Tilted Pelvis/Piriformis Syndrome - Help?

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DrIG

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Just before Xmas I had a treatment with an Osteopath to rectify my pelvis, that I believed had tilted slightly because I had been doing too much hoovering. (I have had problems with my pelvis in the past when it completely locked and left me hobbling around and it was osteopathy that put it right.)
Because I was 9 weeks pregnant at the time he didnt push it back into place, more gentle manipulation that seemed to sort it out.
Only from the day after I became aware of a very tight muscle in my right bottom cheek which was so uncomfortable after getting up when I had been seated for a while. When I am stood up, I hardly feel it but it is most uncomfortable sitting down and getting in and out of the car.
In between Xmas/New Year I returned to the Osteopath with my complaint of a pain in the bum and he did some stretching on my legs but it was hard to pinpoint with touch where the pain was actually was. He wasnt 100% sure it was my piriformis muscle but explained how that area is connected from the bottom of the pelvis to the hamstring and I have been getting pains down my hamstring and the back of my calf.
The treatment didnt do anything to relieve the pain which was become extremely frustrating. When getting into bed and laying down on my back I nearly hit the roof when I lay on that area of my bottom!
I've since seen another Osteopath who I normally go to when my pelvis plays up. He was away over Xmas which is why I went elsewhere. He said he doubted it was the piriformis muscle as I would have felt it when he touched that area, and that he was sure it would ease off considerably now he'd straightened my pelvis which he said was an inch out.
Only the info I have read up on says that the muscle is deep in the bottom and hard to locate? Its now 3 days since he saw me and it is still no better? I'm sick of looking like an old woman stooping over when I get up from my chair. I'm a massage therapist myself and am very tempted to use my vibratory massage machine over my bottom to see if that will help loosen it up.
I've been referred to a physio by my doctor but that could take weeks. She just advised a hot water bottle on it. I just want someone to tell me whats wrong with me. can anybody help??
 
Hiya shellbert and welcome!

My Osteopath told me that Piriformis Syndrome is a 'sod' of thing to diagnose.

I'll have a look and see if I can find any indicators online and i'll get back to you.

Has your Osteopath checked the amount of movement in your L5 - S1 level and your
Sacroiliac (SI) Joint?

Best wishes

SPINELF
 
Have you had your hamstring and calf released ? if they are a source of pain then get them sorted, your Glutes (bum cheek muscles) and deep hip rotators are a compensatory pattern when hamstrings are not firing properly, as a rule of thumb, if you lay on your back and lift either leg up keeping it straight, youshould achieve 90 degrees without the leg trying to bend or feeling tightness, if it is less then you have tight hamstrings.

for your glutes and hip rotators try sitting on a sturdy chair, ie dining room chair and crossing your bad leg over your good leg, so that the outside of the ankle rests on top of the knee of the good leg, then wrap both hands round the knee of the bad leg and pull it gently towards the opposite shoulder, this should stretch the deeper muscles effectively,
another sign of this compensation pattern iss if you foot has started to move outwards when you walk, ie like Charlie Chaplin, if your feet turn out more than 1 and 11 on the clock face it usually means there is an imbalance in the hip rotators.

post here again if you want some more pointers
regards
BGFL
 
Hiya Shellbert.

I’ve had a look around and have cobbled together a few links for you and your family to look at. Some of the material expands on the points raised in biggazfromlincoln post. I have tried to include academic and popular resources in (1) some are abstracts and reports, in (2) some are information from forums, and in (3) some are treatment options from clinics, But there are some crossover subject materials too.

Having read these links Shellbert, I think my Osteopath was right, It is a ‘sod’ of a condition to diagnose, particularly as I read that many Doctors ‘still’ don’t believe that P.S. even exists, let alone know what it is and how to treat it!

Revisiting these links Shellbert, has reawakened my interest in this condition, as I had previously ruled this out for my likely causes, using the process of elimination, but many of my lower lumber spine symptoms also match Piriformis Syndrome symptoms as well, So I think I will speak to my Osteopath ‘or’ maybe visit a Chiropractor in this specialty, to re-evaluate my symptoms in that area. If it saves me going under the knife, it has got to be better, right?

I hope this helps, see what you think!

Best wishes

SPINELF

-------------------------------

Here are some medical paper abstracts from pub med and others.

http://www.massagetherapyfoundation.org/pdf/Case%20Study%20Report%20of%20Piriformis%20Syndrome.pdf

http://www.josr-online.com/content/5/1/3

http://www.ncbi.nlm.nih.gov/pubmed/19403008

http://www.ncbi.nlm.nih.gov/pubmed/11887107

http://www.ncbi.nlm.nih.gov/pubmed/15062719

http://www.ncbi.nlm.nih.gov/pubmed/19011229

http://www.ncbi.nlm.nih.gov/pubmed/10428125

http://www.rcgp.org.uk/pdf/circ_hopayian%20et%20al.pdf


Here are some links to a variety of diagnostics and help ideas from medical forums.

