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Piriformis Syndrome/Sciatica?

alohaaaloha Posts: 9
edited 01/23/2016 - 1:56 AM in Chronic Pain
Hello -

I have been suffering from pain for about 10 years. For the first 8 years or so, it was hard to specifically pinpoint the pain and I had actually thought it was lower left back pain. Only in the past 2 years, I could really feel it radiating in my left buttock when standing up after sitting down for several hours (I have an office job that requires me to sit 10+ hours). The pain this past year has gotten so bad that I've done Physical Therapy. I noticed the massages from Physical Therapy definitely loosened me up and gave me instant relief. The stretches and light strengthening exercises also gave me relief. Now, it was my fault I did not keep doing the PT exercises after it ended and now my pain has gotten worse than ever.

About two weeks ago, I sat at work for about 10 hours and by the time I got up to leave work, I was limping to my car in much pain. Once I got home, I took off my shirt and looked in the mirror and noticed my body was severely crooked and leaning to the right... it looked like my left hip was bulging out and swollen. Upon touching my left back, I could also tell that it was extremely rock solid and very tight. I did some Googling that night and I believe the term of what I experienced was an antalgic lean. I was forced to take the next day off from work and immediately saw a chiropractor. With my antalgic lean still slightly there the next day, the X-Ray my chiropractor took made my lower spine (L1 to L5) look crooked. I am praying very much that I do not actually have a crooked spine and that it was just due to my antalgic lean at the time the X-Ray was taken. The chiropractor immediately referred me to a Orthopedic, who said it looked like I had Piriformis Syndrome. Unfortunately, not much was done except that I was prescribed an anti-inflammatory and was told to buy a Backjoy seat to better my posture. The worst part was the Orthopedic could not even tell I had an antalgic lean... I asked her to look at my body a second time and she said there did not appear to be any red flags. The next day, I went to my primary care physician and requested an MRI. My MRI is expected next week, and I hope it can tell me exactly what is wrong. In the meantime, I was prescribed some Baclofen to relax my muscles.

As of now, I took three days off of work and I have been religiously doing my PT exercises as well as Piriformis stretches from what I can find online. The pain has decreased but I absolutely cannot get rid of the numbing pain I feel in my left buttock when I attempt to touch my toes with my legs straight. I can bend down to the point my hands touch my kneecap and then I feel the sharp numbing pain in my left buttock. If I really try, I can eventually touch my toes after a couple minutes but the pain gets worse... I have a feeling it might be my Piriformis getting inflamed and rubbing against my sciatic nerve from this stretch? I figure it is a normal stretch everyone can do so there shouldn't be too much harm to keep trying?

Anyway, can anyone better describe what I have? My pain from Googling definitely sounds like Piriformis Syndrome, but the part I can't figure out is why I fall into an antalgic lean after sitting for a couple hours? It is incredibly painful and I can't seem to find any articles related to Piriformis Syndrome causing this. I literally just drove around for 20 minutes, and felt my lean happen again after getting out of the car. Makes me question if I actually have something else. Does anyone have any insights to my problem or at least how I can prevent the antalgic lean? I can deal with the butt pain but don't want to be leaning around at work.



  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • dilaurodilauro ConnecticutPosts: 9,859
    edited 01/24/2016 - 7:05 AM
    self diagnosis after doing research and especially if the doctors are not saying the same thing.

    Leave that work up to the professionals. Its good that you do your research and understand., but you can get yourself more worried when you self diagnosis.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • szylszyl Posts: 31
    edited 01/24/2016 - 7:26 PM
    I have gone thru the same piriformis routines for 3 months....and my PT, who is totally excellent, provided me with NO POSITIVE OUTCOME.
    Reason: the nerves and the tingling would not go away....after all of that work. That was the "Tell".

    What does this all mean ? Surgery is the only remedy.

    Please do not provide medical advice. Surgery is NOT the only remedy for piriformis problems. While can be persistent, I went through about 7 months of physical therapy and home exercises with resolved the situation. It did require hard work and dedication to the exercise. Never was surgery an option for me. If you searched patients here you would find scores who had the condition and it was resulted without surgery
    -- Ron DiLauro, Spine-Health System Moderator
  • alohaaaloha Posts: 9
    edited 01/25/2016 - 9:24 PM
    Szyl - can you please list out the exercises you were doing? Currently, I am religiously doing Piriformis stretches, hamstring stretches, and hip flexor stretches. I also do a lot of bridges and some body squats.

