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Piriformis muscle

Hi there

I have a large herniated disc L5S1 my back feels fine and I am going to pilates once a week and a chiropractor twice a week. But the biggest problem I am having is my piriformis muscle. I can't walk more than 100 yards without it going into spasm. I have asked my chiropractor if its piriformis syndrome but she says it is all coming from my herniation. So I was wondering has any body else had this problem and what they found that worked?


  • Hello, Allan_81!

    I am not familiar with piriformis syndrome, but do have an "up close and personal" relationship with sciatica and terrible buttock/leg muscle spasms!  I will say that deep tissue massage has helped me immensely with the pain from the muscle spasms.  Have you asked your chiropractor if deep tissue massage might help? 

    I'd like to welcome you to Spine-Health!  Please click on the following link for some helpful information to get you started!!

    Welcome to Spine-Health
    Kimmy72, Spine-health Moderator
    Firm believer in PMA!
  • Allan_81AAllan_81 Channel IslandsPosts: 11
    Hi Kimmy72

    My chiropractor has done a deep tissue massage on my calf and buttocks which she says has relived a lot of the knots and tightness. But we have only started doing this and I have not really seen or felt any improvement on the spasm front. How long did it take you to see a improvement? And are you still suffering?
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  • wajihwwajih torontoPosts: 27
    If you have a large L5/S1 herniation then your symptoms are least likely to be caused by piriformis syndrome. It not impossible to have both but your symptoms are very much the same what I have with same herniation. Watch if pilates increases your pain. If the pain or any exercise increase your pain level you need to stop it. Having no back pain but radicular pain is not uncommon to have with a disc herniation. The symptoms are indicative of some sort of nerve root compression/irritation. Your MRI should indicate that where the nerve is being compressed...Good Luck
  • Allan_81AAllan_81 Channel IslandsPosts: 11
    Hi wajih

    It's interesting what you are saying about the pilates when I am doing the exercises that are one on one classes the pain increase. The next day  I am sore and stiff but the day after I feel better. But the spasms are always present. What treatments have you found to work?? If I could get the spasms to stop I feel I can get by
  • DaNkinatorDDaNkinator Jeffersonville INPosts: 5
    So I have a follow up question on this.  I've had the pain now for a few months.  I'm also diabetic, so I at first attributed it to neuropathy.  But, it was always centered at my hip.  I then discovered that it could be piriformis syndrome.  I've been doing the stretches and it's almost completely eliminated the actual sciatica pain.  However, I still feel A LOT of tenderness in the piriformis.   It's still tight, and I can't sit for long without pain.  I work an office job,  I have a cushion that's designed for use for tail bone soreness, but I turn it at a 45 degree angle to keep my piriformis from being directly on my chair.  That's my only relief.  If I'm standing, I'm fine.

    So, how long will this pain last?  With the stretching and exercise, will it go away in a bit?  Or is this possibly indicative of a bigger problem?

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  • glynnhuntgglynnhunt PennsylvaniaPosts: 25
    Your chiropractor is likely right. 99% of the time sciatica symptoms come from a disc herniation. The spasms and knots will always return until you fix the source of the problem. Fix your back and they should go away. For warning  pulling knees to chest and stretching hamstrings tended to make me worse. Good luck. Sounds like your on the right track 
  • wajihwwajih torontoPosts: 27
    I agree with glynhunt. Once the disc is herniated the the back muscles go in spasm in order to protect the back or simply telling you not to put pressure on you spine. Even though piriformis is quite low but generally speaking the spasms or cramps may come even down to involve the hamstrings too. This is how events may take place but certainly its not a rule for everyone. Mechanics of back injury are complex and extremely variable. There is no definite pattern or rule that applies to a disc herniation symptoms. If any exercise gives you a instant relief then you are on the right track. I know for sure that if core strengthening exercises are causing pain then you are not ready for these exercises. Extension vs flexion is a confusing debate and should be left for the experts. I personally have tried many exercises over the course of a year and nothing really helped but low impact such as light walk and one of the Mckenzie's extension. I did have a long discussion with a neurologist and he suggested that any phsyio without traction is useless. Honestly I have never gone for traction but finally planning to. So my friend listen to your body and let the pain be your guide and never do any exercise without asking the professionals.
    For Dankinator, if you have not done any imaging(MRI) you are wasting your valuable time. Please have the imaging done so that at least you know what underlying condition you have........Good Luck
  • DaNkinatorDDaNkinator Jeffersonville INPosts: 5
    edited 09/29/2016 - 7:19 AM
    Thank you wajih, I will do that.  I had a great day yesterday where there was hardly any pain.  Today, I wake up and do a few of my stretches and it was all very tender and tight again.  Especially in the hamstrings, just stretching that nearly takes my breath away.

    Also, what do you mean by physio without traction? 
  • glynnhuntgglynnhunt PennsylvaniaPosts: 25
    If bending forward takes your breath away have you looked at going the other way like the McKenzie wajih talks about does?

  • DaNkinatorDDaNkinator Jeffersonville INPosts: 5
    To be honest, I don't know much about the McKenzie method, I've been googling it this morning.
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