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dreamsharkI know this because I have been struggling with piriformis syndrome for the past 6 months, mostly without knowing it. It's getting better now, and I'm pretty focused on figuring out what I need to do to continue the healing process and, more importantly, keep it from recurring.
The piriformis muscles are a pair of little muscles in the human backside that you don't even know you have until they start to hurt. The piriformis runs at a strange diagonal angle that is hard to describe, connecting the sacrum (lower part of the spine) to the top of the femur (hip bone). It's a wimpy little muscle that isn't actually good for much even when it's behaving itself; it's sort of a helper muscle for rotating the thigh outwards. But when you actually ask it to DO anything, it gets stressed out and tightens up, which causes all sorts of havoc in the complicated mechanisms of the hip and lower back ranging from hip pain to sciatica. In my case it's mostly pain and tenderness to the right of the sacrum (in the butt, in other words), with intermittent pain right at the hip bone and some pain radiating around the hip into the groin and occasionally down the front of the thigh. That last part is apparently a mild sciatica. It's not intense, but acts up at night and interferes with my already pathetically poor sleep patterns.
Apparently I also had a misalignment or sprain of the sacroiliac joint (henceforth known as the SIJ) which was causing intense pain just above the right ileac crest of the pelvis (halfway between the spine and the hip). SIJ pain and piriformis syndrome are closely related, but the causality is murky. The piriformis connects to the sacrum right below the SIJ. So a spasming piriformis muscle could pull the SIJ out of alignment, or a misaligned SIJ could pull on the piriformis until it spasmed or tightened up. By the time I finally made a doctor's appointment I had managed to figure out the necessary stretches and exercises to relieve the pain above the pelvic crest and all that was left was the lesser piriformis pain.
Anyway, I've had 4 of 5 scheduled PT sessions now and the whole set of problems seems to be clearing up. Honestly, I think that self-experimentation and the Internet were both more helpful than the PT, but here's what I've gotten from PT:
The piriformis muscles are a pair of little muscles in the human backside that you don't even know you have until they start to hurt. The piriformis runs at a strange diagonal angle that is hard to describe, connecting the sacrum (lower part of the spine) to the top of the femur (hip bone). It's a wimpy little muscle that isn't actually good for much even when it's behaving itself; it's sort of a helper muscle for rotating the thigh outwards. But when you actually ask it to DO anything, it gets stressed out and tightens up, which causes all sorts of havoc in the complicated mechanisms of the hip and lower back ranging from hip pain to sciatica. In my case it's mostly pain and tenderness to the right of the sacrum (in the butt, in other words), with intermittent pain right at the hip bone and some pain radiating around the hip into the groin and occasionally down the front of the thigh. That last part is apparently a mild sciatica. It's not intense, but acts up at night and interferes with my already pathetically poor sleep patterns.
Apparently I also had a misalignment or sprain of the sacroiliac joint (henceforth known as the SIJ) which was causing intense pain just above the right ileac crest of the pelvis (halfway between the spine and the hip). SIJ pain and piriformis syndrome are closely related, but the causality is murky. The piriformis connects to the sacrum right below the SIJ. So a spasming piriformis muscle could pull the SIJ out of alignment, or a misaligned SIJ could pull on the piriformis until it spasmed or tightened up. By the time I finally made a doctor's appointment I had managed to figure out the necessary stretches and exercises to relieve the pain above the pelvic crest and all that was left was the lesser piriformis pain.
Anyway, I've had 4 of 5 scheduled PT sessions now and the whole set of problems seems to be clearing up. Honestly, I think that self-experimentation and the Internet were both more helpful than the PT, but here's what I've gotten from PT:
- 3 serious massages of the affected muscle, plus a pleasant heat pad treatment. The first massage was the one that mattered - I think it broke up some of the deep muscle tightness that was keeping the stretches from really working. The other 2 massages felt nice, but I don't think they really made any difference. Ditto the heat treatment, although it was nice and relaxing.
- The exact location of the sacrum, something I've always been fuzzy about.
- The exact location of the piriformis muscle and how to tell when I'm stretching it. The stretch is simple in principle, but the angle has to be precisely right.
- A high-tech massage instrument for deep massage of the SIJ and piriformis: two tennis balls in a sock. I use that every morning and it really loosens things up. I intend to add that to my morning routine forever.
- Confirmation of some of the stretching and exercise tips I found on line that seemed to be working for me. I would have been more impressed if Molly had volunteered these tips herself instead of focusing on lower back exercises that weren't actually relevant. But when I showed her the things I'd found online she explained a little more about why they seemed to be helping, so I'm planning to continue with them.
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Date: 2010-05-21 12:02 am (UTC)no subject
Date: 2010-05-21 03:09 pm (UTC)