadgets. As is the case for many chronic pain patients, I was recently taken off of the only pain medication that was effective, and became virtually bedbound with raging widespread pain and an inability to straighten up and walk without a major limp. It took awhile to get in to see yet another “Pain Management” specialist, but I did end eventually get a L5-S1 epidural, which has provided better relief than anything else in over a year. Now, one epidural offers only a temporary reprieve, but it seems to have identified a primary pain generator. I don’t know if this information will be useful to anyone, but it might be worth exploring the possibility of lower lumbar spine disease (specifically L5-S1) as a “hot spot”.

  36. Meredith
    November 17, 2016 at 10:38 am

    Hi Gwen, I’m so sorry to hear of all that you have been through. In my opinion, I would look for a good orthopedic doctor in Houston or another large city. You’re symptoms don’t seem to me to be from the piriformis muscle. These symptoms generally are: pain in the bottom, very painful to sit, and terrible nerve pain down the leg and into the bottom of the foot. These are general symptoms, some have more, some less. Best of luck to you, Meredith

  37. Gwen
    November 17, 2016 at 3:31 am

    I across this site when looking for doctors in Houston, TX that specialize in COCCYX pain and SI JOINT pain and now I am curious if this could be part of my problem. I currently live in Mississippi and have been unable to find a doctor with knowledge or experience to help me with my problem. My sister was recently diagnosed with breast cancer and is getting treatment at MD Anderson, so I thought I would see if someone in that area might be able to help me.

    Brief history…I broke my coccyx and had it removed in 1998. I knocked the it completely off (non union)when I fell on my buttocks. The surgeon told me that it was like a tooth and I did not need it. The doctor told me that I had a 50/50 chance of helping relieve the pain by removing it, so I did it. It did relieve a small amount of pain, but years later I am left with more than I could have ever imagined!

    About ten years ago I lost all mobility at my waist. I am no longer able to bend or twist and it continues to get worse. My additional symptoms are:
    – Unable to sit or stand for longer than two hours
    – sharp stabbing burning pain along my waist in my lower back
    – pressure in my anus that feels like somebody is trying to shove a football in it
    – painful to the touch, as if it is really bruised, on both si joints and in the center of my back
    – pain on my sides as if I have fallen but I have not
    – feeling like I have been hit in the back with a sledgehammer
    – si joints seems to slip sometimes which is extremely painful
    – spasms that increasingly are getting worse

    It is extremely frustrating with the lack of knowlege and concern that doctors seem to have with this area of the body. I am an extreme pain all day long and cannot even get dressed, take showers and even go to the bathroom without a lot of effort and pain! I am a 45 years old female that if things continue to progress without finding a doctor to help me, I will soon have to have someone help me because I fear I will be able to do the normal things I should be able to do at my age. I am desperate and am looking for assistance from anyone who is able to offer suggestions.

  38. Alison
    November 15, 2016 at 12:32 pm

    Hi everyone I’m new to this site. I’ve had Piriformis syndrome in my left buttock since Feb 2016. I’ve had many sessions of physio, acupuncture and more recently a Botox injection. I’ve stopped running for weeks on end but nothing has worked. So today I was back at the consultant who has booked me in for surgery in January. Has anyone had this procedure and what were the results. Thanks Alison

    • Elise Harden
      November 20, 2016 at 8:21 pm

      Hi Allison,

      Nice to meet another runner. I had piriformis/sciatic nerve decompression surgery 5 months ago. I’m doing better. Not 100%. But I still have hope. I’m not in as much pain. I still have some nerve pain (ache at night mostly).

      Only advice I have is to be patient. Recovery seems to be a slow process.

  39. Joshua
    November 10, 2016 at 10:05 am

    Hello all,

    I am looking for any suggestions for any types of healthcare providers located in the Northeast that might be of help to someone that is suffering in a similar manner to many on here. I am specifically located in Boston, MA, but I can travel as far south as DC. All the Best, Joshua

  40. November 7, 2016 at 8:46 pm

    Hi Meredith,
    Did your docs do the moving (“dynamic) ultrasound, where one can see the muscle gliding over the nerve? Because that seems to be how PS is ruled out, at least in my case. I must say, it has taken dogged persistence on my part to continue seeking what underlies my cramping & shooting pain, but what’s the alternative? Thankfully, the mid-level practitioner I see at our little local clinic is willing to refer me to everything I’ve asked for, thus far, but I feel like the whole set up is backwards! An expert should be telling me what is needed! Well, that’s what I finally got at UCSF, so I am hopeful that Dr. Aaron Clark’s specialized low-impact disk surgery will close my case! Keep me (us on the blog) posted, as we do learn from one another!
    Best wishes,
    Nancy

  41. Meredith
    November 7, 2016 at 4:45 pm

    Nancy,
    I’m so glad that the piriformis and the nerve looked good to the doctors and I’m hoping the dr. in January will be able to help you. I can’t believe you’ve spent 4 years of your life on this.

    As for me, It’s been 17 months for me, I’ve had 7 injections and my piriformis muscle cut in half and I’m still in horrible pain. Was sent to UAB and the dr ordered a nerve conduction test which I am having on Friday. It seems he thinks mine is related to my spine too and not piriformis. The things we have to go thru when seeking help! God bless!

  42. November 7, 2016 at 10:51 am

    Hello Meredith,
    I think my initial MRI (regular type) only looked at hip area,(done in Eureka), since that is where pain was located (and vertebrae are not mentioned in report). Then, at UCSF, I did the neurogram, with “multiple sequences targeted to the lumbrosacral plexus.” The vertebrae make up much of the report.
    I have had loss of muscle at the gluteus medius & minimus, palpable when compared to right side. The pain hasn’t presented as spinal, mainly as cramping & knotting in the buttock, so evidently the first MRI limited the field. None of the practitioners in this area mentioned neurogram (nor seemed to know what it is) – I learned about this from reading postings here – thank you all! I then requested one be done from UCSF (where I found that Medicare covers cost) as well as a consult with Dr. Jacques, whom a local neurosurgery office said they send their patients to if sciatic pain is involved. I thought she was quite thorough in tests of various types ordered. Three docs hovered over the screen for the dynamic ultrasound, as they moved my leg around & watched the piriformis & sciatic nerve slide on one another. They spent about 30 minutes on this, and were quite sure there was no piriformis nor sciatic entrapment nor scar tissue, as the structures glided with movement. Then, I had tests for enervation of both nerves & muscles below the left buttock, to assess any impinged nerve activity in the nerves themselves & also in the muscles. This is done with mild electric shocks. I had good responses to both, so no evident nerve injury nor lack of nerve activity in muscles.
    So not all that appears as PS is such! I had self-diagnosed, due to lack of education by medical profession on this in my area. At least that’s where it stands now.

  43. Susan
    November 6, 2016 at 9:45 pm

    Hi Risa,

    I’m sorry to hear that you’re in the same situation I’m in. It is incredibly frustrating. If you want to stay in touch off-line, you can reach me at stvergho@yahoo.com. It would be nice to keep each other posted on research, things to try, etc. Having surgery again is always in the back of my mind, but the risk of scar tissue forming is incredibly high. I’ve heard of a procedure that would minimize it, but the search for the right surgeon is incredibly daunting.

    • Jane Turner
      November 7, 2016 at 4:01 pm

      I’m really shocked…it seems like few of the surgeries past the 6 month mark are successful at all.

  44. Risa Hillard
    November 6, 2016 at 9:00 pm

    Susan,

    I likewise had open surgery (piriformis release) and did great for 6 months, then scar tissue developed and is compressing the sciatic nerve. All the pain returned. I’ve done months of PT, massage therapy, and recently underwent a CT guided Hylenex injection (for scar tissue) and it failed. I’m looking for answers and waiting to see what my options are. If anyone else has found a solution after a similar scenario, would love to hear from you.

    • Jennifer Nally
      February 5, 2017 at 3:06 pm

      I live in north w Kentucky. I need this also. Already had l5- s1 discectommy and later fusion. No sciatica release I want a good doctor experienced. Concerned if scar tissue also.

  45. Elise Harden
    November 6, 2016 at 8:26 pm

    No the scarring of the nerve isn’t from the surgery. The nerve has been damaged and had formed scar tissue inside the nerve.

    Upon surgical inspection the nerve was scarred and had become demyelinated.

    Dr Martin said it’ll always be there. I just need to work on stretching the nerve without damaging it further, via gentle nerve glides.

  46. Susan
    November 6, 2016 at 8:07 pm

    Elise,

    Is your scar tissue caused by the surgery? I had open surgery five years ago. Unfortunately, scar tissue formed and is now entrapping the sciatic nerve. It’s never ending for me – first the piriformis entrapped my nerve, now the scar tissue. I’m currently working with a good massage therapist 2x a week to try and relax my muscles and release some of the scar tissue. It’s very slow work.

  47. Elise Harden
    November 6, 2016 at 7:59 pm

    I had a follow up last week with Dr Martin.. I was surprised to find out that the piriformis muscle wasn’t fully released. I guess despite my self education, I don’t understand the complexity of piriformis/deep gluteal syndrome. Whatever area he specifically addressed has helped.

    There is a possibility of an open procedure to discussed later on, if this endoscopic procedure has not addressed the nagging nerve pain.

    He mentioned that I have scar tissue within the nerve. Anyone heard of this?

  48. Meredith
    November 6, 2016 at 3:55 pm

    Hey Nancy,
    I’m curious if you had PR surgery?
    And if you had had an MRI but it didn’t show the herniated L5? I’m so sorry it has taken 4 years for someone to determine what was wrong.

    • Jennifer Nally
      February 5, 2017 at 3:14 pm

      My auto accident damaged sciatic nerve 2002. But doctors don’t know much about this Piriformis syndrome. L5 S2 discectomy 2004, Fusion 2008. Still having a lot of sciatica pain. Scared to have the release because of scar tissue. Know any specialist near KY ???? Thanks

  49. Eric Jones
    November 6, 2016 at 3:31 pm

    I have been experiencing sciatica type pain for 11 months after slipping and falling on the ice. Initially, the doctor treated with oral steroids and then wanted to put me on neurontin for the foreseeable future. At that point I consulted an orthopedic specialist. He ordered an MRI of my lower back since I have degenerative discs and initially he thought one of the discs was pressing on the nerve. Three lower spinal injections later with diminishing relief on each injection, he made an ultrasound guided injection in my buttocks right at the sciatic nerve. That gave me temporary partial relief. He then suggested that muscle spasms were squeezing the sciatic nerve and instructed me to take ibuprofen to relieve the pain. At that point he was done. That was four months ago. Since then I’ve had to discontinue the ibuprophen due to gut pain and I’m living on Tyleno, Flexeril and Norco. Your blog has given me renewed hope. Monday I’m scheduling another visit with the orthopedist to discuss PS. I’m not taking the brush off this time. Instead I’m going to insist he refer me to someone with experience with PS.

    • Jane Turner
      November 6, 2016 at 6:56 pm

      Hi Eric,

      Great information. It’s really important to understand…are these muscle spasms, in theory, at the Piriformis muscle or lower down? Where is the burning pain start, at the middle of your butt (Piriformis) or your lower butt (Quaratus Femoris or Ischium)?

      When you talk about PS it’s crucial to understand that the Piriformis itself is just 1 of of several places, all near each other, that could be causing the pain. To be redundant, read the paper by Dr. Hal Martin in Dallas, on Deep Gluteal Syndrome.

      • Eric Jones
        November 6, 2016 at 8:23 pm

        The pain starts as a burning pain in the foot and then the calf. Sometimes it starts in my thigh about four inches below my butt, but once it starts it won’t subside until I take a muscle relaxer and a pain reliever. Standing helps keep it from starting.

  50. November 6, 2016 at 11:32 am

    As it turns out, my cramped buttock muscle & pain down the leg (about 4 years),was not PS, as far as the various scans can tell, but rather a herniated L5 disc pushing on the sciatic nerve, along with some obstruction in the foramen passageway through the pelvic bone. I have an appointment in Jan. to meet with Aaron Clark MD at UCSF, who specializes in minimally invasive spine procedures, with patients often going home same day.
    The initial doc I saw at UCSF was Line Jacques, and she did a very thorough testing regime: MR Neurogram, spine & nerve EMG & dynamic (moving) musculoskeletal ultrasound.
    I’m glad to know what is going on – it makes dealing with the pain easier.

  51. Meredith
    October 26, 2016 at 7:05 pm

    Hey Krissey, I didn’t have loss of function, but I did have nerve pain that extended to my toes 24/7. I am 3 1/2 months after surgery and nothing has changed.

  52. Khrissy
    October 26, 2016 at 6:12 pm

    Hello everyone,
    I am here again looking for answers. I am now 5 weeks postoperative from endoscopic sciatic neurolysis. I had a lot of scar tissue pressing on my nerve for about a year. It got to the point where I had foot dropped and a lot of weakness in my foot in leg. After surgery, my foot drop is gone but I am still on crutches, with some small amount of walking without. But I still have nerve pain down my leg. My question is for people in a similar situation whose nerve was compressed to the point of loss of function and who had surgery. After surgery did you continue to have the nerve pain? And if so how long did it take to go away?

    • Elise Harden
      October 27, 2016 at 10:49 am

      Hi Khrissy,

      I’m about 4.5 months post op. I didn’t have it as bad as you do. But, I believe my nerve pain is diminished by about 50%. I had a lot of muscle tightness which has been worked out in PT. I still have aching at night, and the crampy ache of the nerve rear to foot, but it’s less often and less intense.

      It takes nerves a long time to heal, 6 months to 2 years or more.

      This last month with the start of PT, I am making considerable progress. So hang in there. It’s slow going, but you’ll see some improvement.

    • Jane Turner
      October 29, 2016 at 8:06 pm

      Hi Khrissy,

      I’m really interested in your experience because it sounds so similar to mine. Please can I ask…

      – where was the scar tissue? Piriformis area (mid butt), or lower down near your thighs? Were you in continuous pain during that year, walking the whole time? Or just episodes now and then? I’m asking about this because, my pain is quite horrible “but” I’m been able to limit it by only walking very short distances and using crutches a lot (6 months now). So I’m hoping to have less scar tissue.
      – Were you able to sit and lie down during that year?
      – Can you sit now without pain? Or is it as bad as walking?

      Would love to connect — Janeturn22@hotmail.com

      – Jane

      • Khrissy
        December 14, 2016 at 12:53 am

        Hi Janet, sorry I didn’t see this until now. I get a little confused on this site and only seem to get some of the replies. Just today, now about 3 months post op, I finally read my operation report. It was really interesting. Apparently I had a mess of scar tissue that ran from ischium to gluteas maximus and ischium to piriformis. In the process it compressed the sciatic nerve as well as the posterior femoral cutaneous nerve. The scar tissue was cleared out and piriformis partially released. Before surgery I was almost always in pain but it was very dependent on activity. If I was reclined in bed I would be in the best shape. So if I never got up and moved I would hurt less…but not practical. Sitting even for short time aggravated it, especially if on a hard surface. Walking was very difficult as well, standing in line, bending …all sorts of everyday activities aggravate it. I also had foot drop and lots of weakness. The last month or so before surgery my whole leg was pretty much numb. Now after 3 month I can say I am a bit bettet. It has been slow and I still am very limited and in pain most days but it takes more to get me there and I seem to be able to do more. I have way less weakness which is great. I am starting to do some basic pilates to help strengthen my core and legs but can only do about a half hour every 3 days. I am hoping I keep getting better. The surgery was worth it even if it really sucked for two months after. I am sending you an email to connect further! Good luck!

  53. Meredith
    October 2, 2016 at 4:51 pm

    Thanks, Krissey!

  54. Meredith
    September 30, 2016 at 2:04 pm

    Hey Krissey, (found your post)
    I was able to move around right after surgery, no problem what so ever. I felt great until 3rd day after the surgery, I guess the heavy sedation wore off and I felt the horrible nerve pain down the back of my leg and into the bottom of my foot again. I’m taking 800 mg of gabapentin 3 times a day, plus Nucynta ER 100mg twice a day and Norco. The pain is absolutely horrible, I think it’s worse than before surgery. If found a great PT though, (Praise God!) that is massaging the muscle and giving me strengthening exercises, and I believe I am getting better albeit ever so slowly.

  55. Meredith
    September 30, 2016 at 1:21 pm

    Hey Krissey, I can’t find your post right now, but my surgery wasn’t endoscopy, he went in through the glute Max and cut my piriformis in half. I truly think I would be well now ( my surgery was on July 5) if I hadn’t had this awful spasm… That I still have 24/7. I have never been on crutches or had my leg in a brace.

    Please let me know if I didn’t answer your question ..

  56. Elise Harden
    September 30, 2016 at 9:26 am

    Hi Khrissy,

    I’m 15 weeks post op from endoscopy release, I’m still in crutches, yuck. I’m not perfect yet.

    I had zero pain for the first 4 days. I was also in a knee brace to limit the motion of the damaged nerve. About day 7 my pain was increased, 7 or 8. It settled down after a few weeks. I never had spasms. Mine does twitch. Hopefully you have some muscle relaxers? And don’t hesitate to phone your surgeon’s office if you have concerns.

    I think mine never hurt early one because there was fluid from the endoscopic procedure protecting the nerve. Once that was absorbed I hurt.

    • Patti
      September 30, 2016 at 12:27 pm

      Elise & Krissey, who r surgeries?

      • Khrissy
        October 1, 2016 at 5:33 pm

        Are you asking who was the surgeon? Mine was done by Dr Timothy Jackson in Pasadena Ca. It was endoscopic surgery so the incision is tiny and will probably be barely noticeable but still in lots of pain after.

      • Elise Harden
        October 27, 2016 at 10:52 am

        Hal Martin Baylor at Dallas. Hip preservation center. I’m pleased. Office could be better, long wait to be seen. Care is excellent.

        Rehab is at Baylor too. See Sruti Maniv in Plano. Best pt ever!

    • Khrissy
      October 1, 2016 at 5:30 pm

      Thanks for the info Meredith and Elise,
      It sounds like it’s a bit different for everyone, so who knows what’s normal. 15 weeks seems like an awfully long time to be on crutches but I can’t put any weight on my left leg without horrible pain and spams. I am taking percocet around the clock now. I avoided taking it around the clock before surgery because I know how easy it is to become dependent. Seems like the pain is a bit better today and yesterday. I also have muscle relaxers I mainly take at night because they really knock me out. I couldn’t do gabapentin because I got horrible side effects. I guess it’s just wait and see for all of us. I am feeling hopeful because at least the pain is not nerve pain. I am guessing he had to cut into some muscle and that’s why I am having the spasms. Well I wish you both luck and hope we all recover quickly!

  57. Meredith
    September 24, 2016 at 1:52 pm

    Krissey, mine started after I had a stroke (at 48) and my right side was affected. As I was learning to walk again I began having trouble with my right knee. They think my lopsided giat is what caused me piriformis to go out, however I wasn’t diagnosed until 8 months later.

  58. Meredith
    September 17, 2016 at 4:42 pm

    Dr. Harsh at St. Vincents, Nuero Spine Center, told me yesterday that he didn’t know why I’m having the severe spasm in my piriformis. It hasn’t come out of a cramp since February, even after the PR surgery. Does anyone know anybody in Birmingham, Al, or the state of Alabama, or the southeast that might be able to help me? Well, anywhere really… Can y’all give me names of doctors and where they are if you’ve had good results?

    • Khrissy
      October 1, 2016 at 5:43 pm

      Meredith,
      I know when reading through this post I saw surgeons mentioned in Florida and Texas. If you search the page (control f) you can probably find the exact posts.

  59. September 13, 2016 at 2:54 pm

    OK y’all. After my second cortisone shot didn’t work I was referred to a pain clinic. That doctor seems to think it wasn’t piriformis but my SI joint. He skipped over the part of my MRI that said my piriformis muscle was enlarged. He also told me it’s very rare and other doctors overdiagnose it.

    I wasn’t a fan because after completing the form and writing I had FAI surgery they asked if I ever had surgery. Then the doctor was reading my old MRI and rediagnosed me with FAI – after I just went through the whole ‘I had FAI and torn labrum surgery’ part. Anyway he decides it’s my SI joint and gives me a shot there. Over a week later and I’m still in pain. I’m trying to see if the doctor who performed my surgery can handle piriformis syndrome because I did not like this guy!

  60. Risa Hillard
    September 13, 2016 at 2:23 pm

    Not a runner, but a “sitter.” Sit in meetings and in front of a computer too much at work. I, likewise, have heard it happens to runners and people that sit too much. I got a sit/stand workstation once I developed PS. I will never go back to sitting all day, but low back pain flares when I stand all day, too.

  61. Elise
    September 13, 2016 at 1:44 pm

    Hi all!

    I was wondering how many here were/are runners when PS reared, haha! Reared.

    I think mine came about before I ran, before biking, before cardio classes. Twice this week, I’m hearing that it’s brought on from running… Just testing that theory out. I’m positive mine flared up at work from sitting.

    I’m about 12 weeks post op, residual hip weakness. Still using crutches and seem to be having si joint pain, f/u next week. The piriformis issue seems 97% resolved. Hooray!

    • Khrissy
      September 22, 2016 at 3:40 pm

      I am not a runner nor have I ever spent a lot of time sitting (office job etc). My pain started after a rear end car accident. Anybody else have pain after trauma?

      • Jennifer Nally
        February 5, 2017 at 3:30 pm

        Auto accent passenger was slammed into my side from crash. Vehicle flipped from impact. Yes. Sciatica and 2 back surgeries 2004, 2008. that were prob not necessary. Tired of pain.

    • Jim
      September 22, 2016 at 4:15 pm

      I was sitting 8hrs and then pounding it out on a treadmill (at an incline). I think there is an addtl factor, which is hyperpronation (i.e. usually flat footed) where ankle rolls in as you walk/run. Flat feet/collapsed arches cause the ankle to fall inward which creates outward stress at the hips, and probably effects piriformis. Same would happen if you have valgus/knock knees. I suspect alignment issues can create abnormal stresses in hip/pelvic muscle complex. Add to that the fact that many runners rely on their quads and have hypotonic(!) glute muscles, so now you’ve got misalignment and the glutes aren’t activating — perfect set up for straining the piriformis. Just my theory.

      • Elise Harden
        September 22, 2016 at 5:05 pm

        Thanks Jim. I can’t deny that I wasn’t doing some running, maybe 5-10 miles a week. I agree it’s just a that luck that seems to set us up for it. I was able to ramp my running up to 35 mpw through the muscle relaxers, chiropractor, pt, and shots. I also spent 3 seasons on the bike (no running) with the misdiagnosis that it was my back.

        Guess I’ll not worry about what brought it on. Just that I’m getting better.

      • Veronica
        September 26, 2016 at 3:26 pm

        Well stated, Jim. There is a looming health crisis of unimaginable proportions, and is just starting to hit its stride. I call the constellation of symptoms “Cubicle Syndrome”, but I believe it is more commonly known as “Sitting Disease”. It is considered more dangerous than smoking to overall health. Exercising after work hours does not counteract the deleterious effects of prolonged sitting for one’s job, especially after having been “strapped in” to a chair and tethered to a monitored phone and computer for 8+ hours a day. As you noted, injuries like sprains and piriformis flares tend to occur when one does exercise. There are early indicators of developing problems (twinges, knots, unusually long-lasting muscle aches and such), but it usually takes some years for the damage to fully manifest and become disabling. The adjustable-height desks and work treadmills came out too late for me, but anyone in a sit-down job should use any of those kind of adaptives before real trouble gets underway.

  62. Athena Fremstad
    September 13, 2016 at 10:37 am

    Tom,
    Research IFI. It is a rare hip impingement and difficult to diagnose. I went to UTSW and saw Dr Chhabra. I also have PS but they believe it’s from undiagnosed hip structural issues. It may not be your hamstring but your quadratus femoros

  63. Tom
    September 12, 2016 at 11:38 pm

    Hi all,

    I went for an exam today and it turns out, my pain is far too low to be Piriformis (says the doc). He says it’s near the ischial tuberosity and trochanter…down near hamstring.

    Maybe an adhesion that is tugging on sciatic nerve in that area. That’s consistent with my latest issue…I can’t do anything that pulls my hamstring (no bridging of any kind) without instant pain.

    • Pam
      September 13, 2016 at 7:00 am

      Tom, which type of specialist did you use to help you determine your condition? I am trying to decide where to go next to solve my mystery problem. My pain is a burning pain that fluctuates in severity. My pain runs between my hip and sacrum.

  64. Meredith
    September 12, 2016 at 6:45 am

    Hi Z,
    I wasn’t able to take Lyrica, it set my leg on fire after 2 doses. I’ve been taking Gabapentin for a year, started with 300mg 3 times a day, now I’m taking 800mg 3 times a day.

  65. Z
    September 12, 2016 at 6:02 am

    Interested in hearing side effects experienced when taking lyrica and other nerve meds, specifics on duration of and amount of weight gain and any ways of combating this. Thank you

    • Veronica
      September 26, 2016 at 3:43 pm

      Early on: unpleasant intoxicating effect, which passes fairly quickly; then delayed reaction time and mildly impaired judgment (serious consideration for driving) for the duration of treatment. Months into treatment: depression and significant short-term memory loss. Negligible weight gain at low doses, which is all I am familiar with, Only slight reduction in pain was achieved,, so eventually it was not worth continuing treatment. This drug is really an anti-convulsant (for seizure disorders), not an analgesic (for pain), but it is one of the very few treatments offered for widespread pain.

  66. Meredith
    September 8, 2016 at 6:16 pm

    Hey Vickie, the pain block helped with some pain that I was having on the bottom of my foot, he gave me a shot in the S1 nerve root, as well as in the Piriformis. Overall it took my pain level down from a 9 to an 8. The Botox shot I got didn’t help me, I hope it will help you.

    So I guess there’s no one in Montgomery that does the surgery? If you go to Harsh ask him how many surgeries he’s done, I’d be curious to know. 🙂

  67. Susan
    September 4, 2016 at 2:37 pm

    Tom,

    My surgeon, Dr. Barbaro, is no longer at UCSF, so telling you about my experience with him won’t really benefit you too much. In regards to Dr. Filler, I never met him. He read my MR Neurogram report, otherwise I had no contact with him. I have to say that dealing with his office was a nightmare though. It took them over a month to get a report to me, and another two weeks after that to get the disc. A lot of unanswered phone calls and emails. It was a very frustrating experience.

    In hindsight, I would have done better research in regards to finding a surgeon. I was told that I needed the surgery, and was referred to the surgeon. I would’ve checked to see how many of these surgeries he had done, and not rely so much on the reputation of UCSF. I would have also travelled anywhere in the U.S. if it meant finding a reputable and experienced surgeon who had done a great many of these surgeries. There are definitely a handful of those in the country.

    Good luck!

    • Tom
      September 5, 2016 at 2:10 am

      Thank you Susan that seems exactly right. I think Dr. FIller and Dr. Tollestrup in Las Vegas are the ones most likely for consideration on the west coast.

  68. Susan
    September 3, 2016 at 10:47 pm

    Tom,

    My surgery was performed by a neurosurgeon, Dr. Nicholas Barbaro. At the time, he was at UCSF, but he is now in Indiana.

    • Tom
      September 4, 2016 at 12:36 am

      Hey, that’s interesting. I was just getting ready to communicate with UCSF about the potential of getting release surgery there. Alternatively I’m considering Dr. Filler.

      Can you tell me any more about your experience with either of these, good or bad? There are huge, huge stakes riding on the next few steps I take, so I’m desperately seeking every scrap of information I can get.

  69. Meredith
    August 31, 2016 at 3:42 pm

    Joe, so sorry you’ve had the issues with your piriformis as well. Mine too radiates down my leg and into my foot. It’s been doing this a good 6 months but last week has been burning so badly that I can’t stand up. So if I have to stand, I put a ice pack under my foot. I am getting my pain meds from Ala Pain Physicians, and I’m curious where you got yours? Was it from Dr. Counce as well?

    I wanted to ask you about your muscle spasms, what did they feel like? Can you describe it to me? And did Dr. Counce give you just one injection of Botox each time or did she put multiple shots in the Piriformis? And can you tell me if insurance covered it? I had one injection of Botox at Ala Pain Physicians but it didn’t do anything for me. And it cost me 700$.

