Health Organization for Pudendal Education

Hi everyone,

I have PN primarily (even maybe exclusively) on the left side. So does anyone know why I would be experiencing intermittent sciatic pain on my right side? Symptoms are pain in right buttock and groin, extending down back of leg and into the foot, sometimes a feeling of lack of circulation and coldness in the foot. I massage the foot several times a day during flares (like today). Unlike the constant PN pain, the sciatic pain is intermittent. Also, when I am tired and/or in pain and/or lazy (and no one is looking), I drag my right foot on the floor, sole down, heel up, and do a little hop after stepping off my left foot. The right leg seems considerably weaker than the left, and harder to lift, especially when wearing winter boots. Does anyone else experience this? I have not discussed this particular symptom with my neuro/pain doctor since we have been focusing on the perineum/vaginal/anal pain. I will raise the sciatic issue when I see him next month.

Also, I was wondering why squatting against a wall relieves my lower back/sacrum pain. I do this while waiting for a train or a bus, and of course get strange looks from passers by. (Sometimes I pretend to be looking for something in my bag. Where DID those glasses go??) Does anyone else experience relief from pain in the sacrum when squatting?

Thanks.

Lernica

Hi Lernica,
Are you perhaps side sitting on your right side, putting more pressure on your sciatic nerve? Or could you be standing for long periods?
An EMG would be a diagnostic if the doc orders it.
Good luck and keep us posted,
RR

Hi Lernica,
I have pudendal and sciatic entrapments at the sciatic notch (diagnosed Dr Filler) because of piriformis syndrome (PS). Mine is worse on the RH side but I do have piriformis syndrome bi laterally although only sciatic involvement on the lh side, no pudendal.
Of course traditionally Dr's will say any sciatic involvement is a lumbar spine problem and an MRI would be a good idea to rule that in or out first.
Mine was all due to a fall and the lh sciatica did not materialise until around 6 months later.
It is just weird that yours would be on opposite sides to be connected to piriformis, however all I'm saying is don't rule it out.
My legs, especially the right one is also SO heavy and as to the squatting I think it's just an extra support to your pelvis instead of the pelvis being the stabalising structure when standing ? ? ?
Try some piriformis stretches You Tube them and see if it makes any difference. If the stretch is very tight or hurts it could very well be PS related.
Dr George Best has a good You Tube video explaining the differences between lumbar/disc sciatica and pelvic/piriformis sciatica.
Take care,
Helen

Thank you for your replies, Helenlegs and RR. MRI is negative for disc involvement. I don't sit at all, so it cannot be sitting-related. (If I sit, I tuck my feet under my bottom so my bottom doesn't touch the seat. I also constantly switch sides.) I do stand alot, and I experience low back/sacrum pain after about 20 minutes. Also, when I walk, I feel a painful pulling/nerve sensation in the sacrum. Helenlegs, I will try those piriformis stretches and keep you posted.

I was thinking that my intense pelvic pain from the PN could be tightening my buttock muscles and putting pressure on the sciatic nerve. What do you think?

I haven't yet seen a pelvic PT (will do in February). I'll discuss it with her and perhaps she will have some ideas.

All the best,

Lernica

Well when you are in pain you do tend to respond by being more tense. I know I often wake with a headache but have decided that it is just because I clench my teeth because of the pelvic pain. That's the trouble with the pelvis there is such a lot involved and when one thing goes awry sometimes other things can follow. I you are tensing your buttock muscles more than usual piriformis could obviously be affected. The sciatic nerve normally runs below the piriformis muscle at the sciatic notch so a hypertrophied, spasmed or tense muscle can interact with the nerve. About 17%( I think) of people have a different configurations of piriformis and sciatic nerve for instance my sciatic nerve travels through the muscle so more prone to PS.
I hope that a few p stretches will solve the problem Lernica I suggested the same to another lady on a back pain forum some time ago and she could not believe how much it helped. infact she said she was cured (my small claim to fame ) fingers crossed that it works for you too.
Helen

Periformis syndrome is one cause of sciatica.

The obturater can also cause it.

http://www.ncbi.nlm.nih.gov/pubmed/19213605

http://www.ncbi.nlm.nih.gov/pubmed/12855348

Lernica, I had the same problems you are describing because the PN pain caused my piriformis muscle to go into spasm and put pressure on the sciatic nerve. Having PNE decompression surgery has cured the piriformis spasm and I have no more sciatic symptoms. It took a year or two after surgery for the muscles to calm down.