Did you notice weakness in the butt since you had the surgery? I am intrigued to know what the effect is. With just the botox I notice a weakness in the butt and hip which makes me just a little extra careful when moving around, especially on stairs etc. Apparently there are other muscles that are stronger than the piriformis that will compensate once the surgery is done, but I really wonder if that is the case and how long it is until they get used to working.
I was very aware after the surgery to check every response. No, no weaknesses anywhere...I wouldn't have known I had just "lost" two muscles...(I had each side done). But I have also had the botox shot and didn't experience what you described....the shot just mad that side really angry...
Everything about my butt hurts right now. Between the various injections, strengthening and stretching exercises it is probably 20 per cent more painful than before. It is so frustrating.
I read some interesting info on piriformis syndrome on Wikipedia. it stated that inactive glutes (from sitting etc) caused reciprocal inhibition from overactive hip flexors resulting in hypertrophy of the piriformis that then produces the typical symtoms. Problems with the sacroliac joint would also affect the glutes and thus the piriformis.
Since I have all these problems it is nice to know that i fit all the criteria. Now if i could just fix the pain!
I am still waiting tohear from the OHIP application.
Shirley
Oh my gosh. I, too, have been diagnosed with piriformis syndrom/SIJD and you are the ONLY person EVER who has described the pain that I am in. I feel like I have battery acid over my soft tissue in my SI, greater trochanter and hip (anterior). It's horrible. Like acid over an open wound. Exactly.
I do not have radiating leg pain, just burning, searing, raw, battery acid SI, gluteal/hip pain. Does this sound familiar to anyone? I am currenlty doing prolo to my SI, gluteals and hip right now. :(
I've been working with endurance athletes ,and people who are suffering from chronic pain, for 18 years. The piriformis muscle crosses over the sciatic nerve and when it goes into a spasm it tightens and puts pressure on the nerve.
Also, there are two muscles, one that originates on the front of the lumbar vertebrae and the other is the quadriceps muscle of your thigh. These two muscles will pull your pelvis forward and down, causing the posterior pelvis to press up into the sciatic nerve, and also causing the piriformis muscle to torque.
As the pelvis is rotating down in the front, the back is moving up. This overstretches already tight hamstrings and is the cause of the burning pain that a person can feel at the base of their butt, down the hamstrings and into the posterior knee. It can even go into the calf and the arch of the foot.
You can self-treat the quadriceps and piriformis muscles very easily, by using your elbow (sliding deeply from your hip to your knee) and lying on a tennis ball to press out the spasms in your piriformis. Then do the stretch for the iliopsoas (low back muscle).
I've seen so many people from my forum, and people who have either come to a workshop or my office, eliminate this painful problem without surgery or drugs. Please look at this muscular situation before you agree to doing a treatment that can't be reversed and that has a natural by-product of scar tissue at the site of the incision. You can either do the treatments yourself, or look for a qualified trigger point/deep muscle massage therapist in your area.
Wishing you well,
Julie Donnelly
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Shirley
Hi Shirley,
Through the years I've had people who have the same situation, when working directly on the piriformis actually makes the pain worse. In each of these cases the source of the problem ended up being the iliopsoas (anterior lumbar muscle) and quadriceps pulling down on the pelvis and causing the bone to press up into the sciatic nerve. As this is happening it overstretches the piriformis so the muscle is pushing down on the nerve and the greater sciatic notch of the pelvis is pushing up onto the nerve, and you're in a world of hurt.
If this is the case then pressing into the piriformis will only put more pressure on the nerve and further stretch an already overstretched muscle.
I suggest you thoroughly work out the tension in your quadriceps muscles and then do the stretch." There are some other muscles that can be pulling the pelvis up in the back (the quadratus lumborum which originates on the 12th rib and inserts into the top of the posterior pelvis) and the lateral rotators (all along the sacrum and inserting into the top of your thigh bone). The lateral rotators are probably the muscles you are massaging when you do the myofascial release techniques because they are all next to the piriformis.
