What type of doc should I be looking for to treat Piriformis syndrome after 20 years and thousands of dollars and constant opiates. I am ready to be done with this.
Person's Gender: Male
Person's Age: 39
Chiro., facet blockers, steroid injections,physical therapy, massage, pills
Hello. This hit you at quite a young age! Was there any preceding trauma? Have you had an MRI of the lumbar spine to rule out a sacral discitis or radiculopathy? How about an MRI of the pelvis to rule out an associated hip or sacroiliac problem? What specialists have you seen so far?
Yes, I have had MULTIPLE MRI's and told by "experts"in their field "there is no way I should be in so much pain. "you need to get some more exercise.... " I have seen at least 3 neurologists most recently at New England Baptist Dr Sabra, I was given the nerve tests in both legs (normal) I do show signs of Bulging in the L5 S1 area but nothing to explain this pain. No one has ever brought up this piriformis Syndrome??? I thought I was going CRAZY. I am on percocet 30mg x3 daily it has stopped working as well. I am service connected disabled for a fall. I run a franchise auto dealership and have the best insurance money can buy. I just want relief....
So the pain started with a fall? Did you suffer any pelvic fractures? An occult fracture in one of the pelvic bones could result in chronic pain mimicking Piriformis syndrome. Similarly, inflammation in the sacro-iliac joint can do this. Have you had a CT scan with thin slices to look at the integrity of the bones and joints of the pelvis?
I'm just wondering how firm the Piriformis diagnosis is. The last resort for treating Piriformis syndrome is surgery, but you would want to make absolutely sure you had the correct diagnosis before proceeding. If you're pretty sure about it, you would want to consult with an orthopedic surgeon who specializes in sports medicine.
20 Years in Internal Medicine, Neurology and Sports Medicine
I was treated for a fracture in my leg from the fall. I have had so many MRI's , I would think they would have caught a fracture? I am going to call my Ortho Surg. who performed my Rotator cuff repair. Thank you for your help
You're welcome. Sometimes a doctor has to think of a possibility before he can actually find it. In your case, every study should be re-examined with a fine tooth comb, or repeated if necessary (e.g. some CT scans don't use thin slices, and smaller fractures can be missed). I hope your ortho doc is able to help you. If he does not specialize in this type of procedure (i.e piriformis decompression), ask him for the name of colleague who does. One pretty good source is whatever ortho/sports medicine group takes care of your local professional team (eg. hockey, football, etc)