I’m still going through this nightmare.
A little background:
I have run nearly 40 miles a week for 20+ yrs. no injuries to speak of.
Changed up shoes that led to planter on left foot. Got cortisone shot. Kept running a few weeks later right hammy got increasingly tight then moved up to piraformis. Couldn’t run and hurt to walk.
So I get deep tissue massage, see my Chiro. Nothing....went to airrosti 5 visits and all stretching and rolling on balls etc made it worse. They suggested a miderol steroid pack. Nothing.
Went to see sports neurologist and after range of motion tests he said not mri needed it’s just the nerve is aggravated. Suggested PT. Tomorrow will be my 4th visit and probably my last. Not any better and the last visit made my tingling I. Lower right leg worse. Yes I started getting slight tingling in lower right leg only. I’m at a loss.

@elise4270 what surgery did you have and how did you know you needed that? MRI?

@dmille2

I had an MRI to rule out discogenic back pain. An EMG that found the nerve impingement. I also had a T3 MRI, with the specialist that can see the nerves, blood vessels and tissue that can be causing the nerve compression. Surgery was endoscopic sciatica nerve decompression.

There are a handful of specialists in the country (usa) that treat it. Mine was in hal Martin in DallasTX. You might phone them and ask if they know someone in your area. Dr Martin is teaching and traveling all the time to share his technique, so I think there's a good chance they can help. They also accommodate people that fly in from all over just to see him. He has some diagnostic YouTube videos and publications you can read. He's worked with doctors in Europe too.

I had steroid shots in the piriformis muscle. If the shots help, its then a positive diagnosis for piriformis syndrome /Deep Gluteal Syndrome.

The pain can be maddening, i know.

Positive signs in my case were point tenderness and if you lay on your back, raise the affected leg and turn the foot/leg inwards, it illicits pain. It's easier if you have someone to help. I am sure it's in his videos.

It does sound like the same nerve impingement I had. Rest the nerve. Do nothing that aggravates it. Mine had become rather damaged. Ice may help. I needed some heat to relax the muscles around it, and took muscle relaxers at night. My hamstring hurt too, but I believe that's nerve pain not the hamstring.

1 and 4. When i started running, i was "injured" shortly after. My mileage was minimal but I worked up to 20-25mpw. I've never built up my pace since I was always running injured. ~9min/mile for my half. Fastest 5k was ~25 minutes. I always had pain. I just ran through it as best I could. It didn't matter if I ran or not, I still hurt. I'm 6 months post OP on itbs surgery opposite side with the same doctor. Piriformis st was July 2016. I'm doing okay on that side. I think I have some permanent weakness though. (Still seeing Martin).

2. I had 2 shots before surgery was scheduled. Since it was scheduled 10 weeks out, I requested a third that did nothing for me. The first one was great.

3. Dr martin is an orthopedic surgeon, with the hip preservation center at Baylor. I went to him with the emg and a regular MRI. He ordered the T3 mri. He did do the ROM tests and others. Oddly, one can have full range of motion and still have impingement.

4. I suspect my injury was that, I was genetically lucky, or it was a fall to that side on roller blades. I was so new to running, I never ran much without this ailment. Mine started in March of 2012. It took me some time to get properly diagnosed and find the right person to treat me. Martin was the 7th doctor I saw with this.

Austin isn't too far for you to come see him, if there isn't someone in Austin. The office staff is... well, they try. Dr martin is worth seeing if you can swing it. I know long drives killed my butt. Tylenol, and heated seats with lots of stops..

Awesome @dmille2! I had one orthopedist tell me piriformis syndrome wasnt a thing. I appreciated that he looked at other causes, but ... Ya missed it doc-all-mighty 😁