    The doctor who did my surgery was Dr. Carter Harsh, which I checked and is in the same practice as Dr. Wilson. When I went back last week he told me that he cut it so that when I sat down the muscle would spread away from the sciatic nerve. Last week he didn’t say anything about cutting it in half. I imagine that is the goal each time until he gets in there and sees what’s going on. It also sounds like a similar procedure that you said Dr. Wilson does. I would think that the surgery would be awesome if I hadn’t had the terrible muscle spasms that I still have. I would recommend it to you, but I hate to do that and you have an issue, but mine was hard the first two weeks. But I still had the sciatic pain and you most likely wouldn’t.

    I’d love to keep in touch since you’re from Birmingham, I’m getting a pain block tomorrow at St. Vincents, Dr. Harsh thinks it might help me, he said he really doesn’t know what wrong with mine being in such a terrible spasm.

    God Bless!
    Meredith

    • Vickie
      September 8, 2016 at 5:55 pm

      Hi Meredith,

      I’m curious as to how effective your pain block was? I’m scheduled for Botox at the Center for Pain in Montgomery next week since the cortisone injections haven’t worked, and I’m about at the end of my rope. If the Botox doesn’t work, I’ll be getting a referral to Dr. Harsh myself…

  70. Tom
    August 30, 2016 at 5:39 pm

    Now hiring!

    I’d like to get find somebody in the SF Bay area who can give a CT-guided Botox shot. Somebody who is good!

    Am having no luck so far. There are places (such as UCSF) but the wait time is long…by then I will have lost my leg (going on 3 months now, my leg is wasting away and I can’t use it).

    Does anybody here want to do the job of finding somebody? Does anybody have any contact info or sources for this? If so I will hire you as a consultant and pay well…

    • Libbey
      September 9, 2016 at 3:43 am

      LOL! I just saw this post.. I have often had the same wish. If only someone would help with figuring ALL this sh**T out since the pain is hard enough to deal with!

      Tom I just sent you a big email but you don’t need to pay me. Let’s just help each other since we are both Bay Area peeps.

    • Robert keller
      September 16, 2016 at 6:12 pm

      Dr. Jan fritz. John Hopkins in Baltimore. He did one Botox and it helped. But then the pain moved to my lower back. He just did a second one two weeks ago. He says it takes 30 days to feel any results. MRI guided Botox. He’s the best.

    • Robert Keller
      June 3, 2017 at 7:54 pm

      Dr. Fritz at John Hopkins. Dr. ALee Dellon referred me to him


      https://polldaddy.com/js/rating/rating.js

  71. Nancy
    August 28, 2016 at 1:57 pm

    Patti,
    I have had 2 cortisone shots in my piriformis and they did not work. Next choice is Botox. Any dr close to Jacksonville, Fl?

    • Pam
      August 28, 2016 at 7:05 pm

      My research showed that Mayo Clinic might have doctors that deal with piriformis.

  72. Pam
    August 25, 2016 at 7:12 pm

    I had a steroid injection in February. It did nothing for the pain, but increase it. I have been trying acupuncture. I have been about 20 times and am skeptical because I still have pain. Has anyone had luck with acupuncture? If yes, how many treatments? I am also needing to get more imaging to actually see what is wrong. I have burning in my right buttock that can stem down my leg. My family doctor sent me to a pain clinic, which is too expensive. I pay $250 each visit just to talk to the doctor. Which specialist would you recommend to help me with piriformis syndrome? Conservative approaches have not seemed to help.

    • Patti
      August 26, 2016 at 9:18 am

      Pam: Botox injections along with prolotherapy and prp has helped me the most. Acupuncture did not help, dry needling helped a little. A good pelvic floor PT can help to ensure you have the right diagnosis.

      • Pam
        August 28, 2016 at 7:09 pm

        Patti: I never heard of those therapies. Are they experimental? Which kind of specialist deals with those therapies? I am at a loss on what to do next. The only Doctor that I have seen for my condition sent me to a pain clinic that only does injections or medication to treat the symptoms. We have pelvic floor PTs, but I don’t know if they diagnose piriformis. Do you ask your doctor to refer you for consult with pelvic PT to confirm piriformis syndrome?

      • Patti
        August 28, 2016 at 7:41 pm

        Pam: I’m in Canada. my very experienced pelvic floor physiotherapist who is trained in Diane Lees approach does the dry needling. It’s basically an acupuncture needle which is inserted into trigger points in muscle and immediately withdrawn. It causes the muscle to relax. I get prolotherapy and platlet rich plasma(prp) injections from a doctor (md) here. Prolotherapy is a dextrose solution which is injected into ligaments and muscles I suppose. Platlet rich plasma is my own blood withdrawn, then spun in a centrifuge to extract only the platelets, then combined with prolotherapy solution and injected into ligaments and muscles. These injections trick the body into thinking there is an injury and the bodies own healing mechanism is stimulated. In one session I would get around 20-30 injections. These sessions do cause inflammation, but they have helped tremendously to strengthen my back. I will find and post a number of links you can look at. For prolotherapy, choose your doctor with care and caution. My prolo doc is an md. I prefer this to a naturopath or other doing injections.

  73. Elise
    August 25, 2016 at 3:04 pm

    Tom, I agree with doyoureyesblog. A standing desk or standing more helped me too. I never sat at work for more than a few minutes. As soon as the pain increased, I’d stand up.

    At home, I always lounged around, never sat on that muscle.

    I’d had an incredibly hard time sleeping at first. It took me almost a year working with my surgeon to have the surgery. I’m glad for his help and insight. No one wants unnecessary surgery. My PT’s were critical in my pain relief and recovery.

    • Tom
      August 25, 2016 at 6:36 pm

      thanks I agree…I also used standing desk for the paist 5 years or so. I used a special pillow in my car that allowed me to recline with butt off cushion at about 45 degree angle, which I found allowed me to drive forever without pain. I found a special office chair which, if reclined 45 degrees on the bak and with a right side special pillow,you could work practically forever without pain (better than standing!)

      i wish i could go back to that!

  74. Elise
    August 25, 2016 at 2:56 pm

    I think it was rock like for some time. I suffered for 3+ years before a proper diagnosis so I really can’t say. During PT last August, it was mentioned that I might be the first person she’s seen with true piriformis syndrome. After the shot, the muscle was much more relaxed.

    I’m 11 weeks post op today. Doing well, just working on strength and keeping the nerve free from scaring.

    My daily pain before shots was 8-9, after PT and a chiropractor that helped with some muscles (ultrasound therapy-low back) and muscle relaxers 4-7, after shots 2-5 (doubled my running distance), today and most days now I’m at a 1. It’s all strength and correcting muscle imbalances.

    You can use a tennis ball to loosen it up. But it’s more likely to just aggravate it without something to help it calm down. (Shots or maybe a muscle relaxer).

  75. Meredith
    August 25, 2016 at 8:34 am

    Elise, I think you’re the first person I’ve seen on here that called your piriformis a rock. How long was your piriformis “rock like” and was it that way before surgery? And after surgery? That’s how mind has been… And still is. My surgery was on July 5, 2016. Thanks!

    • Elise
      August 25, 2016 at 3:11 pm

      Oh sorry Meredith, I replied as if Tom had asked. I can’t yet see what I wrote. I hope it’s on point.

      My surgery was July 16th. It’s not like a rock at all. Throughout the day it occasionally feels tight and I just stretch it out. Seems to help greatly. I’m still ordered on at least one crutch. It does twitch now and then, but nothing painful.

      I wonder how that muscle can be knotted having had been released. Might be a good question for your surgeon. There maybe something they can do.

  76. Elise
    August 25, 2016 at 8:06 am

    Sure Tom, The first shot work rather fast. It’s coupled with a numbing agent, and I felt better immediately. The second shot took 4-5 days to help. The third, just over a week.

    The shots were incredibly painful. I’m not positive why I was in so much more pain that normal. Once I had the piriformis release surgery it was noted that the nerve was damaged and had lost some on the protective myelin (fatty layer). I believe that’s why the shots were sweating bullets kind of pain. Still I went back for more, because they helped.

    Have you had shots yet and are waiting to see if they help? The second shot was probably the most effective. I was also seeing a PT to help work out that rock of a muscle.

  77. Meredith
    August 25, 2016 at 7:29 am

    Tom, I had 4 steriod shots and one Botox, all in different areas of the piriformis each time, and none helped me.

  78. Elise
    August 24, 2016 at 10:00 pm

    Steroid shots helped me greatly. They lasted 2-2.5. months each. The shots were into the muscle, near the sacrum. There are you tube vids. The Botox wasn’t available, or covered by my insurance. Also some research suggest it causes additional scaring. So, if there’s a chance you don’t need surgery, might research the Botox some more.

    My shots probably would have lasted longer but I was running 30-35 miles per week. I imagine that’d work it out much faster.

    Good luck.

    • Tom
      August 25, 2016 at 2:17 am

      Thanks Elise…

      Can you tell me, how long after the shot till you noticed improvement?

      T

  79. Patti
    August 24, 2016 at 7:12 pm

    Tom: cortisone did nothing for me. Advise getting Botox instead.

  80. Tom
    August 24, 2016 at 6:07 pm

    Hey all can I ask a question,,,For those of you who had luck with steroid (cortisone) injections…

    how long on average did it take to get whatever relief you got?
    was it into pirifomis muscle or elsewhere?

    thanks!

    • August 25, 2016 at 8:05 am

      I had my first shot April 2015 and if j remember it was about a week. The shot lasted until recently and I had my second shot on 8/22, I still feel a little bit of irritation but not as much, my dr said it usually takes about a week for it to kick in. I also got a standing desk at work which has helped greatly

  81. Risa Hillard
    August 23, 2016 at 11:08 am

    Libbey: 54 and NOT a professional dancer!!! 😁 I’m an executive. For me, the secret has been physical therapy complete with strengthening and stretching. I have found as long as I do my exercises every day, things go so much better! I had a health crisis in my family and didn’t do them and the pain returned (not as bad as pre-surgery, but definitely much worse than it had been the 5 months since surgery). Strengthening and stretching is the key for me!

    • Libbey
      September 9, 2016 at 3:23 am

      Thank you Risa! This is my rant that I just sent to Tom was unsure about putting it out to everyone because it is such a rant but hopefully there is some small bit that can help someone else.

      Hi Tom and Nancy,

      I am sorry to say that after 8 months (most of 2015/2016) of being relentlessly tortured on multiple levels, physically, mentally, and emotionally, UCSF was a huge wast of time… Because I can not sit long enough to make the hour and forty-five minute commute from Santa Cruz, I had to have my 77 year old mother drive me up and back nearly every 4 to 6 weeks… She sat in on all my appointments and was horrified at just how torturous and inapt these so called Doctors and their staff were. Not to mention the hours spent on the phone tracking referrals, lost paper work, phone calls not returned, canceled appointments that no notification was given for, and then the weeks and weeks waiting for the next available appointment… only to be given a quick 15 minutes and then being told to shove off… At one point because I started crying and saying my life was unbearable Dr Jacques threatened to 51/50 me saying that I was suicidal and that by law she had to call mental health services! Thank god my mother was there or she would have put me in a straight jacket and put me in a 72 hour lock down…Talk about ridiculous!

      As an x professional dancer I have been researching endlessly for help for nearly 5 years and will admit I have made some huge mistakes along the way, but I have also figured out a little bit on how to manage… if you can call it that since living with this condition is constant unbearable suffering… But I have made some progress researching surgeons here in S.C.. There one one Doc who is said to be an excellent orthopedic surgeon, who especially likes doing these types of surgeries. I am still trying to get a referral to get in to consult with him and in fact just today made a little progress in that direction. I have also been researching this surgery overseas where it is much more commonly done and I have been told have a higher success rate because the surgeons have way more experience. It is also a tenth of the cost of what it would be to pay out of pocket here in the US. In fact from what I can tell the much needed first class air fair would cost more then the actual surgery. Also important to note is most insurance companies will not pay for this surgery here in CA anyway. I am meeting with a friend who has offered to write me a Go Fund Me to help have this surgery in Belgium, but I am also terrified because to have this surgery is no small matter it is a very complicated surgery that should be well researched. There is a right way and a wrong way to do this surgery. And most importantly you DO NOT want to get the surgery if you are in a overall weak or compromised condition you will NOT recover well. I am relentlessly try to recondition my body so that when and if I do the surgery I have the best chance of recovery. This is a hard to come back surgery and the ones that make it are physically strong. I am 48 year old female who has been majorly halted by pain, but I also know that any really good surgeon will not touch you unless you are in reasonable enough condition to recover. I would be very happy to combine resources and share more on this information.

      I do have a great pain management guy here in S.C. that did my CT guided Botox and steroid injections… Botox helped some but not enough for long enough, and the steroid made me worse for many reasons. The best management has been Bikram Yoga this is yoga done in a very hot room and working with a naturopathic doctor to decrease overall body inflammation. This has included such things as blood testing for food sensitivities, removal of all the fun things i.e. gluten, sugar, alcohol and yes anything not organic or overly processed, as well as B12 injections, high quality vitamins of various sorts ( some have really helped some not so much) and lastly I am about to start doing glutathione pushes. I also travel with a Zero Gravity chair easily found on E-bay.

      Okay so now that I have droned on and on lol, feel free to let me know any information you might have. I would also be happy to talk on the phone to exchange info more rapidly.

      • shelley Hart
        February 6, 2017 at 8:57 pm

        can you tell me which surgeon/surgery you found in belguim please

  82. Meredith
    August 22, 2016 at 11:41 am

    Tom, 1st of all, may God bless you! I can’t begin to imagine what you’re going through. My situation is horrible for me, but your situation seems so much worse.

    2nd, I would do everything possible to get up and begin using your leg. You know your body better than anyone else does, so you dictate how fast you do things, weighing the pain and the soreness later. Do you have anyone in your life that can help you? Is there anyway someone could help you contact a Pain Clinic in your area to get you some meds while you leap out in faith of regaining strength in your leg?

  83. Tom
    August 22, 2016 at 10:31 am

    Standup or continue to atrophy?

    Everybody I have a question for the group.

    I’ve been bedridden for about 8 weeks and haven’t use my left piriformis afflicted leg at all. No it’s so weak I can’t walk, I’m going to need to do a lot of exercise to get a bow back up again so I can bear weight.

    When you go to therapist called his “de conditioning” — when your body loses so much muscle mass that forgets how to do things. My leg has forgotten how to beat weight.

    The dilemma of courses that this is going to cause huge pain. I don’t know how I’m going to endure it. I’ve been lying in bed avoiding this moment

    Or, I can just stay in bed and let the leg wither away.

    What does everybody think?

    How do you people do physical therapy and read and rehabilitation on your hips after surgery, when you still have your This pain?

  84. Meredith
    August 22, 2016 at 10:01 am

    Ashley, let me know if I left anything out

    Female
    Alabama
    Piriformis release surgery
    July 2016
    BCBS of Alabama

  85. Ashly
    August 21, 2016 at 11:06 pm

    Yes, that would be great. Thank you!

  86. Meredith
    August 21, 2016 at 9:25 pm

    Does anyone know of a good doctor in Alabama?

    • Joe
      August 31, 2016 at 11:17 am

      Meredith, I am so sorry about the trouble you’ve had before and after surgery. I can empathize. I have PS and have had very good results with Dr. Diane Counce (B’ham-Hoover) for Botox treatments, every three months for more than a year. Until then, I was having bad pain and many strong meds – and could not function. My pain extends down my leg to my foot and the radiating nerve pain was much worse than the muscle spasm pain in my piriformis muscle area. Within a week or two of my first Botox treatment I stopped all pain meds – Botox treatment was amazing. I am now having more trouble in differing areas of hip, one of my recent Botox treatments didn’t last three months, I am still very limited in activities, and have been advised by to other doctors to have PS surgery – what I thought was a release of the piriformis muscle. I also saw Dr. Thomas Wilson, B’ham – St Vincent, to explore surgery options. I think very highly of Dr. Wilson, but he said that his procedure would be to dissect away the piriformis muscle tissue away from the sciatic nerve and not do a release. I was reviewing this site to explore for other surgeons in Atlanta or southeast and looking for recommendations. What I have found out is that there are few that do this kind of surgery often because PS is rather rare. I scanned all of your posts and didn’t see who did your surgery? Can you tell me? I have not heard anyone describe a surgical option as cutting the piriformis muscle “in half” though. I will also say that I have not seen anyone on this site say that they had surgery and had no more issues. Maybe those that had no post surgery pain are out enjoying life and have no reason monitor these posts and to reply to messages on this website? I hope that this will help you. God bless!

  87. Meredith
    August 21, 2016 at 8:50 pm

    Has anyone had spasms in their piriformis to where it feels like your sitting on a rock?

  88. Jim
    August 19, 2016 at 5:02 pm

    Ashly, this is a very good idea and could be of major benefit to others dealing with the redtape, I can only encourage others to participate, and will certainly try to be of help.

    • Ashly
      August 20, 2016 at 1:07 pm

      Thank you!

  89. Ashly
    August 19, 2016 at 3:41 pm

    I’m looking to create a list of people who had piriformis release surgery/sciatic nerve exploration and insurance covered it. My surgery was the first in Utah and I’m still trying to get my insurance to pay. So if you wouldn’t mind, could your share your info with me?
    I was thinking I’d just make a list stating:
    male or female
    insurance company
    procedure(billing code if you have it)
    if your insurance covered it

    Example:
    Female
    Neuroplasty of sciatic nerve, 64712
    EMI
    Still trying to get covered

    Mine is being called experimental at the moment. I’d like to tell them that this procedure is happening in other states and insurance companies are covering it.

    If you want to share the above info, I think you can post it here or you can email me at brown.ashly@yahoo.com.

    Thank you!

    Ashly

    • Meredith
      August 21, 2016 at 9:28 pm

      Hey Ashley, I had PR surgery but not the nerve exploration, and insurance covered it. Would you still like my info?

    • August 25, 2016 at 6:27 pm

      male
      United Health Care
      999999 (uncoded)
      yes it was covered

  90. Jim
    August 12, 2016 at 9:14 am

    Hi Matt — this is a question for anyone who has had release surgery: how soon after surgery did you begin PT? One of the big issues with this type of surgery is formation of scar tissue post-op, so I am wondering, how soon your surgeon got you started on PT? Thanks.

    • Meredith
      August 12, 2016 at 9:44 am

      Jim, my surgeon started me on PT at three weeks. Normally his patients don’t have to have PT but I had a severe muscle spasm. My doc may have done a diff release surgery than yours. Others on this site had a diff procedure. Mine cut my piriformis in half kinda in the middle. His PA sent me to PT at my 3 week post op visit because of the spasm. The PT made it worse. Thankfully I found another PT yesterday who does soft tissue release (which feels like aggressive deep massage). Hope this helps.

    • August 25, 2016 at 6:29 pm

      it was roughly 4 weeks if I remember correctly

      • Jim
        August 25, 2016 at 6:35 pm

        Thanks Matt, that’s kind of what I’m being told as well. Had left side released yesterday. Was standing at my office desk working this morning, not finding that I needed any pain meds. I think doing a year of glute strengthening allowed my glutes to pick up the slack right away.

  91. Elise
    August 4, 2016 at 7:59 pm

    Hey Meredith.

    For the doc I saw, I believe all PS patients get crutches. There was no way I could walk without that muscle to stabilize my leg. I’m just now getting some compensation muscles strengthened to walk.

    It sounds like there are different techniques. But I did seem to have some instability before the surgery. Maybe some of my muscles switched off.

    • Meredith
      August 4, 2016 at 9:09 pm

      Hey Elise, wow, that’s crazy, I rode in a wheelchair after my surgery to my car but when I got home I walked up my stairs and all around my house. My surgeon told me he would cut the muscle in two and sew me back up. How did your surgeon explain yours? By the way I live in Bham AL, where do you live? I’m guessing you had a different piriformis release surgery. (I think I want yours! Haha)

      • Elise
        August 5, 2016 at 11:00 am

        Meredith~I forgot, my doc put me on a medrol pack this week to help with inflammation. Don’t hesitate to keep in touch with yours, maybe they have a few more tricks to help you. My pain was significant before I started it. But he also got me back on track with the stretches, I wasn’t pushing hard enough, just doing easy when it should almost hurt.

      • Khrissy
        September 30, 2016 at 2:06 am

        Hi Meredith and Elise and anyone else, I am 10 days post surgery. I am not sure exactly what the surgeon did because he said it depended on what he found. The surgery was endoscopic. Before surgery I had a lot of nerve pain down my leg and had started to lose function in my leg and foot. I wasn’t able to speak with the surgeon directly after surgery because I was all drugged up but he told my husband I had lots of scar tissue compressing the nerve. I am in a lot of pain now, 8 or 9, and using crutches but it hurts so much I am pretty much staying in bed. The pain is more muscle pain, tenderness and a lot of spasms. The good news is I already seeing improvement in nerve function. I was wondering how quickly you recovered, pain lessened and were able to move around the house somewhat normally. I guess I am impatient to get better and want reassurance that my pain is normal. Thanks!

    • Meredith
      August 4, 2016 at 9:18 pm

      Elise ~ it does seem like you had a different surgery. My doc said he was going to cut the muscle in two, how’d your doc explain the procedure he did on you? (I think I’d rather have yours at the moment, I’m at a level 9 in pain)

      • Elise
        August 5, 2016 at 10:56 am

        Meredith,

        I had mine done in Dallas, tx. The tendon was cut at the trochanter, and the nerve freed up by cutting a few accessory branches that tethered it. I don’t see how you walked at all! My leg had zero compensation strength. I was also in a knee brace restricting the extension of my leg, to keep from over stretching the nerve. My sciatic nerve was/is a bit demyelinated.

        I feel like I’ve got a Frankenstein walk! Haha! I can sit now though. I was shocked when I made it thru a whole movie and never once felt I had to put my feet up on the chair in front of me, or found myself squirming to get comfortable.

        I am doing at home nerve glides every day, donkey kicks on the weak side, and crunches twice a day/week in addition to the piriformis stretching. They seem to be helping greatly. I also started pool walking and some swimming this week. I’m sleeping better. Each day the pain is getting less annoying.

        Oh a 9 is horrible! So sorry to hear that. I’m just getting around and mines a 2. If I slack off on the exercises, it’ll be a 7-8 before long. Everything just tightens up, and scar tissue formation will cause the surgery to fail.

        Wishing you the best! ❤

  92. August 4, 2016 at 11:55 am

    cortisone shot for piriformis syndrome April 2015. Doctor noticed my hip was messed up, sent me to another doctor, had hip surgery for Cam FAI and torn labrum. A year later my hip is doing great, but now my piriformis is inflamed again. I continue with stretches and have a trigger point ball that I roll around on that helps for a few hours. It’s not as painful as it was last year, but I can tell it’s inflamed again. I’m going back to my original doctor who gave me the cortisone shot at the end of the month. I’m trying to train for a 10k or half but this pain in my butt is a real pain in the butt. Not sure what to do, continue getting cortisone shots every year and a half?

  93. August 4, 2016 at 11:54 am

    When did you decide on surgery? I went in for a cortisone shot for piriformis syndrome April 2015. Doctor noticed my hip was messed up, sent me to another doctor, had hip surgery for Cam FAI and torn labrum. A year later my hip is doing great, but now my piriformis is inflamed again. I continue with stretches and have a trigger point ball that I roll around on that helps for a few hours. It’s not as painful as it was last year, but I can tell it’s inflamed again. I’m going back to my original doctor who gave me the cortisone shot at the end of the month. I’m trying to train for a 10k or half but this pain in my butt is a real pain in the butt. Not sure what to do, continue getting cortisone shots every year and a half?

    • Elise
      August 4, 2016 at 2:03 pm

      If the shots work and you aren’t maxing out on them, then I say absolutely go that route before you consider a surgical “fix”. I run too, and I’m sure running without the piriformis muscle will be challenging.

    • Meredith
      August 4, 2016 at 2:39 pm

      Dotyoureyesblog ~ I decided in June of this year after I had had 4 cortisone shots and one Botox shot. Unable to sit on any surface, can’t drive or be driven anywhere. Had no life. Of course constant nerve pain to my toes all the time. Sounds like yours isn’t as bad, I truly wouldn’t have the surgery unless there wasn’t an option. Hope this helps.

      • August 4, 2016 at 8:47 pm

        Thanks. Yeah mine isn’t that bad right now it’s more annoying than painful, although it does get painful. Last year before the shot it was pretty bad though

  94. Meredith
    August 3, 2016 at 9:49 pm

    Thanks, Elise. Yes, I am on a strong muscle relaxer and I’m taking 3-4 a day. I went to my post-op appointment last week and the physicians assistant ordered physical therapy. I’ve been twice and it has made the spasms worse. I can’t sit on any surface without pain from these spasms. I plan to try to make an appt with the surgeon soon. Thanks again for your response!

    • Elise
      August 4, 2016 at 9:11 am

      I hope it settles down soon. Can you reign in any activities? I’m still off work and on crutches so the demand isn’t great. Mine twitches but , nothing painful.

      Overexertion sometimes makes mine twitch, even makes my back muscles spastic. It seems after some progress is made, loosening that area up, it gets much better. Don’t give up on the pt. I’m doing regular piriformis stretching throughout the day.

      Nice chatting with you!

      • Meredith
        August 4, 2016 at 2:27 pm

        Elise ~ Yeah, I wonder about stretching (which I do all day every day and have been for a year) I guess it just stretches out the part of the muscle that’s still attached to the hip? From my understanding he cut the muscle in two, so I don’t guess the other part is stretching which may be part of my problem. The only activities ive been doing are loading and unloading the dishwasher and doing laundry. I rarely go upstairs (unless it’s bedtime) to keep from straining the muscle that is already in a spasm. I wasn’t given crutches, not sure why not? Was there a special reason why you were given them? Or does your doctor order that for all his PR patients. I haven’t been to work since my stroke in March of 2015. I was 49 years old. Had to learn to eat, write, tie my shoes, walk, wash my hair, the whole deal… Nice chatting with you too!

  95. Meredith
    August 2, 2016 at 9:11 pm

    I had PR surgery on July 6, 2016 after a year of horrible pain mostly because my right piriformis muscle was in such a bad spasm that I could not get it loosened, so bad it felt like I was sitting on rocks. Now 2 days after my surgery this spasm has come back. I don’t understand how, the muscle was cut in two, and I’ve been taking 750 mg of robaxin 3 or 4 times a day. Has anyone experienced this horrible muscle spams?

    • Elise
      August 3, 2016 at 5:18 pm

      I had surgery July 16th and don’t have spasms. But in the paperwork it was mentioned some people have spasms And I was prescribed a low dose valium just in case.

      If phone your doc/nurse and let them know. Maybe something can be done.

      Good luck, hope you heal fast!

  96. Tom
    July 30, 2016 at 8:27 pm

    Hi everybody, I just wanted to introduce myself. I wasn’t sure there was a specific area to do that so I’ll just do it here.

    My name is Tom and I’ve had PS for probably 20+ years. I’ve been managing it very aggressively I’m keeping it under control for that whole time, unfortunately six weeks ago I ended up bedridden from another disease, and accidentally triggered a relapse of my PS by hitting something with my l left butt. Now I’m in the horrible scenario of having severe PS, including completely left foot and toes which no longer have even the strength to move, and of course the usual pain,which I don’t seem to be able to go to cool down, combined with weakness from too long in bed.

    So happy to find this forum with other people Who understand.

    Would be happy to tell you more about my experience over the years if anybody’s interested

    anyway I have a question : has anybody been prescribed or tried a prednisone therapy, sometimes they call it a steroid shock pack. This is 10 days very high doses of prednisone, which my doctor feels is best way to reducie my PSsymptoms,before I get a cortisone shot.

    I’m hesitant to use High dose steroids because I’ve heard so many bad things about people basically becoming psychotic unable to sleep for days on end, and All kinds of other side effects.

    More important, does prednisone actually work on a PS flareup. If they have been successful for other people in the past I really don’t want to take the risk.

    I’m especially worried about the numbness in the process of miles of my toes I’ve never had this before In all these years.