http://www.eorthopod.com/content/piriformis-syndrome-what-to-do



http://ic.steadyhealth.com/recovery_time_for_piriformis_syndrome.html

http://www.midwestsportsfans.com/2010/06/piriformis-syndrome-symptoms-causes-treatment-sciatica-pain/

http://www.yourhealthquestion.com/answers/january_11/0114111_piriformis.shtml

http://www.imagebasedsurgery.com/treatments-and-strategies/treating-piriformis-syndrome

Here are some links interesting treatment ideas from clinics.
-----------------------------------------------------------------------

http://www.isischiropractic.co.uk/chiropractic_back_pain_piriformis_syndrome.html

http://www.sciatica.org/piriformis/index.html

http://www.youtube.com/watch?v=tFtUgS69rPk

http://www.spine-health.com/conditions/sciatica/piriformis-syndrome-treatment
 
Spinelf, what a great detailed post, I am giving these links to my wife as she is currently suffering, MRI scan tomorrow to clarify the deep seated problem which has not responded to treatment
thanks again
regards
Gary

ps, you may need to get out more !!
 
Many thanks for your time SPINELF!!
I've been for my 12 week scan and mentioned it to the midwife as I'm getting some twinges around my pubis area too which in my last pregnancy didnt happen (spd) till the last couple of months of my pregnancy.
I'm guessing this may be all linked?
I'll have a good read through and discuss it with my Osteopath next Wed but the physio dept should also be getting in touch soon I've been told regarding my referral.
x
 
YES - I've read read 2 papers now that have said that pregnancy hormones play a part in my discomfort.
I will copy these and take them to my Osteopath/Physio !!

I need treatment soon or I'll be in a wheelchair till my due date at this rate...or maybe not as my bottom will tense up even more - ha ha!
 
biggazfromlincoln

You are most welcome, I am just glad you found them helpful.

I hope your Wife finds relief from her suffering soon, please pass on my best wishes!

You are totally right of course! I do need to get out more!! LOL!!! On the other hand, this means that if you need any more info, you’ll know where I am, right!! LOL!

Best wishes.

SPINELF

shellbert

You are most welcome too.

Good luck and best wishes for your Osteopath and Physio visits Shellbert, I hope you get some questions answered and treatment plans agreed soon!

Let us know how you get on?

The shear amount of complications and cross indicators involved with P.S. never ceases to amaze me, its no wonder that Doctors don’t seem to understand nor want to diagnose it,
it’s a nightmare!

Here’s wishing you all the very best with you pregnancy and we all look forward to hearing about your special delivery in due course.

Best wishes


SPINELF
 
Hello

Yo may also want to look at the other light touch techniques - especially The Emmett Technique - which has some very good Piriformis procedures that I have used for problems in this area during pregnancy and at any other time.

You don't say where you're based but if you are interested you can check who your nearest therapist might be on Emmett Technique UK - Welcome to the home of Emmett in the UK.....

Bowen Technique is also used extensively during pregnancy for similar problems.

Best wishes
JJ
 
Well I saw my Osteopath last Wednesday who did some postural work (neck and mid back) and also found the pain in my butt! He did abit of massage on it which does seem to have settled it abit. I've more mobility in my leg. I'm able to put my socks on now as in bringing my leg up to my chest inside of just hoping for the best whilst stood up.
I'm still getting the sciatic pain down my leg though. But I saw the Physio on Friday who did a thorough consultation and said that it may be my lower back discs as well as my piriformis. She said it wasnt as tight as she's seen in some people but has told me not to sit for so long as its then when I find it most uncomfortable when it comes to getting up again. I must admit, I do feel my lower back twinging when moving around so she could be right? So I've been doing abit of hot/cold, less sitting and using a pillow between my legs as I lie on my side in bed. I'll see what she says on Friday when I return. Hopefully she'll try and loosen my piriformis muscle this time.
 
Hi Shellbert, sorry to hear you are having these problems which I am all too aware of. Have you discussed SI joint dysfunction with your physio. I suffer from SI joint dysfunction which has occurred over a number of years of inactivity due to disc problems in my back. I developed nerve problems which have left my left glutes weak and if I dont keep on top of the exercise my left SI joint becomes hypermobile and moves forward. This causes pain in my low back but when the joint moves it also causes piriformis to spasm and then I get some pain in the bottom and then my hamstrings go into over drive and I then have a game on my hands to sort myself out.
SI joint dysfunction can be caused by pregnancy as some of the posts have indicated and your physio can give you gentle exercises to ensure your pelvic floor muscles are maintained and your glute muscles remain strong. If you have a muscle imbalance in the pelvic floor and glutes then piriformis will take over and become hypertonic. The muscle lies very close to the sciatic nerve and if it becomes hypertonic it can irritate the nerve causing referred leg pain and even muscles weakness.
My physio is a treat, she also does acupuncture and when piriformis gets a little out of hand I have an acupuncture session and it sorts me out a treat.
Hope this is of use
Bonnie10
 
Thanks Bonnie for your reply. Its very interesting to see the problems you have sound very similar to mine. I shall mention it next week and see what she says. Will let you know. x
 
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