My doctor is Dr. Howard King, Intermountain Orthopedics, Boise, ID. He specializes in back / spine surgery. No knees, shoulders... backs and backs ONLY. He is THE BOMB, and a funny and great guy. Weird thing is he did my co-workers scoliosis surgery in Seattle 15 years ago when she was a kid. He's relatively young, but been doing this a long time

Susan

if it is piriformis for sure will there be tenderness or pain when the area of the pelvis is palpated near where the muscle is located?

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Trying to find ways to pass the time.

Susan,

Thanks!! Just curious, did you have sciatica in your leg?

S

in short yes, i had screaming 24-hour pain radiating down the butt, hamstring, calf and foot. so bad i could not function without Vicodin or Darvocet at times (and you don't even "function" when doped to the gills on this shit). driving a car was impossible. sitting for longer than 10 minutes was excruciating. got to the point that i could only sleep or lay on my stomach and stare at the tv.

sciatica is a general term to describe when something is irritating the sciatic nerve in your leg. there is a CAUSE for sciatica, it is a sympton of something larger.

Man, that is totally me. It used to be that laying down felt good, but now, it kills me. I'll be ok standing up, you know, not TOO bad, but then I lay down and it feels like a nerve is pinched. The pain in my leg doesn't go away. I am on Vicodin and thankfully I'm not one of those people it knocks out, but I hate being on it nonetheless and I really miss just walking a damned block!! I literally can't do anything but sit up perfectly straight and not move. And I have an ice-pack on constantly. I am just biding time until I can get to see someone who knows what to do. But you know HMOs...they are sloooooow to do anything. They want to try one more shot in my SI joints even though the last two they did in my back didn't help at all.

I am going to push for an MRI tomorrow at my appointment. And if they balk, I will get one on my own if I have to. I'm so sick of being in pain as I'm sure you have been in touch with.

$14,000 is really not that bad. I mean, considering I've spent much more than that over the years on all the different things I've tried.

Thanks for the info. Maybe I'll come out to Boise and see your guy(I'm in California). You never know!!

Cheers,

S

Before surgery, keep in mind that despite the anecdotal evidence you read here, the outcome of surgery is on average no better than PT and is just as likely to be worse as it is better.

Google the SPORT study that Weistein at Dartmouth med school is doing.

Good luck

And for my anecdote . . . piriformis pain is the only time a chiropractor cured me in a single butt zapping session. Prior to that I'd probably been to 10 different chiropractors for 10 different problems without every knowing if they had helped or if it was just time that healed me.

I'm curious as to what the chiropractor did. Wasn't it an adjustment or some sort of trigger point thing?

I wish I could even try PT but I can't even get on my back to do simple exercises. I did ART but the doctor wasn't that experienced and ended up making my back worse. It's now just starting to get back to "normal".

THX,
S

"I'm curious as to what the chiropractor did. Wasn't it an adjustment or some sort of trigger point thing?"

The guy I go to almost always uses this Frankenstein looking machine that feels like you are continually (or maybe very fast off and on) being shocked and he cranks it up to as much as you can stand. He attaches it right where the pain is and I presume it is making the muscle contract very quickly. Lots of tingling all over. As I said, I had never been cured of a pain so quickly.

Maybe there are some chiropractors here that know more about this machine than I.

He also does a total spine adjustment at the end of my appointment but I don't look forward to that and I'm not sure it does any good.

Interesting. Was it a TENS unit, maybe? I've had chiros use one of those machines on my back but never on the piriformis muscle itself. Hmmm...I'm working with a new PT. I'm sure he has one.

I don't like those adjustments either. Especially the one where they twist you into a pretzel position and then jump on you to crack the lower back. My life flashes before my eyes at that one;-)

S

I've been struggling with piriformis syndrome since March of this year. I feel your pain. It was on the road to recovery until a bad, bad PT re injured it in August.

