Piriformis Syndrome - a literal pain in the butt

rebben23
rebben23 Posts: 24 Member
edited November 22 in Motivation and Support
Has anyone had experience with this? I don't have my follow-up appointment until next week, and I am wondering if anyone has some tips/tricks on alleviating the pain until then. I've been icing every few hours and popping extra-strength pain relievers, but I'm still incredibly uncomfortable sitting, walking, etc.
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Replies

  • aeloine
    aeloine Posts: 2,163 Member
    rebben23 wrote: »
    Has anyone had experience with this? I don't have my follow-up appointment until next week, and I am wondering if anyone has some tips/tricks on alleviating the pain until then. I've been icing every few hours and popping extra-strength pain relievers, but I'm still incredibly uncomfortable sitting, walking, etc.

    I've used a foam roller and a lacrosse/tennis ball to massage the areas of most intense pain and it helps a bit. I've also done a lot of acupuncture and massage therapy to help.
  • heybales
    heybales Posts: 18,842 Member
    Look up piriformis stretch on Google and start doing it.

    Not after icing of course, but after muscle is warmed up.

    And you may always have to do it if it's entrapping the sciatica nerve.
  • mysteps2beauty
    mysteps2beauty Posts: 493 Member
    The exercised I used was to sit in a chair, cross leg on side the pain is at across other let where ankle is over the knee, and then bend forward as far as you can. I would do this several times a day. I feel for you.
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  • maryannprt
    maryannprt Posts: 152 Member
    rebben23 wrote: »
    Has anyone had experience with this? I don't have my follow-up appointment until next week, and I am wondering if anyone has some tips/tricks on alleviating the pain until then. I've been icing every few hours and popping extra-strength pain relievers, but I'm still incredibly uncomfortable sitting, walking, etc.

    Follow up with whom? Doctor, physical therapist? Were you given any stretches or exercises? Are you doing them? Do you have an actual injury? (sports or mva related for example) Or is it one of those things that snuck up on you? You can find stretches with pictures or video online to try and many people find them helpful. If your doctor hasn't sent you to a PT yet, you might ask him/her for a referral. Good luck.
  • fitoverfortymom
    fitoverfortymom Posts: 3,452 Member
    Physical therapy, good butt rubbins, rest, stretching.
  • GiddyupTim
    GiddyupTim Posts: 2,819 Member
    Oh yeah. Stretch, stretch, stretch.
    You'll get it better in no time.
    Pigeon pose. Or, lay on your back, lift both legs to a table-top position (feet in the air, shins parallel to the floor.); then cross the ankle of the affected leg over the opposite thigh, just below the knee; then reach down and grab the unaffected thigh and pull it toward your face.
  • try2again
    try2again Posts: 3,562 Member
    GiddyupTim wrote: »
    You'll get it better in no time.

    That's very optimistic of you. I'll pass that on to my hubby who has been dealing with it for 5+ years (after an injury). ;)
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  • try2again
    try2again Posts: 3,562 Member
    try2again wrote: »
    GiddyupTim wrote: »
    You'll get it better in no time.

    That's very optimistic of you. I'll pass that on to my hubby who has been dealing with it for 5+ years (after an injury). ;)

    3 years for me. Some good days some... erm not....

    Yep- my hubby does his stretching routine, is active, and lifts weights, but pretty much lives with some level of pain every day. Not to be a downer for the OP, especially since we don't know the specifics of your situation. Hopefully yours is a short-term issue.
  • GiddyupTim
    GiddyupTim Posts: 2,819 Member
    Sorry if I overstated it. I didn't think it was probably very politic to be negative and douse someone's spirits.
  • rebben23
    rebben23 Posts: 24 Member
    edited October 2017
    maryannprt wrote: »
    rebben23 wrote: »
    Has anyone had experience with this? I don't have my follow-up appointment until next week, and I am wondering if anyone has some tips/tricks on alleviating the pain until then. I've been icing every few hours and popping extra-strength pain relievers, but I'm still incredibly uncomfortable sitting, walking, etc.

    Follow up with whom? Doctor, physical therapist? Were you given any stretches or exercises? Are you doing them? Do you have an actual injury? (sports or mva related for example) Or is it one of those things that snuck up on you? You can find stretches with pictures or video online to try and many people find them helpful. If your doctor hasn't sent you to a PT yet, you might ask him/her for a referral. Good luck.


    Met with my PCP, going to referral appt with PT next week! It's ice, rest, and ibuprofen til then!

    Thank you all for the tips. I've been considering the foam roller, but I'm bracing for the stars I know I'll be seeing! :)
    It's been most painful at 2am after sleeping in the same position for hours. I'm not too sure there's much I can do for that at this point!

    I've never experienced this before, so I'm hoping it's a one-time thing. I'm pretty sure I know how/when it happened so can prevent that exacerbating anything in the future.

    The most frustrating part is that I've been really doing well with a consistent gym routine the past few months, but I know it is MUCH, MUCH more important to not make this worse.
  • heybales
    heybales Posts: 18,842 Member
    Since it will likely only take 1 visit to learn the few things to do (at least I hope they don't call you back to watch you do stretches) - think of activities you do that use your glute/lower back muscles, and have them confirm good form on them.