    Nice to meet you!

    • Jim
      July 31, 2016 at 7:48 pm

      Hi Tom, I’m replying to your question about prednisone. About 3 years ago (and 3 yrs into my PS), I tried a 6-day Zema Pack (dexamethasone), which is similar to, except roughly 10x more potent than, prednisone. Only way to describe the effect was that it changed the ‘frequency” (as in soundwave frequency) of the pain, which went from burning & freezing to a consistent painful white cold/dull ache–similar level of discomfort. Unfortunately it wasn’t a solution for me. As for your other concern about side effects, I had seen people using prednisone on a long term basis suffer with depression and was also concerned about the risks. My neurologist assured me that on such a short-term dose they would be unlikely. I didn’t have any side effects during or following the Zema pack.

      I have a question for you — at what age did you first have PS, what have you been doing to manage PS? Thanks/Jim

      • Tom
        August 21, 2016 at 8:13 pm

        HI Jim

        I got PS first about 25 years ago. i was 30

        at first jusr annoying but then over the years more and more extreme

        for the past 5 years i have not sat in a chair without a right side pillow. Have not gone to movie theater un less i could lie down in the seats on one side. don’t fly. don’t walk more than 1/4 mile.

        always walk on flat or slight decline. swim a lot to reduce inflammatory response.

        for a while i beat it with high doses of naproxen — was able to hijkbut that burnt out my liver, giving me autoimmune liver disease. i am now on steroids for that, but the bedrest from the liver disease has triggered a massive ps syndrome flareup and now after 8 weeks bedridden i can’t use my PS leg at all. foot numb from nerve pinch. Can’t walk even if I ignored the pain, can’t get into a car at all. Can’t even get down the stairs of my house

        my health carrier won’t even talk to me any more.

        i’m trying to get in with Melanie Henry at UCSF or Dr Justin Lo in South SF bay area, but i don’t know any way to visit them. since i can’t travel by car any more, not sure how i would visit them. Maybe by ambulance.

      • Jim
        August 21, 2016 at 8:46 pm

        Tom, I completely understand what you are dealing with — 5 years ago at the worst point with PS, I could barely walk out to my garage. I’ve seen some of the best Drs and pt’s for PS and put together a PT protocol for PS and little by little figured out what works. It has given me 60-70% improvement, although release surgery may be the final effort I try to get closer to full recovery. If you want to have copy of the protocol I’ve put together, shoot an email to libfrom22@yahoo.com

  97. Basheer
    July 22, 2016 at 6:54 am

    matt,
    thank you so much for this website.
    your story is giving me the hope . .I would like to talk over the phone. my email is mbk9 at nyu.edu . Please drop a note . I will call you back.

    regards,
    Basheer

  98. Risa Hillard
    July 19, 2016 at 10:39 am

    Betty: my surgeon was Dr Adam Starr at UTSW Medical Center at Parkland in Dallas, TX.

  99. Susan
    July 17, 2016 at 1:14 am

    Thanks for the info Jim! This is good to know. I wonder why this procedure of “wrapping” the nerve to prevent scar tissue from forming after surgery is not done more often, especially in piriformis surgeries where scar tissue formation can be detrimental to the surgery’s success. It seems a necessary precaution to me, unless I’m missing something.

  100. Susan
    July 15, 2016 at 10:48 am

    I had piriformis release surgery five years ago. Unfortunately, I’m still in a great deal of pain. My last MR Neurogram shows scar tissue entrapping the sciatic nerve (caused by the surgery). For those of you who have had the surgery before, how did you avoid this situation from happening? I did PT and manual therapy afterwards, and I just don’t know how I could’ve avoided it. I’ve been discouraged from having a second surgery to remove the scar tissue because again, scar tissue will form again and possibly make it worse. Any thoughts? Thank you!

    • Jim
      July 15, 2016 at 12:45 pm

      What you’re describing is apparently not uncommon — you should g**gle “Recurrent Piriformis Syndrome After Surgical Release” which describes how patients with this problem had polytetrafluoroethylene pledgets (medical equiv. of Teflon) placed around the sciatic nerve to prevent post-op scar tissue.

    • Tom
      September 3, 2016 at 10:24 pm

      Hi Susan

      Who did your surgery 5 years ago? Also Filler?

      Thank you,

      Tom

  101. Risa Hillard
    July 9, 2016 at 4:25 pm

    Yes, I did PT but haven’t been doing my exercises as faithfully as I should be.

    Yes, I did the shots with Chabbra and they didn’t work for me.

  102. Athena Fremstad
    July 9, 2016 at 4:16 pm

    I just had my MRN done with Dr. Chabbra. He found no split in nerve or muscle. He is recommending steroid directly into the nerve and diagnostic into piraformis. Both were inflamed. Has anyone done this shot with him. I’m a little nervous to say the least.

    • Elise Harden
      July 9, 2016 at 7:29 pm

      Atheana, The shots helped me tremendously. I had a different doctor though.

  103. Elise Harden
    July 9, 2016 at 1:53 pm

    I’m curious. I’ve read a few accounts that people are back to normal just a few days to 2 weeks post PM release. I’m just past the 3 week mark and I still can’t walk normally, and I’m expected to be on crutches another 3 weeks. Are these people for real?

    I have a few fall/winter half marathons planned and am questioning the practicality of meeting that goal. How long before You got back to walking or regular activities?

    I got on my bike today. It was rather comical since I have diminished control of the one leg. I still may brave the trainer.

    • Alan
      July 9, 2016 at 2:36 pm

      Elise
      I had the surgery on May 11. I never really needed crutches but I was in horrific pain up
      until 3 days ago. As if someone turned a switch, the pain suddenly was significantly reduced. I was definitely losing hope but now I’m increasingly optimistic. It’s almost like a miracle after suffering for so long and going through every possible procedure including multiple surgeries. I’m definitely taking one day at a time but three days of relief is thrilling. All I can say is don’t lose hope.

      • Elise Harden
        July 9, 2016 at 3:51 pm

        Thanks Alan. I find it interesting that there’s so much difference. I know my doctor expected me to be on crutches the first 6 weeks. I just wonder what’s the difference. I may pick the docs brain in a few weeks. I was lucky, my pain hasnt been terrible, but I do have achy bouts and pain sleeping.

        I’ve started walking some. I’ve noticed there is no push off pain in my rear/hamstring or numbness in my foot.

        I hope you find lasting relief! Thanks so much for the reply.

    • Risa Hillard
      July 9, 2016 at 3:02 pm

      I never needed or used crutches even at the hospital. I think I walked normally within a week–pain wasn’t ever very bad. I went back to work in 2 weeks–was just tired. I’m 7 months out and still can’t sit for long periods of time without discomfort. It’s a lot less pain than prior to surgery and I’m hoping will continue to improve. I may have something going on now with a disk in my lower back and it may be what’s causing my increased pain now because it was better and over the last couple of months worsened. It’s either that or scar tissue. Surgeon ordered massage therapy 2x/wk for 6 wks which should help if it’s scar tissue. I’ve had problems with scar tissue with other surgeries, so that wouldn’t surprise me. I will overcome it.

      >

      • July 9, 2016 at 3:47 pm

        Routine massage in the area of my greater trochanter was key in relieving post surgery pain.

      • Elise Harden
        July 9, 2016 at 3:59 pm

        I have to keep up in twice daily exercises or scar tissue will form, essentially trapping the nerve again. They include 2 nerve glides and a piriformis stretch.

        My pain level is 2-3, just sleeping or in the same position for hours. Active hours I have little to no pain.

        Risa, did you do PT?

  104. Patti
    July 3, 2016 at 3:52 pm

    Elise-who did your surgery?

    • Elise Harden
      July 4, 2016 at 6:10 pm

      Dr Hal Martin in Dallas at the Hip Preservation Center, Baylor.

  105. Elise Harden
    July 3, 2016 at 2:30 pm

    I had a two week follow up and learned more about my particular condition.

    I did have a branch of the sciatic nerve passing through the PM. I also had 3 accessory branches that were tethered and did not allow free movement of the sciatic nerve. I also have a section on the nerve that is demyleninated. That is probably why I continue to have some slight numbness in my foot and why there’s no pt yet or and thing that involves straighteningthe leg, pulling the nerve.

    I read a few reviews here. I thought about the ones that mentioned some areas that have altered sensations on the skin. The 3 branches that were cut would cause such symptoms, perhaps others have had accessory branches freed as well. I don’t have any noticeable symptoms yet. Just the uncoordinated and weakness without the PM.

    I’m 16 days post op and am doing well. Very little discomfort, no meds, and have been to lazy to get the ice pack :-).

    The pudendal nerve pain has been minimal. I believe that the PNE issue will be resolved completely.

    I hope everyone finds healing and relief.

  106. Lea
    July 2, 2016 at 8:46 pm

    So I want to reiterate a few things I see on. The blog. Again a safe few posts below I am a periforms surgery success. See my prior posts from Feb 2015. My injury was a torn gluten and torn ligaments in my si joint. If u have si joint instability you have to treat both. I treated si joint with prp. Don’t waste your money on prolo. Keep those issues in mind. There are several ways to get piriformis syndrome. You need to treat the cause as well if it was not a direct blow ect…..

  107. Susan
    July 1, 2016 at 3:43 pm

    Has anyone been diagnosed with ischiofemoral impingement? If so, could you share with me how you were diagnosed and your treatment plan? My understanding is that this is a very uncommon diagnosis, and there’s not a lot of information out there. Thank you!

  108. Elise Harden
    June 25, 2016 at 9:59 am

    For those that had the release surgery, or have heard first hand accounts, what was the pain pattern like during recovery? Did it get worse before it got better? Do you know where I can find first had accounts?

    The first 2-3 days I sleep without pain, 0. It was amazing. Then it became worse, 7-8, peaking about day 5 and I went from few otc pain relievers to taking a Rx Tylenol 3 (I try not to take Rx pain killers). I’m on day 9 and still can’t sleep with out the nagging ache, 5-6, in my hip/rear/leg waking me often. But it is getting better. Slowly.

    Most of Martin’s patients start PT the following Monday after sx. Most use a CMP machine for hours a day. He said my nerve was pretty banged up and it was too soon for PT. And sent the CPM back. (Patience grasshopper).

    Of course, now I’m a little concerned that I’m in the 10% that doesn’t get better or the 10% that gets worse. In his research he notes previous abdominal surgery to be a potential complication. I’ve have had previous abdominal surgery.. -_- and the mind runs wild with “oh no!”… If I’m up and about, I have no pain. I’m definitely better than where I was and don’t regret it. I’d think it’s just too early to draw any conclusions. Right? Stay the course.

    Misery loves company, eh?

    Idk if it’s easier, my email is beheyb@gmail if anyone’s is interested.

    • Lea
      July 2, 2016 at 8:33 pm

      My pain was pretty bad for about 2 months. Had continued pain that has been dissipating continually. I had surgery Feb of 2015. Go back and look at my posts from back then. Either under Lea or Lowell. I am now 100% but it took 16 months and lots of work on my part. I know Mt bike wafter ski hike run….whatever I want. I was in terrible pain prior. I like to stop in and read this board now and thenot and give encouragement when I can.. I had open surgery in the Pacific Northwest.

      • sung
        July 25, 2016 at 2:34 pm

        Hi, Lea

        Can you give me information of your surgeon in Pacific Northwest?
        (My email is swpark72@gmail.com)

        I have problem on my priformis and S.I Joint due to rear ended car accident.

        Thank you.

  109. Athena Fremstad
    June 25, 2016 at 8:42 am

    That was very helpful! Thanks, and keep us posted on your recovery…

  110. Angie
    June 24, 2016 at 5:57 pm

    Does anyone know of any surgeons in the Denver, CO area that perform piriformis release surgery? I have an awesome neurologist but he does not treat piriformis syndrome.

  111. Athena Fremstad
    June 23, 2016 at 8:26 am

    Does Dr. Martin totally remove the muscle or leave it partially attached?

    • Elise Harden
      June 23, 2016 at 2:40 pm

      Athena, The muscle was left, only severed at the sacral tendon.

      I’m in a knee brace and on crutches for ~3weeks+ to protect the nerve. So far I’m fine as long as I don’t over do it, careful doing too much bending and straining that nerve. I also had scar tissue removed that was pulling in 3 different directions. All done endoscopically. Just three one inch incisions. His PACU team was great too.

      I had pudendal nerve entrapment too. The release seems to have helped the symptoms. I mostly had a feeling of a need to urinate constantly and painful intercourse.

      My SI joints seem fine, I know it’s early. My hips /SI joints are hyper- mobile. It’d be great if this resolves that issue too. I figure that PM contributed to the torsion.

      I’m looking forward to a return to running program ASAP.

      • Elise Harden
        June 24, 2016 at 7:05 pm

        Quick correction – I am not sure where or how the muscle was released. The surgical photos looks like at the greater trochanter. And that’s where I have some brusing. Idk why I thought at the sacral side. I still have some sciatic pain, maybe that’s why.

        Sorry for any confusion and misinformation.

  112. Elise Harden
    June 21, 2016 at 8:40 pm

    I had piriformis release and sciatic nerve decompression June 16th with Dr Martin in Dallas at Baylor. I’ve had a long road like most people have, 4.4 years. I’m glad to be moving forward. The sx was outpatient, and I’ve yet to need Rx pain meds. I’m really happy with Dr Martin!

  113. Mark
    June 21, 2016 at 10:21 am

    Been there done that and more. Try LYRICA, helps me greatly. 200mg daily works for me

  114. May 30, 2016 at 9:15 pm

    Hello – another person here with possible PS (about 4 years of pain, so far)! My initial pain was diagnosed as trochanteric bursitis, and I was given a very painful cortisone shot, which helped a week or so. Also did a few months of pt.Then the pain morphed into the left buttock After an MRI only reported “mild” medial gluteal tendonopathy, my ND, treating this with prolotherapy, said he could feel entrapment of sciatic nerve by piriformis. He did deep massage (probably like Rolfing), with the idea of breaking up adhesions, but sadly it only helped a day. Now my osteo doc’s office referred me to to neurology office which referred me to a neurosurgeon at UCSF:
    Line Jacques MD
    Nerve Injury Clinic
    Neurosurgery Clinic
    So despite 4 years of trying various modalities, I am actually in more pain now, as what was only present in buttock now radiates down leg to ankle. I read the blog with interest. It seems it is often up to people to seek their
    own treatment, which may or may not work!
    I’ll repost here if I manage to see this neurosurgeon, as many people asked about docs dealing with this in SF Bay Area.
    Nancy Peregrine (nancyperegrine@yahoo.com)

    • Libbey
      August 23, 2016 at 12:53 am

      Hi Nancy, I am very interested in your out come of see Dr Jacques? I also went to see Dr Jacques and I have to say she was a total waste of my time. I am still suffering with my P.S. and I am still trying to get surgery. UCSF gave me such a run around I never new a person could be tortured in so many ways only to be told that P.S. surgery was not commonly done and that I could have all the drugs I wanted but not the one thing that may actually help…surgery. Dr Jacques was a total B**tch. I just gave up on UCSF altogether I heard so many great things about it and it turned out the just wanted a warm body to experiment on.
      Here is my email please feel free to contact me. Libbey- Kittenlibbey@gmail.com

      • Tom
        September 9, 2016 at 1:17 am

        Wow Nancy and Libbey I was just looking at UCSF. Sure glad I saw your comments.

        I’ve been looking at Filler in LA (some bad reviews) and Tollestrup in Las Vegas.

        Any other ideas?

        Tom

  115. Risa Hillard
    May 25, 2016 at 7:38 pm

    Yes, Susan–that’s exactly what it means. Sounds like we have the exact opposite problem. Dr Starr removed as much of the piriformis muscle as was safe to do without getting too close to the sciatic nerve. You will love Dr. Starr if you go see him. Keep me posted!

  116. Susan
    May 25, 2016 at 6:53 pm

    Risa,

    Thank you for your reply about traveling post-surgery! It was very encouraging. I will give Dr. Starr’s office a call to try and schedule an initial appointment.

    In regards to one of your earlier posts – you mentioned that you had a bifurcated piriformis muscle. Does that mean the muscle was partially split and the entire nerve was going through it? In my case, my sciatic nerve splits in two, and 1/2 of the nerve is believed to be going through the muscle, while the other half is not.

    Thanks again!

  117. Risa Hillard
    May 25, 2016 at 1:37 pm

    I met someone at the hospital (in recovery) who had the same piriformis surgery I had/same day from Seattle. She stayed in the hospital a little longer and then stayed in a hotel or with a friend for a week or so before flying home. If she sees this, she will chime in. I don’t think it was easy, but she did it and her surgery was successful also. So, I know it can be done. She flies back for follow-up appts also. I spent 1 night in the hospital, then had a 2-hr car drive home. I could have stayed in the hospital longer, but was doing great and anxious to get home. I would have the same concerns you have, but I know from her experience that you can do it!

  118. James HB
    May 24, 2016 at 5:10 am

    Has anyone had the piriformis muscle/tendon cut off completely, or know anyone who has had this done? This remains an option for me but I haven’t been able to find out much information about what the side effects of having this done are. Supposing cutting the piriformis off completely cures all sciatic or pudendal problems, what other problems can the loss of this structure cause down the line? One thing I have heard is it can cause SI joint pain as the piriformis is the only muscle that bridges the SI joint. Any info appreciated….

  119. Risa Hillard
    May 23, 2016 at 7:24 pm

    My surgeon was Dr Adam Starr at UT Southwest Medical Center (Parkland) in Dallas TX. I am 5 mos post-op and much improved (see previous posts). I am so glad I did it and believe I will continue to improve even more in the months ahead.

    • Susan
      May 25, 2016 at 11:27 am

      Hi Risa,

      Thanks for your referral. I am trying to contact Dr. Starr’s office for an initial consultation. The issue for me is that I live in the San Francisco Bay Area, and since sitting is so painful, traveling even short distances is a big deal. I’m hoping he can do an initial phone consult first, rather than me flying out to TX only to find out he can’t operate, etc. In regards to the actual procedure, what is your opinion on traveling post-recovery? I’m trying to figure out how feasible it would be go out of state for surgery, and then having to fly home soon after. Thank you! Any feedback would be greatly appreciated.

  120. Susan
    May 23, 2016 at 6:46 pm

    Hi Rhonda. Do you know of any surgeons in the San Francisco Bay Area who will do the Piriformis release surgery? I dread having to go out of state for the surgery and facing a plane trip home post-surgery. Thank you!

    • Rhonda
      May 23, 2016 at 8:59 pm

      Hi Susan- I don’t know of any PS surgeons on the west coast. Read through some of the posts on this board to see what you find. I live in NC, and have jotted down those PS doctors east of the Mississippi. I’m sure there has got to be one.

    • Alan
      May 23, 2016 at 9:15 pm

      I just had the surgery last week in Los Angeles. Dr.Carlos Guanche in Van Nuys at Southern
      California Orthopedic Institute (SCOI) He’s a great guy. 818 901 6600

  121. James Mentzer
    May 23, 2016 at 3:34 pm

    I am desperately trying to find a surgeon for Piriformis release surgery. I will not go into the incredible detail of my history with this problem. It mirrors almost everyone else’s experiences with this dibilitating problem. The onset of pain was late 2002. I went through every type of imaging and nerve test mentioned including MRI Neurography. There is nothing wrong, I was told. I self diagnosed myself after constant research. Finally, a DO agreed and tried to use the first method of treatment, PT. It was a band aid. After nine years, I was referred to the renowned Neurologist, Dr. Robert Gerwin, who specialty is Myofascial Trigger Point Release. Dry needling with concurrent trigger point PT was the first time I felt normal. Unfortunately, the problem would eventually return every time. We moved to Botox injections with PT. I thought I had found the magic bullet but even with therapy, after the Botox wore off, the symptoms and pain returned. The last of the injections were late in 2015. Dr. Gerwin felt there was little more to do using non surgical means for permanent relief. He felt the length of time I have had the injury and my age, 47, were an indication the damage was likely permanent. My standard of living is woeful. The compression of the pudendal nerve has cause such a degree of constipation I have gained 50 pounds and have a distended stomach. It has adversely affected my sexual functioning and caused occasional nighttime urinary incontinence. Those are in addition to the constant ache in the muscle and the neuropathy that comes when I choose to overdo things so I can try to be live a normal life and be an involved parent.

    Ironically, I live in Baltimore. The one city a person wants to be in for something so unique and confounding. Yet I can’t locate a physician who performs surgery for the Piriformis muscle.

    Please, anyone let me know who you have used. I, literally cannot continue like this. This isn’t living but surviving.

    • Rhonda
      May 23, 2016 at 6:35 pm

      James-
      Here are some doctors that “I’ve heard” will do piriformis release/sciatic nerve decompression;
      Dr Belzberg, Dr Lee Dellon, Dr Eric Zager, Dr Eric Williams- all in Baltimore area. I’d call them first and ask to speak to their nurses about this to save time..

      The doctors that have performed successful piriformis surgery for several bloggers on this board are: Dr Adam Starr (TX), Dr Heinrich (WI), & Dr Thomas Ellis (Dublin, Ohio). Dr Heinrich only does endoscopic surgery, and Dr. Thomas Ellis only does open surgery. Dr. Meislin- NYC (endoscopic only, I believe)

      Dr Scott McCloskey is a spinal neurosurgeon in Hickory, NC that does the surgery. I found a post by a gal named Jeannie in Dec. 2015 on this board that was very pleased w/her surgery. (She had open surgery; unsure if he does endoscopic). I have an appt w/him in a few weeks. I’m also baffled that there are no PS surgeons in the Raleigh-Durham NC area w/Duke and UNC hospitals here.

      If you peruse this board, you might find others.

      Sorry to hear you’ve suffered for so long. This is an awful pain experience to encounter. One blogger commented to make sure that you’ve consulted with a really good hip specialist to rule out any underlying hip issues that might contribute to PS first. I’m in the process of doing this.

      Rhonda

      • James Mentzer
        May 23, 2016 at 7:25 pm

        Rhonda, thank you for all of the information. It may be I will end up going full circle and returning to Dr. Belzberg. He ordered the MRI Neurography which showed no Piriformis anomalies, which I knew didn’t exist. It may be at the time I saw him, he wasn’t performing this procedure because he referred me to his peer, Dr. Gerwin. Dr. Gerwin is a visiting staff neurologist at JHH but has his private practice in Bethesda, MD. Dr. Belzberg recommended I see him because the image didn’t indicate any issues. I was despondent when he told me this because I felt I had finally found the right person. When I started to tear up and described how I was having spasms during the imaging and I couldn’t believe I was being told there was nothing wrong based on static images, he stopped and said if anyone could help, Dr. Gerwin could. He was correct in many ways. My first appointment with Dr. Gerwin was eye opening. He didn’t need to see any images. He had me walk up and back his hallway. He manually probed the area to find the taut bands of muscle. That was all he needed to see and feel. He didn’t hesitate to do a course of dry needling the trigger points that day. Within an hour of meeting him, I was sitting in a chair comfortably putting my shoes on without any effort or pain. It was heaven. It lasted for awhile when I was able to allow the PT and rest do their parts. When I was forced to over exert the muscles, I erased all of the progress to that point. If I had been able to stick to his regimene, I believe I would be free of the pain and other symptoms. Life doesn’t always allow one to follow the best course of action. The repeated trauma to the muscle has likely caused damage less invasive procedures could have healed. With input from Dr. Gerwin, who believes surgery is really my only option, Dr. Belzberg may be willing to proceed. I certainly hope he is.

    • Rhonda
      May 23, 2016 at 9:10 pm

      James-It sounds like you are on the correct track. From the several posts I’ve read on this board, it seems that if you have a case of PS that lingers, the only true resolution is surgery. With your pudendal nerve issues, etc. that has got to be enough in itself to require surgery.

      I’m experiencing a dr runaround, in which I recently saw one of the top hip arthroscopic drs in the country who has FINALLY seemed to piece together my pain source (complex hip joint issues) that is causing muscle spasm/nerve impingement (PS piece). HOWEVER, I can’t find a hip replacement dr to agree w/his diagnosis, as they all just want to see everything black and white on an xray/mri , otherwise say ” see you later”. Its a nightmare and while the pain is intermittent, it clearly is affecting my quality of life. Like you, I have 2 teenagers that I want to be active with (stay so as much as possible) to maintain some “normalcy”. For PS, everyone’s case is different. From others on this board, I’ve seen some that have had MRNs that show -0-, some that have had PS steroid injections that don’t work, some that have tested negative on the provocative EMG test, but still have PS.

      Best wishes. This board is such a great source of information.
      Rhonda

    • Basheer
      July 21, 2016 at 4:35 pm

      I would like to talk to you regarding piriformis surgery.. my email is mbk9 at nyu.ed

  122. Risa Hillard
    May 22, 2016 at 9:35 pm

    I assume you are experiencing incision pain? I did have some incision pain, but it wasn’t too terrible, but I did take some pain meds during the first 2-3 weeks and then sporadically at about the 7 wk point when pain resurfaced. I started PT then for strengthening and for pain relief. It helped a lot! I’m at the 5-mo point and still have pain at times and can’t sit for long periods, but it’s SO MUCH BETTER than prior to surgery. I believe it will continue to improve over time. I’m sure yours will improve also–just try to be patient–it’s not a quick fix. Slow and steady improvement over time.

  123. Pam
    May 20, 2016 at 6:56 am

    Jim, I would also be interested in what you have been doing for exercise and stretching. I am at a loss to what I want to try next. I probably do need some imaging to see the issue causing my pain, but will have to research to see who even does MRNs. I live in West Virginia and don’t know if we even have MRN technology or physicians who specialize in piriformis muscle problems. Which specialists deal with piriformis release surgeries if I end up going that route?

  124. Jim
    May 19, 2016 at 10:21 pm

    Sure, i’ll put together an emailable pdf file this weekend.

  125. Susan
    May 19, 2016 at 9:15 pm

    Jim,

    Would you be able to share your exercises and protocol with me as well? I’ve been suffering from PS for 7+ years now, and am losing a great deal of strength and flexibility. Your help is much appreciated! Thank you! My email is stvergho@yahoo.com.

  126. Jim
    May 19, 2016 at 9:03 pm

    Patti, shoot me an email at libfrom22@yahoo.com and I can send you some links to youtube demo of some of the exercises. I can write out my protocol, which I am doing 2-3x/week at the gym. There are 3-4 specific exercises that seem to be very beneficial, but I have been doing a lot of stretching for the past few years which may also contribute. I would caution you, as my PT did with me, that it takes almost 6 weeks of strength training to restore muscle strength, so persistence and diligence are key. For many people of age of 40+, the glutes are hypotonic and don’t activate properly.

  127. Patti
    May 19, 2016 at 6:47 pm

    Jim, I’m definitely interested in the physiotherapy protocol. Your description sounds just like me. 5 years, Botox helps, no provocative emg or surgery available in Canada. Went across the border to Buffalo for an mrn – showed compression of the sciatic nerve by piriformis and possibly obturitur internus.

  128. Pam
    May 19, 2016 at 9:01 am

    I am a mom of three boys. Three years ago, I started having burning and tingling symptoms down my right leg at 20 weeks of pregnancy. I had enlarged veins in that leg, so the midwives told me that I have varicose veins and pain would go away after delivery. The pain continued. I had an ultrasound which showed no varicose veins. My low back MRI was normal. I have tried PT and chiropractic care with no relief. My symptoms mostly are in my right buttock unless I impinge the nerve by being on my feet way too much. Sitting in the car is awful. A chiropractor was the first health professional to suggest that I might have piriformis syndrome. I went to a pain clinic and was given neurontin, which was horrible. I have tried a x-Ray guided corticosteroid injection into the piriformis which only exacerbated my symptoms. I am trying to decide what to do next. The only options left are acupuncture, Botox, massage therapy, or surgery. I am tired of being miserable the moment I climb out of bed until I go to bed. It constantly burns. It has definitely affected my quality of life.

