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Piriformis Syndrome - SI Joint Dysfunction

2

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  • Update 
    had my checkup last week. They stitched my incision from the inside and glued the skin together when I had the surgery. Part of my incision came unglued, about a pin hole size. They removed the Durabond tape, and we have been dressing the pin hole ever since. My dr suggested I see a local wound dr, because I am so far from Cleveland. I may need a wound vac to get this pin hole to heal faster since the wound is so deep. I have an appt with wound dr on Thursday. Getting around ok, still do not have an signs of the pain I had before surgery. They have taken me off work two more weeks, because of the pin hole leaking. 
  • Week 7 update - around week. 3 I developed a pin hole leak. My surgeon sent me a wound vac and had me schedule a appt at my local hospital wound center. I went in and they said the pin hole was 2  1/2 inches deep. They got a lot of old blood to drain out and ran a culture. Then they had me get an ultrasound. In the ultrasound they found a hematoma that was 8 inches long and about 3 inches around. They waited two dAys for culture to come back before putting on the wound vac. During that two days the pin hole closed. Culture came back negative for infection. Since the pin hole closed, my surgeon said leave it closed. He didn't want the wound dr to open it back up to drain the hematoma. He said it will absorb into my body. The next week I started to increase my activity by working some on the computer and painting some boards that were placed on horse stands. By the end of the week in started getting some so that achey pain I had before surgery, yeah that was scary! But it didn't travel down my leg.  I called my doctor and he asked What I had been doing, I told him, and he said have you been squatting, I said yes I have some. He said NO , don't squat at all. He started me on a 6 day pedisone pack. The first day on the meds ( my second day back to work in a office)  I thought my muscles were going to cramp their way out of my legs. I left work, went home and started eating bannans, baked potato, anything I could get my hands on that had potassium. I also started chugging water too. I remembered that while I was in the hospital for surgery, they gave me it steroids. I realized my body had not built up enough potassium yet. By evening, I felt much better. The prednisone for 6 days took away almost all the muscle soreness from the surgery pain, but still had some ache in the buttock. Not as bad as before surgery, it was like the clock had been turned back a few years. As the steroids wore off, I told my surgeon I needed my pain pills back,but my dose is much lower than before surgery. I took 4 Percocet a day, and now I take 2. I asked the surgeon, why did I have. Complete relief for 5 weeks the start feeling the ache agin. He said its from the increases activity level. I have my 6 week post op check up  yesterday. The car ride there is 4 hours. By the time I got there at 1:00 pm, I had taken 2 whole pain pills. ( I take my pain meds in Half pill doses. Takes the edge off the pain while being able to function.) the surgeon was happy with the way the doctor incision healed. But I told him I was confused, I thought this would be healed better by now. He said everyone is different and because of the leak, them the hematoma, and what he had to do, he feels it's going to take a few more months before I start to feel a lot better. He had the hematoma checked, it is absorbing and breaking up. It's now 5 inches long and 1/2 inch around. There are a few smaller in size too. He has started me on some vitamins to increase healing, b complex, coq10, alpha lipoid acid and duexis which is an 800 mg ibuprofen with stomach meds. I am also starting  a nerve block pill, neurontin. I am waiting till Friday night to start that. Little nervous about taking it, but hey, it's only temporary and if it helps, it will be worth it. My surgeon has done this surgery countless times, and been successful every time but 2. Those two people had other conditions causing there problems, not Piriformis. 

    I did did some research and there is two reports on recurring pain after this surgery. One report from I believe 2008 was a case study of two men who grew scar tissue and had revision surgery where they put plagets by the siactic nerve so the scar tissue wouldn't aggravate it. Three yr. heck up, they were both doing ok. The dry mentioned that hematomas could diminish the success of this surgery also. But neither of the case studies had hematomas, so not sure why that was put in their report. I have attempted to contact one of the dr from that report but been unsuccessful so far, not giving up yet. The other report was more recent, 2015 I believe, it was a case study with a young women, and they were not successful in revision surgery. 

    My sugeron Ron seems to think, time will heal this. I am able to work in my office, walk with no issues. I do use a stand up sit down work station, with out it, I might not be able to work. The ibuprofen is helping me a lot. I took one at the doctors office from a sample he gave me, and the trip home was so much better. This tells me that even though I can't tell from the outside, deep inside there is still a lot of swelling. 

    only time will tell how this all plays out, I will continue to post. I go back in 6 weeks for another check up. 

    I am still extremely happy I had the surgery, my pain level is no where near what it was before. 
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  • Sunshine113SSunshine113 Posts: 1
    edited 06/11/2017 - 1:45 PM
    Kajeana any more updates? Is there are way to give more information on this doctor who performed you procedure?