    The stretch mentioned by someone above with ankle on opposite knee you hopefully found searching, knee down is mainly glute stretch, which is likely tight too and useful, knee up is piriformis along with a forward/side angle arm stretch out.

    Sort of like the achilles stretch can help the plantar tightness, though not even connected and pulling opposite directions.

    From experience, be a little concerned if they have a wall stack of maybe 16 different stretches/exercises to do for any issues on the body - and your issue is just grabbed off the shelf. If it is - ask why yours is so common an issue.
    There should be enough investigation that they figure out what other muscles have been made tight because of this and need stretching too, and what may have caused this that requires changes. Could take several sheets of common stuff with your specifics highlighted.
  • HobbitSithLord
    HobbitSithLord Posts: 34 Member
    PT for this is *amazing.* I went through PT a few years ago and kept up with the exercises and it only ever bothers me after a very strenuous day now - even then, rarely. In the meantime, those stretches are fantastic, and icing helps the best. I'm sorry you've got to deal with it though - I remember nights so bad I couldn't sleep because of the pain, and my hip buckling under me going down the stairs, etc. It gets better with therapy!
  • Zulu87
    Zulu87 Posts: 119 Member
    Acupuncture really helped me when I had to deal with this. It's funny getting the butt and area done but it really helped me! Heat pads were put on after too. Stretching too but I had to do acupuncture!
  • mrack1
    mrack1 Posts: 31 Member
    Yep. I've had this. Like someone said, look up the stretches online and do them religiously. Daily yoga for 15-20 minutes does wonders as well. Stretching was what healed me. And ibuprofen most days.
  • fittocycle
    fittocycle Posts: 827 Member
    I also believe stretching and a foam roller helps. Also, you might want to try a yoga class. Most instructors are very knowledgeable with which poses can help with tightness and injuries. I've been doing yoga for a few years now. It's made a big difference for me.
  • rebben23
    rebben23 Posts: 24 Member
    Thank you, all! I have my PT appointment tomorrow and have been doing some light stretching every day, throughout the day (after icing). Thankfully the constant pain has subsided!
  • mrsbarnett1012
    mrsbarnett1012 Posts: 63 Member
    Yes, been struggling with this since last year. It's so frustrating!

    I went to PT for a few months in the beginning of the year and honestly didn't see a large improvement with just that. What did really help was going to the chiropractor regularly for adjustments. My chiro also using something called a DMS (deep muscle stimulator, I believe) prior to adjustments and also used a TENS unit on my piriformis too. The TENS unit worked wonders. My chiro also has massage therapists on staff and include that in the treatment plan so glute massages really helped a lot too.

    LOTS of stretching helps. The stretch that works the best for me is to stand in front of something you can get a hold of (counter, pole, door jamb, etc) and, for example if you want to stretch the right piriformis, stand on your left leg and cross your right ankle over your left knee and then while holding on the aforementioned counter, etc, sink down into a kind of squat. This gives you a really deep stretch to the piriformis and really helped loosen it during times it was really spasming and locking up.
  • TavistockToad
    TavistockToad Posts: 35,719 Member
    rebben23 wrote: »
    Thank you, all! I have my PT appointment tomorrow and have been doing some light stretching every day, throughout the day (after icing). Thankfully the constant pain has subsided!

    You shouldn't stretch after icing. Stretch first.
  • Spliner1969
    Spliner1969 Posts: 3,233 Member
    edited October 2017
    rebben23 wrote: »
    Thank you, all! I have my PT appointment tomorrow and have been doing some light stretching every day, throughout the day (after icing). Thankfully the constant pain has subsided!

    If the pain returns, or moves down into your leg I'd go see an Ortho doc, or get a referral to one. You could also have a herniated/bulging disc. The sciatic nerve travels right near (or is it through, I forget) the piriformis muscle. In late 2015 I started having what I thought was piriformis syndrome, kept at exercising and the pain shifted down into my leg and an MRI revealed a bulging disc. I had been lifting a lot recently and noticed the piriformis pain when walking/jogging. Stretches helped but did not solve the issue. It kept coming back. Turns out I had injured the disc not the piriformis itself.
  • nowine4me
    nowine4me Posts: 3,985 Member
    edited October 2017
    Timely post, I’m headed to Ortho tomorrow for the same thing. It doesn’t hurt when I’m active, but hurts like hell if I sit too long or sleep in the same position. It’s from a fall years ago and didn’t bother me when I was sedentary, but running has aggravated it. I’m hoping they’ll give me a cortisone shot, it did wonders for my plantar fasciitis. Has that helped anyone else?

    ETA - chiro and stim did nothing for me.
  • heybales
    heybales Posts: 18,842 Member
    Since chiro has been mentioned, I'll mention something else if the PT indeed says stretching is a much needed step. They may even do this now, seen a few.

    Chiro's and massage therapists seem to be the ones taking the training for ART - Active Release Technique.

    You mentioned perhaps there was an incident that led to this.

    Basically it combines the idea of pressure point therapy, with breaking up the scarring that can occur in injured muscle fibers.

