Sciatica / Piriformis Syndrome

I mentioned this in another when i wasnt sure what the problem was.

Background: I started getting what i thought were severe calf cramps whilts i was doing my LSR's in prep for the London Marathon i then started to get what i thought was the beginning of a hamstring tear as i was getting sharp pains in the back of my knee.

I stopped for just over a week and stuck to the x-trainer. I then went back out for a LSR last sundays and i got the same pains back again but after only 2.5miles. So i walked home and went on the cross trainer but after 3minutes i got a numbness / pins and needles type pain in my feet.

 Decided to go to a sports physio as i thought i may have strained/torn my hamstring, it was then when I was diagnosed with have sciatica/piriformis syndrome. I have an appointment at my chiropractor for tuesday. 

Not sure what to do over the weekend? bugger all(stretching only) light running? try a LSR?

Anyone had any experience of this? 

 I was reading this: http://www.isischiropractic.co.uk/chiropractic_sciatica.html and it sounds very familar.

More so than the symptoms described here: http://www.isischiropractic.co.uk/chiropractic_back_pain_piriformis_syndrome.html

Im confused and worried that ill not be able to run the FLM

 

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Comments

  • If it really is piriformis syndrome then it's the piriformis muscle which has tightened up and is squashing the sciatic nerve. So....what you need to do is get that muscle to relax off and there are some ways to do this:

    1. Sit on a hot water bottle (heat can help the muscle to relax)

    2. Inhibit the muscle. Now this is really painful and often therapists will stick their elbow in the muscle to get it to relax but you can do this by sitting on a tennis ball (so it's on the muscle not so you get a thrill).image

    3. Stretch the muscle out

    Have a little look online for some pictures of where the muscle is but basically it's in the gluteal area. A crude way of describing it begins just above where your buttcrack is and goes out horzontally to your thigh but if it is piriformis syndrome then I expect it will be pretty tender when you poke it.

    Hope this helps

    F

  • Tracey GTracey G ✭✭✭
    I have had the elbow in that muscle and it does hurt but it  helped.
  • Flipper wrote (see)
    Inhibit the muscle. Now this is really painful and often therapists will stick their elbow in the muscle to get it to relax but you can do this by sitting on a tennis ball (so it's on the muscle not so you get a thrill).image

    PMSL!

    Elbow in the muscle technique should be accompanied by rotation of the hip at the same time to stretch the piriformis.

  • Thanks for the tips flipper & co.

     All down the back of my right leg hurts today just from walking around a few shops with the wife. It makes my hamstring and calf feel really tight. Ive been stretching them whenever i can. Im pretty flexible, its just sore!

     I went for a light run last night I managed 4 miles before I started to get the pains down the back of my leg and a sharp feeling in my hamstring directly behind my knee. Im just worried that i can currently only do 4 miles and i need to be able to do 26 in 3 weeks!  image

     I made a physiotherapy appointment for tomorrow morning because my chiropractor is away unit tuesday, i have an appointment with him Tuesday evening. Not sure whether to cancel the Physiotherapy appointment?? I dont wanna chuck £35 down the pan! espcially when i have to pay for the chiro on tuesday!

  • SezzSezz ✭✭✭

    Bennett, sorry to hear you're not feeling so great with FLM in 16 days.

    Can I suggest you get yeself to a Bowen Technique practitioner.  Bowen is a gentle therapy with strong results, working on muscles, ligaments and tendons.  An application where it excels is lower back pain and hamstring problems.   I had a lot of pain this time last year around my hip and after my tutor working over my pelvis, I was able to run 20 miles over a weekend.   1-3 treatments is possibly all you will need.  Message me if you would like any more info or if you need help finding a therapist. 

  • Bennett04

    How did your sports physio diagnose piriformis syndrome and did you have a lumbar spine/.disk problem ruled out? There are some tests that your physio or chiro can do that should be able to tell if indeed it is your piriformis causing the sciatica or if the problem is actually coming from somewhere else, your lumbar spine/disk for example.