    This past weekend, I got to a point where I loosened up completely and could touch my toes without much pain, which made me incredibly happy. But the same night, I had to sit for about 3-4 hours at a wedding and I was in complete pain afterwards walking. My back tightened up completely and I was thrown into an antalgic lean once again. The electric stimulator works well to loosen up my back so I immediately did that once I got home and also iced my butt. Today, I went into work and stood/walked every hour. I just ended work and I am in an antalgic lean again. The act of sitting itself does not hurt, but it's when I stand up where I feel a really sharp pain. Trying to bend backwards also hurts really badly when I first stand up. I am at home now and just did my stretches to loosen up. My lean isn't horrible now, but I am using an electric stimulator to better loosen up my back/butt muscles. I plan to take a walk after this as I feel it loosens up my legs up a little. But seriously, how can sitting cause me to fall into an antalgic lean everytime! It's happened the last four times I've sat down for an extended period of time..... and it is very irritating.

    My MRI is scheduled for next Thursday, which really sucks that I have to wait so long. It seems everyday this week will be the same cycle... work, come home and stretch, use the electric stimulator, sleep, repeat :(

    Members are not permitted to give you medical advice including exercise routines


    Before you try any supplement, herb, over the counter item, exercise program, mechanical aid, brace, etc always consult with your doctor to make sure you get their approval.
    Some of these products may be very effective, but no two individuals or medical conditions are alike. What works for one, may cause trouble for another..

    Liz, Spine-health Moderator
  • Joe house said:
    I don't have the lean thing going on my piriformis problems is related to my SI joint dysfunction. I do PT three times a week my PT uses tools on my piriformis si joint legs inguinal tendons. The method is called the Graston technique. It helps me a lot to ease the pain and makes it easier to move. My pt gets aggressive and I will be bruised from it but it is worth it. . I also get ultra sound treatments. I have not had much luck with stretching yet because it compresses the nerve and makes it worse. I also can only sit for five minutes and I can only wear sweat pants for the last seven months. My goal is to calm down the nerve so I can do the exercises. You need to find out why your leaning. I go out of alignment all the time can't stay in not strong enough yet. I used to wear a SI joint belt which help to keep me in alignment but with the piriformis problem I had to stop for now. Try not to aggravate your sciatic nerve by over doing it. I was on gabapentin which helped a lot but it made me feel drunk all day so I could not drive. It may not have that side effect for you ask your doc. Good luck I hope you get better soon.
    I actually just bought a foam roller and while the pain is often felt in my left buttock, I can recreate the pain when rolling over that SI joint area you mentioned. Did you manage to conclude your SI joint dysfunction from an MRI?

    I've also read from another poster in a different thread about ultra sound treatments. What type of doctor do you go to for that and what does it actually do? I'd like to inquire more about it.

    And yes, I know I shouldn't be foam rolling my lower back but I just wanted to see if I could better pinpoint the pain. It was very interesting to find this one spot can recreate the numbing pain in my left butt and also sciatica-like pain to shoot down my left leg. I'm curious if my MRI over my lower back would show this.

    And for my update, I had an antalgic lean again after work yesterday. I actually tried something new and stood up all day (except for a 1 hour meeting and my normal 30-min driving commute from- and to- home). I actually felt like I was in worst pain than ever before so I finally went to the ER to get it checked. I showed them my crooked body and they just concluded it was muscle spasms. They injected something into my arm to relax my muscles and prescribed me more medications--anti-inflammatories, muscle relaxers, pain meds. I actually asked for a MRI there but they said they wouldn't give it to me and that it was only for extreme emergencies. Unfortunately, I still need to wait until next week for my MRI. Again, I'm working from home in bed today but it's the only way I feel minimal pain. I plan to still continue doing my stretches and light exercises now as I can't feel much pain doing it now versus after a long workday.
  • alohaaaloha Posts: 9
    edited 02/01/2016 - 9:49 PM
    I spent a great deal researching this past weekend, and I have actually ruled out SI joint dysfunction. My personal self-diagnosis is a herniated disc in the L4-L5 or L5-S1 vertebra, but I am still waiting for my MRI to confirm this. A herniated disc that is compressing my nerve would explain the numbing pain I am feeling in my left buttock when I bend forward, and I have also read that a compressed nerve could cause muscle spasms as it is the body's reaction to stop further pain. It would also explain the antalgic lean I was experiencing, which is my body's way of compensating and pulling me away from the pain (where my nerve is being compressed). Again, this is a personal self-diagnosis and I am not a doctor.

