Piriformis Syndrome with PMR

[Barnaby2]

I have had a terrible day today starting with not being able to get off the sofa. WE had to call an ambulance and paramedics needed to give me gas and air for the pain before taking me to hospital where they gave me Oramorph. I am home again and have oramorph from GP for the weekend before going again to hospital on Monday. GP on duty in A and E suggested pain might be Piriformis syndrome-has anyone else had this?

[PMRpro Ambassador]

A bit more than piriformis for me, involved a few other muscles, my entire back was as hard as a tiled floor! But the sacro-iliac pain was obviously on a par with yours - although 800mg ibuprofen got me to a stage I could shuffle to the lift and car for OH to take me with him to go to the ED as he went to a blood appointment. I was in so much pain even the triage nuse was sympathetic. They kept me in - wonderful triple therapy of infusions of high dose NSAID plus steroid in the morning and i.v. diazepam as a muscle relaxant at night The first day was brilliant, I could move! The second night of i.v. diazepam was fine until it triggered a massive episode of atrial fibrillation. On day 3 they assumed it was the high dose pred so didn't give me that but the nightime diazepam showed its true colours. It is a rare but well known adverse effect. So I was handed to the pain clinic for the slow approach. It is there, never really get past it as I have a scoliosis but have it reasonably under control.

[TheMoaningViolet in reply to PMRpro]

Your comment about the triage nurse made me laugh. My husband was in agonising pain with a gall bladder stone on the move, was brought to A&E at his hospital as he was at work when it started and the triage nurse accused him of faking it. He had gall bladder surgery 2 weeks later.

[PMRpro Ambassador in reply to TheMoaningViolet]

This week's version was the other way round - OH has recurrent GI bleeding due to radiotherapy late effects. On Monday he could not get the triage nurse to accept you can have bleeding without pain!!!!

[SheffieldJane in reply to PMRpro]

What a nightmare! Diazepam is my go to drug for fear. I had no idea it could do this. Endoscopy, Colonoscopy, cataract op - even my first full body MRI.

[Theziggy in reply to SheffieldJane]

My daughter had a very adverse reaction to Diazapam

[SheffieldJane in reply to Theziggy]

Now I know. I have had a small dose twice in my life with no ill effects and had planned to ask for a medically supervised dose for ordeals coming up.

[Odosmum in reply to SheffieldJane]

Jane, I keep a small supply of 2mg pills for when my back will not relax. I usually take one at night and it does the trick. It is useful for sleeping in strange beds too, as I never seem to be able to relax sufficiently to have no pain in the morning before getting up. Not much experience of strange beds this year!

[SheffieldJane in reply to Odosmum]

No! Even that would be an adventure. Thank you. When it’s right for you, it is a useful drug. It is the only remedy for my husband’s occasional back spasms.

[PMRpro Ambassador in reply to SheffieldJane]

Intravenous diazepam though - not the oral stuff. It is very rare - but i.v. diazepam isn't used that commonly unless the situation demands it:

"Diazepam is an anxiolytic, anticonvulsant and central muscle-relaxant. Diazepam is used to relieve anxiety and provide sedation in severe acute anxiety or agitation and for the management of agitation associated with delirium tremens.

Diazepam is used to relieve acute muscle spasm and tetanus."

[whitefishbay]

I have it but not like you. My neighbour is a physio and I do them when I remember. Walking helps. Mine was caused by wfh and sitting in a bad chair.

[Charlie1boy]

Sorry to be a bit late in answering, but yes it seems, according to my physio that I have piriformis syndrome, although, clearly not as bad as you and PMRpro!

I have had PMR for approaching six years, and for very nearly the past year have experienced a nerve type pain at the top of my thigh at the front, which has got progressively worse. It seems that my femoral nerve is being squeezed by the piriformis; it was very uncomfortable to walk.

Fortunately, my wife is a retired PE teacher, and she has been giving a painful physiotherapy treatment, which , together with heat straight afterwards, is helping a lot. Also, sitting on a tennis ball at the right place helps!

I did try upping my pred dose for two days to 10mg, but that didn't touch the pain.

Good luck.

Paddy

[PMRpro Ambassador in reply to Charlie1boy]

Yes - that front top of the thigh pain being sciatic was news to me - I'd missed the branches that run there!