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Sciatica or piriformis

AnonymousUserAAnonymousUser Posts: 49,671
I have had leg pain since September. The pain is mostly in my butt, making it difficult to sit for long periods and in the back of my thighs. My doctor ordered a lumbar x-ray, it came back with nothing wrong, and he sent me to physcial therapy. I have had no lower back pain. But, I have had cramping and tinging pain in the legs down to my ankles and toes. The PT gave me a lumbar roll to use and wants me to get up every 15 minutes, as well as lie on my stomach every 2 hours for 2-5 minutes. Now that I have been using the lumbar roll, my back hurts if I don't use it. I have never had back pain like this before.

I am wondering if I really have priformis instead? I walk 1-3 miles a day, use nautalis equipment, wear good supportive shoes, lift correctly, etc. I have never had back injuries and can't think of anything that would have hurt my back.
My job is sedentary - I work 4.5 hours a day making collection calls. I have a second part-time job doing the books for a bridal shop- and this is usually 3 hours a month.

Just wondered what others have done.



  • An x-ray of the back shows very little except for situations involving bone. In order to see soft tissue you will need to have a MRI.

    Piriformis syndrome has symptoms that are very similar to that of a herniated disk. But it is one of those diagnoses that some spinal specialists do not believe in. Usually symptoms are worse when sitting. Have you asked your PT about this possibility? They can put you through some movements that are a good indication of whether you have pain coming from the piriformis muscle or ligament, or not.
    They can also give you exercises that help to stretch out the piriformis muscles. Or you can find them online or in books on back pain or stretching.

    If your pain does not improve, you might want to make an appointment with a spinal specialist or a physiatrist who could order the MRI and provide some thoughts on what may be causing your pain.
  • spent 4 months going to a chiropractor being treated for "piriformis syndrome" when in fact I had a massively herniated l5-s1 disc. Today, I have permanent S1 nerve damage because I "waited" so long.

    I had pain in my buttocks as well - no back pain. I was in shock when I was told it was a blown disc. I thought back pain came with back trouble. NOPE.

    Please insist on an MRI or change doctors. You don't want permanent nerve damage!! And if it is the S1 nerve, that's why sitting bothers you so much. I had to stay reclined 23 hours a day until I got my spinal cord stimulator a month ago.

    Take care,

  • I was mis-diagnosed with piriformis syndrome for 6 months. Waste no time requesting an MRI. Best of luck to you!
  • I have had the same thing- no back pain-until today. I was given a lumbar roll to use. It is next to impossible to use with my current desk arrangement at work. I am sorry to see that you have had to have surgery. Hope things continue to get better!

  • I will mention that to the PT at my next appointment. My husband has piriformis and I have done some of the stretches he does and they seem to help - namely the stretch that pulls on the hamstring.
  • I heard about a treatment called Vax-D that might be beneficial. It's not chiropractic, it's not traction, and there's no surgery involved.

    If you want more info, try googling "VAX-D Chicago." It's FDA approved, but only offered at a select number of places. I've found the website for American Back Center in Chicago to be really informative.

    Good luck!
  • After 3 months on Naproxen and muscle relaxers I asked my Dr. for the MRI. I could barely walk and still working until I got the results of the MRI. At the same time after getting my MRI I collapsed at home after a heavy assignment at work but the next day when I got up I couldn't walk for 4 days except to go to the ER in the evening because my Dr. was on vacation and got a prescription for pain meds. It's been one year off work so far. I've gotten physio, accupuncture, traction, excercises and TENs machine and only the injections and meds have helped with the pain. I've been refused surgery twice because my EMG is normal. Ask your Dr. for an EMG also. I'm on long term disability from work and they have to keep my job for 2 years and hopefully I'll get better with time. Good luck and hope you get your MRI soon. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Have you used the vertebral axial decompression table before, and if so, what condition do you have that qualified you for it? You keep recommending this all the time and I don't recall you posting about yourself. Are you a rep or a fellow spiney?