    There is definitely a point when bending forward where I get "stuck" due to the pain in my left buttock, and I've realized my hips are likely in that same position when sitting. I think sitting is essentially me being in that "stuck" position for a long time, and the pain is causing muscle spasms. Maybe my herniated disc is leaking fluids in this position, causing it to compress my nerve. Again, just a theory.

    I went to a dinner for 3 hours this past Saturday and had some pretty sharp pain when standing. At this point, this is not surprising as I've learned sitting long hours = more pain when I stand up. One observation I noticed though was when bending forward, while very painful in my left buttock, actually gave more relief than bending backwards when standing immediately after sitting for a long time. Bending backwards just created a sharper pain but only after sitting. On a normal day of laying in bed, I can bend backwards without too much pain.

    Another random observation I noticed when doing my daily stretches was particularly in Child's Pose. When I take a deep breath and inhale during Child's Pose, I can create a ton of pain in my left buttock/left lower back area. The pain increases if I inhale deeper.

    Aside from that, I have continued my daily stretches which primarily consist of stretching my hip flexors, hamstrings, and piriformis. I've noticed that I am definitely more flexible now that I have been doing these everyday for 2 weeks. On some days, I am able to touch my toes with relatively little pain in my left buttock (but always with pain), but some days it just really hurts. Still unsure why, but I assume it has to do with some inflammation. But at this point, I figure flexibility and mobility can't hurt so I just keep trying. [edit]
    Additionally, I have also been doing my daily body squats (10-20 reps, 2-3x a day), standing lunges (10 reps each leg, 1-2x a day), bridges/butt lifts (10 reps, 3-5x a day), and press-ups (10 reps, 2-3x a day) I can feel my bridges getting stronger as I can lift my entire butt with each leg and the other leg extended out (about 10 reps).

    Walking on two occasions has made my pain almost completely go away, where I could touch my toes with not too much pain after my walk. When I am able to do this, I actually try to incorporate crunches and leg lifts to work on my core abs. I generally am unable to do crunches due to the pain I feel in my left buttock.

    If anyone has a similar story to share, I'd greatly love to hear it. Just patiently waiting for my MRI which should hopefully be this week (my insurance company is requires prior authorization of MRIs, which is what I'm waiting on).


    Before you try any supplement, herb, over the counter item, exercise program, mechanical aid, brace, etc always consult with your doctor to make sure you get their approval.
    Some of these products may be very effective, but no two individuals or medical conditions are alike. What works for one, may cause trouble for another..

    Liz, Spine-health Moderator
  • http://www.spine-health.com/forum/pain/chronic-pain/piriformis-syndromesciatica
    Aloha said:


    numbing pain I am feeling in my left buttock when I bend forward

    There is definitely a point when bending forward where I get "stuck" due to the pain in my left buttoc
    sitting is essentially me being in that "stuck" position for a long time, and the pain is causing muscle spasms.
    pretty sharp pain when standing.

    when bending forward, while very painful in my left buttock, actually gave more relief than bending backwards when standing immediately after sitting for a long time. Bending backwards just created a sharper pain but only after sitting.

    On some days, I am able to touch my toes with relatively little pain in my left buttock (but always with pain), but some days it just really hurts.

    Walking on two occasions has made my pain almost completely go away,

    Hello Aloha.

    I can relate to a lot of what you describe as I have many of your symptoms (with the exception of the leaning). You write that your provisional "personal self-diagnosis is a herniated disc in the L4-L5 or L5-S1 vertebra". However my self diagnosis, after getting opinions from various specialists, reaches a different conclusion to you! I will now visit another specialist to discuss my hunch and see if there are any tests to check on whether it is correct. I wonder if this may indicate that it's worth seeing a specialist in your case.

    For what it's worth, I suspect I have piriformis severely trapping the sciatic nerve and causing irritation but the symptoms are tricky to interpret correctly. Let me explain some of the tricky interpretations.

