I am a 30 year old female who was diagnosed with piriformis syndrome at age 27. There are several factors of my medical history that have exacerbated the symptoms and problems for me.

First, the curvature of my spine causes me to lean more to the right putting greater pressure on the right foot and leg when standing and the right buttocks when sitting. Second, at the time I developed piriformis syndrome, I was also suffering from peripheral neuropathy, a painful nerve disorder. The heightened sensitivity of my nerves caused additional duress to the sciatic nerve and piriformis muscle when I was sitting. In a short period of time the compression of the sciatic nerve led to piriformis syndrome.

My diagnosis came after a nerve conduction study and several MRI's. I went to many doctors in search of answers to why I was in so much pain. I saw 2 neurologists and 2 neurosurgeons to confirm the diagnosis and to seek treatment options. The nerve conduction study confirmed the compression of the nerve at the sciatic notch and the lack of nerve signal going down my leg. The short head of the biceps femoris was affected which simply means my hamstring muscle was not getting any signals from the sciatic nerve since it was pinched off above. Although walking was difficult, I learned to compensate and in time the nerve paths grew new routes as confirmed in subsequent MRI's. The result was a limping gait and intense pain at the sciatic notch, across the full length of the piriformis muscle and down the back of my leg through the hamstring muscle. The additional neuropathy in my foot left me wishing I could have the whole leg removed.

The neurosurgeons suggested a horrific and terribly invasive surgery so I elected to continue with physical therapy, chiropractic care and pain medication. Over time I have seen slow progress and cycles of improvement. Exercise is the main component of my success. When a pain management specialist suggested I may also have hyper-mobile syndrome, I switched from stretching exercise to weight training. The idea was to shorten the piriformis muscle instead of lengthening it with stretches. In most cases, stretching the muscles relieves the pressure on the sciatic nerve, in my case it only made the muscle larger creating more muscle to compress the nerve. Resistance training has developed the muscle but it has shortened it and the effect is positive. My overall health is better as a result of the exercise and my ability to deal with the pain I experience is increased because of the endorphins produced from exercising.

The intensity of the nerve pain is difficult to quantify and describe in words. The pain of piriformis syndrome is intense and changing. One minute a mere stroke of fingertips across the skin is unbearable while the next a deep probing pressure is required to get into the depth of the sciatic notch to release the pressure. Sometimes I poke ink pens into my buttocks in an attempt to relieve the pain. Nothing truly relieves the pain but I keep trying just the same.

During the past three years I elected to receive several Marcain injections directly into the piriformis muscle. I also had steroids injected into the muscle to reduce the inflammation. I'm not sure if I recommend the injections or not. They definitely do provide temporary relief for a few hours that justifies the procedure. However, the second day the injection sites are quite painful and the pain seems more intense once it returns. I do like the Marcain injections as they are not as painful and numb the muscle so that it cannot be felt. This a a wonderful feeling while it lasts.

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