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Pain Concern
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Piri Formis

Hiya all. I am new to this site, and have had constant pain which has been diagnosed as Piri Formis. I am on Amytriptaline 10mg. Paracetamol and Ibuprofen 400mg. I have had physio along with 6 sessions of acupuncture, which have had a positive effect, but I still get pain in the middle of the night when I am sleeping (unfortunately, I am not a very good sleeper anyway). Can anyone give me any tips please? During the day, I am slowly getting back to my old self, and the pain killers are ok then. Thank you in advance for your replies. Sorry this post is a bit long.

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When I have had problems with my piriformis the only thing that has helped has been exercise. Now, as long as I do my exercises every morning I don't have pain.

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Thank you for that. My wife and I go for walks which help, but I mostly get the pain when I am in bed and wake in the night with it. Sometimes in the day, I can't get comfortable.

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do a few exercises at night just before you go to bed enen lying on the edge of the bed with the sore side on the floor, that will give it a good stretch there are also special exercises on utube for the piri formus musles as mine are tight too, its a horrible pain. stretch it before and after walking especailly is important. it will help,

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Thank you grace111. I will try that

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Pigeon pose in yoga as well as log pose are very helpful. Try stretching it out til you get to 3 times a day for 15 minutes. Should do wonders

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Sorry Pinky2233. What's a pigeon pose?

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Wow. I am a 65 year old man. Haha that would kill me πŸ˜…

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There are many ways to modify this pose to make it comfortable

I had piriformis problems and only until I could stretch the muscle myself and keep it pliable with frequent long holds did the problem start to go alway

That problem is completely gone

Dr Fishman in Nyc is the guru on Piriformis Syndrome and all things yoga.

Maybe there is a yoga teacher who can find a comfortable way to access this pose.

I can suggest starting by bending the front leg just a little in the direction shown in the video and put a pillow or yoga block under the bend hip.

Good luck

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Thank you very much

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you did not say where the pain was

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The pain comes from my buttocks into the top of my thigh and into the calf. Very uncomfortable . I suppose I shouldn't moan about it as when it happened in Feb of this year, I could not walk

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How did you get diagnosed? Your family doctor, a specialist? Asking because l have exactly the same pain...for six months now first on right side and now on left. Always comes in in the night, wakes me up. No doc so far has been helpful at all. Pain goes does unto thighs which feel heavy and achy. Was afraid to try physio in case in did more damage.

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I sleep on a flat door covered by a thin carpet. The hardness of the wooden surface forces me to relax before i go to sleep. This is in contrast to a soft mattress where body tension does not matter. Then you pay for it when the body tenses even more and something then complains badly and loudly.

It will take a little bit of time to get used to a harder surface. Investigate and see if it improves things or not.

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Thank you johnsmith

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I had a discectomy in 1992 which was a relief from the immense pain I was in due to carrying heavy things

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Hi, I find that the night time pain is a very different beast to the daytime. For me it's all I can focus on. I have found a great heat pad, it is really useful, mine is like a little square mini electric blanket. I can lie on it or position it where it's painful without it being uncomfortable like hot water bottles etc. I also find listening to pain therapy music or hypnosis tracks are not only relaxing as they help with breathing through pain etc but it's also distracting, I like Mark Grant, (change your brain change your pain - EMDR) and Paul McKenna has good pain one too. They are all non invasive things you can try that won't do you any harm but if nothing else it will relax you. Your favourite audio book is also a good idea. I know it can sound "airy fairy" and I was initially skeptical myself but I like the idea that I can affect my pain without having to Increase drugs etc. Mindfulness is also another path to tread. You would be surprised how distracting these things can be. If your pain is as excruciating as mine you will give anything a go even if it takes the pain down just a notch it's worth a try! I really hope some of the suggestions that have been posted have some impact on your pain!

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Thank you very much LJS. I appreciate your comments and thoughts. I will look further into your suggestions. I may give the audio book s go

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You are more than welcome, just hope some of them work for you!

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Hi just- typing

I'm sorry to read you are suffering with Piriformis . Very painful. I had it for several years and exercises didn't solve it but helped. I was being treated for another problem at a pain clinic and had injections for the Piriformis which solved it. What a help that was!. I was on higher painkillers than you too so if the pain is not being helped by yours I'd get a referral to a pain clinic. They will look at your drugs as well as gp's have a limit as to what they can prescribe!. I do hope yours improves soon,sympathise at level of pain!.

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Thank you Misty14

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I am battling this at the moment, I was referred back to physio 3 times and had 18 sessions in all, also deep tissue massages every week which was financially crippling me,was doing the exercises and stretches every day you have to build and strengthen the glute muscles, I was advised against walking in the early days ,it was agony anyway ,as it compounds the piriformis with every step and makes it worse, i was off work and couldnt walk for 3 months, was swallowing paracetamol and ibuprofen by the packet , then co-codomol and naproxen, then tramadol, I was also using heat and ice sprays it only took the edge off it, I cried many days and nights from the pain but persevered ,it is not an overnight problem , 8 months on , yes I feel something but would say I'm nearly back to fully fit and off all medication, my body was so twisted out of line from the way I was holding myself in pain and I ended up with bilateral sciatica as well, you can overcome it ,I am 52 and my problem originated from the way I was standing, walking and tensing up after a torn stomach muscle , I went back to work after 3 months it was hell but I got through it I still do the exercises and strength building and swimming which has massively helped, good luck and don't give up

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Well done Cazzie66. I truly hope you don't get it again. I remember back in the early 90's before I had my op, I was in spasm. It makes one feel so down. Thank you for your positive reply

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Thank you Osidge

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Hey

I have had back/hip/sciatic and piri formis pain years.