    • Jim
      May 19, 2016 at 9:51 am

      I have battled PS for 5+ years, tried everything, nothing came up on scans, including MRN. Multiple provocative emgs all indicated bilateral PS. However, at the verge of having PS release surgery last fall, I started a program of exercise that seems to be resolving the problem; I haven’t ruled out surgery, but delaying to see how far I can recover. In my case, it involves strengthening and activating the glutes (max and med.) It wasn’t until I saw the 5th physical therapist, that this program was recommended, so it’s not necessarily something people are commonly being guided to by their PTs. I have gone from having pain within 15mins of sitting, to going 2-3hrs before it becomes annoying, but not crazy like it used to. At this point, I avoid a lot of bending at the waist and squatting activity, which still aggravates the condition, so I have kept yardwork to only short stretches of a half hour to an hour. I should add, that having tried everything, the only thing that gave any relief previously was botox, but that was extremely expensive and not a long term solution. If I feel this program provides a ‘solution’ I’ll write out the protocol for anyone else who would like to try it — at a minimum, it will greatly improve your glute/hip strength and flexibility prior to PS release surgery, and probably make the recovery all the quicker.

      • Jim
        June 22, 2016 at 2:12 pm

        For anyone else that would like a copy of my PT protocol for PS, feel free to email me at libfrom22@yahoo.com. This came about thru treatment and advice from some of the people in the medical field who “get it” and understand PS, like Dr. Loren Fishman, Dr. Mitchell Yass, Esther Gokhale, and a very astute Austrian PT who has had success treating it. I should add however, that like many of you I have had to go down the long and painful road of trial and error that is common with this syndrome. I’m not sure there is a nonsurgical “cure” for PS, but this protocol has made it far more manageable.

  129. Shelley Masttoianni
    May 18, 2016 at 5:29 pm

    Hello, my name is Shelley and I am all new to this. I live in CT and am having debillatating pain from which I believe to be piriformus syndrome. I have been in pain for 5 months and have had several injections. Two in my spine, did nothing for the pain, one in my sacro-lilliac joint again nothing. I had one in my piriformus muscle in January and one again yesterday. It help take some of tha pain away. Are there any meds that anyone has taken that has given them relief. I was just given a prescription for lyrica and tizanidine which insurance won’t pay for and I don’t want to waste my $. Any help would be appreciated. I can not go on like this for much longer.Thank you

    • Jennie
      March 23, 2017 at 3:13 pm

      Shelley, if you’re still looking for information, I’m in CT and have been doing the piriformis run around for two years. I have finally found competent surgeons who have both finally diagnosed it correctly AND a excellent orthopedic surgeon who has done the surgery before.

  130. Jim
    May 10, 2016 at 6:52 am

    Doctors who describe “typical” PS patients probably have not encountered many. My symptoms are similar to yours–primarily triggered by sitting and bending or squatting, anything putting pressure on or activating the piriformis.

  131. May 9, 2016 at 6:08 pm

    Hi all,
    What was your pain symptom like? My doctor said typical PS patients complains considerable pain when your pain area is pressed, which I don’t have. Also only sitting or lying down for a long time give me the problem. Walking, running, or climbing doesn’t cause pain for me. Is there anyone who didn’t have pain when pressed or only feel the pain when sitting/lying down but still was diagnosed with PS by other tests or got cured after surgery?

    • Marc
      May 10, 2016 at 5:41 pm

      I had the release sugery, my pain is when I am sitting or laying down. I can lay on the floor and not hurt as bad, and that’s where I have been sleeping for a lot of years. My doctor is sending me to Dr Starr in Dallas.

  132. Shelley Scherer
    May 9, 2016 at 12:17 pm

    Help! Does anyone know of a Dr in Colorado who treats PS with Botox?

    • Jim
      May 9, 2016 at 2:52 pm

      I’d suggest attacking this from a different direction. Have a look at Xeomin (botox) website and contact them to see if there is a study sponsored by a doctor in your area. Xeomin is a more refined form of botox and the mfr (Merz Pharma) has been running double blind studies – participants are not charged, and the study covers the cost of PT for several weeks. IF you happen to get the placebo, they will provide a genuine xeomin injection at end of study at no cost. Otherwise, botox for PS, is off label, and the cost can run $2000-3000. Good luck!

  133. Bob
    April 26, 2016 at 10:22 am

    It is true that he does not do the open surgery and only does the release. I had mine done through him earlier in the year. I was/am dealing with multiple issues though. Unfortunately for me, the piriformis was a minor issue. I tore the labrum in the hip and my glute while training for a marathon. The piriformis issues were minor in comparison. Thankfully, I do not have to deal with the entrapment issue.

  134. Geneva Maloney
    April 22, 2016 at 3:52 pm

    Are there any doctors in the Tampa Florida area or close to Tampa area vet treat the piriformis syndrome problem ?

    • Bob
      April 25, 2016 at 10:01 am

      Geneva,
      I do not know of any in Tampa but I have not lived there in years. I do live in Jacksonville, which is about 3 hours from you depending on where you live. I used Dr. Hakim and he is awesome. He was with Bahri Ortho but switched over to Southeast Orthopedics. I had the surgery on a Thursday or Friday. I was walking that day. I used crutches anyway for two days but was back at work the next week. I rode a 100 mile bike race not long after. Great surgeon and a great guy.

      • Rhonda
        April 25, 2016 at 8:05 pm

        Hi Bob-
        Did you post your story earlier on this board? If so, around what dates did you post it? Does Dr Hakim perform endoscopic and open piriformis surgery? Did you have an MRI neurography? Just curious about “your story”. I’m glad you had a successful surgery.

      • Athena Fremstad
        April 26, 2016 at 7:08 am

        I live in Orlando and called Dr. Hakim. His nurse was unbelievably nice. She explained that he only does the tendon release and does not go up the nerve:(. I haven’t found anyone reputable in FL so I’m going to see Dr. Chhabra and Dr. Starr in Dallas. I have already had the tendon release and it did nothing for me.

      • Geneva Maloney
        May 22, 2016 at 10:38 pm

        Thanks Bob for the info. What is Dr Hakim’s first name so I will find the right dr. Someone told me to contact Dr Ghaza at Mayo Clinic in Jacksonville, F, but they told me to call back in the fall. I started PF exercises and they help some but it has affected my left hip and both sides of buttox has been totally numb since last Dec, creepy sensation on left side and into thigh, so real I looked to see if My leg was moving, left foot partially numb as well as all my right foot and my legs don’t want to move. Back of legs still get hot and tingle and hurt and burn but I don’t have as much pain as I did.a month ago. However, I’m glad the pain has calmed down but I find myself disabled with all the other problems. I read all these stories and the symptoms vary from case to case. I haven’t heard anyone remark about their hip and buttox and feet were numb for months and the creepy feelings.

  135. geneva Maloney
    April 22, 2016 at 3:45 pm

    I live in Bradenton Florida and having sciatica pain I thought and the drs also. I have had 6 back surgeries and that was the first conclusion. However, after a series of cat scans they found my back was solid. Still I had epidurals that did nothing. I elected to go to a spine doctor and he shared with me my back was solid there was nothing at all that they can do for me. He added the only thing he knew would be a spinal block. After that they gave me a website to go on to about the spine and that’s where I found the piriformis syndrome information. In the beginning my primary gave me pain medication that took the edge off. I cannot walk very far and I don’t have the energy. One site showed some exercises so I’ve been doing those but I’m still losing energy. I need help to find a doctor in my area who can help me. I am 71 and have been active all my life.

  136. LC
    April 20, 2016 at 12:05 am

    hello team! I am so glad I found you. I have had all injections, PT etc and still no relief. Can anyone recommend a surgeon in the SF Bay Area. I am ready to try surgery.

    • Kay Borkowski
      May 7, 2016 at 2:03 pm

      Try looking at the Stanford web site and see if any of the doctors are interested in lower back/leg pain. Maybe Dr. Carragee?

      Kay

  137. Nina
    April 17, 2016 at 3:37 pm

    I am 6 weeks post right piriformis release, i did not have a bifurcated muscles, just tight. I am still experiencing tremendous nerve pain when sitting. Can you tell me about your recovery and what your pain was like?
    Thanks

    • Marc
      April 17, 2016 at 6:53 pm

      I did not experience the nerve pain after my surgery. In 6 weeks I felt like it help some but the spot in my hip has never felt normal. I still have flare ups that can be pretty painful and that area in my hip is still not right

  138. April 16, 2016 at 10:54 pm

    I am Marc and I have been suffering from this for a long time. I tried the shots and the therapy and finally had the periformis sugery last October. I think it did help but still I am surffering and still sleeping on the floor for the past 5 years for the most part. I had the release sugery and until I found this blog today was unaware that you can have C-nerve running into the periformis musele and can have part of your periformis remove. I am from northeast Arkansas if anyone has any doctors recommdations around Memphis or little rock or Dallas I sure would be thankful sincerely Marc

    • Risa Hillard
      April 17, 2016 at 8:06 am

      My surgeon is Dr Adam Starr at UT Southwest Medical Center (Parkland) in Dallas and that is exactly what I had done. My piriformis muscle was bifurcated and compressing on the sciatic nerve. He removed as much as he could while avoiding the nerve. I consider the surgery to be very successful and am still continuing to improve (4 mos post-op). I can sit again and sleep!

      • Xander
        April 17, 2016 at 10:24 am

        Hi Risa, just curious. Was it Avneesh Chhabra who performed the MRN for you as well? Thank you – your post is encouraging.

  139. Susan
    April 16, 2016 at 8:31 pm

    I’ve had three MR neurograms done. Two at UCSF (in San Francisco) and the latest one at the neurography institute. My first one was pre-surgery, the second one was two years post-surgery, and the third one was two weeks ago. I’m still having lots of pain, so my doctor ordered this last MRN to see if I have scar tissue as a result from the surgery. He insisted that I use the neurography institute this time around – supposedly Dr. Filler has the most detailed reports and is the most experienced. The problem with going anywhere else is that the test is only as good as the radiologist who looks at the scan. If he or she is not thorough or hasn’t been trained correctly, the test isn’t going to show much. My first MRN didn’t show much, just a slightly irritated sciatic nerve; however during the actual surgery, my surgeon found my nerve going through the piriformis muscle. Shouldn’t that have been caught by the radiologist in the scan? Anyways, I’m still waiting to get back Dr. Filler’s report (it’s been two weeks so far – apparently this is not a priority for him). I also have to say that Dr. Filler’s costs are over the top. They don’t take insurance, and I have to pay for two separate scans to get the left and right sides. Whereas my MRN from UCSF included both sides for comparison purposes. Just some things to think about.

    • Xander
      April 17, 2016 at 10:17 am

      That’s the dilemma I’m having as I have bilateral leg and buttock pain – the strange thing is sometimes the pain is in only one leg while the opposite leg feels fine (and then vice versa). Other times it is in both legs at the same time.

      I’m not sure what to do at this point – whether going to Nuerography institute or a hospital that can perform this test?

      • Risa Hillard
        May 22, 2016 at 9:46 pm

        Xander: Sorry I missed your post. Yes, Dr Chaabra read my MRN and wrote the report.

    • LC
      April 20, 2016 at 12:07 am

      can you recommend a surgeon in the SF bay area?

      • Susan
        April 20, 2016 at 10:04 am

        My surgeon, who was at UCSF, has left the area. I’ve been looking for another surgeon in the Bay Area since I think I’ll need to have a version of the surgery again. It seems most of the reputable surgeons are not around here. If you’re willing to travel, that might be your best bet. Though for me, recovery from the surgery was difficult, so I can’t imagine flying home post-surgery.

  140. Risa Hillard
    April 16, 2016 at 3:39 pm

    Mine was done at UT Southwest Medical Center in Dallas, Texas.

    • Xander
      April 16, 2016 at 6:12 pm

      Thank you Risa!!

  141. Jim
    April 16, 2016 at 2:30 pm

    Most of the major radiology centers can do an MRN. I had mine done at Lenox Hill radiology in New York. The MRN is done with a Tesla 2.0 scanner. Copay was $40.

    • Xander
      April 16, 2016 at 6:13 pm

      Thank you Jim, is their a specific radiologist/doctor in New York that you might be able to recommend?

      • Jim
        April 16, 2016 at 9:04 pm

        Xander, it seems that the ability to detect symptoms of PS with an MRN scan is debatable. Part of the problem is that they take a static picture while you are lying straight in the scanner. In my case, I don’t generally feel a lot of pain in that position. My thinking may be uninformed, but I would think it would be more effective to take the scan in the F.A.I.R. position at which point the sciatic nerve is usually impinged or irritated if you have PS. Perhaps even a short video clip with the patient moving into and out of F.A.I.R. position. That’s why the provocative EMG is able to identify PS, it re-creates the position that causes a problem with the sciatic nerve at the level of the piriformis. If you need an MRN, have your doctor write you an Rx for a radiology center in your area that has a Tesla 3T machine (I incorrectly referred to it as a 2.0 earlier). I had mine done at Lenox Hill, 61 East 77th street, although Weill Cornell also does them. I think the senior technician at Lenox (who does all the MRNs) was trained by Dr. Chhabra from UTSW. IF MRNs all depend on only ONE doctor in California to read them correctly, then it raises a lot of questions in my mind.

  142. Xander
    April 16, 2016 at 11:19 am

    Hi everyone, forgive me if this was already posted but I was wondering if you can help me as I’m trying to find a Dr. or Hospital who can perform a Nuerography test (MRN) in the US? I am in the Boston area, I’m not sure if there is anyone in the Northeast that can do this besides the Nuerography institute. Is there anywhere else in the US that can do this without going through the Neurography institute?

  143. Risa Hillard
    April 11, 2016 at 6:06 pm

    You are correct in that it is a standard diagnostic tool. I was the first patient my surgeon performed the piriformis release surgery on that did not have a positive result with the steroid or Botox injections. I had no pain relief with either. However, I had classic PS symptoms and the MRN showed a bifurcated Piriformis muscle compressing/ entrapping the sciatic nerve. Although both my surgeon and I would have liked to have had this additional confirmation, we both believed I had classic PS and perhaps the dr that administered the injections didn’t reach both parts of the piriformis muscle since it was bifurcated. In the end, it was my decision and I had undergone many tests to rule out the lower back causing this pain. I decided to have the surgery as there really weren’t any other options available to me–this was it. Worst outcome is it wouldn’t work. I’m 4 mos post-op and it did work! The nerve takes a long time to heal because it’s scarred, so it will keep getting better and better. It’s a slow process and you aren’t immediately 100% healed, but I did feel better very soon and could start sitting some. Long car trips are still painful and I can’t sit upright for hours on end. Other than that, I have no pain. I didn’t think the surgery itself or recovery was bad at all. In fact, by far the easiest surgery I’ve ever had.

    • Rhonda
      April 14, 2016 at 6:38 pm

      Risa-
      Thank you for your reply. Interesting.. when I went to see my chiropractor for 3 wks in February (ART therapy), I told him how I was thinking about asking my dr for a piriformis steroid injection and he said it would not work if my piriformis was bifurcated by the sciatic nerve. I’m literally going to mention this to my pain mgt specialist at my next visit to see what he says. I’m currently going thru the diagnostic injections (facet joint today), etc to rule out lower back/disc issues. My spine MRI shows a mild bulging disc at L5/S1 with a “high intensity zone”, and he wants to rule any issues out with that. My hip MRI shows tranchoteric bursitis, subgluteal bursitis, illiospas tendonitis, and that’s about it. My pain area is left buttock where piriformis attaches near sacrum area, across buttock, outer hip, into groin. It spans down back and front of middle thigh to outer thigh about half way down (incl. tensor fascia latae). I believe these are all connected to pirif. Sometimes outer left calf pain.

      I’m going to another top specialist for another opinion soon, and to another orthopedic dr with a D.O. designation, and a spinal neurosurgeon who does PS surgery w/in the next few weeks for all of their consultations in hopes of being able to reach some conclusion. No OTC pain meds, or oral steroids work for pain. Tried 2 rounds of PT and (2 wks each, 3x/wk) by 2 different PS’s and pain was aggravated. Dry needling helped once for 2 days. Thought about trying PT again, but am unsure. I’m doing daily piriformis stretches 2x/day. Exercise is very challenging. Tried to gently lap swim for 25 min (1st time since Nov), and it felt great, despite ok pain level at the time…..1 hr later, major butt pain spasm. Heating pad and took flexiril before bed.

      I’m so glad I found this board.

    • Alan
      May 22, 2016 at 3:01 pm

      risa,

      I just had the surgery last week and I have significant post surgical pain, which feels different than the pre-surgical pain. How long did it take for the surgical pain to ease. I’m feeling cautiously optimistic but I’m still taking more pain meds than I’d like. Any info from your experience would be appreciated.

    • Betty Rich
      July 19, 2016 at 6:18 am

      Risa Hillard…where did you have your surgery done? Who was your Dr… My ps and sciatica sound so much like what you had and after 19 years and no help from any of the injection, exercises, pt etc..I seriously looking into surgery..

  144. Rhonda
    April 11, 2016 at 4:13 pm

    Question to all of you that have had Piriformis Surgery…..did the Piriformis Steroid injection provide relief for you, AND did your doctor consider it as a primary diagnostic tool? I have had 2 piriformis steroid injections (by my pain mgt dr) and neither have provided any pain relief. In fact, this last one increased my pain for a few days afterward. My dr claims that this is the primary diagnostic tool in determining PS and that all of his patients that have PS have had pain relief from this injection.

    • Jim
      April 11, 2016 at 7:09 pm

      I’m interested to hear others input as well. In my case, I was diagnosed with provocative-EMG test. I had steroid shots, but they had little effect. Also had Botox shots — 1st time not much effect, 2nd time decent reduction in pain which lasted for 6 weeks.

    • Bob
      April 12, 2016 at 1:28 pm

      Rhonda,

      I had two injections and it never relieved an ounce of pain. I had the surgery and it was quite easy but my pain is still there as bad as ever. The surgery was a cinch though. Not bad at all but I did not have the open style.

  145. Tracy
    April 3, 2016 at 8:30 pm

    Resa and I had the same surgery on the same day with the same surgeon and coincidently we both had a bifetcated piriformis. If I remember correctly, hers showed up on the MRN. Mine wasn’t discovered until surgery.

    • Rhonda
      April 7, 2016 at 6:20 pm

      Thank you Tracy.

  146. Patti
    April 3, 2016 at 8:27 pm

    Hi everyone, I’ve had lidocaine injected into my piriformis under ultrasound guidance in my prolo doctors office. I’ve also had cortisone and Botox injected into the piriformis under CT guidance in the hospital by an anesthesiologist. The location of where they put the needle in, in each case is very different. I’ve had much better results with the CT guided injections. I also have a split piriformis.

  147. Risa Hillard
    April 3, 2016 at 8:18 pm

    He knew from the MRN, but of course was confirmed during the open surgery. I only have pain on the right side–none on the left side.

    • Rhonda
      April 7, 2016 at 6:21 pm

      Thank you for replying, Risa.

  148. Rhonda
    April 3, 2016 at 7:40 pm

    Matt- Is there a difference between a CT guided vs an ultrasound guided piriformis steroid injection? I understand that a CT machine is more detailed, but….. Second question is- would my Pain Mgt dr have CT machine on site? He is one of 2 Pain Mgt drs onsite in conjunction with a Neurology office.

    • April 3, 2016 at 7:45 pm

      I recommend that you ask your Pain Mgmt physician.

  149. Lisa
    April 1, 2016 at 8:32 am

    Hi, I am new to this site and have been having pain in my hips and lower back for several years now, but is under control with PT and exercise.
    I fell hard on my rt. Knee the end of Dec. 2015. A few weeks later I got pain in the back of my thigh when driving.
    I was told by the PT that is was muscular. Now that it’s getting worse, I went to a spine and pain center and had a series of knee and back xrays this week and am scheduled for an EMG.
    I am so glad to have found Matt’s blog and this site as it looks like I need a functional EMG. I called the Dr. This morning to have the order changed to included functional.
    I am doing a lot of stretches and hope I’m not aggravating this condition that at this point I have diagnosed based on the info I came across last night.
    I live in northern VA. Matt, based on the info on Dr. Heinrich, it looks like I may need to see an orthopedic sports medicine physician.
    Does anyone have a recommendation for a dr. In the northern VA area to include DC?
    Thanks very much.

    • Garry Rund
      April 1, 2016 at 4:11 pm

      Nirschl Orthopedic Center: Derek Ochiai MD. He is very familiar with PS and issues of the hip. Most DR dont know what to do and just refer you to someone else. I have seen Ochia and he is very knowledgeable and can usually help. Dr. Gwathmey at UVA is also very good.

  150. Patti
    March 30, 2016 at 8:00 pm

    You might have sacroiliac joint dysfunction, especially if you don’t have any lumbar spine issues. Some people say that piriformis syndrome rarely happens alone, that weak si joint ligaments cause instability and the piriformis tightens in response to this. I’m not sure I believe this theory, but it’s out there. I also seem t have bilateral piriformis syndrome, with pins, needles, burning backs of thighs, difficulty sitting. Try to see a good physical medicine and rehabilitation doctor and also see a pelvic floor physiotherapist trained on Diane Lees approach. Sometime dry needling helps to release the muscle giving some temporary relief.

  151. JD
    March 30, 2016 at 7:40 pm

    I had piriformis syndrome 9 years ago that was relieved with a Botox injection. I believe I have it again but this time it is in both sides. Botox didn’t work this time. Very strange thing this time is that usulally only one side hurts at a time. I also have pain in both feet. I also have a tear in my right hip labrum which no dr’s want to touch due to my other odd symptoms. Anyone ever have piriformis pain switch sides on them or am I the first. All my spinal MRI’ s are clean.

  152. Mark
    March 17, 2016 at 4:26 pm

    Try Lyrica!!!

    • Jim
      March 18, 2016 at 4:36 pm

      There was a good article this week (3/15) in the Wall Street Journal, “Your Medicine Metabolism” describing a possible reason why gene variations can have a radical effect on the response of different people to pain meds — basically we all metabolize meds differently, so for one person the med works wonders, the next gets no result, and the next feels like they’ve overdosed and gets the negative side effects. I tried an extensive slate of meds prescribed by neurologists during the first 3 years of my journey with PS. I concluded that I basically cannot tolerate any of them. Even when I started seeing some benefit, I’d immediately have intolerable side effects — serious rashes, etc. Lyrica was a disaster for me, as was Cymbalta, but I am glad to hear that you are benefitting(!) Only thing that has helped in that department for me is benfotiamine, at 300mg x 2/day. Seems to lessen pain level slightly.

      • March 18, 2016 at 4:41 pm

        Sadly medication only dulled the pain temporarily for me.

  153. Rhonda
    March 16, 2016 at 7:36 pm

    DONNA- I live in Cary, NC and have been struggling with PS for 5 months. I’ve had a similar experience to you. I was diagnosed w/ PS in Oct. 2015, had 2 wks of PT which aggravated my condition, tried oral steroids, otc meds and non worked. I’ve had a hip, spine and pelvic MRI which show bursitis on more so on my left side, some tendonitis, but nothing major. I’ve gone to another doctor and have had multiple injections which haven’t worked. Tried another round of PT for 2 wks in Jan and it caused more pain. Tried chiropractor (ART) for 3 wks in Feb and no luck. I’ve tried stretching. There is a PS dr in Hickory NC- Scott McCloskey that performs piriformis release surgery. I’m also trying to find a PS dr in the Raleigh Durham area. Let me know if you’d like to chat. Pain is consuming my life as well. This is pretty awful.

    • Marina Curto
      April 3, 2016 at 3:26 pm

      Donna, I have an appointment scheduled with Dr McCloskey on April 22nd. I have bilateral PS. Currently left side severe flare since Dec 2014. Have you seen Dr McCloskey? He seems to think he can help me. I live 4 hours away and really hope he my answer.

      Marina C

      • Rhonda
        April 3, 2016 at 7:07 pm

        Hi Marina- You replied under my post (Rhonda), however, addressed it to Donna. Nonetheless, I haven’t yet seen Dr McCloskey. There is a post by a gal named Jeannie from Dec. 2015 that had PS surgery by Dr M and was very satisfied.
        What treatments have you had so far? Are you getting a referral to Dr M? I’ve been round & round w/doctors. My1st orthopedic dr diagnosed PS, then after PT aggravated my condition and I oral steroids & OTC meds didn’t work, he referred me to a spine/orthopedist dr in the same practice to rule out other issues. This dr tried several injections, etc (I feel in wrong area, targeting tranchoteric bursitis, which is secondary to my PS), however would never consider PS, or even try a PS injection, so of late, I don’t have a PS diagnosis. I believe I do have PS based on symptoms. I’m now seeing a Pain Mgt Dr and going thru a series of injections to rule out other spine/back issues. I’m starting to question his expertise in PS. Initially he said I had it, however I didn’t get any relief from first piriformis steroid shot and he said that I must not have PS. He has already ruled out SI Joint problems. I’m going to another Pain Mgt Dr this week for a second opinion.
        I look forward to hearing from you and wish you the best from your upcoming appointment.

      • April 3, 2016 at 7:11 pm

        Get the injection under CT right into the piriformis.

      • Marina
        May 25, 2016 at 10:42 pm

        Rhonda. Sorry for the delay in responding. I saw Dr McCloskey in Hickory , NC. On April 22nd. I have to say I was VERY impressed with him. He actively listen to my history. And he agreed that I have bilateral PS. Thankfully only the left side is currently flared constantly since Dec 2014. Dr McCloskey is requiring two test before we schedule surgery. A updated MRI of my back to rule out any secondary issues. My last MRI was Jan 2015. Also a CT guided injection directly into the piriformis which he said the initial response would be 10 times the pain I am experiencing on a daily basis. This reaction is what he consider the first positive. Once they successfully reach the piriformis muscle they will inject the muscle with lidocaine to numb. He said that as soon as the numbing medication wears off the pain, siactica, PS will come right back. This is his second positive and he said without question he would proceed with piriformis release surgery with these two positive reactions and based on my history and all the failed attempts of trying to get relief. I am currently waiting on my insurance. They are trying to get a Gap Exception which will allow Dr McCloskey to be paid as if he is a In Network Provider due to the fact that he is the only Neurosurgeon we have found in NC that performs Piriformis Release surgery. This will make the surgery financial obtainable for me. If all goes well I hope to have a surgery date by next week. I would recommend Dr McColseky to anyone that is ready to talk to someone who will listen!!! I’ll keep you up dated. ( Dr McColskey is with Catawba Valley Neurosurgeons)

  154. March 15, 2016 at 12:36 pm

    Hello I need help!!!! Does anyone know of anyone in the Wilmington or Raleigh area of NC that is an expert on piriformis syndrome. I have been dealing with this for 6 months and to those that have lived this for years my heart goes out to you!!! My story is very similar to most of the post. I have had injections, PT. massages and meds. I am constantly trying to stretch. It seems now I am getting to the point the pain is starting to consume me!!! Any suggestions would be greatly appreciated!!!!

    • Elisa
      August 14, 2016 at 6:31 pm

      Did you find anyone? I’m in Jacksonville and need someone.

  155. Patti
    March 11, 2016 at 5:26 pm

    I’ve got some experience with the Doctors at the University of Miami. You couldn’t be in better hands, what an excellent hospital!

    • Lisa
      April 14, 2016 at 8:39 am

      Could you provide Dr names for Miami? I am in Naples.

      • Patti
        April 14, 2016 at 6:23 pm

        Lisa – my son was treated at the Ryder Trauma Centre for problems unrelated to piriformis syndrome. I found the doctors there to be of the highest quality, but I can’t recommend anyone for our problem.

  156. Lisa
    March 10, 2016 at 5:17 am

    I was just diagnosed with Piriformis Syndrome today, after weeks of severe pain and an MRI of lumbar spine which showed no disc herniation. I wish they had done the MRI on the buttock where the pain was so that we could see for sure what was happening. Doctor recommended PT and I am continuing pain mess, Percocet. It really is excruciating. I cannot sit at all. With mess I can lie down and stand only while shifting weight from one foot to the other. I’m wondering how well physical therapy has work for others and how long until it gives some relief.

    • Elise
      March 11, 2016 at 3:32 pm

      I had 2 rounds of PT for PNE and piriformis issues. It helped greatly. The steroid shots also have been amazing. Good luck.

