Hi VicGirl - Did you have any luck finding a surgeon in Australia that would perform piriformis relief surgery. Every specialist I've spoken to is very patronising when you raise the subject, and it seems that this surgery only has momentum in Europe and the US. I've had severe pain for almost 4 years. Left side went first, then right side 2 yrs later. No lower back pain, but piriformis is rock hard and I've done considerable physio and massage to unlock them, but it doesn't work. Can walk and run, but cannot sit without extreme pain in buttock and a tearing sensation on outer thighs/hamstrings, and your commentrary from a few years back seemed very similar. I've very recently had spinal fusion of L5/S1, and I'm not confident it's what my problem is, despite an underlying pars fracture that was the only thing that turned up. Cortisone injections of L4, L5, SI Joints, Piriformis and Sciattic nerve (buttock), plus Caudal Epidural did nothing to relieve pain....and I mean zero. Interested in your thoughts or anyone else who suffers a similar problem, and end up needing to take horrendous oxycodone meds long term.
I'm very interested in your post as I'm yet to find any physio, neurosurgeon, sports doctor, GP or other professional in Canberra who has the expertise to first accurately diagnose me as having piriformis syndrome and then treat me for the condition. Not that I know I actually have the condition but I suspect I do. Do you mind if I pick your brains as you seem to be way ahead of me in terms of understanding of this condition???
So I can't actually help you atm and I don't wish to hijack your thread either but personally I am fed up with chronic pain which I have a very long history of starting way back in 1983. I know it can be a tad tedious listening to others talk about their own condition especially when you want answers for yourself but if you could see your way to having a short read and possibly responding with your experience, who knows maybe over time we could join forces in sharing info in search of a long term fix.
I'll try to keep my history as short as possible. I had what I suspect was a protruding disc in 1983 as a Soldier where I was told everyone has back pain so stop malingering. In 1989 CT Scans were new which showed two protruding discs which caused ongoing but bearable pain even though I was by that stage a professional Firefighter. In 1995 the L5S1 prolapsed completely whilst picking up a piece of paper. I was facing re-deployment but after intensive rehab I got over it to a point. Then I had a total disc replacement in 2005 after aggravating things on the fireground and where the real problems started. I was in constant bad pain so My GP at the time prescribed pain relief for nine years until I was red flagged by the ACT Health's chief pharmacist. Yes, I was on obscene levels but I was between a rock and a hard place so it was time for me to be retired on invalidity at 52 years of age. That was 5 years ago where a spinal cord stimulator didn't really work but a fusion from S2 - L4 helped a great deal at the beginning of last year and I was able to get off the pain meds (wasn't that fun).
Now I have problems with both SIJ's with either the left or right taking turns in causing lots of pain. My current physio believes I need to strengthen the muscles in my left glutes which I've been doing pilates classes and home exercises for. The trouble is, they only seem to make things worse. I have been wearing an SIJ belt for months which initially was great but over the months I've found stretching the right piriformis muscle nearby to the hypermobile SIJ makes a big difference. What I really found interesting in your post Johneb was how dry needling was effective. I have only had it done in the piriformis once and the relief was incredible. Like you though it was only short term and I haven't been able to have it done again as the physio practice has a two week break every school hols.
Personally I don't know how you can do any gym work as I have trouble walking and sitting with lying down my only relief.
Again my apolgies for what seems like my hijacking your thread with my 'Poor Me' story but you are the only person I've read about who seems to have the same condition as myself.