  • I think it's totally up to you  Bennett04 who you see about this but a prioroty has to be to get a proper diagnosis. There's no point having wonderful treatments and stretches for a tight piriformis if it turns out for example,  you're compressing a nerve root in your lumbar spine - it will be wasted time which is something I bet you feel you don't have at the moment with FLM approaching. 

    I'm an osteopath so would of course recommend osteopathy, but like all professions out there the standard of practitioner varies so if you already have someone you trust then I would stick with them. But of course, that's just my opinion.

    Hope you get some relief soon and FLM isn't consumed with too many anti-inflammatories.

    Keep us informed.

    F x

  • Thanks for the info guys & gals.

     I went to see a physiotherapist on saturday morning. Got ok, still pretty confused though! She had a good look at my posture and spine. She pointed out that the lumbar part of my spine curves in more than most peoples which apparently puts much more pressure on the shock absorbers and making the possiblity of pinching a nerve more probable?!?! she also said that my pelvis tilts forward.

    I tried to go for a light run sunday morning - needless to say it wasnt successful! image Im still not sure if it isnt just a calf/hamstring problem? The pain just feels like a tear/pull/strain - but for all i know thats what the sciatic/piriformis pain feels like?

    I've decided no running at all between now and the FLM (Only 13 days!) X-Train only! Ive also got a 10% Ibuprofen anti inflam. gel to massage into my calf & hamstring.

    Im just confused!!

     Hopefully my chiro will be able to help on Tuesday.

    I just wanted a painfree marathon after running in pain for most of last years with my ITBS problems. One thing after another!

  • Hi,

    I also have this problem, the doctor has told me it's sciatica. The  pain is like cramp but 100 times worse. Its starts just under my backside area goes down my leg to behind the knee & my foot goes numb with pins & needles I have had the same symptons for about 8 weeks and it's getting worse, although i can still run, it's just afterwards that im in alot of pain. With London just under 2 weeks away i don't know what to try next. I was thinking of seeing a chiro but as it's expensive i'm not sure it would help. Although if i can be painfree for London then it will be worth paying. I too just want a painfree run as this is my third London & the last two times i was in pain with different things image

    I'm taking painkillers but to be honest they are not really working. Any advice please!!!

  • sounds exactly the same as me dud, i've only had the pins and needles once and that was whilst cross training. I get the cramp feels after only a mile or two of running. Sometimes i can do 4 miles. Ive decided not to run at all between now and the 26th. Dont if this will help or not? probably not. Got a chiro appointment tonight @ 7pm. Ill let you all know how i get on...
  • Dud

    Sorry to hear you're having this problem so close to FLM too.

     Sciatica is a symptom of something and you need to find out what that something is especially as you are getting neurological issues with the numbness and pins and needles and it's getting worse. It's possible you could have a lumbar spine/disk problem so i'd get it checked out asap if i were you.

  • Thanks for all the advice. I have an appointment tomorrow to see a sports physio who i spoke to earlier. She seems almost certain (although will tell when i see her) that i have pirifomis syndrome. She thinks because when i raise my leg the pain stops then it is possibly not sciatica. Hopefully tomorrow i will be more sorted out. I have been told it will probably be quite painful to relieve that muscle. Will keep you all informed.
  • Went to see my chiro yesterday.

    Didnt really hear what i wanted to. He had no definitive diagnosis, although he imagines the nerve is trapping in the lower lumbar section of the spine although everything is inline. Just told total rest between now and FLM (12 days). He also massaged all down the back of my legs and behind my knee was an absolute killer!!!

    I guess only time will tell...    

    I will however continue to sit on hot water bottles and tennis balls!  image

    Forever the optimist.....

  • Bennett04

     I would use a slightly different approach... as chiro thinks it's a trapped nerve in the lumbar spine i would stop using the tennis ball as you could be further irritating the sciatic nerve as it runs through your glutes and try using some ice (frozen peas is fine) instead of heat - you can use it on your lower back (even if it doesn't hurt there) and also on the areas where you are feeling the nerve pain. Heat will just increase any inflammation and therefore pain, ice will do the opposite which is what you want.

    If it doesn't go away, perhaps you need to go and see a specialist doc of your choice for a more thorough lumbar spine exam and perhaps an MRI. It could possibly be disk related.

