Health Organization for Pudendal Education

Just wondered if there was anyone else with piriformis syndrome too? I was diagnosed with complex varient piriformis syndrome with sciatic, pudendal and gluteal entrapments at the sciatic notch by Dr Filler when he held a clinic at Harley St in June although a previous MRN showed pudendal entrapment at alcocks canal too.
I have recently had a guided piriformis injection which worked fantasticaly for 8 days and is still slighty improved 2 weeks later. I still have scaitica, with the main problems at the back of my thigh and heel where I get a daily build up of pain until walking is extremely difficult. The build up has improved since the injection but is returning.
Now that the main pain that is my piriformis muscle has improved I have realised that my pundendal issues may be associated with my sit bones or ischial tuberosity. I could not identify a separate pain there before as my piriformis pain was all encompasing. The pelvic area is so complex and once there is one mechanical problem so many others seem to follow. I used to feel as if I was somehow 'cheating' when I had to write my pain and referred pains down but there really are SO many.
I have a nerve block injection lined up for 24th Nov which will help in the diagnosis as well as provide extra pain relief. Diagnostically it is quite interesting but at last I do seem to be getting somewhere.
Helen

Helen, my pudendal pain caused the piriformis to go into spasm and impinge on the sciatic nerve -- hence piriformis syndrome. Pudendal nerve decompression surgery has essentially cured the piriformis syndrome because now that the PN pain is mostly gone the muscles elsewhere have relaxed.

This might not be the case for everyone but just wanted to let you know of the possibilities.

Thanks for that Violet, interesting. . . . I think I may be the opposite way around as my piriformis pain was before any pudendal pain, but until the blocks and injections etc are done who can say . . . but I would put money on mine being PS then PN. The piriformis injection did not seem to affect the PN unfortunately but I know that Dr Greenslade will look at that in the new year when he has assessed how well my piriformis injections have helped.
Thanks again, take care,
Helen

There are some very interesting piriformis surgery reports on the Yahoo site. http://health.groups.yahoo.com/group/piriformissyndrome
Not sure if anyone here suffers with piriformis as well as pundendal problems as I do, but Dr Hal Martin is doing piriformis surgery arthroscopically and only leaves 3 small holes in the hip/bum area. There is a video showing his technique. This must be a much better option as the build up of scar tissue post op seems to be a big problem.
http://www.arthroscopyjournal.org/artic ... 870/addons
http://www.drhalmartin.com/pages/drmartin.htm
I must say I am very heartened by this new surgery, could not afford to go however. Hopefully the rest of the world will catch up soon.
Dr Martin did go to Brazil and operated on 4 piriformis patients there as he was a friend of their doctor. One who posts on Yahoo is doing very well indeed.
Take care
Helen

Thanks for the reports!

xxxxxx

Thanks Ellen, yes you did.
That's the trouble with pelvic problems. . . . they can just buILD. Then it's a question of trying to figure out what came first and try to get that sorted. Easy ha ha!
I think I have mine sussed tho' as I had a 'defining' fall, major muscle spasms and egg shaped lump in my P muscle for 3 -4 months afterwards. The lump was in such a specific site which is still always sore to the touch but back then would make me swoon (not in a good way ) when pressed.
Trying to get anyone medical to actually listen was another matter and still is.
I am currently working myself up to ringing my GP (British) to get an appointment, another easy step one would think but I have been involved in Doctor wars for some time now and don't relish the prospect. Just stating that, has made me realise what a wimp I am being. . . .she who hesitates etc,
Doing it NOW! I think I said something about being pro-active to you in a different post. . . . .time for me to do as I say!!

Helen

Helen,

I have priformis syndrome, which has caused issues with my pn, sciatic nerve, si joint, glutes, hamstrings and today...I just found out that all of this may be cause by a labral tear in my hip joint. I had such horrible lumps (tps) in my piriformis, and my first botox injection only lasted 2 months. I had another this past January, and although I get some pain in my piriformis, it has not (thankfully) got back to a level 10 in pain. Some day, all of this will become common knowledge (I pray anyways).

Kathie

I hope so too Kathie,
A lot of people have reported labral hip tears being the cause or at least part of the pain problem. Will you be able to get the op needed to hopefully get that sorted?
Take care,
Helen

Hi - am new here having just found out from my chiropractor that I could possibly have PN.... but big problems in the left hip and piriformis muscle which I have had for a good year or more. Wondering if this has caused the PN as, looking back, I went untreated for a year due to financial restrictions and during that time had continual backache, hip pain that would wake me in the night when I tried to turn over and then 2 PN flares (didn't know that's what they were at the time - thought Menopause!!). Those were about a year ago. Another flare two weeks ago and reported to my chiro who said I had to call my GP if "anything" went numb or I lost control of my "functions".

Having now looked at the symptoms of PN I can identify that I have been having "some" of the symptoms in the last 12 months - but put it down to back pain, age, etc. etc.

My dilemma now is... do I try and see my GP (practically impossible to get an appointment and when I went about 10 years ago for a sprained rib I was left in the waiting room in agony and a prescription for painkillers sent out to me - hence visits to the chiropractor)..... or.... do I make a private appointment with the Bristol team (I live about an hour away) and cut out the "it might be this, or that", and get a definite diagnosis one way or the other?

As my symptoms, although sometimes limiting, have not as yet, stopped me doing much - I would really like to hit this head on asap.

Would appreciate any advice anyone might have - plus any experience of the Bristol team would be useful too.

Polly