    I too get a big increase in pain when bending forward. I also got pain when crossing my leg and, in particular, when twisting to turn a corner. I assumed this was all due to hip arthritis but now wonder if the pain turning corners is due to contraction of the piriformis causing it to press on the sciatic nerve.

    When I am in pain, any stretches of the piriformis hurt like crazy at the time because they may be making the piriformis press onto a sore nerve but the next day that nerve pain shows an improvement.

    The rear buttock where the piriformis is is often sore when pressed as if it is in spasm and if I use gentle pressure to relax it then the next day it is better but if I use too much pressure then the piriformis hurts the next day although the sciatic nerve pains seem better.

    The pain (perhaps from the piriformis or maybe the sciatic nerve) seems to refer itself to the outer hip and misleadingly presents very much like hip osteoarthritis - which I also happen to have but wasn't diagnosd until I had an MRI. The hip arthritis own pain flares up the next day or two when I walk more than a mile but the walk seems to help the piriformis and associated sciatic pain.

    What a mix up! As you can see there are a lot of interpretations involved, any one of which I may easily be mistaken about. I will take my observations to either a pain specialist or a rheumatologist to see if they can make use of them.

    My sciatic pain manifests itself mainly in the calf and foot but I don't think that's useful for diagnosing the origin of the pain.

  • alohaaaloha Posts: 9
    edited 02/02/2016 - 6:09 PM
    I am definitely not ruling out my piriformis compressing against my nerve either but I find it so strange that it just started happening all of a sudden. It definitely is very tricky to figure out. What type of specialist are you seeing for your piriformis? Is it just the pain specialist and rheumatologist you mentioned?

    For me personally, I have a hard time pinpointing the pain just by pushing my buttock but I know it is in that region. When in pain as well, I am unable to go as low in my pigeon pose or pull my leg as far back doing my piriformis stretches (which I predict is piriformis inflammation or irritated nerve).

    Another significant observation I had last night was that I am unable to put both feet flat against the wall to stretch my hamstrings. While I am able to do them one leg at a time, doing it simultaneously causes a huge nerve-like pain throughout my left leg/buttock that is hard to describe. It definitely does not feel right. I did notice more pain in my left leg when I got up this morning too after trying this stretch. Basically, it seems common that when both of my legs are straight (either standing or laying down), I am unable to bend towards them. I think I am definitely compressing a nerve in these positions, which is unfortunate considering sitting puts me in a similar position.

    MRI was finally approved for this Thursday, so will need to wait and see.
  • SavageSavage United StatesPosts: 5,476
    edited 02/02/2016 - 7:49 PM
    Welcome to Spine-Health
    Please click on link for helpful information!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • So got my MRI results today:



    TECHNIQUE: Routine imagine of the lumbar spine was performed on a 3.0 Tesla scanner without IV contrast.

    Straightening of lumbar lordosis without listhesis.  Vertebral body height is preserved.  No suspicious marrow signal abnormality.  No fracture.  No epidural fluid collection.  Conus medullaris is normal, tip at L1.  Nerve roots are grossly normal.  Paraspinal muscles are normal.  No gross abnormality of the imaged retroperitoneum.  Intervertebral disc height and signal are maintained throughout the lumbar spine.  No significant disc bulge or herniation from T12-L1 to L4-5 where the spinal canal and neural foramina are widely patent.  At L5-S1, a left paracentral focal disc extrusion measuring 8 x 2 x 9 mm there is a left lateral recess and may impinge on the cross left S1 nerve root without narrowing the L5-S1 neural foramina.


    I was prescribed with Tramadol-Acetaminophen (Ultracet) and Nabumetone (Relafen) to fight pain and reduce inflammation, respectively.  According to the doc, I have a nerve impingement and was told it will heal itself when it is not inflamed.  I was also told to do more stretches that stretch the body.  An example he gave me was holding my body up as if I were to do tricep dips and to just let my legs dangle.  He said this would reduce pressure on my spine.

    Not sure what to make of this as I just Googled "focal disc extrusion" and it defines it as a herniated disc.  I would have expected my doctor to tell me if I had a herniated disc, but he didn't.  Question now is whether a 8 x 2 x 9 mm herniated disc is considered large.  Need to do more research.