This Dr. has been the greatest help to me so far... and he's a triathlete, really nice guy (not that the two are synonymous):

http://www.craneclinic.com/index.php

Thanks for the link. I am in CA though. I'm curious if you did the prolotherapy with the platelet rich plasma? I have had many, many rounds of prolo. I think it did help in some ways but overall, it wasn't the cure-all I hoped it would be. When I say I've had alot of rounds, I mean like over 20. This doctor is the first I've seen who uses something other than dextrose or sodium morrhuate(sp?). I have no idea if there's any science behind it. I'll have to do more more checking. But I am curious.

Thanks!
S

I've only had one round, two weeks ago. I've noticed an improvement, but the long term will be the real test. I've been looking into it more to and would be interested to see any data you drag up.

J

did your doctor administering the prolo use floroscope to make sure delivered accurately....

what area of body delivered?

i know a world class older age grouper that has used prolo for his bad back...successfully

my doc did not think prolo was the way to go for me, but reluctantly gave me a pain doctors name, which i may eventually try if facet block doesn/t work....or discectomy

No, none of them used a floroscope. I've had three different doctors. All the treatments were to my lower back and around the SI joints. One doctor did the majority of the treatments and then the two others did one each. One of the doctors said the first one didn't use strong enough solution. He told me that that could have been why I didn't respond as well as he'd hoped. So, he then proceeded to give me injections that put me in the worse pain of my life. I can't even describe the pain. I never went back to him. From everyone I have talked to it shoudn't have hurt that much and indeed the first two doctors gave me injections that only caused minor pain. None of the doctors I know of here in California use the floroscope. I actually had no idea it was used n anything other than steroid injections. Thanks for enlightening me. I'm always happy to learn something new.

I'm curious why your doc didn't think it would help you?

S

If it helped, that's a really great sign I think. I would definitely try at least a couple more. It definitely helped with this weird cracking thing my back used to do. It would get out of place to the point where I'd have to arch back to get it back into place. It was really disconcerting. I always worried that one day I'd go to pop it and something bad would happen. That doesn't happen now. I can only attribute it to the prolo tightening things up.

Do you have any doctors that do this treatment in SLC? I see that the doctor you went to was out of state, right? Is your pain just in the piriformis?

I hope you continue to improve. Being off my bike sucks! Most depressing thing ever.

S

first, the world class age grouper who gave me advice said...never get prolo without floroscope (xray) & use real doctor....another STer told me he got help but no floroscope but his problem was ,if i remember correctly, more hip area than back....plus he was a young fellow, 30ish

the older athlete got his at pain center at mayo in jaxville florida, the youngster in sarasota area.

when i was really having bad back pain last year i talked with older athlete and he told me about prolo...plus not only was there back pain, it just seemed like my guy wires for the back (muscles and ligaments) seemed weak. i did core work and that helped some and still continues to help. there is still something (disc, facet, something???) that throws me into tolerable pain, but just a sense all the muscles are working overtime to protect the spine & difficulty loading the spine. mild movement is ok. hard to describe, but feel like when waking besides sore/stiffness my entire lower body is hanging by a thread. seems like the muscles are much stronger, but since my back goes out many times during the year the ligaments probably never really heal. i've only bike and swam the last 8 weeks. the minute i try 5 minutes of running boom i can feel the back begin to go.

but my doctor is probably correct in trying facet block first. it seemed after about my 3rd visit over the last 7 months he was more accepting of the notion that prolo could be helpful. but his initial reaction when i first mentioned it, went over like a lead ballon.

i even wonder sometime if with all the adjustments i have received from chiro, have we damaged some of the joints with the aggressive nature of the adjustments. i have been getting adjustments since 1994. since about 2000, i'll bet i got adjusted at least 10 times a year. they seemed to work up until summer 2006. had major crash at im fla in 2003 which seemed to set off chain of events where several problems resulted: hip/groin pain, torn medial meniscus (surgery 2006), more frequent back episodes, and lastly patellar tendinitis in good knee.

more info than you needed, but i love this sport and would like to do it and do it as well as the accomplished older triathletes like jon adamson, bill riley, marcos alegre, etc....i wanna be an active MAD DOG!

crazy thing is with all these problems, when i can train painfree, my swim is still pretty good, bike good, it's just the run really is tuff. very frustrating, but not near the scale others have to bear.

chiro says try aquabike, not many of them and just do seem appealing.

facet block tomorrow....i will post when i've had time to evaluate

good luck!