    • Mark
      March 11, 2016 at 3:40 pm

      Lisa,
      Been dealing with this issue for over 2 years now. I was addicted to percocet for a year and buy did that ease the pain but you can’t live that way. Here’s why to do IMMEDIATELY. change from the percocet to 200 or 300mg of LYRICA a day. That got me off the percocet as of a year ago and reduced my pain by 85%. I’m working with the top neurosurgeons and Ortho people at the University of Miami after having pain specialists do multiple epidurals and a 3 hour hip surgery that did no good. Switch to Lyrica and let me know how that works but don’t let anyone put a knife to you yet.
      Mar

    • Jim
      March 11, 2016 at 4:21 pm

      Lisa, PS is a beast, we all can share our stories. The big problem is that it is not straightforward or entirely comparable from case to case. What works for one person, may have little benefit for another. There are some things to check for — if the PS is not associated with an identifiable issue such as asymmetry or a traumatic event, it may be a result of hypotonicity among the hip/butt muscles, namely the gluteus max, min and medius. Once a person hits their 40s, there is a higher incidence of these muscles becoming hypotonic, it even happens with long distance runners — their quads do all the work. When the glutes are not being used, they stop firing… and become more hypotonic. In response, when you do any exercise that requires glutes, your body will do everything possible to avoid activating them, using other muscles like the piriformis instead (and straining it in the process). Eventually the glutes no longer activate. Relearning how to activate the glutes and strengthening them, may be a step in the right direction to reduce the severity of PS. It has been for me. I worked with a good PT, who used a combination of radial shockwave and strength/activation training — the latter being far more important than the radial shockwave. RS on its own may have no lasting benefit. I still have a lot of challenges with PS, but it is becoming more manageable — I am hopeful that if I stick with my strengthening program the PS will slowly resolve.

      • Patti
        March 11, 2016 at 5:30 pm

        Jim your analysis is right on. I feel like I just drag my gluten around behind me and they’re not firing. My problem is I haven’t found a pt who thinks like this and therefore haven’t gotten on a good activation then strengthening program. A sports medicine doctor told me early on that it’s extremely difficult to retrain the flutes to fire. Any other tips you can share are most appreciated!

      • Susan
        March 12, 2016 at 4:04 pm

        I’ve had PS for six years. I went to a chiropractor who specializes in sports injuries. His emphasis for me was to re-train my muscles and to get my glutes firing. Initially, my glutes were completely “dead” – I had no idea how to even fire my glutes. But after working with him for six months, I can get both sides of my glutes to fire – no problem. The key is having the chiro or PT do manual therapy, in conjunction with very specific stretches and strengthening exercises to do at home.

  157. Susan
    March 7, 2016 at 9:49 pm

    Does anyone know if an MR Neurogram will show hip issues (FAI/bursitis/labrum tear)? I am getting a neurogram done for my piriformis issues by Dr. Aaron Filler in L.A. Thank you!

    • JIm
      March 8, 2016 at 10:23 am

      I’m not familiar with the technique Filler uses, but if it is done as an MRI using the neurography protocol, it would show other structural issues within the pelvis, including fractures, deformities, asymmetries, lymph node enlargement, etc.

  158. Susan
    March 7, 2016 at 8:50 pm

    Does anyone know if an MR Neurogram will show hip issues (FAI, labrum tear, bursitis, etc.)? Thank you! I’m getting one done for my piriformis.

  159. Jim
    February 29, 2016 at 8:34 pm

    I’m not sure ‘resolve’ would be the right word. I am battling it with a fairly specific protocol for strengthening and activating glutes (min, med- & max), and also a yoga-based stretching protocol. It’s slow going but I am gradually getting to the point where I can manage with an occasional Advil.

  160. Susan
    February 29, 2016 at 7:22 pm

    Has anyone had piriformis issues on both sides? I have had piriformis syndrome on the right side for six years (I had surgery four years ago, unsuccessfully). Now I’m getting similar symptoms on the left side. Not sure what to do about this. Thanks!

    • Jim
      February 29, 2016 at 7:43 pm

      Yes, bilateral, 60:40 left-right, confirmed with provocative EMG. Both sides began at same time.

      • Susan
        February 29, 2016 at 7:58 pm

        Hi Jim, thanks for your response. How were you able to resolve your bilateral issues? I haven’t been able to fix the piriformis issue on the initial side. Now with pain starting on the other side, I’m getting a bit anxious. Thanks!

      • Jim
        March 1, 2016 at 8:29 am

        Sorry for any confusion, my reply somehow got posted to the top of this comment board.

  161. Elise
    February 27, 2016 at 10:46 am

    I was hoping someone would clarify something.. The talk of surgery from the anterior approach, from the front of the pelvis? Just curious, the doc I’m working with won’t address issues in the front of the pelvis, like my pudendal nerve entrapment will be referred to a specialist. I don’t yet know his particular approach the the sciatic nerve, open or keyhole, or if he plans on PM release. I understand I’m a bit of a challenging case, my left is “a mess”. Over the last month I have partially lost the ability to curl my 1st, 2nd and 3rd toes. I can’t find any information relating it to sciatic nerve damage, just tarsal tunnel issues.

    If anyone has had both issues addressed in one surgery I’d like to hear about it and the doc you found. I’m facing 2 separate surgeries.

    Thanks everyone.

  162. Risa Hillard
    February 19, 2016 at 5:43 pm

    Dr. Adam Starr at UT Southwest Medical Center – Parkland

  163. Tracy
    February 19, 2016 at 3:18 pm

    Matt, UHC denied my first surgery scheduled for 30Nov2015 as they thought it was going to be arthroscopic. It took 2 peer to peer conversations and it wasn’t until my surgeon explained it was open surgery that it was approved. UHC indicated that they no longer pay for arthroscopic as many times it is unsuccessful and a second surgery is required. I’m just stating my experience. You’re surgery was in 2012 right? Things may have changed since then. Being armed with knowledge and potential obstacles is the best way to approach any situation.

  164. Risa Hillard
    February 19, 2016 at 2:42 pm

    Just want to echo what Tracy said. I had the exact same surgery on same day with the same surgeon as Tracy with amazing results!!! My piriformis was also bifurcated with the sciatic nerve being compressed by the two muscles. It has been 2 months since my surgery and I am going all day without any pain which is unbelievable to me!!!

    • Lynn
      February 19, 2016 at 4:14 pm

      Hi Risa,

      Do you mind sharing the name of your surgeon and contact info.

      Thanks,

      Lynn

    • Rhonda
      April 3, 2016 at 7:55 pm

      Risa-
      How did the dr know your piriformis was bifurcated? From open surgery or an MRI neurography? Did you have bilateral piriformis?

      • Risa Hillard
        April 3, 2016 at 8:25 pm

        I apologize…I thought I answered this post. Surgeon was Dr Adam Starr at UT Southwestern Medical Center (Parkland) in Dallas, TX.

    • Libbey
      August 23, 2016 at 1:16 am

      Hi Risa,

      Thank you for your amazing information regarding your P.S. I am a 48 year old women in reasonable shape. I am also an x professional dancer but I am wondering about age and surgery recovery would you mind share what your age is?

  165. Tracy
    February 18, 2016 at 10:26 pm

    The difference is that the arthroscopic approach snips part of the tendon at the hip, thus lengthening the piriformis muscle. The open approach is a 9-11 inch incision between between the glut muscles to give the surgeon a full view of your sciatic nerve in relation to the muscle. So if your muscle is bifercated and the nerve is going through the center of the muscle (or over it) or the nerve is split and wrapped around the muscle, the arthroscopic approach will not solve your problem. Also check to see what procedure your insurance will cover. UHC does not cover the arthroscopic approach.

    • Patti
      February 19, 2016 at 10:42 am

      Thank you! I was wondering if there is a difference wrt the open approach vs the anterior method mentioned as done by dr hakim in Florida.

      • Athena Fremstad
        February 26, 2016 at 8:43 pm

        Patti can you give me more information on Dr. Hakim or how you heard of him. I live in Florida and haven’t found anyone who treats PS let alone do surgery. Any info would be great!
        afremstad@aol.com

    • February 19, 2016 at 11:18 am

      UHC covered it for me Tracey.

  166. Susan
    February 18, 2016 at 1:06 pm

    Hi Chris, thanks for your response. That’s great that you were able to recover so quickly from your surgery. I’m not sure why my recovery took so long. It was several months before I felt somewhat back to normal. In regards to your surgeon, Dr. Hakim, I see that he is an orthopedic surgeon. Did he have a specialty (e.g., hip surgeon)? I guess I’m trying to figure out what type of surgeon to look for. My last surgeon was a neurosurgeon who specialized in peripheral nerves. Just wondering if I should be focusing more on orthopedic surgeons with an emphasis on hips. Thanks so much!

    • Chris
      February 19, 2016 at 10:56 am

      He is an Ortho who specializes in Arthroscopic hip procedures. I do not think that there are many that are able to perform it this way yet. There may be some that “can” perform it but you may want to check out how many times that they have actually done this. As for Tracy’s comments, she is right about the entry points but I am not sure about the bifercation. She may be right and she may be wrong. I have no idea since I do not suffer from that. Since you already had the surgery, I doubt that you would have the situation where your sciatica is running through the piriformis again, but I am a patient not a doctor so you may want to ask them about that. I have BCBS not UNH so I can’t speak to that. Your doctor should be able to tell you what they can get covered and what they can’t.
      If you are sure it is piriformis, look for an Ortho that specializes in Arthroscopic hip surgery. There has to be one in California. I think the Stedman Clinic in Colorado does it.

      • Tracy
        February 19, 2016 at 5:02 pm

        Chris, I had open surgery on 14December at UTSW in Dallas. I had a bifurcated (split) piriformis muscle and the sciatic nerve was going through the center of the muscle. I was born this way but didn’t start having pain until I fell off a counter painting and broke a notch of bone off my pelvis adjacent to my SI Joint. This was found through a MR Neurogram. The piriformis was rubbing on the sharp bone and fraying the muscle which kept it in spasm. The artroscopic approach would not have worked for me. The surgeon Resa and I used requires a MRN and BOTOX in the piriformis before he will do surgery to make sure it’s piriformis syndrome. I also had several injections and a consult with their spine specialist to rule out my back and hips.

  167. Susan
    February 17, 2016 at 10:21 pm

    i have had piriformis syndrome for over six years. I had piriformis release surgery three years ago. Unfortunately, the surgery didn’t relieve the pain; in fact, my pain is gradually evolving. I believe that scar tissue from the surgery may be involved, and am looking for a new surgeon to do the surgery again (my old surgeon is no longer an option). Is there any type of scan to detect scar tissue? I live in the San Francisco Bay Area – anyone know of a surgeon in this area? I’m willing to travel. For those of you who had to travel for surgery – how did you handle the consultations and follow-up? Did you have to fly back and forth? Also, how were you able to travel home post-surgery? It took me weeks to recover from my first surgery. I can’t imagine traveling home that quickly. Any advice would be much appreciated. Thank you!

    • Chris
      February 18, 2016 at 11:58 am

      Susan, I had the surgery a few months ago in Jacksonville, Florida. Dr. Hakim did the surgery. He is now with Southeast Orthopedics. It was a very easy surgery to come back from. I was weight bearing right away. I used crutches for two days but it was not really necessary. I had the surgery on Friday and was working on Monday with no problem. It hurt a little to walk but not bad. I rode a 100 mile bike race 4 weeks after the surgery. it was really nothing at all. His anterior approach cuts less muscle, which makes it faster than ever to come back from. Different doctors have different approaches. It is quite from from California and I am sure that there are a few doctors closer that specialize in this type of surgery.

      • Patti
        February 18, 2016 at 5:58 pm

        Hey Chris, do you know what makes dr Hakims approach different from an “open” approach vs an endoscopic surgery. I’m contemplating having sciatic neurolysis and piriformis release by my local neurosurgeon who specializes in peripheral nerves just like Susan. Ty

  168. Dkobren@gmail.com
    February 9, 2016 at 11:03 am

    I would like to hear more about your recovery. I had the same surgery last Monday at NYU with Dr. Meislin.

    For the first time, I’m finally feeling relief from my sciatic pain. I also dealt with a misdiagnosis of my pain, all of my doctors thought the pain it was coming from my back. After doing research on my own, I diagnosed myself with piriformis syndrome. I demanded a botox injection to confirm. The injection worked! But only for a few days… It did give us a confirmation that I do have piriformis syndrome.

    Turned out I had an accessory head on my piriformis muscle and bursitis. So, I had s similar surgery done. He released the head that was pressing on my nerve and removed the bursitis.

    I was sent home with instructions to use crutches for two weeks, and go back to work in a month. What was your recovery like? Were you given the same instructions?

    Thanks,
    Danielle

    • Chris
      February 9, 2016 at 12:17 pm

      I used crutches for 2 days but just as a precaution. I was full weight bearing after that with no problems from the surgery. I rode a 100 mile bike race 4 weeks after the surgery. It was really not a difficult one to come back from. Unfortunately more of my pain was coming from my torn labrum in the hip than from the piriformis. Lucky me, I had a few issues.

  169. Lauri Buffum
    January 23, 2016 at 9:46 pm

    looking for a doctor near New Hampshire that does the piriformis release surgery. Any recommendations? My mother has been suffering for 5 years as well and we have done everything imaginable. Currently taking Lyrica and pain meds with no relief. Just had another unsuccessful shot. Couldn’t find anyone on Google search. Please help.

  170. Becky
    December 21, 2015 at 9:54 pm

    I have been suffering for a few years with the same symptoms. I have a anterior
    torn disc in L4 and my SI joint is locked up from a car accident. After a nerve conduction test today It was confirmed I have Piriformis syndrome. I have had numerous ESI injections, prolotherapy and am currently getting dry needled every week at Physical therapy. My question is have you ever had a Botox injection in the Piriformis muscle? My Dr suggested that be the first thing we try.

    • Patti
      December 23, 2015 at 1:16 pm

      Becky: I also have an annular tear at L4, apparently Sijd and piriformis syndrome. I recently had a CT guided piriformis Botox injection. It helped but not that much sadly. Everyone is so different, it’s definitely worth trying it. I’ve also heard that Mayo recommends a series of three Botox injections to obtain the most benefit.

  171. Tracy
    December 19, 2015 at 11:08 pm

    Does anyone know of surgeons in Canada that specialize in piriformis syndrome? I live in Saskatchewan but am willing to travel to nearby provinces to get help

    • Patti
      December 20, 2015 at 11:32 am

      Hi Tracy, I’ve asked this question too. I live in Ontario. I’ve not found any doctor in Ontario who specializes but I have found a neurosurgeon at my local hospital who specializes in peripheral nerves. I am under his care, he is ordering cortisone and Botox injections for me (ct guided piriformis injections done in hospital) and he would do open piriformis release and sciatic neurolysis if I let him though he is hesitant. I believe you can find surgeons who can do piriformis release, it’s just that they don’t do many, so the question becomes whether you are comfortable with that scenario. At my neurosurgeons office I called their “special case” as they say they rarely see anyone with piriformis syndrome. Also you will want to be very sure that piriformis syndrome is the root of your problem and not sacroiliac joint dysfunction, hip capsule issues or lumbar spine issues. In the US I believe piriformis surgeons use a provocative emg to diagnose. They also don’t do those in Ontario. Sigh. It’s an uphill battle.

      • Wendy
        February 22, 2016 at 12:45 pm

        Hi Tracy, I also live in Ontario (Burlington) and have been suffering with Piriformis Syndrome for over a year now. Can you tell me the name of your neurosurgeon and what area of Ontario you live in? I am at the point where I would like to have the entire muscle surgically removed!!!!

        Thanks so much for your help!
        Wendy

      • Patti
        February 22, 2016 at 4:08 pm

        Hi Wendy, I live in Ottawa. My neurosurgeon is by no means an expert regarding piriformis syndrome and I’ve not had surgery either. I would recommend finding a peripheral neurosurgeon in Toronto and seeing where it goes. Ask for an mrn, I understand they are done in Ontario now. The real experts with a number of piriformis surgeries under their belts are in the US sadly.

  172. Elise
    December 17, 2015 at 1:14 pm

    Hello everyone. I’ve battled Piriformis syndrome for 3.5 years now. Feb 2015 I was diagnosed with pirifornis syndrome. I believe it’s bilateral, although only the left has been tested.

    I am currently seeing Dr Martin in Dallas at Baylor. I’ve just finished a round of PT for PS and pudendal nerve entrapment. I had a steroids steroid shot back in mid October that work very well.

    For years I was told it was my back and I needed fusions, thank goodness I waited it out as long as I did. February I saw Dr. Alok Chaudhari in Ft Worth to see what he could do for my back. He was through enough to request additional testing and found the PS. Amen to honest doctors.

    I run, (like I have piriformis syndrome -not well), no longer bike, and plan to start some aqua jogging.

    Just wanted to say, I’m one more with PS, And not having any fun with it.

    Thanks everyone for posting here.

  173. Lea
    November 29, 2015 at 5:58 pm

    See my entry from March 11 this year. I meant to do this on Thanksgiving. When we went around the table on what we were thankful for…it was easy this year! I want to give all of you hope. I am doing better than I ever imagined. I still have periodic minor pain but it does not limit me in the least. I am back to the gym for one hour 5 days a week. Playing with my kids! And generally enjoying life again. God heard our family’s prayers and all the glory to him. My surgeon said one to two years to full resolution of pain. I know I will get there. Do not give up hope!

  174. James HB
    October 23, 2015 at 3:09 pm

    Hi Matt

    Firstly thank you for this website it has given me much useful information and encouragement.
    I have been suffering for 6 years with what I now strongly believe to be a bilateral piriformis problem, after having explored many other possible causes over the years.
    In the last 2 months I developed trocanderic bursitis symptoms on top of my existing pains and I have just been treated for this with steroid injections in each femur. The pain pattern associated with the trochanteric bursitis vanished, but I was left with the original symptoms that I have had for so long.

    Having read that you had trochanteric bursectomy, I wanted to ask you, or anyone reading this who may know, what relation you think this condition has to the piriformis.
    I am keen to know if my recent bout of trochanteric bursitis is further evidence of the longstanding piriformis problem as I am finding that medics here in the UK are in need of some persuasion as to the very real and devastating effects a dysfunctional piriformis can have. I would be very grateful for any thoughts, my email is JamesHB80@gmail.com.
    Thank you
    James

    • October 23, 2015 at 3:13 pm

      James, my bursitis was caused by long term Piriformis Syndrome. It was easily resolved during the scope of my hip.

      • James HB
        October 23, 2015 at 3:19 pm

        Thank you. It’s good to know that this will hopefully count as further evidence in isolating the piriformis as the cause and I just hope I will be able to find an end to this as you did!

    • Tracy
      December 22, 2015 at 2:17 am

      Hi James, I too was diagnosed with trocander bursitis with my PS. A steroid injection helped but it came back after a few months. I just had a “Open” Piriformis Release and despite the incision pain, my hip feels great. My Radiologist said the bursitis was caused by over compensating while walking from the PS.

      • Lynn
        January 18, 2016 at 4:41 pm

        Who and where did you have your surgery? Thanks!

    • Tracy
      January 27, 2016 at 6:36 pm

      Lynn, I had it @ UTSW in Dallas.

      • Lynn
        January 27, 2016 at 9:16 pm

        Thanks! Can you give me the name of your doctor?

  175. Chris
    October 14, 2015 at 3:38 pm

    Gina,
    Perhaps I should clear up some of the information that I left. I have known about the torn labrum for 3 years. I first felt it while training for Boston 3 years ago. I had many xrays and 2 mri’s, with and without contrast. I also had multiple diagnostic shots in many places prior to even getting those mri’s. I first though that it was piriformis as did my doc, who did an injection there. It did nothing. I did several rounds of PT and had shots in every place you can think of. Even after getting the torn labrum results I did not have surgery as this other pain was present. I went to multiple orthos and pain mgmt docs. The hip guys would say it was the back and the back guys would say it was the hip. I left that practice and went to another one. Same thing occured. I took some time away from docs and running. Nothing changed. I was going to go to the Stedman clinic in Colorado for the labrum repair when I found out about Dr. Hakim in Jacksonville. I went to him and he looked at all of my records. He felt like the other docs protocols were correct but that there were 2 problems, which was confusing the others. We did another mri to confirm the labrum tear and see how it had progressed. He was also looking for a torn glute. The tear had progressed but the glute was intact. He still felt like I should hold off on the labrum surgery as their was something wrong with the other pain. He did not feel it was consistent with a labral tear. My groin pain and hip pain was definitely from that. They glute pain he felt was not related.
    In the end, we decided on surgery for the labrum and for the piriformis. We decided to to them seperately because we may get lucky and find that the piriformis was resulting in more of the pain than the labrum. It was worth the shot as it was less intensive. In the end, I got some relief from the pirirormis surgery but the hip pain is still too intense so I have to have it done. Dr. Hakim will be the surgeon for both.
    What I really liked about Hakim so far is that he is not a hammer looking for a nail. He is really a last resort surgeon. I had another doc trying to schedule me for a si joint infusion. I can honestly tell you that this post may be long but my list of things thrown at this injury is extensive and expensive. I thrown the kitchen sink and then some at this. I am not fond of doctors or surgery but at this point I have no choice if I want my life back.

    • Patti
      October 14, 2015 at 4:13 pm

      Chris: what about the torn glute? What did Dr Hakim say about that?

    • Gina
      October 14, 2015 at 4:59 pm

      Thank you for your reply. I hope by spring you can get back to your activities. I fully understand what a long journey you have been through. I have had my own, only reversed. I want anyone reading your post that this is NOT the standard protocol to fix piriformis first, then fix hip structural issues. At least it is not in accordance with the four hip specialists I saw, which includes Dr. Henrich. I am not a doctor, or medical proffessional, but have spoke to many people and many doctors. All four of my very skilled hip doctors said to fix the hip structural issues first, then the piriformis may calm down. I have spoken with other people who have had their piriformis released, only to have to correct hip structural issues that went undiagnosed. If a doctor releases the piriformis muscle because it is hypertonic, without fixing the hip structural issues, the hip can continue to deteriorate, the muscle become weak and then the piriformis is not there to stabilize it and the hip can deteriorate more. That is what I have learned along my long journey and speaking to others. Unfortunately, I was not one of them that the piriformis muscle calmed down after fai and labrum surgery. It took 3 years to diagnose the FAI and labrum surgery and by then the piriformis was so hypertonic that the sciatic nerve attached to the trochanter, deep rotator muscles, as well as the piriformis muscle. The doctor actually had to shave the trochanter to stop the sciatic nerve from gliding on it and getting irritated. I have had a super long rehab from the OPEN piriformis muscle release and sciatic nerve neuroylsis surgery because my glutes were so weak that I could not even get them to fire. I am finally closer to being over this big long 7 year journey mess of a mess. I am sitting, standing, walking etc., pretty much pain free. However, I have to take frequent breaks from sitting, as I fear that I can develop scar tissue and have fibers attach to the sciatic nerve and develop problems again. I stress anyone reading this post to go to a doctor that specializes in femoral acetabular impingement. Have your hips checked out with a MRI with contrast and a MRA to make sure you have no impingement and labrum tear which is causing the piriformis muscle to over compensate. If you go to Dr. Henrich, or any other doctor specializing in FAI, they will want to rule out your hips first. I decided not to have scope surgery by Dr. Henrich and had OPEN piriformis tendon release and sciatic nerve neurolysis surgery from Dr. Thomas Ellis in Dublin, Ohio. I am very glad that I had open surgery, as if I had scope surgery, my leg would not have been moved and the doctor could have missed the sciatic nerve rubbing on the trochanter.

      I wish you well, pain free days ahead and an awesome next year!

      • Zinggi
        November 9, 2015 at 10:53 am

        Hi Gina, your problems sound similar to mine, unfortunately I’m not pain free at all. I had twice hip surgery because of Fai, then piriformis tendon release and neurolysis, now spondylodesis L5/S1, but my sciatica and butt pain persists. Are you sure that your nerve was entrapped or at least irritated by others than the piriformis? Even by the trochanter? I find that very interesting, because my surgeon told me only the piriformis can make problems. It would explain though why I still have an irritated sciatic nerve which drives me crazy ( and invalides me!) I really don’t know what to do next, my doctors neither.

    • February 26, 2016 at 9:02 pm

      Chris, I live in FL and have been searching for a surgeon that works on the piraformis. Can you tell me if he did just a partial release? I’ve already had that done and it didn’t help. My surgeon in GA said it was probably because the sciatic goes through the muscle. Does he do any imaging like and MRN?

      • Chris
        March 1, 2016 at 1:05 pm

        Athena, I am not sure that I actually know the answer to that. I do know that my piriformis was not running through my sciatic nerve. My doctors notes says that it was a piriformis release but I do not know if that qualifies as partial or not. He is affiliated with Southeast Orthopedics now, so I am sure that they have all of the imaging available. I had all my imaging done at Precision Imaging in Jacksonville as they are far less expensive and more convenient. They are open at night, weekends and 7 days per week. I find them to be really good. I used Baptist for an MRI when I was with a JOI doctor. My out of pocket, after insurance, was more than Precision charged my insurance company. 3 times more. My cost, after insurance, was less than lunch at Jimmy Johns.
        I am not sure where you are in Florida, but if you are close than you should call Hakim. I am assuming that you are in North Florida, as you went to a GA doctor unless you are in the Pan Handle.

  176. Chris
    October 14, 2015 at 12:32 pm

    Patti, I used Farid Hakim or Bahri Ortho in Jacksonville, Florida

    • October 14, 2015 at 1:34 pm

      Chris, I’m confused. Why did you name two different physicians and put an “or” between? Please explain.

      • Chris
        October 14, 2015 at 3:24 pm

        Typo. It was Dr. Farid Hakim with Bahri Ortho.
        My apologies.

  177. Patti
    October 14, 2015 at 11:50 am

    Does anyone know of a good piriformis surgeon in Canada?

  178. Patti
    October 14, 2015 at 11:43 am

    Who was your piriformis surgeon?

  179. Patti
    October 13, 2015 at 5:59 pm

    Today I had a CT guided piriformis Botox injection at the hospital here in Canada. They put in 100 cc’s of Botox (or 1 ml) and told me to be a couch potato for 48 hours. 1) how much do they usually inject in the U.S.? 2) how long does is usually take to take effect? 3) how many Botox injections into the piriformis can one have and how far apart should they be? Thank you!

    • Jim
      October 13, 2015 at 6:54 pm

      1) how much do they usually inject in the U.S.? — I don’t believe there is a ‘standard’ amount — in my first round I had 100u in both sides, second round a few months later was 300u on the left side. There are a couple forms of Botox and they measure differently depending on whether they’ve been purified of protein or not. 2) how long does is usually take to take effect? Mine began providing relief about 7-10 days after I received the shots. 3) how many Botox injections into the piriformis can one have and how far apart should they be? Again there are no strict guidelines, but in theory Botox should be effective for 3-4 mos. in my case the relief lasted about 6 weeks. I should note that I’ve read that Botox can permanently weaken the piriformis by about 10%, so multiple rounds can over time have a cumulative effect. Also note it is possible for the body to develop immunity making subsequent rounds less effective. Your mileage may vary.

      • Patti
        October 13, 2015 at 10:49 pm

        Thank you!

  180. Jim
    October 1, 2015 at 1:15 pm

    Has anyone here tried Radial Shockwave Therapy? A friend of mine said the they are using this for patients who have not had favorable results with other therapies. It is used to break up adhesions and scar tissue that form as acute pain progresses to a chronic stage and is more resistant to treatment.

    • Julie
      October 1, 2015 at 3:52 pm

      I am getting this done on the 22nd of October, have not had it before but can let u know how it goes

    • Patti
      October 13, 2015 at 10:51 pm

      Where do you get this treatment?

      • Jim
        October 14, 2015 at 8:24 am

        Generally it’s performed by a PT. The RST machine looks like an ultrasound wand, but acts like a mini jackhammer, delivering a quick repetitive shockwave to the soft-tissue. The idea is to break up adhesions, scar tissue, etc.

    • Chris
      October 14, 2015 at 11:31 am

      I had a chiropractor that practices ART do this. I went through multiple sessions but it never did anything for me.