It's a frustration when you have piriformis syndrome, but I've seen it release on so many thousands of people through the years that I believe you'll be able to get relief too.
Wishing you well,
Julie Donnelly
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You now have the nerve being impinged in two different ways, and the person has severe sciatic pain/numbness. When you release the tight muscles the pelvis can rotate back where it belongs and the pressure is removed from the nerve.
BTW, I have not "cured" thousands of people. Aside from my clinical practice, I have taught workshops for many years, and have also worked with people through my forum and the books and DVDs I've produced. Through these various methods I have been able to show people how to self-treat the tight muscles and take the pressure off the pelvis and sciatic nerve. And no, it's not "hokey," it's just a logical outcome of looking at tight muscles and releasing the pressure.
Julie
Piriformis surgery...anyone else out there had it, and had a full recovery or at least 80%? DId you have worst pain than before the surgery for a time? I'm experiencing nerve pain down into my foot that is close to the level it was prior to surgery....
At this point, you may know more than I do, but I am currently 3 weeks post op with Dr. Filler and I am having pain quite similiar to the pain before I had surgery. I am told this is normal to the nerve healing and should resolve in 3 months. Please let me know how you are doing at this point.
Hello, I am new to this website today. Have read most of the comments. I had piriformis release surgery. I am from OK and the doctor is Hal Martin in OKC. He is an excellent surgeon. I recommend him highly. I also had a couple other things performed. I had to have some bone reshaping in that was impinging on the hip. I also had 2 labral tears repaired. Then an open incision on the side of my hip to release the piriformis muscle. The first 2 procedures were performed arthroscopically. That part was a "piece of cake" compared to the piriformis release. I had about 12 weeks of physical therapy. We did not do any stretching of the piriformis muscle -about 6 weeks- until it had time to heal again. It's very painful when you begin to stretch that muscle after the surgery, but if you know this going in you will be ok. I was told to expect about 3 months initial recovery. It has been about 4 1/2 months now and I am still have pain in the piriformis and sciatic nerve. I have also been told that it takes quite a long time for that nerve to heal. I had a traumatic fall about 14 years ago that was a direct hit to that region of the hip. I am a very active person and after many years of physical therapy and dealing with the pain..mostly the sciatic pain down my right leg, I found this doctor and he said he could fix it. Sounded like wonderful words to me! I trusted him and know him to be quite well known and respected by the medical community. It you want more info about him he is located in Oklahoma City, OK
I am having to learn patience in the healing process, though. For those of you who have just had the release surgery, I think we need to expect it to take a while for the nerve damage to heal. I, too, just hope that I have not waited to0 long for this nerve damage to be healed. Dr. Martin is still working closely with me and we are trying several things to see what we can do to help the pain. I do a lot of sitting at work and that does really aggravate the problem. When I am up and down more it helps. Working out in the gym which I do 3 days a week makes me feel the best. Stay as active as your doctor will let you. Do all the exercises you need to do daily. All of this has helped me. It has actually helped me to read your comments. There is obviously a hugh world of people out there that need help with this syndrome. Best of luck to you all.
The two most recent posts are very similar to all those I have seen for the last couple years. Nobody seems to be very pleased with the results of the piriformis release. If the individual who had the release by Dr. Filler would be so kind as to keep the rest of us posted on his progress over the next few months, that would be greatly appreciated. As far as Julie the massage therapist goes, thanks for the explanation, but surely to God you don't think that all these people suffering haven't been through the gammet concerning stretching programs. I do notice that you have a website attached to you replies, which is very typical, trying to sell people something. I did look at the site, and it had some serious misinformation. For example the claim that you cannot stretch hip flexors with a bent knee. If one were to do your stretch, standing and leaning backwards at the counter, one would not feel much in the area of the hip flexors. However, if you kneel down on the affected leg and contract your abs you can totally recognize a stretch in the affected psoas. Anatomically, the hip flexor does not span the knee joint, so to claim the knee has to be straight is an absolute falsehood. Shame on you for trying to sell people your false cure. Hip flexor stretches would have little to no impact on piriformis syndrome, as anyone who has it will confirm.