You're funny. I wanna be an active MAD DOG too!!

Too much information...there's no such thing IMHO. I get so much useful info from this site and ST has the most helpful folks I've come across on a forum.

Yeah, I know about the lead balloon effect. Most doctors are like, "Huh? Prolo what?"

And don't get me started on the knees. "Patellar tendonitis" in your GOOD knee? Oy!

I know what you mean about how everything in your lower body feel like it's hanging by a thread. I feel very fragile like just the slightest move the wrong way and I'll be done for. I did some PT with a new(and very knowledgable) PT the other day and even just the most basic stretches did me in for 3 days.


Good luck with your facet block. Definitely keep us posted. Believe me after prolo, those wimpy needles they use for the facet blocks don't seem like such a big deal;-)

Hey has anyone ever told you whether you can ever have too much prolo?

Thx,
S

you're right....facet block was piece of cake. got it 5 hours ago.

so far so good!

Awesome!! Thanks for posting. Now, don't worry if you get the "cortisone flare" either tomorrow or in a few days. I'm sure they told you that might happen, but if not, sometimes people get a flare-up and the pain gets worse for a bit before it gets better. Let me know how you're doing in a few days. I hope this helps you.

Best,
S

Hi Mike,

I wanted to get your opinion on something if you would be so kind. Is a cortisone injection the only way diagnose a disc problem? My doc wants to do another epidural to see if my sciatic pain is caused by my discs. He said that it was one of the diagnostic tools they use to tell if it was disc related. I just worry about long-term effects on my system as a whole from the steroid. Also, a different doctor wants to try doing the injection in my SI joints. If I'm having sciatica, which do you think would be the more appropriate location(the epidural or the SI joints) to try? I wish there was another way. So far, I haven't gotten much relief from the shots I've gotten. I had one epidural over a year ago and it didn't do much at the time but at that point, I wasn't having leg pain. The facet block I had about 5 months ago did nothing. The docs say that there wasn't any reason to do another MRI as the treatment(the injections) would be the same. As it stands, it's going to be like January before I can a shot. Can you say FRUSTRATED??

Thx,
Shana

Is your back still doing well? I'm considering signing up for IM FL even though I've had to take this year off from racing due to a back problem. I finally found out that I have a small annular tear in my L5/S1. I also have a cyst in the same area. I haven't been recommended for surgery at this point as the pain is not horrible, just a nagging pain that I tend to feel in my glute and hip. I've tried PT and cortisone but neither really helped much. Are you still able to run long distances? This is my biggest concern as I don't want to make the problem worse but I don't want to quit triathlon either. It's been a very frustrating year with not a lot of answers.
Kathy

You might want to explore the cyst as the problem. If it's a synovial cyst pressing on spinal nerves it might rspond to cortisone but eventually surgical intervention probable. My experience. Lots of acetaminophen will get you thru race day if you don't solve it.

It's a Tarlov cyst and I did have an appt with a neurosurgeon to discuss it but he cancelled it with the explanation that I'm a non-surgical case so he won't see me. Didn't even look at the MRI - only the report. I have no idea really what exactly is causing my pain.

I will skip the obvious, then, and answer your original query abouy running...at least my experience. Running, et.al., was a function of how much discomfort one is willing to absorb but the act of runing sometimes mitigated the pain after 40 minutes or so. Again, acetaminophin in 2000 mg doses and higher worked for 12 months as did the first epidural.

Are you willing to share the routine you followed that set you on the road to a stronger you? I seem to be struggling with similar issues. Been to an ortho specialist and only confirmed scoliosis and tilted pelvis but nothing that has set me on to a rehabilitative program. Kind of feel in the dark. I read your post and feel some sort of hope that I may be able to walk properly again, even possibly enjoy the outdoors...