    ***************************************
    Members are not permitted to recommend or name doctors 
    Liz, Spine-health Moderator

  • I am almost four months post op now. Saw my surgeon the first week in June. I got the news that for two reasons my recovery is taking a very long time and could take up to one year post op to be 100% again.

    First reason, I had piriformis for almost 8 yrs before surgery. That was alot of stress on that area and because you use the muscles in this area for walking, sitting , almost everything you do, it takes a very long time for them to calm down and get better.

    Second, my hematoma is taking what seems like a lifetime to completely absorb. The last ultrasound showed it breaking up, but still causing me pain by putting pressure on different nerves, not the siatic. The pain is still dull and achey, but not as deep and not traveling down the back of my leg like it did before surgery. When the weather fronts come in, its the worst!!!!! My family doctor believes, because i have a history of SI joint strains, part of the weather changing pain is from that, but also the scar tissue forming. I have had other surgery s where  up to a year post op the weather changes did cause a little aching, but nothing like this. But this is a much larger scar, was a much deeper cut.

    So I have good days and bad days. Some good days I need no medication at all. Others I have to take the prescription pain meds, only about  2 a day which is half of what I took before surgery. I also found relief from lodicaine patches. They numb the area pretty good. That also tells me this is different pain than before surgery because lodicaine patches didn't work before surgery. 

    I was released by my surgeon to start doing as much exercises as I can handle without pain. I did stop the prescription ibuphoren and the muscle relaxers. My body just isn't used to taking so many meds and I realized they weren't helping much anyway. The stretches I can do now do help with pain. 

    I just hope and pray as both the surgeon and my family doctor say, this pain I have now will go away in time. Going to continue increasing my exercises and see how my pain level is in a few months. If I am not seeing any improvement, I may request an MRI to see if the hematomas are gone and or if scar tissue may be causing an issue. 

    FYI  about the  reports I mentioned in my last post about having complications with this surgery and having revision surgery. I contacted two of the surgeons that are state side. The one told me he didn't know much, he was just an intern at the time. The other surgeon told me he stopped taking care of people with this condition because he was never able to repeat the positive results again with the revision surgery. 

    Once again, I will state, I am so glad I had this surgery. It is a tough recovery road, but the key word in that statement is, recovery!

  • Dawn GDDawn G Posts: 6
    edited 06/25/2017 - 11:38 AM

    I just found this.  I had a 5 level fusion 7 months ago and after 4 months, I was rehabbing very well.  THEN I developed Piriformis Syndrome.  I know this is what it was because I had it before.  I just had my first injection into the piriformis muscle, but it has not helped.  Not a single doctor suggested PRP.  Anyone else out there had PRP for Piriformis Syndrome?

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  • Note to Dawn. I had two condtions, SI joint dysfunction - was an overstreached tendon and Piriformis Syndrome. PRP helped the heal the overstreached tendon to hold the SI joint steady. PRP didnt heal the Piriformis Syndrome. I had to eventually have the muscle released. for 6 years massage therepy , chiropractor adjustments and exercises did well for the Piriformis. IT was when I strained the SI joint really bad that the piriformis muscle then got really bad. After I had the PRP for SI joint, the Piriformis was really bad. Surgeon said I had fiberous tissue in the PM that was strangulating my siactic nerve. 

  • UPDATE: I'm making progress!!! SLOW progress , but at least it is PROGRESS! It has now been almost 5 months since my muscle release surgery, and then the development of hematoma. Surgeon and family doctor said it is going to take up to a year post op to fell much better. I have hired a guy who has a master degree in Physical Therapy and is an Athethic Trainer. He is amazing to say the least. I only get to see him once a week, but its great to have a coaching through this. He works me out for about 1 1/2 hrs and then gives me glute muscle exercises to do at home 3x a week. I am down to 2 pain pills a day ,  2 -  800 mg of ibuprofen and lodocain patches each day. When storm fronts come through the pain is at its worse. But I am feeling stronger and a little better each week. He also has me use heat, alot of heat to help absorb the hematoma. I know that I can walk in his gym with pain, and walk out with no pain. This tells me I am on the right track. I am so ready to put an end to this 8 year journey and glad I see the light at the end of the tunnel. 

    My guy told me I am the fourth person he has helped after this type of surgery. He believes by this fall I should hopefully be off the pain meds. I feel so blessed to find someone to help me through this that knows what they are doing. 

    My second visit he had me on the tread mill to warm up for 25 min. I was shocked to realize how weak my whole left leg was. Every muscle in it was tight. My right leg felt nothing! It showed me how out of shape this condition and surgery made me. The next week on the tread mill was better and I got a whole mile in at an incline. 

    This is one tough surgery to recover from, considering I have no other health issues to contend with. 

    I am so thankful I found a surgeon that knew what he was doing, and now a great therapist. I cant wait for the day when I can say I am off my meds. That is my goal, to be pain free from this horrific condition once and for all!

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