  • Bennett, if chiro suspects trapped nerve why isn't he / she doing lumbar traction to release it?

    All the heat / ice etc is doing is treating the symptoms not the cause at the moment.

    Heat vs ice is more complicated than what Fikalina describes - most people don't like ice on their backs. I use it for very inflammed acute patients. Most repsond better to heat as it eases muscle spasm more than ice does. Depends very much on pts symptoms. Use whichever gives you most relief - because that's all it is - topical pain relief.

    I hope the enforced rest helps things settle down a bit for you.

  • I love ice on my back - has done more to treat my sciatic symptoms than anything and sure beats taking painkillers and anti inflams. Heat made it much much worse. But that's just my personal experience with a disk issue.

    With numbness and pins and needles, i'd get myself checked out thoroughly before i'd let a chiro traction my back.

  • Fikalina, yeah ice calms things down. Traction's great for pins & needles - not as scary as it sounds - it's a very gentle glide that frees off the spinal nerves... (though chiros will work different to physios & other therapists), so don't know if they'd use same techniques as me... I use it a lot and have success with it.

    Hope you're getting somewhere with your probs image

    Bennett, bear in mind there's only so much physical therapists can do - as has been said, if it's a disc problem, then you'll need MRI investigation to see the extent of the damage and take it from there.

  • Yeah, i think i am, cheers Siance image
  • Hi all, went to see a different Chiro on friday, she was a little more optimistic but i am still suffering with pains down the backs of my legs, worse when sitting at my desk at work.

    I think it is piriformis syndrome as when do the sitting on the tennis ball massage it sends the exact pain i get down the length of my leg. So would i be right to assume the nerve is trapping in my piriformis muscle?

     Should i keep on massaging with the tennis ball or would it make things worse? Likewise with the hot water bottle?

    Thank you!

     Not long to the FLM now!!!!!

  • Bennett04 , optimistic is fine but what is she doing to help you? what has she diagnosed you with and what treatment plan has she outlined? Sounds to me like you are still waiting for a firm diagnosis and treatment plan .?

    Its very difficult for anyone on this board to advise you on what you should do especially as you don't have a firm diagnosis. As previously suggested and as you haven't made any progress, perhaps you need to go and see a specialist doc of your choice for a more thorough lumbar spine exam and perhaps an MRI.

  • Neither Chiropractor or Physiotherapist have said "it is definitely..." but they have all said that my pelvis tilts forward thus creating a more acute angle in the lumbar section of my spine and that this might where the nerve is pinching. I also get a strange (i wouldnt call it a pain) feeling in my piriformis a tingly/twitching sensation (a bit difficult to describe) whilst sitting.

     But you are right, none of the three professionals that i have seen have said "you are definitely suffering with.... & it is eing caused by....

     I have another chiro appointment tomorrow afternoon, ill see if i can get some clearer answers...

  • good luck Bennett04, hope all goes well tomorrow

  • for those who want in the short-term just to run the LM and need therefore to treat the symptoms:

    1. I second fikalina re. ice: get yourself a special ice pack from Boots and whack it across the lower back, pushed round a bit to the side that's giving you bother. Every evening between now and the race and loads the evening before. I strap mine on with a belt so I can at least move around and do stuff while icing.

    2. Go to your GP and get a prescription for diclofenac and co-drydamol - the standard treatment for sciatica symptoms. The diclofenac alone should make a big difference as it's a lot more effective than ibuprofen. Star taking it now (normally 3 x 50mg a day) and take a double dose the night before race, after eating. The co-drydamol is an extra painkiller for those really suffering - save it for the night before the race, after dinner. (The codeine can make some people feel a bit spacey - so might not be ideal for race day.)

    3. Mixed messages on stretching, but my physio reckons the glute stretch - on back on gloor with one knee pushing back your other knee crossed over it - will help.

  • Cheers Adrian! Good info, I was going to go for Asprin & Coedine but i guess my GP can prescribe something stronger...
  • a good anti-inflammatory is key Bennett and I'm afraid aspirin and even ibuprofen seem to be pretty ineffective at calming down sciatic nerve irritation. Diclofenac however does the trick in my experience.