    I had basically reached that point where all the stretching that should have been done for glute wasn't helping actually remove the tightness leading to a tilted hip leading to sciatica issue. I was asking a friend massage therapist if I was missing a stretch, she showed be a variation to include the quadratus lumborum which was terribly tight - and mentioned she had gotten trained in ART recently.
    We talked, I researched, made sense, but skeptical as always.

    Found a chiro recommended by a workmate that didn't do the standard 3 x weekly for 6 wks monkey business.
    He found some spots, he stretched the muscle through them, I'm sure I cried or wanted to (cries of good pain of course) - and next day it was better.
    Muscle wasn't as tight - and I think that was the only treatment for that issue.

    I'd gone back for other issues after some injury or overuse, and the tell-tale signs of muscle just not seeming to stretch, especially when both sides start tight but only one improves.
    1-2 sessions is it, always based on how I felt about the improvement.

    For him with me, adjustments seem to be an after thought if even needed. I'm the one asking then usually, but always after a stretch of the affected region, helps get the joints moving they way they should (I don't believe in the "popped back in place", neither does he, with me anyway, but rather things should move, not get locked down).

    Just an idea if the stretching still seems to leave it tight, or very soon afterwards.
  • try2again
    try2again Posts: 3,562 Member
    edited October 2017
    heybales wrote: »
    Since chiro has been mentioned, I'll mention something else if the PT indeed says stretching is a much needed step. They may even do this now, seen a few.

    Chiro's and massage therapists seem to be the ones taking the training for ART - Active Release Technique.

    You mentioned perhaps there was an incident that led to this.

    Basically it combines the idea of pressure point therapy, with breaking up the scarring that can occur in injured muscle fibers.

    I had basically reached that point where all the stretching that should have been done for glute wasn't helping actually remove the tightness leading to a tilted hip leading to sciatica issue. I was asking a friend massage therapist if I was missing a stretch, she showed be a variation to include the quadratus lumborum which was terribly tight - and mentioned she had gotten trained in ART recently.
    We talked, I researched, made sense, but skeptical as always.

    Found a chiro recommended by a workmate that didn't do the standard 3 x weekly for 6 wks monkey business.
    He found some spots, he stretched the muscle through them, I'm sure I cried or wanted to (cries of good pain of course) - and next day it was better.
    Muscle wasn't as tight - and I think that was the only treatment for that issue.

    I'd gone back for other issues after some injury or overuse, and the tell-tale signs of muscle just not seeming to stretch, especially when both sides start tight but only one improves.
    1-2 sessions is it, always based on how I felt about the improvement.

    For him with me, adjustments seem to be an after thought if even needed. I'm the one asking then usually, but always after a stretch of the affected region, helps get the joints moving they way they should (I don't believe in the "popped back in place", neither does he, with me anyway, but rather things should move, not get locked down).

    Just an idea if the stretching still seems to leave it tight, or very soon afterwards.

    Thank you for this! I've been following this thread in case something new was mentioned and this sounds very promising... I'll mention it to my hubby. He had a freak accident at work that involved a large tear of his glute and lots of scar tissue. Only problem is, we live in a semi-rural area and I'm guessing it may be difficult to find someone trained in a newer technique, let alone a no-nonsense chiro like yours who doesn't view it as their job to keep you coming back! What area are you in? (Edited: whoops- never mind! Saw it on your profile!)
  • canadianlbs
    canadianlbs Posts: 5,199 Member
    edited October 2017
    stand on your left leg and cross your right ankle over your left knee and then while holding on the aforementioned counter, etc, sink down into a kind of squat.

    just going to say that i probably wrecked something deep in my hip by over-applying that stretch. not to take from its validity, but i can't stress strongly enough how important it is to have enough support that you can control every bit of the depth . . . and to be GENTLE with it.

    actually, being gentle with any muscle that's in actual spasm is critical. if you push it too hard when it's set to fight you, you increase your chances of tearing it. and then you have a whole world of brand-new troubles that could have been prevented.

    /public service annoucement
  • heybales
    heybales Posts: 18,842 Member
    It's been around since early 2000's actually, even though I didn't find it until after 2010 I think.
    Most seem to be registered with the ART, not sure if that's free for them or they pay. But good place to start for search of providers.
    http://www.activerelease.com/index.asp

    Not sure how to tell if it's one that will do one and done - or attempt the revenue stream by keeping you coming.
    Or it's my attitude coming in, they know they aren't getting much out of me.
    Perhaps my cheapness, I mean thriftiness, is visible.

    It may not be the solution, it's not a magic bullet, but if reason for issue is scar tissue in fibers that can be broken up by stretching through them - it can work.
  • try2again
    try2again Posts: 3,562 Member
    Thanks for the link, @heybales !
  • nowine4me
    nowine4me Posts: 3,985 Member
    just as a follow up. The Ortho ruled out PS for me (I was convinced that's what it was) and he ordered an MRI.
  • deannalfisher
    deannalfisher Posts: 5,600 Member
    similar to ART - if you can find a massage therapist that does myofascial release - it helps a lot of my issues
This discussion has been closed.