    Other words in this MRI report that did not seem to get any attention while at the doctor's office:
    "Straightening of lumbar lordosis without listhesis"

    If anyone wants to help me out and better describe what that is, I'm all ears.
  • AntroAAntro Posts: 3
    edited 02/07/2016 - 8:59 AM
    Hi Aloha.  I think careful observations are one thing but I believe they should not be used for self diagnosis.  That was the point I was trying to make in my previous post here.  

    If it was me I would take your observations along to your doctor and let them figure it out.  As I was trying to show, there are many complex interactions which can fool a lay person and sometimes fool a professional.  

    (1)  At the end of 2014 I saw a PAIN SPECIALIST (anaesthetist) who saw the hip cartilage was worn to the bone on the MRI and referred me to a hip surgeon.

    (2)  The HIP SURGEON said it was too early to replace it.  I noticed baclofen helped but he advised that he had never used baclofen for any hip patient.  He observed the pain was more severe than he is used to seeing in his hip replacement patients.

    (3)  Then I saw a FOOT SURGEON in case I had trapped a nerve there by "rolling" my foot many times over the years but he determined my foot pain was not coming from any abnormality of the foot.  

    (4)  I am now due to go back to the PAIN SPECIALIST although I expect to be referred on to a RHEUMATOLOGIST which is what I would want.  I am still going to the pain specialist in case he can offer insights into what may be happening from a nerve point of view.  As I have had this pain for 18 months now an have had a similar bout only five years ago, I wonder if I am looking at a surgical option to ease possible impingement on the nerve. 

    If you don't mind me asking, how old are you?  Of course age is an important factor, although not the only one, when it comes to osteoarthritis.  Alternatively could you have got hip wear and tear, perhaps from an injury, which has been creeping up on you.  I must have had significant hip wear for at least 5 years before it was detected.

    I actually tried something new and stood up all day (except for a 1 hour meeting and my normal 30-min driving commute from- and to- home). I actually felt like I was in worst pain than ever before so I finally went to the ER to get it checked.

    My experience of this pain from my hip area is extremely severe.  I am quite literally nearly losing consciousness when it occurs and will go into a state of confusion ("delirium") from pain which isn't nice to experience.  I get this every day and only in the last couple of weeks has this eased enough for me to form full sentences in my head such that I can write this sort of message.  I don't want to start a misery competition here but I could never have managed to attend a meeting or commute.  For the last 4 months, I have been almost completely housebound with daily pain but I do stagger out to walk a short distance in order to prevent my hip seizing up even if walking is difficult but I found I was flaring up the worn joint which felt remarkably like the other piriformis pain I got on days when the hip was rested. 

    I hope your MRI shows something useful although my own experience is that an MRI doesn't always help.  You sound as if you have private medical insurance which I do too but in private medicine the various specialists can be a bit separate from one another.  Also, you can call the shots more easily in private medicine but it can be all too easy to make a misjudgement about who to see next.  Unfortunately my GP is far from pro-active and doesn't co-ordinate these specialists, so I have to do what I can.

    I found piriformis stretches helped but they were pure agony at first and I couldn't do them.  After giving up for 9 months, I tried them again and with extra baclofen slowly they seemed to help.  My piriformis was extremely painful the following day after I rolled a tennis ball over them and this may have caused it own pains which may have led to tightness and spasm of the piriformis leading to further impingement on the sciatic nerve.  I also used to get pains in the front near the inguinal crease which may have been a trigger point or muscle tear or referred pain or whatever.  Into the bargain, I also got very bad iliotibial band pain which may have been due to an inflamed hip joint from over exercise (back then I would walk as far as I humanly could to help the problem) or maybe from over-stretching the piriformis.  

    I mentioned before many of these interpretations in my case.  Who knows exactly what's happening?  Ha!  It's too complex to work out 'deterministically' by interpreting first one symptom and then linking it to another individual symptom.  I think this really needs a doctor who can recognise the overall pattern of symptoms.