  • Just back from the chiro.saw two of them today as the first one wanted a second opinion. Just as well because the second chiro said the opposite to the first. The first said its in L4 and L5 and it wouldn't be good to run. Then I asked for a second opinion and he said its definitely in my piriformis. I am seeing him again thursday. He said ill do no long term damaged by running although it might be sore. He has told me to do some intensive glute medius exercises strengthening and stretching.
  • Well things not looking good for me either. After last week being told it was piriformis syndrome, i am still, if not in more pain than ever. So i went to a really helpful chiro today. He told me i def have a trapped nerve. It probably wasnt piriformis as the siatic nerve comes from that area as well. He said the massage may of actually made symptoms worse as it's putting extra pressure on the nerve.(not what i wanted to hear after it costing me £30!!)My pain goes from my backside down my leg, behind my knee. My foot has a fuzzy feeling as soon as i stand up. Anyway he did quite a bit of work to try to release pressure from the nerve pinching but was told could take days if not weeks to settle down. I know i can't pull out of London, ive come to far but have to forget any sort  of time i had planned & just hope it's not to painful to run on. I tried a run yesterday but had to stop, far to painful. Only time will tell, i am so fed up at the moment. I wish London was a month away & not Sunday!
  • I don't know anything about chiropracters but I'd be suspicious of anyone making a firm diagnosis about exactly how and why the nerve is being compressed without having seen an MRI. Sounds like guesswork to me.

    Just out of curiosity, why does everyone go to these chiropracter people and not simply a back specialist!?

  • Bennett04 - i'd be pushing for a lumbar MRI referral if I were you seeing as your chiros cannot agree on your diagnosis. You'd need to see a doc for this as a chiro cannot refer you directly.

    dud - same for you i reckon if your sy is causing that trapped nerve and you need to find out what it is.

    Adrian, I dunno, i think maybe people don't realise they could have something as potentially serious as a prolapsed disk so maybe they feel that going to see a neurologist or equivalent is a bit OTT so they start with chiro or physio. Also, most cases of back pain resolve themselves in 6 - 8 weeks (not ours though!). I started by seeing a physio who (quite rightly) referred me straight to a sports med doc for a lumbar MRi referral as soon as he thought my symptoms could be lumbar spine related. Once the results of MRI were in, i was referred back to the physion for bog standard core work. Unfortunately, this physio did little to help aleviate the symptoms i was struggling with so i dumped him and in desperation took myself to a chiro who does Active Release Technique as I'd read this can help a lot.  I was sceptical and if i'm honest, a bit nervous about seeing a chiro but he has been fantastic and he asctually wanted to see my MRI before he did anything and was able to tell me more about what it showed than what the Sports Doc passed on to me. Out of all the health professionals i've seen so far, he has without doubt helped me the most, particularly with the advice to use ice NOT heat as was recommended by dumped physio!

    Out of interest, when you say back specialist, do you mean a neuro surgeon or something like that?

  • Hi, I'm a longtime lurker but had to de-lurk when I read this, as I'm getting over the same thing at the moment. My symptoms were as you describe, in fact even now I'm getting better I can still sometimes feel the 'weird tingly feeling' you describe.

    Physio ruled out sciatica due to disc problems because I wasn't getting any pins and needles, and treated me for a mild hamstring strain. (I must have slightly strained the muscle, because before I caved in and went for physio I'd spent 2 weeks frantically overstretching the tightness). It wasn't until approx 4 weeks later when the muscle had healed but the 'shooting' pains hadn't improved (and if anything were getting worse, especially after sitting for long periods) that he thought of piriformis syndrome. He then changed tack and gave me deep stretches for the glute area, got the elbow in (ouch) and did 2 sessions of trigger point work on my back (ouch again). It's getting much better now, but it's been slow and frustrating.

    Btw, once he'd explained why he was working on my back, I did some research on the net and found this website was quite useful for info (http://www.painclinic.org/musclepain-backhipbuttockleg.htm).

    Hope you don't mind a newbie sticking her oar in, but I thought my experience might be vaguely useful?

    Hope Sunday goes well for you image

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