    Hi KellyJean :H If I were you, I'd get an MRI done soon. It's important to get a diagnosis so that this can be treated appropriately. Like everyone mentioned, x-rays won't show soft tissue injuries, only problems like arthritis, fractures, and DDD for example. If they do an MRI of your lumbar spine, they would be able to tell if the problem originates there. Does your back start hurting and does the pain radiate down into the hip, buttock, all the way down to your foot? If so, is it right or left sided? I hope you get this figured out. Take care :)
  • It was the weirdest thing. This pain in my buttocks, I called it my RBP - random butt pain. lol I would walk around digging my fingers in the middle of my buttock as it made it feel better. Hubby finally asked me if I could refrain from doing that when we went to the mall. lol I just knew what felt better.

    When the PT told me I had a blown disc (prior to the MRI, she could tell within 5 minutes of working with me and a leg lift?), I was defiant. NO way!!! Boy, was I wrong.

    I was in such denial and also have a stubborn streak. I was going to get better, I just knew it!! lol

  • Hi All,

    I've been called for jury duty in April. Wondering if I should request a letter from my doctor to be excused? I know there is no way to know how I will feel in April and I guess that is my concern. Jury duty here can last anywhere from a week to longer depending if you get put on a case or not- sometimes it can last three weeks. From what I understand from people who have served, it involves a lot of sitting. It will take me over an hour to get to the court, and then about 8 hours of sitting and then an hour drive back. I am told you are not allowed to leave the building.
    Going forward, and assuming they can get the pain under control, will I always be limited to sitting for short time periods?

    Thanks for the advice!
  • Kelly, if you really think it may be pyriformis syndrome which can mirror back pain and is very seldom diagnosed correctly I would suggest you take a look at this website http://www.nervemed.com/aboutaf.html There isn't a more renowned person in the US on this subject and detecting it. I made the mistake of listing to a Dr and had a fusion for the same type of thing your going through and have been paying for it. My origional issue of pain in the rear is still there and now I have more back problem that you would ever want. Good Luck in your quest....
  • The PT was able to lift both my legs all the way ( while I was lying on my back) and told me I was very limber. She did say that I appear to have less strength in the left leg than the right leg- whatever that really means, I don't know. Actually doing a little better today. I can sit, but get pain in my hips. Random spots of pain my my calves. Yesterday, my toes were numb again for several hours, so who knows. Lying on my stomach like the pt wanted ( she said this is a stretch???) and I was starting to get pain my legs doing that. It seemed like I couldn't avoid any pain yesterday!

    I'm 41, so it looks like you and I are pretty close in age...
  • Welcome!

    I so agree with the MRI (if at all possible). Butt pain can be a lot of things. I've been diagnosed with piriformis, SI joint dysfunction, ishial tuberosity, high hamstring tendonitus...finally the pain was linked to my spondy with the corresponding nerve impingment, revealed with an MRI
  • Another even less common issue could be pudendal nerve entrapment. There are so many nerves and ligaments that feed off the spinal column into the pelvic region that it can be difficult to diagnose when it is not something obvious like a disc or stenosis.

  • VLK has posted so many times with the same words. He has to be a rep or working for them. Everytime a post says sciatica he appears. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • well, let's see- the pain at this point is basically in my butt and hips, and the back and sides of my thighs. There is a spot on both butt checks that I can push on my butt that is always painful. The pain is always in my legs and butt. If I get pain in my lower back, it seems to be after sleeping, but it's rare. I can bend all the way over and touch the floor without pain. I can also bend backward with no pain. The pain is usually on both sides at the same time. I asked the PT if it could be performis or a herniated disk and she said it didn't make any difference. She did ask how I know about performis (my husband has it). All she could tell me is that when she did the raised leg test, I seemed limber, but weaker in my leg leg. The thing is, my husband is more limber than I am and last night, when I needed to stand on a kitchen chair, I had an awful time climbing on to it and then trying to get off because it seems like the muscles are overly tight. It seems like the exercises the PT is giving me are basically, to lie on the floor, do extensions ( like a modified push up), a twist to move pain from the side to the center and a stretch to strengthen the glutes. She wants me to sit as little as possible. I'm really not sure that the phyiscal therapy is really making that much difference. If this really is performis, but she has me doing exercise as if it is a herniated disk, will this still heal?
  • wow, amazing that there are so many possibilities from this!
  • I will have to look into that. Hopefully something can be figured out that will solve the problem.
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