piriformis

[KellyJean]

Hi, I am new to this board, so not sure if this is the right place to post..
I started developing pain in my left calf back in September and thought it was a pulled muscle. The pain continued for about 6 or 7 weeks, and went away for two. It came back with a venengence and by New Year's Eve, I found that my left leg alternated between feeling like it was on fire and being numb. I have had several occasions where my feet and toes go numb for hours at a time. I went to my doctor two weeks ago and he has referred me to physical therapy. I am wondering if anyone else has had this, and how long phyiscal therapy lasts. There are days I am okay, and other days when I am in a lot of pain and have to get up every 20-30 minutes. Stop and go driving in traffic is very painful.

I am scheduled for jury duty in a few weeks and wondering how to cope since I can not always sit for long time periods. Wondered how others have dealt with this.

Thanks

[Kathi49]

Hi Kelly Jean,

I have had PT for the Piriformis. What my PT did was to use deep heat ultrasound and then just used a sort of trigger point compression. I believe it took about 3 sessions before it was completely released. And she also gave me some exercises to do. But to answer you completely I was really there for pelvic floor PT. It just so happens I was complaining about the pain in the cheek and down my leg and she treated it at the same as this other. The PT lasted about 6 weeks and I was going twice a week. I know how bad it hurts to be in stop and go traffic; I had to lean on the right bun all the time when driving and still have to be careful about too much pressure on the left. :eek::)

Oh, and about Jury Duty. I can't sit for long periods of time either due to the lumbar/pelvic stuff either. But there should be a stub attached to your summons where you can state it is a hardship. If there is, just explain the problem and return it. IF you do NOT hear back from them, then you are free of Jury Duty. At least that is how it is Indiana.

I hope you can get some relief with PT.

[KellyJean]

Here in Ohio - cuyahoga county, I think you have to get a doctors note and hope that they will accept it. I think you have to call them back to find out their decision too. I take it that this becomes a life changing situation with the piriformis?

[lobelsteve]

Who made th diagnosis?
What imaging was done?
What exam maneuvers were done and postive? (Pace or Frieberg's signs)

You describe something that does not sound typical of the piriformis muscle.

[cindybear]

I had my docters write up a paper saying that I was disabled with severe head pain and could not be under any stress due to an inoperable aneurysm,,I do not ever have to go to jury duty ever again..You could probaly do the same thing..Cindy

[KellyJean]

Hi lobelsteve,

I haven't offical had a diagnosis yet- I start my first physical therapy session on Monday. The numbness comes and goes, and I get a lot of pain in the back of my thighs, my ankles and I have a sore spot in each butt cheek, the right being the worse, yet my left leg has the worst pain.
I occasionally get sharp pains in the legs that feel like my legs are being squeezed in a vice grip. I almost always have some kind of pain behind my knees into my lower thighs. I am also getting lower back pain, which is something that I do not normally get.
Lumbar x-rays shows no slipped or bulging disks.


Any idea what this could be, if it isn't piriformis?




Who made th diagnosis?
What imaging was done?
What exam maneuvers were done and postive? (Pace or Frieberg's signs)

You describe something that does not sound typical of the piriformis muscle.

[KellyJean]

I had my docters write up a paper saying that I was disabled with severe head pain and could not be under any stress due to an inoperable aneurysm,,I do not ever have to go to jury duty ever again..You could probaly do the same thing..Cindy

Cindy,
I am so sorry to hear about your having an inoperable aneurysm. I hope all goes well!

Kelly

[lobelsteve]

Hi lobelsteve,

I haven't offical had a diagnosis yet- I start my first physical therapy session on Monday. The numbness comes and goes, and I get a lot of pain in the back of my thighs, my ankles and I have a sore spot in each butt cheek, the right being the worse, yet my left leg has the worst pain.
I occasionally get sharp pains in the legs that feel like my legs are being squeezed in a vice grip. I almost always have some kind of pain behind my knees into my lower thighs. I am also getting lower back pain, which is something that I do not normally get.
Lumbar x-rays shows no slipped or bulging disks.


Any idea what this could be, if it isn't piriformis?

Only your doctor can tell you that.
http://emedicine.medscape.com/article/308798-overview

It is much less likely than lumbar radiculopathy and the treatment is different.

[KellyJean]

Well, hopefully it is something that physical therapy will cure. I hope I won't need surgery!!!

[Kathi49]

Kelly Jean,

Good luck! I wanted to ask if you have had an MRI done...to show the soft tissues. Xrays won't show the whole picture.

In any case, I had both radiculopathy, facet issues and the piriformis problem. But heck I have pelvic floor dysfunction and a fractured coccyx. :rolleyes: The radiculopathy presents or presented differently. The L5/S1 issue I have presents more laterally down my leg, ankle and little toe. The piriformis was right in the cheek and went down the back of my leg. I can't recall if it went into my foot or not but I don't think so. All I can really say is that when it was released, the sciatic-LIKE pain went away. I think I would try the PT...easy at first, and see if it helps. If the pain worsens, I would stop. That's what happened to me originally; doing lumbar PT and not knowing that at the same time I was making some other things worse. :eek::) Try and see if you can't get an MRI if you haven't done so already.

