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Leg pain...can't get a diagnosis

Hi all,

 I'm new here and just wondering if anyone has any insights to share or went through something similar. 

I'm a runner and I am very tight and inflexible. Always have been. This may or may not be important but last October I started to get some pain right above my (pardon my language) butt crack.  After sitting on a metal chair for a few hours one day it got worse so I went to urgent care a few days before a half marathon. The doctor told me it was coccydynia, sit on a special cushion, run my race and don't worry about it. So I did. I found that when I get some blood flow in that area when running it gets better.  That pain will come and go occasionally but really has not been a problem. 

I would say in late January or early February, I began to feel what I thought was a very faint strain type of feeling in my back upper left leg which I thought was my hamstring. By late March it was really starting to bother me a bit more and in the beginning of April I sat for many hours on an uncomfortable metal chair for work and that seemed to just make it go nuts. 

 I took a few days off running, iced it. That did not help so I went to my chiropractor. He said it was piriformis and gave me some ART, said  do stretches and clamshells. I also did some acupuncture. After about four weeks of that it hadn't gone away. I made an appointment to see the PA of the orthopedic surgeon who did my knee surgery ( different leg ) a couple years ago. This took a few weeks to get in - after an exam of all about 1 minute he said hamstring tendinitis.  Sent me to PT and gave me three weeks of meloxicam. That did not help. I made an appointment to see my surgeon who also does sports medicine, but that ended up getting pushed back because he was out for a few weeks for a medical procedure. In the meantime, he ordered me a pelvic MRI and when I finally did get back to see him which was mid June by this point, I heard him read my MRI outside the door and send a different one of his PAs in to tell me my hamstring is beautiful,  and maybe it's a pinched nerve. I got a six-day super dose pack of prednisone and an appointment to follow up in two weeks with their nonsurgical sports medicine doctor in the practice. 

 Prednisone helps for about a day. I see the sports medicine doctor, who spent a good deal of  time with me but really didn't know what this is. Thought it might be sacroiliac, so I got an injection which did not help. So I  had a lumbar MRI and went back to the sports medicine doctor. I have a bit of facet joint arthritis which is more defined on the left side. I also have a disc that is symmetrically bulging and there's a little bit of narrowing. However, the doctor does not think this is causing my pain and has ordered me physical therapy within a different practice, w a PT  trained in back/spine, I think McKenzie.  He feels that this is coming from my spine, as opposed to the piriformis. He says if this does not work, maybe we would try a facet injection just to see if that works. 

I have not done any meaningful cardio since April.  Any type of semi vigorous activity aggravates the pain, which is a pretty constant and dull sensation  right where my butt cheek and lleg meet. Sometimes it will go down the back of my thigh, but not even halfway. There is no tingling, there is no numbing sensation.  If I spend a lot of time sitting on a long car ride, I will get a little bit crampy feeling higher up on my left butt cheek near the piriformis area. That area is very tender to palpitation.  While the sports medicine doctor had mentioned possibly trying a  piriformis injection if the SI didn't work, the last time I saw him he backed off from that, saying that there's controversy as to whether piriformis syndrome exists and because the sciatic nerve is in there that would make this injection problematic. 

 I tried pool walking and that aggravated it; today I was cleaning out my refrigerator and bending and squatting to take the drawers out and put them back after washing aggravated it. When I walk back-and-forth across my yard to clean up after my dog, that aggravates it. There truly seems to be no cardio exercise I can do at this point but does not aggravate it. 

I picked up the books by Dr. John Sarno, who feels that undiagnosable back pain can be caused by repressed emotions, stress and tension. I can accept that, although I feel like there has to be something missing.  When the pelvic MRI showed fibroids, I went to my gynecologist who assured me that they are small and in the location they are in, are not contributing to the pain (I read they can aggravate the sciatic nerve).  I've even thought about asking my GP for an antidepressant like Cymbalta because that supposedly can help with muscular and nerve pain. I'm starting to get very depressed because running and fitness are such a big part of my life, and the anxiety they helped me get rid of is starting to come back.  I am afraid this will go on forever. I  don't even know what kind of doctor to go to should I try for second opinion. 

 I've started to go to gentle yoga about a week and a half ago and I've gone to three classes so far. It doesn't aggravate it, but I have yet to see if it helps. 

 If you've made it this far, thank you. I'm just feeling desperate and don't know what to do. 



  • dilaurodilauro ConnecticutPosts: 13,526
    It does seem that just about anything you do aggravates your situation. But honestly, after reading your discussion and the various doctors feedback, I am not sure what your problem really is. Without knowing the cause of the problem, its almost impossible to treat it.

    Piriformis syndrome cab be hard to identify, only because many of its symptoms are related to other spinal problems. I am not sure what your doctor told you about an injection being a potential problem because it would be near the sciatica nerve. The sciatica nerve does lie under the piroformis muscle, so extra caution in administering the injection is important.

    I have had two steroid injections into my SI/Joint area. The first did not help much, but the second one cleared it up and I havent had a SI/Joint problem since March 2016. I also know of other members who have had this injection as well as something for their piriformis syndrome and none of them talked about an injection potentially cause a problem (near the sciatica nerve). I would check with them again to make sure that is what they said.

    Please read
    Sciatic Nerve Video
    Types of Sciatic Nerve Pain
    When is sciatica pain a medical emergency?
    Why does your sciatic nerve hurt so much
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • Hi Mom if Girls -  I found your story and was curious if you found the cause of your pain. I have been dealing with something similar and when I read your post I thought it was the closest to my experience.  I have started the pain since November and feel we are in a guessing game.  If you get this note, I’d much appreciate your reply.  Thanks and hope you have sorted out your pain!  Best

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