This is what ive learnt over years ice when it gets very inflammed. Heat when u just want some relief. Buy yourself a foam roller it was best 20 quid ive spent as u can find ur own pain areas and roll it out. Yoga!!!!! Yoga !!!! I do a few yoga stretches every day morning and night and it has helped massively! There are a few great sites on youtube that a actual chiro or osteo will talk u through exercises for ur piriformis.

I did all these as i had been on painkillers and naproxen so long my liver and kidney were bad so i decided i had to sort it all without them.

Walk aswell , laying down doin nothing is worse thing u can do when it hurts u need to stretch it out as it is hurting as it shrunk....

also a very good chiro or osteo never a physio! Not good enough for that kind of prob. I have seen 3 not one helped me... i now have a great osteo and chiro and i alternate between two when it gets bad( i know which ones best for which pain) .

I now have hardly any pain most of the time and it down to them

And all the exercises and knowing ur limit... never over do it or u know ur goin to pay for it.

Also i just read u get it at night before u go to bed do some piriformis sciatic exercises so ur all stretched out for bed... coz it when ur relaxed they all shrink hence the pain before bed

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Thank you Lulububs. The advice I have received on this site has been amazing. Every single post has had something positive. I have so much to help me and your post is another positive. I can look into a lot of what you say

. Thank you

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Hey,

I'm In the exact same situation as you.

I've had to find the problem myself however as I too have been to the gp many times in the past and been through 3 physios and only one of them diagnosed me with piriformis.

I've had my back scanned via MRI and there is nothing pressing on the sciatic nerve so not back related.

The way you can confirm piriformis syndrome, from research and trial and error, is to be in a sitting position, place both hands on outside of knees, and try to push legs outward against hands but do not allow knees to rotate with hands. If this aggregates the pain then you can safely say you have tightness in the piriformis muscle on that side.

Using that test I can formulate state that I have issues in my left buttock.

Specialists will mostly claim that piriformis can only be an issue on one side, but I've found this not to be the case. There are roughly 20 or so different muclses that all work together to give you 3 dimensions of movement in your hips.

Usually if you have piriformis on one side then you'll likely experience issues on the other side but not in the same area. I believe this to be the body unconsciously shifting weight of the piriformis side to the other and so over bearing the "good" side which can cause issues as well.

So, you may be asking, how the hell can you fix this.

Knowing the above can certainly put your mind at rest. The test I mention above is something no gp or specialist will do but it's so simply to try at home and can confirm this particular issue, without expensive scans.

The way I am currently trying to resolve piriformis is by doing the below.

I go on daily walks, around an hour a day. This helps to build, stretch and get blood flowing into the muscles around the problem area. It's also good for basic conditioning. As stated in other posts do not spend time sitting or even laying on your back, this will not help and will aggregate the issue.

If you are truly exhausted, you can use heat to relieve the issue. You can buy a electric heat pad for around 30 pounds on amazon. This so called Dreamland Intelliheat Heat Pad. I use this at work along with a desk riser from a company called YoYo. Using those both help me get through the day. I also have heated seats in my car too which helps massively.

Exercises;

I currently do bridges, this will build the bigger muscles in the buttock area. Do 10-15 reps for 3 sets twice a day. When you reach the top of the movement you can hold it, ensuring the butt is doing the work and not the legs and back.

Side-lying leg raises will help build the piriformis. Only do 10 reps for around 3 sets to begin with. Do those twice a day.

I would first stretch the butt before doing the above, then do those exercises.

At this point you will be in pain, but this is when you go for an hour's walk. When you return you can apply ice packs to the painful areas which will reduce the swelling and help you get the sleep you require to aid the healing process.

Like yourself I've been on 10mg of Amytriptaline for the past 10 months. It's help massively but you can't simply stop taking them, you have to lower the dosage over time.

Objectives are simple with piriformis.

Reduce muscle weakness in buttock area.

Reduce swelling with ice packs.

Be consistent with your favoured routine, got to keep it up for months at a time.

Talk to your gp and direct them to the help you need, physio is best place to start.

Hopefully you'll get better soon, I really do help.

Please share any information you get, specialists your been too that helped for example would be a god send to others like myself, very hard to come by.

Any exercises that you find that work as well would be super appreciated.

Good luck !!

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Thank you painintheass! Such interesting information. Not a good thing to have. Apparently from what my Doctor said, it was due to me driving with my right foot on the accelerator and allowing by leg to fall to the side. Up till this happened, I used to find it comfortable . Not any more though.

Thank you for taking the time to write out the info.

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