It’s not usually recognized by physicians. It is pain that travels down the leg from the lower back and is very uncomfortable. For me, I was unable to sleep. When I saw my doctor, rather than deal with my insurance company for approval for an MRI, he wrote it off as gallbladder trouble. After pleading with the insurance company, and being diagnosed with a herniated disc, I was then able to go for physical therapy. It was then I finally started to recover.
It was my physical therapist who first told me about piriformis syndrome. He said many people don’t realize they have herniated disks until they are discovered at autopsy. Often, sciatic pain is treated with pain medication and physical therapy. In pirformis syndrome, the sciatic nerve travels next to or through the piriformis muscle, deep in the buttock. If the muscle goes into spasm, the patient experiences sciatic pain. Sometimes the pressure is extreme enough to cause permanent damage, (such as weakness and numbness) in the leg and foot if not treated in a timely manner.
Strenuous twisting of the torso (like shoveling snow), bending and lifting at the waist, prolonged sitting (as in driving or sitting at a computer), or falling on ones’ butt can cause the piriformis muscle to go into spasm. It starts with low back ache, pain and weakness in the leg, and sometimes numbness in the foot, all classic symptoms of a herniated disc. An MRI is needed to rule out herniated disk, however, piriformis syndrome will not be evident on CT or MRI scans. Rather, a clinical diagnosis is made by specific examination of the piriformis muscle.
In physical therapy, while lying on my back, I was asked to bend my knee and bring it across my chest to the opposite shoulder. The pain was excruciating. As the hip rotated, the piriformis muscle was stretched and the spastic muscle was stressed. Exercises to relieve the discomfort involved stretching the hamstring and piriformis muscle. Eventually, I was able to sleep at night, only for a few hours at first, then gradually through the night. Pain medication did nothing for me except turn me into a sleepless drunk. I’ve also heard massage helps to relax the spastic muscle, and of course warm showers and compresses. Over the counter NSAIDS help relieve inflammation.
I am living with my herniated disk, but am highly motivated and do my exercises morning and evening. I learned the proper way to lift in physical therapy. I do not lift more than ten pounds. I modify the way I do certain activities not to stress my disk and to prevent the piriformis muscle from going into spasm. I do however have reduced sensitivity in my foot, presumably from delayed treatment. Hopefully, I will be able to avoid surgery and another episode of sciatic pain.
