Piriformis release surgery, anyone???

Newbie

Really angry huh? Interesting.

Everything about my butt hurts right now. Between the various injections, strengthening and stretching exercises it is probably 20 per cent more painful than before. It is so frustrating.
I read some interesting info on piriformis syndrome on Wikipedia. it stated that inactive glutes (from sitting etc) caused reciprocal inhibition from overactive hip flexors resulting in hypertrophy of the piriformis that then produces the typical symtoms. Problems with the sacroliac joint would also affect the glutes and thus the piriformis.

Since I have all these problems it is nice to know that i fit all the criteria. Now if i could just fix the pain!

Newbie

Piriformis surgery...anyone else out there had it, and had a full recovery or at least 80%? DId you have worst pain than before the surgery for a time? I'm experiencing nerve pain down into my foot that is close to the level it was prior to surgery....

Member

Carrie and Rob Ihave had botox injections also. I have atrophy in the gluteal maximus and do feel weakness in that area but amnot sure it is caused by the botox. I think atrophy in the gluteals goes along with piriformis syndrome. Rob, so sorryabout your increased pain after surgery. That makes me nervous as I am probably going to Dr. Filler for an assessment and surgery if needed. I can't write much more now as I have been sitting too long at the computer. Keep us informed Rob. I kdon't want to think surgery would make me worse.

I am still waiting tohear from the OHIP application.

Shirley

Member

The reason I am still awake is because I am having terrible burning in the butt, the hip, the leg and the foot. It feels like someone poured acid all up and down my right side on an open wound.

Oh my gosh. I, too, have been diagnosed with piriformis syndrom/SIJD and you are the ONLY person EVER who has described the pain that I am in. I feel like I have battery acid over my soft tissue in my SI, greater trochanter and hip (anterior). It's horrible. Like acid over an open wound. Exactly.

Member

Sorry if that post didn't make sense, I was quoting Scamp from earlier postings.

I do not have radiating leg pain, just burning, searing, raw, battery acid SI, gluteal/hip pain. Does this sound familiar to anyone? I am currenlty doing prolo to my SI, gluteals and hip right now. Sad

Member

I've been working with endurance athletes ,and people who are suffering from chronic pain, for 18 years. The piriformis muscle crosses over the sciatic nerve and when it goes into a spasm it tightens and puts pressure on the nerve.

Also, there are two muscles, one that originates on the front of the lumbar vertebrae and the other is the quadriceps muscle of your thigh. These two muscles will pull your pelvis forward and down, causing the posterior pelvis to press up into the sciatic nerve, and also causing the piriformis muscle to torque.

As the pelvis is rotating down in the front, the back is moving up. This overstretches already tight hamstrings and is the cause of the burning pain that a person can feel at the base of their butt, down the hamstrings and into the posterior knee. It can even go into the calf and the arch of the foot.

You can self-treat the quadriceps and piriformis muscles very easily, by using your elbow (sliding deeply from your hip to your knee) and lying on a tennis ball to press out the spasms in your piriformis. Then do the stretch for the iliopsoas (low back muscle) that is on my website: http://www.julstro.com under the section "Muscles and Pain" and "What's Happening Exactly."

I've seen so many people from my forum, and people who have either come to a workshop or my office, eliminate this painful problem without surgery or drugs. Please look at this muscular situation before you agree to doing a treatment that can't be reversed and that has a natural by-product of scar tissue at the site of the incision. You can either do the treatments yourself, or look for a qualified trigger point/deep muscle massage therapist in your area.

Wishing you well,
Julie Donnelly

Member

In reply to Julie Donnelly, when anyone presses on the piriformis muscle or I use a tennis ball directly on the muscle it increases my pain and causes the muscle to go into more spasm. I had a massage therapist do active release and I came away with worse pain in the butt down the leg and into the foot. I have to use gentle myofacial releases and sometimes it helps to release the muscles around the muscle but not directly on the muscle.

Shirley

Member

Hi Shirley,

Through the years I've had people who have the same situation, when working directly on the piriformis actually makes the pain worse. In each of these cases the source of the problem ended up being the iliopsoas (anterior lumbar muscle) and quadriceps pulling down on the pelvis and causing the bone to press up into the sciatic nerve. As this is happening it overstretches the piriformis so the muscle is pushing down on the nerve and the greater sciatic notch of the pelvis is pushing up onto the nerve, and you're in a world of hurt.

If this is the case then pressing into the piriformis will only put more pressure on the nerve and further stretch an already overstretched muscle.

I suggest you thoroughly work out the tension in your quadriceps muscles and then do the stretch that is shown on http://www.julstro.com in the sections titled "Muscles and Pain" and "What's Happening Exactly." There are some other muscles that can be pulling the pelvis up in the back (the quadratus lumborum which originates on the 12th rib and inserts into the top of the posterior pelvis) and the lateral rotators (all along the sacrum and inserting into the top of your thigh bone). The lateral rotators are probably the muscles you are massaging when you do the myofascial release techniques because they are all next to the piriformis.