  181. Sandy
    September 15, 2015 at 4:26 pm

    Has anyone used a doctor in VA for this surgery. Specifically UVA?

    • Gina
      October 15, 2015 at 8:50 am

      The doctor that was there moved to Denver, than California. I had surgery with Dr. Thomas Ellis is Dublin, Oho

    • GR
      October 27, 2015 at 6:03 pm

      I too suffer from PS and live in the Charlottesville area. I have seen several MD at UVA and they couldn’t help me. Referred me to Duke but he only prescribed PT. Have had several injections (temp help), PT several months X4 and still debating surgery. email me at deepdive915@juno.com and I will share the details.

  182. Patti
    August 6, 2015 at 5:06 pm

    Angelica, if you have Facebook there are many piriformis and sims face books groups with large numbers of members who should be able to suggest doctors in your area.

  183. August 5, 2015 at 9:55 pm

    I am having Piriformis release arthroscopic surgery next week with Dr Hal Martin of Dallas. Any recommendations for after this surgery?

    • Gina
      August 6, 2015 at 11:50 am

      I would research your doctor ant the type of procedure and his results of success with his treatment option for you. There are many pros to having open surgery. As for suggestions after surgery, take it slow, and rehab thoroughly.

    • Shuffleman
      August 6, 2015 at 1:37 pm

      Douglas, I had mine about 6 weeks ago. It was really easy to come back from. I used crutches for 2 days just to be safe. I did not need them though. For the first week or two, I took it easy and just walked reasonable slowly. After that it has really been a matter of soreness from the incision area. I have no problem walking and have even started riding my road bike again two weeks ago. I clearly do not have my full strength back yet but it is getting better every day. I will say that the one thing that I did not expect is the extreme exhaustion at the end of every day. This week has been far better but I have been really tired. My drive home from work has been hard because I keep nodding off. I have had to get a candy bar every day before riding home to keep myself awake.
      All in all, this surgery and recovery was a cinch. Unfortunately for me my hip labrum is also torn so I had a double wammy. That gets surgery in Dec and I can’t wait as I want to resume my running.

      • Patti
        August 6, 2015 at 4:57 pm

        That’s amazing, congratulations! Did you have sciatica / leg pain prior to surgery? Lower back pain? Best wishes for a continued smooth recovery!

      • Shuffleman
        August 10, 2015 at 9:43 am

        Hi Patti. I did have pain in my glute and lower back. It never went below my glute. My problem is that I have a torn hip labrum requiring surgery as well. No telling which came first but it was probably a compensation thing according to the Dr. We thought that we would do the less intrusive surgery first to see if it cleared up more of the pain. It did clear up some of the pain but the bulk was coming from my hip, which is bad for me but it was worth the chance and it had to be done anyway. My back does not have nearly as much pain in it as before. I was hoping that it was this causing the glute pain but it is my hip doing that.
        I read a lot of horror stories about this surgery but it really was not bad at all.I actually rode my bike 50 miles this weekend and was able to keep pace with the other riders. I definitely do not have full strength yet as pedaling up the hills was tougher than normal but it is getting there.

      • Patti
        August 11, 2015 at 9:13 am

        Than you for your reply. My symptoms differ from your. I have nerve pain in my legs.

      • Gina
        October 14, 2015 at 11:59 am

        I am sorry you had to go through the piriformis surgery only to learn you had a torn labrum. Time and time again, I tell people to get their hips checked by a hip doctor that specializes in femoral acetabular impingement. Hip structural issues can cause the piriformis muscle to over function and compensate. Usually if people fix their hip structural issues first, the piriformis muscle stops over functioning and becoming hypertonic. You are not the first that had to go through a PS surgery, to have their hips fixed after.

        May I ask who did your PS surgery and who is doing your labrum surgery? Have you been checked and had a MRI with contrast and a MRA? Are you sure you don’t have an impingement that caused the labrum to tear? I wouldn’t want you to repair the torn labrum, only to have a cam or pincer impingement, which tears the labrum again, requiring more surgery. I hope you have a speedy recovery and get back to running in the spring!

    • Risa
      September 13, 2015 at 8:17 pm

      Douglas, I was wondering how you are doing as I am considering setting up a consult with Dr Hal Martin. I have gone through PT, fluoroscope guided steroid injection in the piriformis, CT guided Botox injection in the piriformis with steroid injection in the sciatic nerve all unsuccessful. I now stand all day at work (and everywhere) as I cannot bear to sit–had work purchase a standing computer workstation for me. I live 2.5 hrs away from Dallas and am currently being treated at UTSWMC in Dallas. I had CT scans and MRIs but piriformis syndrome was finally confirmed by a very high tec, expensive MRI (can’t even think what it’s called right now) that shows my piriformis muscle has an accessory belly to it (almost like an extra muscle) and it is contributing to the problem.

      Thanks for your help!

    • Charlie
      October 13, 2015 at 1:07 pm

      I am thinking of consulting this doctor for refractory piriformis syndrome, how did your surgery go?

  184. Summit1
    August 3, 2015 at 2:29 pm

    You need to get a thorough exam by a doctor specializing in sciatica/PS. Get a provocative EMG for definitive diagnosis of PS. Your symptoms do not sound particularly representative of PS, but possibly SI joint related (and that is of course simply a guess). If you’re near NYC, see Dr. Loren Fishman.

  185. Tony
    August 3, 2015 at 10:13 am

    I too have begun to experience pain in my buttock area which at times is excruciating. It’s especially bad whenever I stand up from a sitting position or getting in and out of bed. My family doctor has stated I have Piriformis Syndrome after just a regular physical exam. I’m doing PT now but it doesn’t seem to help at all. I’m not taking any medication for the pain since that only masks the problem. I’m a 55 male and can’t trace this back to any specific injury. It scares the hell out of me that some of you have experienced pain for years and mine has only been for the past two months. At this point I can’t take it another day. I appreciate reading your posts and at least I’ll feel a little more knowledgeable when I see my doctor again next week.

  186. Peter
    July 9, 2015 at 7:19 am

    Hi,
    My name is Peter and I am a 60 year old male, living in the Netherlands (Europe).
    I feel like I am 40 except for the pain in the back of my upper left leg.
    I like cycling, walking and climbing, but since 7 years I cannot stand longer than a few minutes or sit longer than a few hours.
    Laying down on the floor is how I spend my free moments.
    It started 7 years ago and since then I tried everything; dry needling, acupuncture, cortisone injections and much, much more.
    Finally I was diagnosed Pyriformic Syndrome and had open surgery a week ago.
    The first 2 days the pain was completely gone!
    But now it is back and I am getting desperate!
    Did anyone of you have the same after surgery?
    Is it going to be any better after a long period of time?
    Peter

  187. Eileen
    June 26, 2015 at 4:10 pm

    Hi
    I came across this thread/article when looking for hints to combat piriformis on a long flight. I experience this pain three weeks ago initially it was just sore but after I saw a sports injury guy who massaged my whole body I cannot walk for any distance. I’ve now been confined to bed for 2 weeks. I’ve seen my GP twice and had a visit to accident and emergency. The doctors have suggested Trochanteric bursitis or sciatica. I am taking morphine, tramodol, diazepam and an anti inflammatory tablet. The sports guy and my osteopath (spoke to him on phone) both suggested pirifomous syndrome (I had never heard of this)
    I am due to fly to America next week for 17 days and am so worried that I will be affected by the long flight that im thinking on cancelling the trip.
    Any suggestions on how to eleviate the pain during the flight?
    Eileen

  188. Carol in Texas
    June 23, 2015 at 1:55 pm

    June 23, 2015
    I am in the Frisco / Richardson / Plano Texas area. Does anyone know a doctor in this area who treats piriformis syndrome?
    In May I had x-rays with dye and a CT scan and was told nothing wrong with my back but I did have sciatica and then proceeded to have shots in my SI joints. Still had aches in my side. Next doctor — xrays…said I had bursitis… another shot in my bursa on left side.
    Of course none of these shots affected my piriformis muscle. I STILL have issues with it.
    Anytime I have to do steps…or heaven forbid stairs ..I have to PULL myself up them. I have been able to walk a lot more a lot further since I got the SI joint shots but I still need mobility.
    When I get pains… I feel like my entire left butt has just broken…. and get shooting pains down to my knee. I call it broken butt. I cannot lift my left knee upwards.

    I see adv. for “pain doctors”… I live on tramadol. I don’t want to live on pain Rx. I want it fixed.
    Do massages help? Physical therapy? accupuncture?
    ……….had this since summer of 2010.

    • Carol in Texas
      June 23, 2015 at 1:56 pm

      Trochanteric Bursitis…that is what I got a shot for in left hip

    • June 25, 2015 at 2:08 pm

      Carol I just had surgery in Dallas. Email me critesw@att.net

    • July 23, 2015 at 4:40 pm

      Carol, I’m in Richardson, TX and need a doctor for PS. I’ve had 3 back surgeries in the last 2 years, but now I have a lot of pain in my sacrum area, right buttock, right hip, right leg. I control the pain with hydrocodone and gabapentin. I’ve had numerous injections, but no relief. Currently doing PT. Did you find a doctor?
      Thanks, Tom

      • Theresa
        August 5, 2015 at 10:57 am

        I see some folks from Texas on here. Who are you seeing and where. I love in North Houston but will travel to another Texas Doctor if you know of one. Please help. I am only looking at open surgery.

    • Gina
      August 4, 2015 at 10:22 am

      Adam Start in Dallas Texas

      • Gina
        August 4, 2015 at 10:25 am

        His name is Adam Star. Not start….. sorry for the typo.

  189. June 17, 2015 at 8:09 pm

    Reading your notes has made me feel much less alone with this piriformis syndrome.
    I have been through the mill. Dr. Fishman diagnosed this a couple of years ago.
    I have had this pain for about 4 years. I need a spinal fusion but the neurosurgeon doesn’t
    want t put me through the ordeal and still have me unable to sit,stand,walk, drive.
    Dr. Fishman’s steroid injections helped but only briefly. No luck with the Botox.( dr. Fishman
    Was an incredibly lovely kind man)
    I live in So. Florida and have family in Boston. Does anyone know of physicians who do
    The release surgery in either of those area? Also platelet injections.
    The last few years have been a nightmare. This year I have been almost totally on the
    “Couch on an ice pack with my dog.
    Kathy: I know this is asking a lot but I tried to get dr. Fillers MRN in Weston, Florida,but
    my insurance : Medicare and Blue cross/ Blue Shield Medex. wouldn’t pay . As a retired,
    disabled widow $4,000 is BIG. Would you consider sharing the names of the papers
    you used. I would follow through and try to find the extracts and have them copied.
    I would be so appreciative. I am very discouraged. Feel like my life has collapsed.
    Maybe this test would show in print what Dr. Fishman diagnosed with an EMG.
    Despite, many folks who had no luck, with the surgery, I’m so desperate I’d try it.
    This is no life as you all know only too well.
    Thank you all for sharing your experiences good and bad,,doctors names,treatments tried.
    Wow! There are a lot of us just lying around. My poor dog, Gracie begs me for walks!!

  190. Chris ryan
    May 24, 2015 at 8:40 pm

    This is an interesting post. I have traveled the same road as many others here. I was training for the Boston Marathon one day in 2011 and the pain in my trochanter hit me. No falls. No warning. I took a few days off of running and the pain moved to my left glute. I originally thought it was piriformis. Chiro and prednisone did nothing so I went to the ortho. He thought torn labrum and put me in pt and then an MRI. Then it was off to pain mgmt, where they injected, piriformis, labrum, facets, si joint and an epidural as well as it band and hammy. Nothing was working. I went to an ART practitioner and massage therapy. I went to a different ortho and went through more rounds of shots, needling, acupuncture and pt. nothing. I took some time off of everything and went to a different pain mgmt guy. More shots and even neuralisis of facets. I tried prlotherapy and prp with a different dr who felt like it was si joint.it did nothing but hurt my wallet and I felt it was not my problem anyway. I went back to my pain mgmt guy and we talked about everything. He sent me to a different Dr. Who specializes in arthroscopic hip surgeries and is in my town, Jacksonville. We know from multiple MRI’s that my labrum is torn but this Dr feels like there is another problem causing the glute pain. He wanted to do one more epidural to rule out the back, before undergoing surgery for the torn labrum. Now that I have ruled that out he feels like piriformis surgery is the way to go before the hip surgery. He thinks more of my pain is coming from that than the hip. He also feels like the surgery is far less invasive with an easier recovery. I am having the surgery on the 12th of June with Dr. Hakim. My other ortho feels like he is the best arthroscopic hip surgeon in the state and top 5 in the country. I am concerned about the recovery time but he is confident that it will be quick. My pain was primarily in the glute and hip area but it has moved to my lower back on the left as well. I do not take any meds as they never touch the pain and I hate them anyway. Ice is my friend. I have many packs at home and at my office. This will not beat me but it does hurt me all day everyday. Sitting is the worst.
    I will repost after my surgery to let others know how it went. I will say that the Internet is a scary place because most people with good results don’t post, they just move on. Thus, we are left with the horror stories that scare us. I asked many pt’s, not affiliated with the practice about my drs results. They are a great source of info as they see the results. Check with them while checking out drs. My prayers are with each of you as we travel down this road. Also remember that what works for one may or may not work for another. This is new ground and very difficult to diagnose and even that can be wrong. Many drs can be hammers looking for nails. I think my prolotherapy guy was one of them. I spent a lot of money on that and he was confident that it was the si joint. When his treatment failed he said I was 1 of only 2 with that result. He wanted me to get an si joint fusion. No thanks.

    • Chris ryan
      June 17, 2015 at 7:49 am

      I had my piriformis release surgery 5 days ago. I was able to bear weight right away but used crutches anyway for 2 days. Pain from the surgery site prevents me from sitting. I have remained on my back or standing. I feel Ike there is no pain in my back but it is too early to tell. I get my staples out in two days and should know more by then.

      • Carol in Texas
        July 6, 2015 at 9:16 am

        Hope you are doing better Chris.
        What was stapled? Was this not one of those surgeries with a teenytiny incision?
        Where do you live and how did you find a doctor?

      • Jim Wucher
        September 10, 2015 at 9:02 pm

        Chris, I also live in Jacksonville and am debating on weather to do surgery here. Please let me know hoe you are doing as of Today sep 10th. Please email @ wucherjm@msn.com with contact info… Would love to call and discus

      • Angie G
        October 13, 2015 at 3:44 pm

        Chris,
        How are you doing? Running again? How’s your pain? Thanks, Angie

      • Chris
        October 14, 2015 at 11:22 am

        Angie,
        My problem is really two fold. I have a torn labrum and then the piriformis. I am not running simply because my pain level shoots up about an hour after the run. I could definitely run if I wanted to though. I am scheduled for my labrum repair for the 11th of November. As far as the piriformis goes, it really was quite simple. The pain from it was alleviated right away. I am guessing that I could have run 2 weeks later. I was riding my road bike 50-100 miles on my long days within 3 weeks of the surgery. My Dr. was not sure if the Piriformis was the primary driver of pain or my torn hip. They were both an issue but the hip was more of the pain generator. I can finally sleep on my side and less of an issue with sitting since the surgery though. I have read a lot of horror stories but I can honestly say that it was no big deal. The sight of the surgery left about a 5″ scar but overall there are zero issues with it. I was at full strength very quickly. My advice is simply to find the right doctor. There are those that would like to do the surgery and those that have done it many times. Find the guy that has done it many times.

      • Chris
        October 14, 2015 at 11:29 am

        Carol, I had staples where the incision was done. I would estimate that there is a 5″ scar there now. I live in Jacksonville, Florida and used Dr. Hakim. He is with Bahri Orthopedic.
        I actually found him through my pain mgmt. guy. I have a torn hip labrum and have fought if for too many years. I had seen the other hip specialists in town and none of them do enough of these surgeries for my comfort. I was going to go to Colorado for the surgery until I found Dr. Hakim. I am glad that I saw him as he is very well known in the field of arthoscopic hip surgery. He is the Dr. who realized that I had 2 problems and not just the torn hip. I had a ton of shots and nothing worked. None of the docs figured it out until I saw him. He recommended I do the piriformis release first because it was not as invasive. The thinking was that it that was the primary generator of pain then we could skip the other surgery. This is not the case but still it did relieve the piriformis pain. It was a quick recovery time. I had the surgery on Friday morning and was fine to work by Monday. I stayed home anyway but was back on Tuesday.

      • Patti
        October 14, 2015 at 11:45 am

        Chris who was your surgeon?

  191. Gina
    April 14, 2015 at 2:16 pm

    Hello Matt and All –

    I had a piriformis tendon release and sciatic nerve neurolysis surgery on 3/31/2015. After reading Matt’s blog, and talking with others, who have not had success with orthoscopic piriformis release, I feel obligated to share. Having a piriformis muscle tendon release orthoscopic, may not be the best option for everyone. For some, like myself, OPEN surgery is the best option for a chance of a full recovery.

    Prior to finding a doctor to treat me, I tried every single treatment option available, yet I still had the buttocks pain when I sat, stood and walked slowly. For some reason, if I exercised hard, like walked fast, or did a bunch of squats, my nerve pain would go away. However, after an hour or so the pain returned with vengeance. In addition, to the piriformis, buttocks pain, I had corresponding ankle and foot pain in the center of my foot. If my butt pain was raging, so was my ankle pain. The two pains went hand in hand. When they disappeared, both were gone, but when they hurt, both hurt.

    Prior to surgery, I had (3) piriformis muscle, cortisone injections which provided me relief for 15-18 days. However, as soon as the cortisone wore off, the pain returned in both my buttocks and foot. I had a provocative EMG done, which came back negative for piriformis muscle syndrome. However, as I now know, it was a false reading. It could have been negative because of my hyper mobility, or because the “H-wave” test they did only tested for the tibial branch of the sciatic nerve and not the peroneal branch of the sciatic nerve. My doctor said that because I had a break (butt and foot pain only) in the sciatic nerve pain, my peroneal branch of the sciatic nerve was the part of the sciatic nerve that was impinged.

    On 3 3/31/2015, I had surgery. I am glad I had open surgery by Doctor Thomas Ellis in Dublin, Ohio. If I would have had orthoscopic surgery, it would NOT have been a success. Open surgery was the only way. It was essential for the doctor to see every muscle which runs under the piriformis muscle and to see how the sciatic nerve was rubbing on my tronchater (bone). If I would have only had scope surgery, he would not have been able to move my leg around and see how the sciatic nerve was catching. He may also have not seen the nerve embedded into other muscles.

    Dr. Ellis said piriformis was super-super tight. He released it, moved my leg around and when he looked at it again, it retracted already. As a result, he shaved the tronchater (bone) to make room. He said my sciatic nerve was rubbing and being irritated on the tronchater. He also said, since the piriformis muscle was so tight, it was compressing static nerve into the other muscles deep rotator muscles below piriformis. My sciatic nerve was embedded in a lot of my deep lateral rotators, as well as piriformis muscle. With his finger, he released the sciatic nerve from the muscles. He did not need to use instruments, just his finger. He said that he didn’t want to use instruments to prevent scar tissue. He said, when he made room by releasing piriformis, the piriformis stopped pressing on sciatic nerve into the other muscles. He is pleased with surgery and thinks I will have long term benefits from the surgery. Fingers crossed! What a relief!

    I am two weeks post operation today and on crutches for another 2-3 weeks. I am able to sit for (1) hour increments and it feels good. I think it is safe to say that my nerve pain is gone. Although I have moments where I feel pulling on the trochanter, where he released the piriformis tendon. When I get that, I feel some tingling and sensation in my ankle. However, it is not even a (½%) of the pain I was in before surgery. Prior to surgery, I was at an eight (8) pain level most days. Now, I just have surgical pain, discomfort, some twitches, tingles and tingling. The doctor said that it can take (3) months for all of my nerves and muscles to heal. At this rate, I am extremely pleased with my results and I hope my healing continues and I make a full recovery.

    I hope this post helps others think about what the best option for surgery is.

    While recuperating, I came across a few articles that I feel are resourceful. I hope they help others.

    Healing well wishes to all! – Gina

    ARTICLES:

    The piriformis muscle syndrome – An exploration of anatomical context, pathophysiological hypotheses and diagnostic criteria:
    http://www.sciencedirect.com/science/article/pii/S1877065713000663

    Retro trochanteric sciatica like pain current concept: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195768/

    Sciatica Solutions: Diagnosis, Treatment, and Cure of Spinal and Piriformis. By Loren Fishman, Carol Ardman : https://books.google.com/books?id=1aFqmZBrRqEC&pg=PA67&lpg=PA67&dq=superior+gemellus+sciatica&source=bl&ots=KcVDfL7CZk&sig=czI7NzNWYwYxoz3Ib_RgBInsugM&hl=en&sa=X&ei=cCooVamKAcWbgwTAw4HwBg&ved=0CEwQ6AEwCg#v=onepage&q=superior%20gemellus%20sciatica&f=false

    • April 14, 2015 at 3:12 pm

      Im very happy for you Gina. If the surgeon recommends physical therapy I suggest you go very diligently. I hit a ceiling during my recovery, and physical therapy broke through it. Exercising those muscles post-op was so critical to my success.

      Please keep us posted.

      • Gina
        April 14, 2015 at 3:54 pm

        Yes. The doctor will prescribe physical therapy after six weeks. However, after spending $3,500.00 In physical therapy at $25.00, each session, the doctor said I am a professional at it and didn’t think I would need much…. Lol

    • Angelica
      June 27, 2015 at 4:14 pm

      Hello Gina,

      I’ve read all posts here and am in search for help with this huge problem that everyone on this forum has. I live in Los Angeles and am desperate.

      I’m curious as to to how you are doing since your surgery since I have suffered with this since mid 2011.

      Also wondering how do you think this happened to you? Thanks in advance for your response.

      • Angelica
        August 5, 2015 at 3:18 pm

        Does anyone know of a doctor in the Los Angeles, California area?

    • Carol in Texas
      July 6, 2015 at 9:19 am

      Gina – ok its been a few months. Are you willing to share with us how you are doing and if you went back to work and daily routines and are training for some big marathon now???

      Plus, what type of doctor did you go to for the open surgery and how did you find him?

      those of us in other states need sage advice of the experienced.

      Hope all is well in Ohio.

      Carol from Hot Texas!! July 6 2015

  192. Mark
    April 1, 2015 at 5:38 am

    53-year-old male living in South Florida. I began having symptoms almost 3 years ago. After neurosurgeons ruled out any spinal problems I consulted with an orthopedic surgeon who thought my pain might be coming from my left hip into my left buttock and radiating down my left leg. After 3 1/2 hours of hip surgery and the recovery from it, The exact same pain returned. Consultant another neurosurgeon who ruled out spinal problems. Becoming frustrated, I sought the help of a pain management specialist (orthopedist) locally. The first injected my left separately actually and then my L3,4,5. My pain remained at the same level and I continued taking Percocet 20/650 about twice daily. He attempted to switch me to Dilaudid 8MG and then morphine ER 15MG. Neither helped me as well as the Percocet did. I’m now under the care of a more competent neurosurgeon from the University of Miami (UHealth) Who suspected Piriformis syndrome based upon my history, symptoms and what we had tried in the past. He ordered a pelvic MRI with and without contrast and based on the results he ordered an interventional radiology just to inject steroid around the piriformis muscle for diagnostic purposes. I got between two and three days of relief from this procedure before the pain returned. After seeing him today, he is now more convinced that this is Piriformis syndrome. He does not do this kind of surgery and told me he would consult with another neurosurgeon who could possibly point us in the right direction. For the two or three days after the procedure, when I was out of pain, I believe I was suffering from withdrawal symptoms from the Percocet when the pain returned I began taking Percocet again, alleviating that problem. This neurosurgeon as well as myself are concerned about the medications I’m taking for pain and the long term problem I’ll encounter because of it. For this reason, he is referring me to a pain management specialist through the university which I will be seeing on Thursday. I’m in so much pain now that I am taking Percocet approximately three times daily and for the breakthrough pain adding the morphine and dilaudid. I found this site while trying to educate myself, which as you all know, is quite difficult especially when you’re debilitated with all this pain not to mention the drugs. I’ve been reading many of you talk about a provocative EMG and an MRN, I believe from what I’m reading either would confirm the diagnosis. As a pilot and retired air traffic controller, I’m quite used to highly technical and complex scenarios however, i’m beginning to find this quite a bit overwhelming to say the least. I’m joining this form and writing this post in search of education and enlightenment. Any information, opinion or guidance that some of you may provide me given the point I’m at would be most appreciated. Contacting me directly for any of you that believe that would be more efficient would certainly be most welcome. My email: SkyBoss1@gmail.com
    I welcome any help that any of you believe would be of assistance to me and as you know, time is of the essence. Most sincerely, Mark.

  193. March 27, 2015 at 12:39 am

    Matt,
    Could you please tell me who did your neurolysis with your botox injection and how that was done? Thanks!
    Tisaacs72@gmail

    • March 31, 2015 at 9:49 pm

      Dr. Malcolm Hatfield. Botox was not effective.for me.

      • hurting
        March 31, 2015 at 11:51 pm

        Can u describe ur botox experience? How many injections? Time frame before u knew it wasn’t working?did Dr give reason for its failure?

  194. Patti
    March 12, 2015 at 6:47 pm

    How many people have or had pelvic asymmetry, anterior or posterior rotation of their hip bone / illium because of piriformis symdrome? Can the piriformis cause pelvic rotation?

    • Mrs A
      March 13, 2015 at 11:37 am

      I think it happens the other way…pelvic rotation pulls on the piriformis and entraps the sciatic. When the nerve is trapped and then cannot floss, we end up with the pain. Walla… Piriformis syndrome.

      • Patti
        March 13, 2015 at 6:09 pm

        I know it happens the other way around, but I’m wondering if anyone had been told that the piriformis was the driver and/or had pelvic assymetry which corrected once they had piriformis release surgery. That’s the information I’m looking for. My doctors and PT are telling me that my sij is good, and that my pelvic assymetry is caused by muscles pulling on the joint or ilium. I’m trying to figure out whether or not to believe them.lol. Or to believe my prolo doctor and go for prp into the sij. I have little back ache but lots of nerve pain in my legs.

    • Gina
      March 14, 2015 at 5:08 am

      Personally, I would believe a PT and Doctor. I actually feel my piriformis muscle yanking on my femur and sacrum. I can do a runners stretch, force my femur back by activating my rectifemoris and psoas muscle. I get relief that way. Actually, all nerve pain goes away. Prolotherapy is not covered by most insurance companies and there is likely a reason for that. I have heard of people getting relief from it, but never a permanent resolution. My surgeon told me I could try a botox injection or Prolotherapy, but it most likely would not be a permanent resolution. If you can afford to pay for it on your own, it couldn’t hurt. It may provide you some relief temporary at least

      • Summit1
        March 14, 2015 at 9:39 am

        Slightly off topic–has anyone here tried or heard of anyone getting MORE than a temporary benefit from platelet rich plasma (PRP) injection? PRP has a reputation of being ‘experimental’. I understand the theory of how it works but not aware of any extensive double blinds, etc.

      • lea
        March 14, 2015 at 1:04 pm

        Summit 1_ I have had lasting benefit from prp for my si joint instability. The prp doc wanted to inject the piriformis muscle but I declined. Prp can cause an increase I. Scar tissue. It is not the cure all that some docs seem to think. However it does work. There is a reason so many extremely rich professional athletes use prp. There have not been double blind studies because who pays for them? There is not a drug company involved. It is all your natural body fluids reinjected to promote healing. This is not an indictment of the drug companies who do amazing work, it is just pure economics. By the way, prolotherapy was not covered by my insurance but prp was.

        To cover another question posed, the si joint and piriformis does play a synergistic role. A loose si joint does cause piriformis spasms as the flute muscles attempt to stabilize the joint. Over time the muscles adapt to a constant state of contracture which makes it difficult to get the si joint to stay in appropriate alignment. For those with both issues (si joint and piriformis) both need to be treated in order to get better. I chose to fix my si joint by prp as much as possible prior to surgery. Solidifying my si joint did reduce my piriformis spasms but I still had pain from nerve entrapment and scar adhesions.

