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Lower back or piriformis???

Destring1DDestring1 Posts: 4
edited 04/23/2015 - 4:06 AM in Lower Back Pain
I was suffering with terrible pain in my lower back/butt that radiated out thru my hip. I consulted a hip doc who ordered MRI of my back. He could find nothing with hip and suggested I see back doc. The back doc said it appears a bulging disc was impinging on my nerve. I had 2 epidurals with limited success. They just calmed the area down but did nothing for my issue. Then the back doc said I would need surgery as I had 2 joints that were rubbing together. He never touched the affected area or showed it to me on the MRI. Needless to say I was taken aback as I am a very fit individual. I took my medical records to another orthopedic. I told him I thought it was my piriformis. He went over my MRI with me and said he saw nothing on it that would be causing my pain. Only thing he found was normal aging (I am 63). He did a couple of flexon tests and found my back/glutes/abducor muscles are extremely weak on the painful side. I am now getting PT to strenghten everything. My poor piriformis muscle was trying to compensate for all the weak muscles around it. So moral of my story, trust your gut feelings and find a doc who will listen to you. I hope my experience helps.

Welcome to Spine-Health

It would be very helpful if you could provide us with more details. So many times we read about members who have different tests and they all come back negative. The more clues and information you provide, the better chances in finding out what is wrong,

Here are some questions that you should answer:

  • - When did this first start?
    - Was it the result of an accident or trauma?
    - What doctors have you seen? (Orthopedic, Neurosurgeon, Spine Specialist, etc)
    - What Conservative treatments have you had? Which ones?
    - What diagnostic tests have you had? And their results (MRI, CTScan, XRay, EMG, etc)
    - What medications are you currently using? (details, dosage, frequency, etc)
    - Has surgery been discussed as an option? (If so, what kind)
    - Is there any nerve pain/damage associated?
    - What is your doctor’s action plan for treating you?

Providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.

Please take a look at our forum rules: Forum Rules

Please remember that no one at Spine-Health is a formally trained medical professional.
Everything that is posted here is based on personal experiences and perhaps additional research.
As such, no member is permitted to provide

  • - Analysis or interpretation of any diagnostic test (ie MRI, CTscan, Xray, etc)
    - Medical advice of any kind
    - Recommendations in terms of Medications, Treatments, Exercises, etc

What could be good for someone could spell disaster for another.
You should also consult your doctor to better understand your condition and the do’s and don’t’s.

It is very important that new members (or even seasoned members) provide others with details about their condition(s). It is virtually impossible to help another member when all the details we have are
I’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?

Diagnosing spinal problems can be very difficult. In many ways its like a game of clue. Especially, when the diagnostic tests come back negative – no trouble found! Then its up to the patient and the doctor to start digging deeper. The doctor is like a detective. They need clues to help them move along. So, you as the patient need to provide the doctor with all sorts of clues. That is like it is here. Without having information about a condition, its impossible for anyone here to try to help.

Specific comments :

Personal Opinion, not medical advice :
It is true that we need to listen to our bodies. However, there is a point when we may not know what the root cause of a particular problem is. Thats when we go to the medical field to get their analysis. Some times, clinical examinations can be enough, if not, additional diagnostic tests, such as CT-Scans, MRIs, X-Rays can be done to pinpoint a problem. Many times the results of those tests are absolute and have identified the exact cause of the problem, and the doctor would identify what would be done to correct this.

Most of the time, conservative action plans would be put into place. All done to avoid surgery. The times when conservative actions may not be exercised to a great extent is when their is nerve impingement. When a nerve root is compromised, the longer it goes untreated, the potential for much longer recovery and possible permanent nerve damage exists. But that is something only your doctor can communicate.

I always encourage patients to go for second opinions, especially when you have doubts or when surgery is being offered. Having a second pair of eyes look over test results plus perform clinical examinations is very important. I feel that you need to have two doctors agreeing with the formal diagnosis. When you have two doctors with different opinions, I would seek a third opinion.

--- Ron DiLauro, Spine-Health System Moderator : 04/23/15 10:01 est


  • Hope3HHope3 Posts: 752
    edited 04/23/2015 - 9:09 AM
    Wow another one going through pain in these areas.
    Does your butt, hip, waist, lower back into groin area hurt to touch.
    I am being told it is nerve pain due to issues with my SI joint.
    Seems like there is so much that can go on down in that area I am
    getting freaked out hoping the TP I just started will help.
    Do you go swimming did they recommend that to you they seem
    to think that will be a huge help.
    I pray the TP works for you and please post your progress it sure would
    help those of us dealing with these issues.
    Thanks and wish you the best
  • I have similar pain as you, with a clean lumbar and hip MRI. I have all the symptoms of piriformis syndrome but haven't been formally diagnosed since it's such a hard diagnosis to figure out. A lot of doctors want to think everything is coming from the back. Sometimes it is, but sometimes it's a muscular issue (which is likely caused from other factors, which it sounds like you're addressing). Good luck to you!
    1 1/2 years chronic pain in butt, hip, and sometimes low back. 7 steroid injections (piriformis, s1, si joint, hip joint). Hip labral repair arthroscopic surgery 12/2015. Sciatic neurolysis 12/2015.
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