It's a frustration when you have piriformis syndrome, but I've seen it release on so many thousands of people through the years that I believe you'll be able to get relief too.

Wishing you well,
Julie Donnelly

Member

I continue to scour the net for reports of people who have been cured by Dr. Filler, from piriformis syndrome. I HAVE NOT FOUND ANY. I am a physiotherapist and have wrestled with this for almost 5 years. The cost of this procedure is astronomical, and nearly everyone who has had it, that I have read of, is either still recovering, or disappeared from the net. As far as the massage therapist who claims to have cured thousands of people from this, that is complete hokey. 90 percent of all back pain will resolve on its own within two months, and so therapists who take credit for this are seriously misguided. I have spent a lot of time and money also, and I caution everyone not to be misled. What happened to Elliot, the lawyer who had this surgery?

Member

I disagree with you. As I have explained in my previous posts, if you consider the physiology of the movement of the pelvis when the iliopsoas is contracted, and the quadriceps are forced to shorten and therefore putting another strain on the pelvis, you will understand how the pelvis is pressing up on the sciatic nerve. Also, as the pelvis is rotating due to the tight iliopsoas muscle, it causes the piriformis to torque and stretch, pressing down on the sciatic nerve.

You now have the nerve being impinged in two different ways, and the person has severe sciatic pain/numbness. When you release the tight muscles the pelvis can rotate back where it belongs and the pressure is removed from the nerve.

BTW, I have not "cured" thousands of people. Aside from my clinical practice, I have taught workshops for many years, and have also worked with people through my forum and the books and DVDs I've produced. Through these various methods I have been able to show people how to self-treat the tight muscles and take the pressure off the pelvis and sciatic nerve. And no, it's not "hokey," it's just a logical outcome of looking at tight muscles and releasing the pressure.

Julie

Newbie

Newbie

Member

The two most recent posts are very similar to all those I have seen for the last couple years. Nobody seems to be very pleased with the results of the piriformis release. If the individual who had the release by Dr. Filler would be so kind as to keep the rest of us posted on his progress over the next few months, that would be greatly appreciated. As far as Julie the massage therapist goes, thanks for the explanation, but surely to God you don't think that all these people suffering haven't been through the gammet concerning stretching programs. I do notice that you have a website attached to you replies, which is very typical, trying to sell people something. I did look at the site, and it had some serious misinformation. For example the claim that you cannot stretch hip flexors with a bent knee. If one were to do your stretch, standing and leaning backwards at the counter, one would not feel much in the area of the hip flexors. However, if you kneel down on the affected leg and contract your abs you can totally recognize a stretch in the affected psoas. Anatomically, the hip flexor does not span the knee joint, so to claim the knee has to be straight is an absolute falsehood. Shame on you for trying to sell people your false cure. Hip flexor stretches would have little to no impact on piriformis syndrome, as anyone who has it will confirm.

Newbie

Hello all,
I have been suffering for a year now. From what I understand of nerve healing, it does take a VERY long time for nerve damage to heal. I got to experience this myself when I had a nerve nicked in my mouth during a dental procedure when I was 12. For at least two years afterward, while the nerve healed itself, the pain was excruciating. I could not even touch that part of my lip and mouth and suffered from the painful tingliness that often accompanies nerve healing. I still don't have complete feeling on that side and I'm 27 now, but the pain finally lessened. I still get that pain if I do something stupid like bite my lip or crunch a chip wrong. I think that most of us will just be happy to get rid of that constant and unending nerve pain, but even after the nerve is no longer compressed, it will take time and pain for that nerve to have any kind of true healing. Unfortunately, this just means that there is no miracle cure or easy fix. I myself will get surgery as soon as I am financially able, since the PT has done nothing for me. But the PT DOES help a lot of people so I can't discount it. I think you have to find what works for you. Unfortunately some people do try to benefit from those in pain (both from the medical and PT communites). We have to be smart. If it hurts you worse than the normal amount of pain you deal with on a daily basis, then it's probably not for you. Of course, a small temporary increase in pain is expected in any healing process.
But I digress....a lot.
I hope that everyone here eventually finds some kind of relief, temporary or otherwise. I'm still in search of mine.
Take care all,
Kayti

Member

Ronnyjotten, you are misquoting me and I'm not going to get into a shouting match with you because you like to argue. I've worked with too many people who have gotten better for me to have doubts about what I teach.

I did not say that a person is doing anything with the hip flexors when you do the stretch leaning backward, you are only stretching the iliopsoas. When you kneel on one knee and lean back you are doing the same thing, only closer to the floor. To stretch the hip flexors you need to move in the opposite direction (left leg toward the right, right leg toward the left). Primarily I teach people to find the trigger points that are shortening the length of the muscles, putting a strain on the insertion point at the joint.

I stand by what I teach, I'm fine about you not attending one of my workshops. Good luck at what you choose to do to help yourself, I'll continue doing what I do.

Julie

Julie

Piriformis release surgery, anyone???

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