Piriformis syndrome

[Helpmypiriformis]

Hello

Hope you are all well. I hope I could get some advice please. I’ve had this dull achy uncomfortable and stabbing pain in my butt cheek for many years. I tend to have regular Accupuncture for it, which helps to relieve the tension. However it never really goes away. Sometimes during the big even after an Accupuncture treatment, it wakes me up crying out for a massage or wanting something to really knead out the knots I feel following a thorough massage. When it flares up, it’s a dull achy “sweet” but extremely uncomfortable pain. Sweet in that when I massage it vigorously against my bed stead, it gets to a point that it actually feels good being relieved, if that makes any sense. After the massage, I can then feel the pain coming to the “surface.”

Accupuncture sessions are quite expensive and it worries me that this has been going on for so many years. I used to do a lot of exercises and I still jog (a jogger not a fast runner) but I don’t know if that actually makes it worse or improves it. After a jog, I really enjoy the release and stretch I get but it doesn’t totally eliminate the need for Accupuncture. I’m not sure if I’m explaining it well but it feels like it needs a good kneading if you see what I meant. I almost tend to want to give it a good bashing. That’s the feeling I get.

Has anyone had this and would you be able to suggest things that helped? Thank you very much indeed.

Big should read night

Try a tens machine for inbetween acupuncture sessions if you find that helps. Or one of those spikey massage balls (or a normal tennis ball) if you feel like it needs a good kneading!

Thank you Emma. I have always do that with a massage ball and a kneading. However I find these time consuming - Accupuncture, massage with ball and kneading. I don’t do them everyday though. Perhaps I should knead every day for a while. I thought perhaps I’m missing a trick or something. My exercises have reduced since I had a baby last year but I’m trying to build up again. I do love jogging though and I’m quite sensible in that I’m not running a fast pace. Thank you again

Have you thought about seeing a chiropractor instead? Mine went into spasm a couple of years ago and I've had problems since. The chiropractor had to massage it out for me. The first time he couldn't touch me by hand without it being agony so used a massager and gradually after a few sessions he was able to knead it by hand. I would say definitely keep on top of the exercises, also apply heat/ice/spray.

My yoga teacher just posted a link to this series of poses that are supposed to help:

yogauonline.com/yoga-pose-library/piriformis-pain-yin-yoga-sequence-alleviate-piriformis-syndrome-symptoms

Do you sleep on your side?
Sleeping with a pillow between your knees or sleeping on your back will help to stop straining your piriformis overnight

I have it and was told it was due to one leg being shorter than the other I now wear orthotics made for me, they really help, if I don't wear shoes all day with my orthotics then I will be in pain.

I stopped running for a while and had deep tissue massage until it released significantly. Never had a problem since. Took about four months of no running with a massage most weeks during that time.

Thank you so much for all these tips. I do Yoga too and it helps a lot. However I haven’t been to a class for a few months since I moved. I do some of those yoga poses at home and would keep at it. I would look for a local chiropractor, thank you. Yes I sleep on my sides too!

Pillow between legs, a good physio appt (or search physio exercises for piri formus and figure of 4 stretches, also on a chair.

Tennis ball or spiky ball is probably going to give best relief but you may need to do some active muscle building exercises to build a week muscle up. Pilates / physio is best for this and a physio who is also a Pilates teacher and post natal Pilates / physio person is probably you best bet.

You may need some adjustments or your pelvis checking which a chiropractor can do but physios can too and imo are much better value.

I think with this it’s best to get to the route of the problem. Mine came on after too much running where my glutes weren’t firing and hips were tight. Piriformis took over and overworked and thus became tight and inflamed.

Long term glute strengthening exercises have helped me avoid any further flare ups. I’m meticulous about firing up glutes before I run and stretching piriformis and hip flexors afterwards. Plus lots of foam rolling or on a tennis ball.