  • SavageSavage United StatesPosts: 5,476
    edited 03/14/2016 - 12:03 PM
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • It's been about a month since I've posted an update of my L5-S1 herniated disc experience.  It took me one month to schedule an appointment with a particular Orthopedic (that my primary care physician recommended), who I just saw this past Friday.  Fortunately, the Orthopedic works in the same Medical Center as where I received my MRI, and so he was able to pull it up on his computer instantly to walk me through my MRI results.  He showed me how my disc extrusion was located between the L5 and S1 vertebra and on the left side, likely pinching on my left S1 nerve.  He also showed me that my lumbar spine was not curved as much as it should be (that is, my lordosis curve was straighter than it should be), but he seemed confident it was due to the muscle spasms I was experiencing.  He described the size of my disc extrusion (8mm x 2mm x 9mm) as being about a 5 on a scale of 1-10.  He did mention that I am a candidate for a Microdiscectomy, but he also thinks it can heal on its own over time.  He mentioned if I was experiencing severe numbness and having drop foot (which I wasn't), then he would recommend the surgery.  I described to him my current nerve pain and how I was still waking up crooked daily, and he recommended a shot to see if that would help relieve the nerve pain and fix the problem.  It seems my body compresses on the S1 nerve in my sleep (in all positions) and so my body naturally leans away from the pain.  He made the referral to the pain management specialist for me and now I am just waiting for the call to schedule my shot.

    Overall, I am feeling much better since I started this herniated disc journey 2 months ago.  I've been working from home these last 2 months and created a makeshift standing desk using old textbooks.  At first, I was able to only stand for about 4 hours before I had to lay down for a break.  But now I am able to stand for about a whole 8 hours.  I am supposed to return to work in one week and I am a bit nervous to see if I can sit again.

    I am able to sit for a meal and stand without sharp pain, but sometimes I do feel like my nerve is being tickled when standing after sitting.  For the most part when I stand now, I do not feel much pain at all.  I also make it a point to not do any movements that aggravate my nerve.  For example, I never bend forward at the hips and always squat for everything, including rinsing my mouth after brushing my teeth.  Sleeping has been tricky as I had to play around with which sleep position hurt the least.  I currently do not sleep on my back or stomach as those seem to cause me more pain.  I am forced to sleep on my side (either side seems to be fine) with knees bent in a fetal-like position and with a pillow in between my legs (this was something I picked up online as a good way to sleep on your side in keeping your spine straight).

    During this past month, I have also been seeing a Physical Therapist where they mainly teach me exercises to strengthen my core and mobilize my spine.  To be honest, I felt some of the exercises were causing more harm than good so I highly recommend for anyone going through this to study your own body, note what is making things worse and avoid doing those painful activities.  Also raise your voice to your PT if something is hurting.  I literally called my PT after because the piriformis and hamstring stretches with my left leg were causing me quite some pain, and he recommended that I don't do it if it was causing me pain.  It was only after I stopped doing those exercises where I felt my nerve pain significantly decrease.  My PT also massages my back while I am on my side as I mentioned to him that I feel a burning sensation in my lower left back while on my stomach.  Swimming was approved by my PT so I have been diligently swimming twice a week at a minimum for about 30 minutes.

    Research shows that most people recover from a herniated disc in 6 months, and I am now hopeful that I will feel better by the 6-month mark.  I am still unable to bend forward, so I just avoid it completely.  And my left hip still seems slightly inflamed as it sticks out more than my right (it looks like I have a love handle on my left side whereas my right side is more straight down).  I was prescribed with some Lyrica and that also seems to have helped with the nerve pain and possibly some of the left hip swelling.  Hard to tell as I am only on day 3 with the Lyrica.  But I will keep posting to give an update on my progress.

    MODS - is it possible to move this thread into the Lower Back Pain forum?  Now that I know what situation I am dealing with, I feel this thread better belongs in there.  I would also like the right audience who have experienced something similar to share insights on my situation.  Thanks.
  • MarWinMarWin OhioPosts: 326
    If you research you may discover that supine is the optimal sleep position. Have you tried the supine position, with no pillow, and use about a 2" roll under you low back (about 1-2" below your bottom rib). I sleep with one almost every night. I sit at a desk all day. Well I split sitting with standing. Keep in mind, too much of any position can have offsetting results. Think of assembly line workers on their feet all day. They have back problems just the same. However, even with splitting up sitting/standing you should still often take breaks and change up your routine. 

    By the way....I LOVE THE FACT that your doctor said you're a candidate for surgery, but opted against it for now. Lordosis is fairly easy to correct with the proper exercises (non of which include ab work:)). At least what I did to correct mine! 
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