[KellyJean]

No MRI yet. I guess I will find out more as time goes by.

Does the pain get better with time? I am wonder if this is something that will require the extra stretching down the road - if that is the worst of it, I will be happy.

How do you handle work with this situation?

[drcorish]

Where did you get the diagnosis about the piriformis...? your doctor?
This usually causes more deep buttock and back of the thigh pain rather than calf pain. Although the numbness is consistent with some nerve pressure.
I suggest some stretching before jury duty and dont cross your legs, this can inhibit blood flow and squeeze the peroneal nerve which would also cause numbness in the calf and feet.
Good shoes and good posture may also help, but mainly stretching before, and whenever you get a chance.

[KellyJean]

Thanks for the advice. Actually, I do not have an official diagnosis yet. My husband does have piriformis and had simliar symptoms. It actually has gotten very painful for me to sit and has been since late November. The pain in the calf has mostly subsided, and I notice that the pain is mostly in either butt check or in the back of my thighs so that sitting is painful. Some days are better than others and things feel normal, but on the days when this acts up, it is very painful. I also tend to have a lot of pain in the back of my ankles, and on Friday, had the pain go down to my toes. I ignored some of this for a long time- I have had off and on pain in the back of my ankles and calves for a few years now. But, I am concerned that it seems to be getting worse instead of better. I know that piriformis is supposed to be rare, but I guess I wouldn't be surprised as I have a few other rare things. I am just hoping that I will be able to get a clear name for this and a way to manage the pain.

[KellyJean]

I went to the physical therapist today and my doctor had my symptoms listed as sciatica. So, the PT had me lie on my stomach to see where my pain was. She gave me a lumbar roll and told me to use this, and to get up from my desk every 15 minutes at work, and to sit as little as possible. I use shoes with good arches (SAS brand) and am already walking 1-2 miles and sometimes three on a daily basis. I am usually very careful how I lift things and how I sit. All the furniture in my house is solid and not stuff that you sink in. After using the lumbar roll, now the small of my back hurts - a lot. I almost never have back pain, but she told me the goal is to move the pain from my legs to my back?? I guess I am confused. My exercise for now is to lie on the floor on my stomach. (She wanted me to try and also do that at work, but I can't do that, so it will be limited to before and after work. ) That's it. Also, I was told not to lift things and not to shovel snow ( which could be interesting here in February.....!!!) I was told I will go for four more sessions and then back to my original doctor. Most of my pain is in the back of my butt and down my thighs.

If the lumbar roll is causing me more pain as I use it, should I stop? My next appointment with the PT is in two weeks.

[Kathi49]

Hi KellyJean,

Are you placing the lumbar roll in the small of your back? If you are, that's the wrong way. It actually should be placed higher; kind of below your bra line and higher than where the small of your back starts. So that when you sit you can push your backside to the back of the chair yet the lumbar roll pushes you forward and bit up; supposed to take the pressure off your cheeks. I am using mine right now as I sit and type this. It is pushing me forward and the sit pressure is on my sit bones where it should be.

Sorry, I didn't mean to sound abrupt but I had to be shown a couple of times how to place the lumbar roll. :D And it will be a bit uncomfortable at first because you are not used to it. I bought one for my husband too and he didn't like it at first but now has it strapped to his computer chair. Try it the way I mentioned and see if it doesn't make more of a difference. I know when I slouch or the roll slips, I can feel the pressure in the cheeks.

I am sorry to hear the PT didn't do any more but maybe he/she will do some different things in the next sessions. And again, you may need an MRI to find out what is really wrong. But even so and with my own lumbar/sacral problems the lumbar roll helps. It just forces me to sit in the way that I should. Your PT is right though...be careful about the length of time you are sitting. You should get up and move around every 15 minutes...I was told the same thing.

And I got tickled about your SAS shoes. Don't you love those? I have 3 pair of SAS sandals that are like walking on clouds. And again, the PT is right about the shoes. My podiatrist once told me that if you can bend the shoe in the middle...no good. It should only bend in the front. I have found that to be true since I switched a long time ago from keds :rolleyes: to better pairs of shoes. Big difference! :) I miss my Keds though. ;)

[KellyJean]

Thanks for the advice on the Lumbar roll. I think I had it too far down! The PT told me to put it down near the bottom of my sweater and near the top of my pants, but where you mention to place it seems to work better.

My husband introduced me to SAS shoes several years ago. I had heel spurs and those have been great in getting rid of those. I do wish the SAS had better treads on them. When we get snow and ice up here in Northern Ohio, they can slip, if you aren't careful! But, they sure last longer than a lot of other shoes. I haven't tried the Sandals- I have the oxford style shoes.

[KellyJean]

I have been told by the physical therapist not to sit for more than 15 minutes. She hasn't told me for how long I will only be able to sit for that amount of time, only that eventually we will build up my siting time. I hope there are other ways to get this fixed besides just not siting and lying on my stomach ? I work part-time, and can not afford not to work, but it is difficult to get up and go for a walk every 15 minutes, plus lie on the floor every two hours!