      • Patti
        March 14, 2015 at 7:16 pm

        There is a facebook group dedicated to sijd and prolotherapy, prp etc… . There are a number of people there who have had prp to the sij and lumbar regions. Prp isn’t a treatment for PS, right?

      • Patti
        March 14, 2015 at 7:19 pm

        Gina: agreed! I’m going to try a piriformis botox and after that maybe prp to my sij and lumbar. After a few months break as a snowbird, I’m heading back to Canada the first of April to meet with all of my doctors and decide a way forward. I mostly have DOMs (every evening). It’s difficult for me to distinguish if it’s muscle or nerve pain. Feels like nerve. If I’m lucky I spend most of the day relatively pain free (on pain killers). Once I stop moving, in the evening all hell breaks loose.

      • Patti
        March 14, 2015 at 7:24 pm

        Well stated Lea!

  195. lea
    March 11, 2015 at 5:43 pm

    Count me as a success story for open surgery with neurolosis. My nerve was trapped within the piriformis as well as adhered to the ichium (pelvis). I am 4 weeks post op and feeling better every day. My piriformis was only cut enough to release the nerve. The skill of the surgeon is more important than the open vs closed argument. I am a very active 35 yo male and been in pain for 4 years. This blog has been important in my diagnosis and recovery. Do not give up and be your own activist. By the time we get to this point I would argue most of us know more than the general practitioners we start our journey with. I found my surgeon by writing letters to the most prestigious teaching hospitals in my area. If I lived closer I would have considered Matt’s surgeon. All I can say is do not give up! God is with you and will never forsake his flock! Very short overview of prior treatment: 5 mris , multiple steroid injections in spine, piriformis botox and steroid, Dr scheriling in MO, prp (fixed loose so joint which along with blunt trams may have been trigger). Eventually diagnosed by a super duper ultrasound and an open minded neurologist. My surgeon was an orthopedic surgeon.

    • March 11, 2015 at 5:55 pm

      Congrats Lea!

    • Summit1
      March 11, 2015 at 6:27 pm

      That fantastic to hear Lea — can you indicate either here in the forum or offline (summitview66@gmail.com) who the surgeon was and where he is located. I’ve pretty much exhausted most alternative treatments over past 4.5yrs and now running pain at 7,8.9 levels, so I am very appreciative of ANY leads. I’m in NYC area, but will travel if need be. (BTW, Matt my apologies for posting so much).

      • lea
        March 12, 2015 at 11:22 am

        The decision does take a step of faith. It took me almost a year after finding the surgeon to go forward. As far as my surgeon…..he is the head orthopedic surgeon at a prestigious spine center at a teaching hospital. He is extremely talented and down to earth. As stated above I found him by writing letters. He first declined to see me before his staff changed his mind. He had performed about 100 surgeries after becoming familier with the condition after a family member was afflicted. I am going to respect his wishes and not publish his name or location. As we know, this can be a controversial diagnosis and treatment. In his words, he is a spine surgeon and just knows how to diagnose and trat this condition. He does not want to be overwhelmed because he is trying to teach surgeons. However, it is a blessing he is teaching the up and coming spine surgeons that this condition exists. I live about 3000 miles away from you and you have great resources in your area. I have spoken to fishman on the phone in NYC. He seems like a nice man. Have you seen him? Try writing g letters as I did. Remember, most good docs have an ego and keep that in mind when conversing with them. God is with you and I will be praying.

      • Summit1
        March 12, 2015 at 1:33 pm

        Lea, thx for your comments. I have met Dr. Fishman and am being seen by very capable partner who did my prov-EMG, however they do not perform surgery. Have been searching for a surgeon with experience in PS in this region and haven’t found one. Probably will have to travel (hurts just to think about it). Glad you found a solution… if you have anything you would rather share offline, you’re are welcome to drop me a note (summitview66@gmail.com). GB/JIM

      • Gina
        April 14, 2015 at 2:28 pm

        Summit1 – I heard Dr. Alan Belzberg at Johns Hopkins is familiar with piriformis muscle syndrome. Perhaps he may be a resource for you to get out of pain. Good luck!

        http://www.hopkinsmedicine.org/profiles/results/directory/profile/0005517/allan-belzberg

    • Patti
      March 12, 2015 at 7:48 am

      Great news Lea! So happy for your successful surgery and amazed when you describe the problems the sirgeon uncovered. How does this happen to the sciatic nerve, all of this entrapment? I’m also considering surgery, but I’m scared to death, as there is no difinitive way of diagnosing in advance. Thanks for posting. I would also be interested in knowing who your surgeon was. I’m in Ottawa, Ontario, but will travel for surgery if necessary.

    • Patti
      March 12, 2015 at 7:53 am

      Lea: how were you diagnosed? I’ve been diagnosed with sijd and have had 8 rounds of prolotherapy. I still have pelvic assymetry which the pt has not been able to correct. She says its miscles pulling on the illium.

      • lea
        March 12, 2015 at 12:24 pm

        I originally hurt myself moving a boat on a trailer that resulted in a torn ligament in my si joint. Physical therapists diagnosed the unstable si injury but docs swore it was a disc. Eventually I was seen by Ed stiles (Google) as he was teaching a continuing Ed course at my pt. He recommended prolo for si joint. In addition I had incredible glute spasms and nerve pain. He thought it would go away when so joint was stable. 6 rounds of promo did nothing. Switched to prp and it worked like a miracle. My so joint became stable but still had intense leg pain. Long story short found neurologist to do diagnostic studies. Tried to get him to do provocative emg but he declined. Regular emg still led to a diagnosis of piriformis syndrome. I was sent to a pain doc who tried a botox shot with no benefit. Two steroid shots helped temporarily. A doc in the office was trying out new ultrasounds to buy one. I was asked to come in and they wanted to see if they could image my sciatic nerve with it. They were able to and when moving my leg while imaging my nerve with the ultrasound they were able to see the nerve yanked by the piriformis muscle. At that point they diagnosed me with the nerve running through the muscle and I knew I would never get better without surgery. The surgeon I found took everything into account and agreed to do surgery. The nerve being scarred to the ichium was a surprise and probably due to a drama in the past (sports or work). The two entrapments working together produced my intense pain. Had it just been one or the other I may have been able to manage it. I was confident in mybsurgeon when he told me he was going to trace my sciatic nerve from where it entered my pelvis until it exited. If he had not he would not have found the nerve scarred to the ichium by the hamstrings. If you have surgery please look for a surgeon who will look beyond the obvious piriformis region. (please disregard typos I am using my phone. My surgeon asked me not to sit for six weeks post surgery)

      • Patti
        March 12, 2015 at 6:45 pm

        Lea: thank-you this is very helpful. I also was diagnosed with si joint dysfunction and I had “severe anterior rotation” as a result of a manipulation by a physiotherapist. I’ve had 8 rounds of prolo, cortisone injections, lots of pt manipulation – but I still have pelvic assymetry with the right illium forward. I will probably go forward with prp in the spring as well as a piriformis botox. It’s nice to know that some people are finding relief through the surgery. I know that I don’t have a split piriformis due to an mrn I had done.

    • Mrs A
      March 12, 2015 at 10:55 pm

      Lea: Ive read most of your thread and I just wanted to thank you for sharing your story. The information therein is incredibly necessary for this forum. So much of ps is related to Sijd so reading how both you and your Drs navigated between the two, back and forth is telling. You are also correct when you say that most of us on here are more educated than the generalists that we see. We stay that way and learn more and more by folks like you who take the time to post.
      I actually had the piriformis release surgery (scope) done 2.5 years ago but the Dr clipped a gluteal artery and chose to abort surgery. Though, that’s not what we were told.. He told us that he aborted because he found a huge amount of scar tissue on my sciatic nerve and once he was finished de reading that, he was sure that the scar tissue was likely the cause of my pain and so that’s why he decided to abort. My bad luck continued and 5 days later Drs evacuated a hematoma (the size of a cantaloupe) from the back of my leg …(16 inch scar)The hematoma sat so heavy on my sciatic over the 5 days that I became paralyzed from the knee down.

      My biggest focus now is working on regaining function in my foot which still remains partially paralyzed and infected with a kind of nerve disease called CRPS which is cripplingly painful. I still have the ps, plus lots and lots of other problems as a result of the botched surgery. Drs need to know about this condition and figure out how to treat this so we all can live pain free lives without disabilities. I’ve never told my story before on here. I figured if I was learning things from all of you, then I should share so that someone might learn from me. God Bless you all!

    • Gary Manis, Jr.
      March 17, 2015 at 8:40 am

      HI, I’ve read your story. Wow that great news! I think this could be my problem?? I been there a done just about everything you have, if not more. I to we’ll was VERY active in cycling.. but with my leg issues, well thats no longer. But Where is the surgeon and whats his name?
      seventit@hotmail.com Thanks, Gary

    • Gary Manis, Jr.
      March 17, 2015 at 7:46 pm

      Hi, Its good to read about your success!. I need to have this test done myself?
      Whats the surgeon that helped you? seventit@hotmail.com Thanks, Gary

      • March 20, 2015 at 5:00 pm

        Dr. Scott Hardin in Milwaukee area.

  196. Paulette Little
    March 9, 2015 at 4:54 am

    Dr. Chambi does not do endoscopic procedures. I will not name the surgeon who harmed the people I know of. I am aware of the bad reviews for Chambi, but for this particular procedure, he is flawless, at least in my opinion. He is a neurosurgeon, and this specialty has the most lawsuits in general. I think he was accused of doing unnecessary surgeries. In the case of the sciatic nerve, he first has EMG’s done and does a particular exam that tells him if the surgery is necessary.

  197. hurting
    March 8, 2015 at 11:24 pm

    Anyone involved in Dr. Loren Fishman study, would like to converse, off line,if possible

    • Summit1
      March 9, 2015 at 1:56 pm

      Happy to talk offline. Here’s a link to the study: http://manhattanphysicalmedicine.com/piriformis_trial.html
      I’m 50yrs old, in excellent health, was very physically active prior to PS, now 4.5 yrs into PS, and 8wks into this study. I have tried many things–ironically the things that work the best in day to day mgmt. are the basics–for me they have not eliminated the problem but they have brought me back from being nearly immobilized. email: 9d406036@opayq.com

  198. Patti
    March 8, 2015 at 7:00 pm

    Summit 1: what is the bad doctor database?

    • Summit1
      March 9, 2015 at 6:10 am

      Google it and you’ll find it. I’m looking for a very experienced doctor with a long list of positive patient outcomes. Piriformis release is a specialized surgery. I’m in NYC area.

  199. Paulette Little
    March 7, 2015 at 10:42 pm

    I had my sciatic nerve decompressed by Dr. Israel Chambi in Santa Ana, CA. He used a surgical microscope. This is not an open surgery, yet it is not endoscopic either, so it doesn’t cause the adverse effects the endoscope may cause. I know of several patients who had surgery using the endoscope, and they are much worse off because of it. I did not improve a lot after the surgery, but I also have pudendal nerve entrapment, so my case is complicated.

    • Summit1
      March 8, 2015 at 12:44 pm

      When you refer to other patients that underwent endoscopic treatment, were they also patients of Dr. Chambi? Dr. Chambi came up on my search, but based on what I read in the “bad doctor database” is not on my own short-list.

      • hurting
        March 8, 2015 at 11:28 pm

        How long have you had problem, how far into the study are you, any positive results yet, if this doesn’t work do they do surgery themselves?

  200. Gina
    March 6, 2015 at 10:46 pm

    There are lots of dangers going scope, you can’t see everything as well and get to everything as easy. Some people have the sciatic nerve entraped on more than one muscle. Also there is a sheathing that develops around nerve that may need to be removed to have nerve pliable again. It is better for doctor to see everything. The con to open, is you could develop scar tissue. The recovery time is not much longer.

    • Summit1
      March 7, 2015 at 10:44 am

      Makes sense–interested to hear how your meeting on Monday goes–feel free to shoot me an email if you prefer. I am wondering if there is any element of the diagnostic process which would cause one to lean more toward scope or open. I also am curious whether there are any studies of post-operative outcomes which would shed light on success rates in one procedure vs. the other. Seems to be so many unknowns–I get a bit lost in the weeds.

    • Summit1
      March 7, 2015 at 6:07 pm

      Gina, from what I’ve read, release of the Piriformis is only half the battle, the other half is hopefully avoiding or preventing post-operative scar tissue. Here’s a link to a case study where Teflon was used to wrap the sciatic nerve to prevent scar tissue from tacking it back down. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505267/pdf/11999_2008_Article_151.pdf

  201. Mr. Miley Parrish
    March 6, 2015 at 9:08 am

    I had piriformis muscle release surgery 12 years ago at the Cleveland Clinic after 3 years of pain. It has not helped. I suffer every day with pain when I sit. I was 55 years old when I had it done and I regret that I had the surgery.

    • Gina
      March 6, 2015 at 12:31 pm

      Mr. Miley Parrish – did Dr. Bolhman do your surgery? He is diseased. What did he do? Did he only release the piriformis muscle? Did he debris the sciatic nerve form the muscle? Did he remove the nerve sheathing that develops from the nerve being damaged? Curious. I am going to see Dr. Ellis in Columbus, Ohio, as there are no doctor’s in Cleveland to discuss what I am going to do about this issue for me. Would love to hear more about you and your experience. Thanks.

  202. Summit1
    March 2, 2015 at 9:22 am

    Fwiw: I am currently participating in a study of the use of Xeomin (Botox) in treatment of Piriformis syndrome. I am participating thru the office of Dr. Loren Fishman and Dr. Allen Wilkins (NYC) and it is funded by the pharma company, so no cost to participants. For those who haven’t tried it, may be worth considering. I’m halfway thru the study, so not at a point where I can comment on efficacy (don’t know if/which side, etc. I received placebo). The study involves several weeks of PT in combination, also funded by the pharma.

    • Sue
      March 5, 2015 at 2:01 pm

      How did you find this study and are they accepting any other patients?

      • Summit1
        March 6, 2015 at 7:44 pm

        The study is being run by Dr. Fishman (great guy and Martin Short lookalike). They can take up to 100 participants and I am approx #50.

  203. Alex Gonskij
    February 13, 2015 at 7:10 pm

    Hello ! Can you tell me more specific about your exercise routine ?

  204. Connie
    February 1, 2015 at 4:15 pm

    Has anyone used any of the spinal surgeons at The University of Virginia for piriformis release?

    • Kandace Compton
      March 20, 2015 at 1:22 pm

      Hi Connie! Did anyone ever get back to you on this? I’m in the DC area and am looking for a doctor near here.

  205. sara
    December 12, 2014 at 7:03 pm

    Who wrote the original post stating that they had a successful Piriformis release and success with sciatic nerve relief from entrapment? Who was your Doctor? I have same condition and can not find a good surgeon to be honest, there are not a lot of surgeons in the US as is but research shows poor outcomes from the ones I have researched anyhow. Please inbox me who helped cure your condition, I am desperate for relief. Thanks -Sara

    • Gina
      December 18, 2014 at 1:59 pm

      I am in the process of interviewing doctors for a surgical release. I can tell you I am impressed with Dr. Henrich in Milwaukee, he helped Matt, the person who the blog belongs to. I am also getting a second opinion from Dr. Nabril Ebrheim from the University of Toledo Medical Center and was thoroughly impressed with him too. I heaqrd of Dr. Hal Marin in Baylor Texas . I saw some posts about Dr. Scott S. Katzman, M.D. in Orlando Florida. – I have not had surgery, just in the process of interviewing doctor’s for surgery now that I have a diagnosis. https://www.youtube.com/watch?v=E53d0sEpcI8 – I hope this helps.
      The you tube video is from Dr. Ebrheim.

      • Summit1
        March 3, 2015 at 3:40 pm

        Hi Gina, any update on your interview process. I have 3 doctors on my shortlist, but have only just begun considering this route. Thx.

      • Gina
        March 6, 2015 at 12:34 pm

        Summit1 – So far, I like Dr. Henrich, but he only does scope. I practically ran out of Dr. Ebreheim’s office. He wanted to put a neuro stimulator in my back for the pain. I am going to Columbus, Ohio to see Thomas Elllis Monday. He does open surgery. There are pros and cons to open and scope and I am leaning towards having a open surgery. Have you had any luck? What have you been finding?

      • Summit1
        March 6, 2015 at 8:36 pm

        I had the impression that scope was the way to go as it is less invasive and consequently a shorter healing time. I’d be VERY interested to hear pros and cons vs open.

      • March 6, 2015 at 9:13 pm

        Dr. Heinrich is a great resource for this question. Just my suggestion.

      • Sunshine
        January 18, 2016 at 10:16 am

        I really think after reading all of your post here and some other that maybe I can have a few ppl help me as I am a complicated case and have undergone many spinal fusions and never helped amongst millions of other things in the last 5 yrs and im only 35 yrs old single mom of 3 with a special needs son and a daughter with medical issues with many surgeries herself as did my other daughter. But thankfully my middle one had her surgery and only one major surgery when she was 14 mths old and the only one that has never had issues since besides being almost a 14 yr old hormonal teenager. But I dont have time right this moment. I’ve been readinf this blog for hrs now. All night long. I live in central Florida. And ive also been disabled the past 5 yrs. I have so many things going on and out of all the surgeries I have had just in the last 5 years which I had them all back to back on the dot each year. Within a 4yr period and still at the end of my rope. Was told nothing else could be done except a pain pump which I hate the meds they rarely help and it’s NOT a fix its a bandaid bc many dr dont really care and I’ve had many of those dr. I refused the pump and they said my only option was the spinal cord stimulator and meds. Well I lost all faith all last year after yet another botched fusion has made all of 2015 a huge mess and depression and pain and the excruciating pain in my hip and butt down my leg in my groin area and to my foot and toes. Its kept me from using my right side and rushes to the hospital to be turned away dr saying god knows what. But finally I came to the point after being in bed mostly about a year bc I cant sit stand walk drive which wow driving is the worse being the pain is all on my right side. And I hate that my kids see me in this pain. They feel helpless and im having to parent from bed. Thankfully my older girls are teenagers oldest almost 16 and has been my saving grace. But I cant do dishes laundry cook. No sotting standing for more than about 10 mins. The horrific spasm I get in my hip and but all the way down my leg to the point I want to die. Its hard as a rock. Toes curled its horrible. All day and night long my body jumps like I was electrocuted. My whole body. More my hips down. Im dealing with similar issues with my neck as ive had 2 fusions in my neck and a total of 3 L5- S1 fusions. 1 was years ago and no problems back then no hardware or anything back then. But I’ve had the 4 fusions just in a matter of 4 yrs and still going on my 5th year im declining so bad. I tried to get into the mayo clinic they denied me. I did just find an amazing dr and after a few physical exams in his office. He tells me about this Piriformis syndrome. Never heard of such a thing and ive already had many injections in my SI Joint and I know there is an issue with it or I think Iknow as the first one I had when I coucouldnt walk and hospital turned me away I went straight to my pain management dr who sat there for 4 hrs of me crying screaming wanting to die and im not like that I do my best to hide my pain. Well there was no way of hiding this. My bf had to carry me in and finally 4 hrs later they took me to the back to put me under the florscope x ray machine they use to do the injections and gee the dr was shocked and the office at this time was now closed and he did an injection right away awake and all. But almost instantly my toes uncurled before their eyes and foot started to release and took some time for the rest of my body to release. It just has been hell. He is pushing me to have this damn stimulator and not happy that ive pushed it off bc its his other dr who signed me up last yr to have a stimulator and before you know it he had a neurosurgeon say oh no we cant do that right now you have a huge herniated disc under your fusion in your neck. Told me I could be paralyzed if he did the stimulator surgery bc the disk was so bad and no I had really no complaints up in my neck. They made it seem so serious and we all want to trust these dr who swear there here to help and was ready to schedule me asap and said after I had that cevical fusion then they would do the stimulator. Well ive had so many complications since that surgery Dec 2014 from the day I woke up. Now my upper body neck shoulders havent been the same. But they say my spine looks good. Anyways after all the complications and then my pain dr went MIA and I found out he was mis diagnosing me for the last 2 yrs. Now the medical director of pain management is seeing me and pushing the stimulator surgery on me again. Even wanting to do it for free. Gee bc he knows his practice has screwed me big time. Anyways I just found these new dr with great reviews and have been praying bc this is no way for anyone to live at all anymore. My life as a single mom at 35 is in bed bc I can’t do anything. Even laying in bed is painful. So today I will be calling for physical therapy as my Dr wants me to start off going 2-3 times a week for 6 weeks. With people to treat me for PS. The only thing is, is Ive been down that road many times. No not for this but I’ve had injections. Just not in that muscle that I didnt know I had. But the pain is so bad and I feel as im at the worse of the worse with this and dont know if PT will be able to help me. 😦 I have looked up the simple exercises and talk about painful. I am only hoping that maybe the massage therapy part and other things they can do will help. But that muscle is constantly spasming. It never stops. Days with appts or doing anything at all on my feet or sitting makes it that much worse. So lets hopeI can continue to learn about this Piriformis Syndrome and hope to hear more stories so I can become aware of everything and know what I am up against. I saw somewhere that there are pages on facebook or groups and I will be checking those out later after I get some sleep. Hopefully bc Im exhausted from the pain and no sleep at all which is a normal thing I can’t seem to find anything to help relieve my pain to help me. Son sorry this is so long and I wish I just went ahead and posted at the top and not as a reply from an old post but I didnt think I would get into everything right now.. But definitely would love more information. I hope this post goes through as this is my first tine finding this site. Feel free to email me with any help or advice. I would greatly appreciate it. Just in the subject line in email Piriformis Syndrome so I know not to ignore the email as I get a lot of emails. Thank you so kindly in advance and to everyone for sharing. Things are starting to make more sense just reading these post then what small info I have seen on a few sites before I found this one and so glad Im not alone. My email is mahaynes25@gmail.com
        Thank you so much for taking the time to read. Im just a mess and hoping this dr is correct bc so many others have had no clue and told me I will end up in a chair and that I wont have any quality of life and will only get worse. So please keep me in your prayers my kids need me and I need my life back. I will keep you all in my thoughts and prayers as well.
        Sincerely, Michelle aka Sunshine

    • Angie Goodgame
      February 1, 2015 at 5:56 pm

      Thanks for the suggestion Cece. I am seeing a different Chinese Medicine Dr.in La Grange. Im just now seeing your post or I would have tried to see Sheng Li Wang. I’m getting tremendous results seeing Dr. Lorene Wu. I’ll definitely keep Sheng Li’s name handy. How are you feeling now?

  206. Patti
    December 4, 2014 at 7:16 pm

    Walker : my MRN was also done by Dr Filler!

  207. Patti Sanghwan
    December 4, 2014 at 11:33 am

    Walker: who did your MRN? I had one done and got the same report as you.

    • Walker
      December 4, 2014 at 1:20 pm

      Hi Patti, my MRN was done by Dr. Filler.

  208. Angie Millikin Goodgame
    October 26, 2014 at 1:58 pm

    Walker, I’ve been following your story because I have terrible foot pain too. What has your Dr been able to tell you lately?

    • Walker
      October 31, 2014 at 1:43 pm

      Hi Angie, I got another MRN done last week, so I’m waiting for the results to see what my next move.

  209. Angie Goodgame
    September 11, 2014 at 8:54 am

    Ask your Dr if you might have RSD. Sounds like peroneal nueropathy at a minimum. Where do you live? You should fly to Chicago and see Dr Lubenow at Rush Medical if you’re able. High doses of Lyrica will help a lot, like 600mg per day, or 150mg 4x day.
    My heart goes out to you…

  210. Paulette
    September 2, 2014 at 8:58 pm

    If continued entrapment is the cause of your continued piriformis pain, it must be the reason for my continued sciatic pain as well as the continued pudendal nerve pain. Have you ever considered that your pain continued pain may be due to a damaged nerve related to the entrapment?

  211. Kathy S.
    September 2, 2014 at 3:25 pm

    Hi Everyone I just wanted to update on my recovery after the piriformis release on April 1st. I thought I was getting better but when I would work or drive the pain was coming back. Standing too long, walking too much and as always driving are the worse for causing pain. Bottom line had another MRN done and Dr, Filler read it and the sciatic nerve is still entrapped (i have split muscle and split nerve configuration). Apparently in %90 of the patients releasing the tendon at the femur is enough to relieve the pain. Dr Katzman is also doing the second surgery and I am hoping and counting on a FULL recovery. For me there can be no other outcome 🙂 Once again I am back to not being able to drive except to work (3 1/2 miles) but even that little amount is enough to irritate the nerve but then again so does my work. I love what I do and have not let up on work because there is a light at the end of the tunnel. Days I am not at work I am recovering from work. I am basically home bound unless my husband drives me somewhere (even that is uncomfortable but not nearly as bad as driving which is intolerable over 5 minutes). The surgery is scheduled for September 15th and i will update as often as I can. Wishing everyone well, Kathy

    • Patti
      September 2, 2014 at 8:49 pm

      Best of luck with this second surgery!

    • Walker
      September 2, 2014 at 11:33 pm

      Hi Kathy, sorry to hear your recovery hasn’t gone well. As for me I did have the piriformis release on both sides back in the beginning of July, unfortunately it did not help alleviate the pain at all. In fact I feel worse then before the surgery. Its gotten harder to sit for prolong periods of time. I can only sleep on my stomach now which is not a good position for me to be in, as it gives me tingling sensations in my tailbone area that travels into my buttocks and down into the feet. I can’t stand for very long either. My feet hurt so bad I can’t even wear sneakers anymore. So at this point I don’t know anymore what is causing all this pain or what can be done. I’ll give a little explanation of my situation and how I got here.
      About 4 years ago I fell off a ladder and landed on the concrete on my backside hitting my head and buttocks. Got X-rays and showed no broken bones. Then a year later I fell down a flight of medal stairs breaking the end of my tailbone which I didn’t find out until two years later. They never bothered to look that far down in the MRI when I had the fall, but anyways, shortly after that I started having problems with my feet. So I saw a podiatrist who said I had plantar fasciitis. Over the next 2 years I saw multiple podiatrist who treated me, had injections of cortisone, I tried PRP injections, had a couple of surgeries, did physical therapy, and got no relief in my feet at all. Over the years my focus was always on my feet, I never paid much attention to the pain in my buttocks and coccyx area because it wasn’t bothering me much since i was always standing. Once I was forced to start sitting more because the pain in my feet got so bad, that’s when I started having the pain increase in my buttocks. I saw a neurologist who diagnosed me with peripheral neuropathy, tried different meds which were no help at all for the pain. About a year ago I had the MRN done and it basically said my sciatic nerve shows significant hyperintensity near the piriformis, that there is a flattening of the nerve at the sciatic notch and also that I might be suffering from neuritis. Fast forward a few months I finally had coccyx surgery in early February where they removed just the broken section of my tailbone, the rest of it was fine. It is a slow painful recovery, I’m still healing from that one. Then in July I had the bilateral piriformis release which hasn’t helped. So now I have a such a hard time dealing with chronic pain everyday in my feet, buttocks and tailbone areas. I try my best to do basic stretching and strengthening exercises to keep from being stuck in bed all day. I use ice and heat pads to help with the pain, take pain killers. If anybody has any ideas or suggestions, I’d love to hear them.
      Kathy I’m curious to know, you said that walking and standing too long causes you pain, are you having pain in your feet or in your back?

      • Patti
        September 3, 2014 at 4:13 pm

        Walker I am amazed when I read your story, that no one ever suggested to you that you may have a sacroiliac joint injury from your fall. It’s worth looking into. I have had symptoms similar to yours and I’ve been doing prolotherapy for the sij and it is helping. No surgery here!

      • Walker
        September 3, 2014 at 9:16 pm

        Patti, thank you for your feedback. I will look into it and see if it provides a solution to my chronic pain. Dealing with pain in my buttocks is bad enough and I also have to deal with pain in my feet which makes it so hard to walk or stand for more than 5-10 mins Now that I think about it last summer I had MRI’s done on both my feet and there was no mention of me suffering from plantar fasciitis. Then I had the MRN a few months later and the doctor stated that my sciatic nerve is flattened and theres thickening at the level of the sciatic notch and continues into my hip. it sounds to me that that is what is causing my feet to hurt. If I rub on a spot on my leg where you can apply pressure to the nerve, it hurts like hell and the pain travels into my foot. My feet sweat a lot for no reason. I get numbing and tingling sensations in my legs when I’m in my car. Its just a nightmare dealing with this everyday.
        Did you have any pain in your feet as well Patti?