Avoid rolling the muscle when it’s inflamed and painful as this makes it worse. When inflamed and in pain icing the area and ibruprofen helps reduce inflammation.

Hello,

I know the thread is very old…..just wondering years down the line if things have improved Helpmypiriformis ? I have been struggling for about a year trying sports massage, exercises, swimming twice a week but nothing really helps. Have been told by Dr to take gabapentin but am very reluctant. Is there a light at the end of the tunnel ?

I've had this for nearly two years - gets worse every so often and then slightly better but never goes away. I'm fine when walking about and not too bad sitting- however lying down for any length of time (especially at night) makes it hurt. I've tried icing and heating which gives some relief, TENS which helps. Physio exercises, massage by Chiro, Naproxen, Pilates, Diclofenac gel all make no difference.

I dream of it one day going away but currently just learning to live with it.

Sorry to hear you’ve been struggling for a couple of years. Have you had any official diagnosis? My mri scan back in January showed an inflamed sciatic nerve and no obvious disc problems other than wear any tear. I had an X-ray on Tuesday but my physio said it was unlikely to show anything up. I just want to know what’s wrong with me!!

My symptoms go off at night so I can sleep but as soon as I’m up the leg nerve pain starts and then alternates into bottom tingling and soreness when I sit. I do have some better days but they are few and far between. I’m wondering whether to stop seeing sports physio guy and try chiropractor. It’s all so expensive though and I just keep throwing money at it in hope of an improvement. So very wearing to live with.

My diagnosis came from a physio that the GP referred me to - didn't get an option of investigations (maybe should ask for some!)

I spent quite a bit on chiropractors and sports massage - felt good at the time but didn't last so I stopped that.

In the scheme of things I know it's probably quite minor but it really does impact on my quality of life

Are you taking any medication at the moment for it? I’m so fed up with it I’m wondering whether to start the gabapentin? I’ve started swimming twice a week which I enjoy at the time but don’t know if it helps.

Have you tried foam rolling, massage gun or the tennis ball thing?

I take cocodamol at night if it's giving me grief which helps dial the pain down - Ive tried regular Naproxen from the GP and that made no difference.

The spiky ball works well for temporary relief but doesn't last. I'm doing regular Pilates and swimming - again it's a temporary relief (but like you I enjoy it so it's good for mental health and to keep the rest of me going physically) I think it's all about temporarily being distracted by the pain really - it dials down when I'm absorbed in something or by people.

I was wondering about Gabapentin but afraid it might make me a bit of a Zombie (my brain doesn't need anymore fog than I've already got)

My physio said my pelvis was slightly out of line which was causing the piriformis pain. DR still thinks it’s a disc problem though….

Can I ask how/what your pain feels like? During the day mine ranges from either a nerve pain/ sensation down my leg or a horrible tingling/fizzing sensation in my buttock. It’s always there but varies in intensity. I also find my pain goes through the roof before and during my period. I’m 51 and going through menopause which doesn’t help.

I agree with you about the gabapentin. The side effects look grim. I’ve also got diazepam as an emergency but haven’t taken that either. I try to avoid paracetamol if I can. Probably my own worst enemy!!

I get this! And lots of other pain issues, which plagued me for years. The curable app has changed my life and it’s very rare I get pain flares. I’d definitely recommend checking it out (there podcast like mind like body, is great too, especially if you’re reluctant to pay for an app at first).

I'm a few years post menopausal so can't comment on whether periods affect mine. The pain is mostly a dull ache in the left buttock and a burning sciatic pain to just past my knee and when it's really playing up to my heel - I could draw a line where it hurts. I often feel as if there's an itchy feeling deep inside the affected gluteal muscles that needs a sort of internal scratch!

I probably should be more proactive about getting medical help - I'm cautious about being perceived as a heartsink middle aged patient who's always at the GP for something or other.

I use the Calm app which has some managing pain options - it's helpful in the short term and helps in all sorts of other wellbeing issues as well