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what are suggested remedies for piriformis syndrome? i have had physical therapy and a cortisone shot. the pain still remains and can be quite debilitating at times. i am only 60 years of age. are there other recommendations that i can try or return t

3 doctor answers4 doctors weighed in
Dr. Heidi Fowler
Psychiatry 25 years experience
Hello. : Hello. There is a techinique in medical acupuncture that is exceptionally effective for pyriformis syndrome.
Dr. Justin Rothmier
Sports Medicine 19 years experience
First : First off all let’s define your problem. The true definition of piriformis is buttock pain that radiates down the leg past the knee. With that said, piriformis syndrome is often diagnosed based solely on buttock pain and palpable tenderness along the course of the piriformis that is associated with pain upon sitting or with activity. So with that said, a great initial start is physical therapy, ice and nsaids. However, not all physical therapy is created equal. The best approach is to strengthen the gluteus medius and piriformis to build endurance, and to stretch with dynamic stretching techniques. Often piriformis syndrome is a result of over training, and the muscle becomes fatigued. So the best pt approach is to strengthen the muscles and build endurance. So if your pt was mostly comprised of e-stim, riding a bicycle and stretches, you didn’t fully address the problem. Your physician should be able to re-examine you and determine if the muscle strength has improved. Other approaches that can be successful are massage and acupuncture. If despite these treatment strategies, your symptoms continue, i would reconsider the diagnosis. Did you actually tear a muscle, etc? Perhaps an MRI would be helpful. Lastly, if an MRI is normal, and pt, acupuncture and massage have all failed, then nerve studies (EMG) could be helpful to prove the nerve is entrapped. In that case a Botox injection into the piriformis muscle may alleviate the pain. Good luck.
Dr. Douglas Chang
Physical Medicine and Rehabilitation 21 years experience
Might not be pirifor: http://www.physio-pedia.com/Piriformis_Syndrome However in a 60 yo i would have a high suspicion for hip arthritis and lumbar stenosis/sciatica (before jumping to a diagnosis of "piriformis" syndrome).

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