      • Patti
        September 4, 2014 at 7:45 am

        No, no pain in my feet.

      • Walker
        September 4, 2014 at 11:26 pm

        Thats good Patti that you don’t have to deal with the feet pains. It ruins my all day.

    • Cheryl Golden
      September 3, 2014 at 5:07 pm

      Who did your first surgery? Was it Katzman in Tampa?

      • Kathy S.
        October 14, 2014 at 6:43 pm

        Hi Cheryl I am SO sorry for not responding sooner. Lierally have not checked my email for almost 5 weeks and even then it is a quick peek and I miss many. I dont; use it for work and i become overwhelmed by all the messages and just ignore it. Anyway…last 4 weeks were spent recovering from my second surgery on the piriformis and sciatic problem. While I am better I am still having a lot of pain. Now to answer you question. Yes it is Dr. Scott Katzman but I saw him in Altamonte Springs (Orlando). Have you gone to him or heard about him? Would love to hear your opinion or what you have heard. Thanks for your patience, Kathy

    • Walker
      September 11, 2014 at 12:54 am

      Hi Kathy, I was wondering what kind of surgery are you having done now?

      • Kathy S.
        October 14, 2014 at 6:53 pm

        Hi Walker, my apologies for not getting with you sooner. I had the surgery 1 month ago. The 2nd MRN after the 1st surgery showed that the sciatic nerve was still or again entrapped near the sciatic notch. Dr. Katzman found that the piriformis muscle had wrapped around the nerve and “tacked it down” with scar tissue. This time muscle had to be cut to free it. Te jury is still out on how successful it is going to be. Also had a bursectomy on the femur on same side this time. That has added to the pain. I have days when I dont feel any leg pain and others where the leg pain returns as intense as before. I am still hopeful that this is the healing process. Time will tell. How are you and what did DR. Katzman say when you went back? How are you doing any improvement or right back where you started? I am hoping for any relief for you, I can’t imagine having this in both legs……my heart goes out to you. Take care, Kathy

      • Walker
        October 31, 2014 at 1:55 pm

        Hi Kathy, I got a 2nd MRN done just the other day, I’m still waiting for results. I’m in lots of pain still, its very hard for me to sit or lay down but as soon as I stand up the pain goes away, but then my feet are in terrible pain. Its a back in forth battle for me I’m wondering if my sciatic nerve is running in-between the piriformis muscle making it worse for me since my surgery. How are you recovering from your 2nd surgery?

      • Walker
        December 1, 2014 at 1:29 am

        Hi Kathy,
        Just wondering how you are doing? I hope this 2nd surgery has done before for you and are feeling much better. I received my MRN report back and as suspected the right piriformis is now entrapping the sciatic nerve and as if that wasn’t enough, I have my right obturator muscle which is in significant atrophy and is in spasm irritating the nerve also. It’s become increasingly difficult to sit down or even lay down. I see the doctor next week to see what’s the next step. I hope others out there are getting the solutions they need to get through this debilitating problem.

    • Angie Spurgeon
      February 22, 2015 at 2:16 pm

      Hi, Kathy, I am just curious as to what kind of car you drive. I have the same problem, even the short distance to work was agony. I drive a Honda CRV. I borrowed my sister’s car for a month or so, and it made the drive for short distances a little more bearable. 1 1/2 weeks ago I had the piriformis release surgery. I can barely walk. Just tiny little steps, which takes forever to get anywhere. Seems worse this week. Doctor didn’t tell me anything about this. Did you experience this, and how long did that take to get better?

      • Patti
        February 22, 2015 at 6:38 pm

        Angie – who was your surgeon? Did you have endoscopic or open? I haven’t had surgery but I find that any vehicle with high seats is less aggravating, like a pickup truck. I use whatever I can find, like a good firm wedge cushion to raise my car seat up. They say your hips should not be lower than your knees.

  212. Angie Goodgame
    August 29, 2014 at 2:52 pm

    Hi. I’m so happy to find people who “get it”. Does anyone know a Doctor who will do piriformis release in the Chicago area. Please avoid suggesting Dr. Benjamin Domb. I would be so grateful for any insight. I’ve been disabled for four years now and need the piriformis released. Thanks!

    • Cece77
      January 19, 2015 at 11:53 am

      If you believe in alternative medicine, I know a Chinese man in Chicago and Downers Grove, Sheng Li Wang, who was referred to me by three different people at three different times. I finally went to him! I had had cell phone damage to blood vessels and nerves in my head/ear and was in severe pain for 6 years…Sheng Li Wang cured it within three visits – accupuncture and energy. I also had a pinched nerve in my chest (from waterskiing fall – hanging on too long) that was causing a lot of pain and he fixed it in two visits.

      I now believe I have nerve issues with the piriformis – pain down inner thigh and up by the groin (due to walking funny from foot issue – need implant in my big toe and will have surgery in 3 weeks). After reading these posts I plan on going to Sheng Li Wang immediately to resolve this issue!!

      • Angie Millikin Goodgame
        February 14, 2015 at 12:02 am

        Cece,

        This is my third week working with Dr Lorene Wu. The acupuncture is really helping me! My spirits are finally high again. How are you feeling? Are you considering Piriformis release surgery?

  213. June 2, 2014 at 12:49 am

    Hi guys…I am from an island called Mauritius and I am only 25. I have been suffering from buttock and hip pain for 3 plus years. Did couple of MRI, x rays, EMG, blood works, physio, deep tissus massage, infiltration for pudendal nerve and nothing worked.
    3 days ago I did piriformis infiltration and now the pain is kicking back. I cannot walk, stand for long and cannot sit…quit working and life is a misery….. What more can I do?

    • June 2, 2014 at 7:18 am

      need to go get a provocative EMG, which is not the same as the standard EMG

      • June 2, 2014 at 7:35 am

        Thank you so much for the advice. Unfortunately the test is not available in my country, not even an MRN….

      • Julie
        June 4, 2014 at 12:24 am

        Hey Mat do you mind if I ask the price of the surgery? I am from Australia & no Dr here performs the surgery that way. I may need a trip to your surgeon

      • June 5, 2014 at 9:22 pm

        About $20,000 if you were paying in cash with no insurance benefits/coverage.

      • Kathy S
        February 2, 2015 at 8:21 pm

        Hi Matt, I saw Dr Katzman for follow-up on my last surgery and I mentioned this site to him. He wanted to get the address for it. I told him I would but then realized I should ask your permission. I think he was curious because I told him I’ve had another patient who posts to this site. Let me know what you think. I respect whatever decision you make. Again thank you for this forum.

      • February 4, 2015 at 1:41 pm

        Thanks for asking Kathy. Please give the site address out to whomever you want.

      • Kathy S
        February 2, 2015 at 8:26 pm

        Correction: Another patient if his who posts to this site

    • Kathy S.
      June 5, 2014 at 11:30 am

      Hi Qaysar, Your island is a beautiful place. Unfortunately you are limited on treatment choices. Botox injections helped a lot for me in the first couple of years. Then they stopped working. For myself because a have a structural anomaly (split nerve and split muscle) surgery became my only option. Am still recovering and having some relief but it is taking awhile. I am sure there are places where those on your island go for for complicated medical surgeries and treatments. That will probably be what you will have to do to get a resolution or solution to your pain. It was very difficult for me to get the appropriate treatment and I live in Orlando Florida and I knew my diagnosis long before I was treated appropriately. I am not sure what your medical options are but I would have done ANYTHING to get relief. That is a common theme amongst people with PS. My heart goes out to you and anyone suffering with PS, it is a long painful road. Take care. Kathy

      • June 5, 2014 at 9:25 pm

        Thanks for your taking the time to provide Qaysar a thoughtful reply Kathy. Very kind words.

    • June 6, 2014 at 12:07 am

      Thank you so much Kathy….I’ll keep on looking…did someone ever get relief or even partial relief from Acupuncture?

  214. Patti
    May 12, 2014 at 9:07 pm

    Matt, you say that you know of many other people who have had piriformis release and have been worse afterwards. Do you know why they are worse? Or any examples of why one would become worse?

    • May 13, 2014 at 3:57 am

      No I dont.

      • Patti
        May 13, 2014 at 12:47 pm

        Okay. Thank-you anyway!

    • Julie
      June 4, 2014 at 12:27 am

      This is what I have heard also. Most surgeons in Australia will not even perform the surgery. So to hear of Matts success leads one to believe he has found a very good surgeon.

  215. Julie
    May 5, 2014 at 8:59 am

    I have been suffering Piriformis Syndrome for a year now & it has been agony. I have had 7 cortisone injections, Physio & all the other treatments people have said. I have not had the surgery but am starting to consider. My physician said that it is rarely successful. So I’m interested in people’s experience on wether the surgery gives permanent relief.

  216. Kathy S.
    April 7, 2014 at 12:12 pm

    Hi Matt, my name is Kathy and last week (4/1/14) had piriformis release surgery. My journey also has been a long one of suffering (4 years) with attempting many treatment modalities with only temporary relief. The most relief I ever had was from Botox injections. The first injection I was pain free for 9 wonderful months, the second for 6 months. After that nothing worked for long, either a couple days or weeks and when the pain returned it was worse than before the injections. Last year alone I had 3 Botox and 2 steroid/marcaine injections. Surgery became the only alternative. I had an MRN (neurography study done which confirmed what I already knew. In fact, I had a split piriformis and a split sciatic nerve. The nerve split above the P. muscle and one section ran through the muscle the other behind. The sciatic nerve rejoined below the muscle. The surgeon said the sciatic nerve had been flattened and of course, like yours took quite a bit of work to release.

    The magnetic resonance neurography is the ONLY study that can visualize what is happening with the nerves. Unfortunately, it is not a well known study (neither myself or my primary had heard of it) I am a nurse practitioner and was surprised how underutilized it is. The study is expensive ($4,000) after 3-4 months of arguing with the insurance company I finally got it covered by proving with peer reviewed journal articles that it is not experimental. By definition for insurance companies experimental = no peer reviewed articles, I faxed 60 pages of peer reviewed articles to the appeals board. I got it covered %100. There were only 2 places in the state of Florida that had the study available. This is just FYI for those suffering and need “proof” that they have PS. Make sure you get it approved in writing before you get it done.

    Now back to what I was posting about to begin with. I am interested in hearing the specifics about your recovery. I took 3 weeks off but i work in an urgent and work 10 hours shifts. After reading about your recovery being 3 months I am concerned I won’t be ready. I have worked those same shifts for four years with extreme pain so not sure I wont be able to again. Would love to hear about your experience. I tried to go to the other page for your contact info and it led to a page about a female with SIJ problems. If you could help direct me to your contact info that would be great.

    A final note, the chronic leg pain I had was GONE for the first three days after surgery. It has returned but am told to expect this for up to one month because the sciatic nerve can become agitated because of the manipulation during surgery. I believe %100 that the surgeon fixed the problem. I just wont be free of the nerve pain for a bit longer, I hope. My surgeon Dr. Katzman is wonderful and well known and sought after from all over the country. i will post updates if the pain doesn’t resolve as I expect it to.

    Matt, thank you for this site. PS is painful and the path often long for relief. My heart goes out to all of you.

    @Tasha Dr. Filler is the neurosurgeon who developed the neurography study i had done. He is the one who read my results. As far as I know he is the owner of the technology and the only one doing the MRN. His reviews weren’t great but for just having the neurography study and the reading of it I didn’t have any problems except for financial stuf with the office but that was eventually resolved.

    Thank you,
    Kathy

    • Patti
      April 28, 2014 at 9:29 pm

      Who was your surgeon Kathy?

      • Kathy S.
        April 30, 2014 at 4:51 pm

        Hi Patti, My surgeon was Scott Katzman with Laser and Spine Institutes. Sorry about the slow response last couple days have been rough. I am a nurse practitioner and work in an urgent care center. I worked my first 2 shifts Saturday and Monday and am seriously paying the price. In pain since, still hopeful that this is just going to take time.

    • Walker
      May 7, 2014 at 12:39 pm

      Hi Kathy, how are you recovering from your surgery?

      • Kathy S.
        May 8, 2014 at 11:57 am

        Hi Walker (?) I am 5 weeks and 2 days after surgery and I am starting to see some improvement. By improvement I mean that if the pain kicks in (which it does frequently) my recovery time is much less. For example, when I used to drive even short distances (3-4 miles) I would be in pain for 12 to 18 hours. Now, my recovery from any activity, sitting and standing for too long are the worse right now (I have only tried driving once and found out it was too soon so I get rides to and from work) is less than 6 hours but that is with taking additional pain medication and muscle relaxers. I know that the problem (impingement) was fixed as well as the entrapment of the sciatic nerve. After reading recovery times up t 3 months I am still hopeful that the pain will go away at around 3 months. I am not driving yet as it triggers the pain but had to return to work last week. I am in significant pain by the end of the day. My days off are spent resting and mostly lying down as it is the most comfortable position. My expectations of full recovery by this time were WAY to high. I am hoping that there is not another area that has impinged the sciatic nerve post op. I believe that the recovery is taking this long because the nerve was entrapped for 5 plus years and it will take time to heal. The impression I get is that the nerve is “angry” as it is going through this healing process. My concern when I wrote that post to Mark was that I still was needing pain medication this far out in my recovery. Decided that it is what it is and take it as long as it is needed. I hope this information helps you in some way.

        I will post updates on my recovery, thank you, Kathy

    • Walker
      May 8, 2014 at 2:29 pm

      Yes thank you, I’ve been dealing with a bilateral sciatic entrapment at the piriformis. Been dealing with this for 3 years and I didn’t find out until I had an MRN read by Dr. Filler. I had that back in October. I’m scheduled to have surgery next month. I’m hoping for a speedy recovery. I’ve been dealing with severe pain from the piriformis down into my heels. I can hardly walk anymore. My heels are always hurting since my sciatic nerve is swollen on both sides. I have the same doctor as you and he’s great. I’m looking forward to this surgery.

      • Patti
        May 10, 2014 at 7:52 am

        Who is your surgeon?

      • Kathy S.
        September 2, 2014 at 7:57 pm

        Did you have you surgery yet Walker? I was wondering how you were doing. I updated my post today and Dr Katzman is doing a second surgery for the piriformis (explained why below) Sept 15th. Would love to know how the surgery went and how your recovery is going. Best wishes, Kathy S

      • Walker
        September 3, 2014 at 2:02 pm

        Hi Kathy, I had the surgery in July and no improvement. I’m still having issues with sciatica, heel pains, trouble sitting, standing and sleeping. I’ll see the doctor next week to see what’s else can be done. What kind of surgery are you going to have?

      • Patti
        September 16, 2014 at 9:07 pm

        Kathy, wishing you all the best for your second surgery. Hope all went well.

      • Sham Sham
        October 7, 2014 at 3:36 am

        I  just wondered if anyone had the perineal branch of PFCN  and midlde clueneal nerve remove for pelvic pain? If yes, please let me know if it numbs the entire leg of does not go beyond butt crease.If it goes beyond the butt crease and up to back of the knees how difficult the walking becomes.ThanksShawn

    • Julie
      May 13, 2014 at 4:10 am

      Hi Kathy

      Where does Dr Filler work from? Im from Sydney Australia

      Regards

      Julie

      • Patti
        May 13, 2014 at 12:52 pm

        Dr. filler is based in California. There are imaging centres across the US where one can have the MRN done, the images are then forwarded to dr. filler in California for reading. He has a website. Just google Dr. Aron Filler neurosurgeon California. The website for the MRN is http://www.neurography.com. I’m Canadian and I had my MRN in Buffalo and self paid $4000 approx. definitely worth it! Apparently they also do MRNs at John Hopkins and perhaps a few other large hospitals in the US. They don’t do them in Canada.

      • Kathy S.
        May 23, 2014 at 9:55 pm

        Hi Julie, Patti replied with the info on Dr. Filler. THe MRN is absolutely worth getting, even with the price. I fought my insurance company for 4 months and they finally covered it at %100 but it took a lot of work. Obviously the work was worht the time. The best thing about the MRN was that it was PROOF of the problem. Most of the docs I saw in this area didn’t believe that I had PS. I am planning on writing letters to them to further educate them. I even told them that botox injections took away the pain for 9 months 1st time and 6 months with the 2nd injection. I am in the medical field and this is called “diagnostic” as the treatment supported the diagnosis. Yet one of them still wanted to do a rhizotomy in the lumbar region and said he couldn’t explain why the botox worked. It boils down to the fact that they can make much more money doing the other procedures rather than a botox injection. Sad but true and it makes me incredibly angry that I suffered for another 3 years because of the lack of “proof”of my condition. Sorry about going off on a tangent but this is why the MRN was finally what i needed to proceed with my treatment which ended up being surgery.
        By the way update 7 weeks and 3 days and the pain in my leg is starting to go away for 2 days at a time when off work. Yay!! Just not having the leg pain for a few hours is heaven much less a couple of days!! Still have pain start and stay if I drive even short distances but sometimes it is just the buttocks pain and still no leg pain. However, after a 10 hour day at the clinic i am in pain for a few hours if not overnight. Definitely improvement and getting better all the time. Sitting, standing too long are still the other triggers but that, I know, will go away with a bit more time.
        So Walker good luck with your surgery you are really in great hands with Dr. Katzman, he really cares about his patients which can’t be said about all surgeons!! Everyone at the surgery center was great!
        Take care all and I hope all of you find relief soon. PS is challenging to say the least and relief from the pain is an answer to my prayers! Kathy S.

      • Kathy S.
        October 14, 2014 at 6:28 pm

        Hi Julie, Dr Filler is in California. Look up the Neurography Institute and you can find the address there. I haven’t seen him for PS but have had the MRN’s done through his Institute and he is the one who reads them. (He developed the MRN). He has some terrible reviews on the web but others who claim e is wonderful and changed their lives with their improvement after surgery. Most of the negative complaints were about the office staff and that seeing and being treated by him is expensive. If paying out of pocket for the MRN it is about $4000 which is costly as many insurance companies consider it as experimental (it isn’t) and won’t cover it.. fought my insurance company but it took ALOT of work for it to happen and they ended up paying %100. Well worth the work in the end. Hope that helps Julie. If you have any other questions please feel free to ask anytime. (Although I am sporadic about checking this site but I usually do once a week or so.
        Take care and good luck.

    • Sandi
      December 18, 2014 at 8:35 pm

      Kathy S. – I am in Florida and I am trying to find out more about Dr. Katzman. I was diagnosed by Dr. Michael Buscemi with bilateral PS based on regular EMG and symptoms. He wants to do surgery on both sides but I am not really wanting to go straight to surgery without more proof this is the issue. I started out with foot pain about 2 years ago that has progressed into sciatica pain and my left hip has lost so rotation ability. It feels my right one is now starting to do it too. Someone said I need to have my SI joints looked at to make sure that is not the problem. I had 2 orthos say my symptoms don’t match my MRI and CT scans that show slight left bulge. I went to a neurosurgeon who said my mri showed normal wear and tear that people live with all the time without pain. I mentioned I had glutus medius sprain in right leg several years ago. He said he thought I might have Piriformis and sent me to Dr. Buscemi. Any help you can give me about Dr. Katzman I would appreciate it.

      • Kathy S
        February 2, 2015 at 8:13 pm

        Hi Sandi I am so sorry for the delay. I had my 3rd surgery December 31st with Dr. Katzman again. My case is complicated to say the least and too much detail to go into why 3 were needed. Every individual’s case is different as would be how well they respond to piriformis release. When I first contacted the group Dr Katzman is with he called me and spoke to me about the surgery and what it would entail. He answered all my questions which one of the surgeons I saw basically would not do (arrogant). I hope you find relief from your pain as everyone on these pages knows PS is agonizing at it’s worst and irritating at its best. It has literally taken a couple years of my life away due to limitations in driving thus socializing with friends and family to not even being able to drive to the grocery store 4 miles away. If I would do these things I paid a steep price and ultimately wasn’t worth the risk. I am almost 5 weeks post op and have definite improvements in my la
        Eg pian that had not occurred with the 1st two surgeries. Inspired have had hours and hours of no leg pain YAY. It does return but I am hoping that is just part of the verve healing itself. Also had porcine tissue placed over the sciatic nerve to prevent scar tissue from returning (which had happened after the second surgery). Sandi good lu I and I wish you an end to your suffering and pain. I am including my email so that you can contact me if you want more details abouy the surgeries. Klts@mskees.com plz keep in mind that I do not check my email frequently. As soon as I do and see a message from you I will respond.

    • Brent Todd
      March 1, 2015 at 2:32 pm

      Hi Kathy, I live in Tampa and just spent my first weekend without being able to get out of bed. I get a searing, stabbing pain in my flute when I try to take one step. I would love to speak with you about your treatment and experience with Dr. Katzman. I went to another orthopod in FL two days ago and was sent home with anti inflammatories, which as anyone here knows just won’t cut it. I am an active 38 year old with two young kids and desperate for relief. How can I reach you? This is my first post so I don’t know if a copy goes to your email as well?
      Matt, thanks for setting up this site.
      Regards (and in excruciating pain),
      Brent

    • Summit1
      April 14, 2015 at 1:01 pm

      “I faxed 60 pages of peer reviewed articles to the appeals board.” Kathy is there some way I can get a copy of these? Thanks.

  217. DR
    March 27, 2014 at 5:13 pm

    Do you know of anyone or heard any results of dry needling the piriformis? Much different from acupuncture, as dry needling goes deeper and hits the hypertonic muscle fibers. Thank you.

    • Patti
      May 13, 2014 at 12:55 pm

      I’ve had dry needling done into the piriformis three times. It has helped, depends on the severity of the situation. I’m in bad shape after being badly hurt by a PT. I’m also undergoing prolotherapy for the si joint and piriformis. I’ve just had three sessions so the verdict is out on the prolotherapy. They say one needs to do a minimum of four sessions and more like 6-8. Prolotherapy is he’ll on earth, but it is helping otherwise I wouldn’t continue. It’s another option for piriformis problems.

      • Mo
        June 30, 2014 at 4:03 pm

        HI Patti – Just learning abt PS as the symptoms fit me to the tee — long time 4+ year suffering active male 37 —

        I have been doing Prolo therapy + PRP injections with short term success, however we’ve never targeted the piriformis
        How has the treatment worked so far for you ?

        Thanks –
        Mo
        NYC

      • Patti
        August 17, 2014 at 3:44 am

        Hi Mo, I’ve now had 5 prolotherapy sessions targeting the si joints. I have good days and bad days. I’ve improved with prolotherapy but not enough to go back to work yet (ie to sit for any length of time or to significantly reduce my pain meds). Next week I’m having a ct guided piriformis cortisone injection. The verdict continues to be out on prolotherapy for me.

  218. Tasha
    December 31, 2013 at 11:16 am

    Hi all, We are in the Seattle area and looking for an MD to help us with a plan for my husband’s Piriformis Syndrome. He has been dealing with treatments, procedures and pills for 6+ years. He has had an EMG, MRI, SI Joint injection and 2 Piriformis injections in the past 6 months. His pain has GREATLY increased down the leg, through the buttocks and around the knee since his last injection 8 days ago. He is scheduled for a neurogram at the UW today. We are seeking a provocative EMG provider as well.

    Has anyone used or heard anything about the following, Dr. Attaman (Seattle, WA), Dr. Chung (Polyclinic / Swedish Seattle), Pain Managment Consultants (Walnut Creek, CA), Arizona Pain Treatment Center (Phoenix, AZ), Dr. Aaron Filler (Santa Monica, CA)?? I have confirmed that all of these providers are familiar with PS and administer Ultrasound or fluroscopic guided botox injections.

    Thanks!!

    • Michelle
      January 8, 2015 at 11:30 am

      Did your husband have any luck with finding a doctor in Seattle that could help him?

  219. December 19, 2013 at 3:21 pm

    Hi Matt. Have you or anyone you know with this problem ever try Rolfing for treatment? Thank you. Hope you are feeling better.

    • December 31, 2013 at 9:33 pm

      I did not try rolfing. However, I did try something that is somewhat familiar. You can look up Russ Schierling or visit his site at: http://www.doctorschierling.com/ . He is very familiar with, and treats piriformis syndrome symptoms using a “no-tech” non-surgical procedure. It is worth noting that Russ was successful at curing my leg pain permanently, but was not able to cure my buttock pain. I did indeed have piriformis tendon release by Dr. John Heinrich.

      • lowell
        February 4, 2014 at 9:00 pm

        I am looking into seeing Dr Schierling soon. Could you fill me in on his process. Did you find it worth it? How many times did he treat you? Thank you.

  220. Paulette
    October 30, 2013 at 3:20 pm

    Hi, Matt,
    Thank you for writing. On Monday I went to the Centeno-Schultz Clinic in Denver and had injections into the adductor tendons, hamstring tendon, and the PFCN. I have found that much of my pain comes from tight tendons. Of course, it is difficult to stretch those muscles, because it inflames the pudendal nerve terribly. My basic problem is anatomical. My lumbar curve is too high, pulling things too tight, like a wedgy
    . In short, I need a revision scoliosis surgery, but I am afraid to do it. I sent my info to Dr. Lenke, one of the best deformity surgeons in the nation.and asked his opinion. So, basically, I am not in as much pain since the injections. I am hoping the relief lasts through the holidays. I am trying not to irritate things, so i am still not sitting much and definitely not bending. I hope things are going well for you. Paulette

    • November 1, 2013 at 9:42 pm

      Paulette,

      My heart goes out to you. I wish there was something I could do or say that would help you get some relief.

      I am doing very well. I pray that someday you too are free of pain. Don’t give up…keep fighting.

      With Warm Regards,

      Matt

  221. Doreen
    March 18, 2013 at 3:22 pm

    oh my…to have found a site that people who understands…

  222. Shawn
    October 19, 2012 at 12:54 am

    Hello Matt:
    I am glad you are doing well with PT. If you remember I had split priformis syndrome. I am still looking for a surgeon and may visit Dr. Heinrich. I was just wondering if you could tell me if your walking and standing was difficult before surgery as well. Was it effecting your knee and increase leg weakness. I had these issues even though I am doing my PT regularly.

    • October 20, 2012 at 6:41 pm

      Yes, standing for long periods and walking far distances were not pleasant. However, the reason for that was because of hip weakness. Having had Piriformis Syndrome for five years caused me to be very inactive. Being very inactive leads to loss of strength and stamina.

  223. Paulette Little
    July 31, 2012 at 9:22 pm

    Thank you for your reply, Matt. Like, Laura, I am impressed with your surgeon’s meticulous, detailed transcription notes. If it is an indication of his surgical methods, I think it may indicate the reason for his success. You mentioned getting an EMG. My EMG for Dr. Chambi indicated entrappment of the peroneal nerve, which was taken care of. I do not have leg pain, only severe tightness and pain in the gluteal region. Do you think a Potter MRI would be helpful to Dr. Heinrich? Thanks again!

    • July 31, 2012 at 11:34 pm

      Paulette, I’m not familiar with a Potter MRI. So sorry. I didn’t bring one to Dr. Heinrich, but let me give you my opinion. Why the heck not bring it if you have it? It will give Dr. Heinrich another method by which to know your unique anatomy. If you don’t have a Potter MRI study I suggest contacting his office to see if it is beneficial. I can tell you that my Provocative EMG study was crucial. And, in addition, my results from the Piriformis Muscle injections.

  224. Paulette Little
    July 29, 2012 at 9:12 pm

    As you know, I underwent sciatic neurolysis in March, 2012. Four months later, I have the same tightness and buttock pain as before surgery. Did you have any of these symptoms before surgery? If so, have they been alleviated since your surgery? Life for me has become unbearable. Thank you for responding.

    • October 29, 2013 at 10:03 pm

      Paulette,

      How are you feeling? I haven’t heard from you in a while I am praying that you are doing well.

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