Ive had 24/7 twitching in my left piriformis w/ tingling/ numbness/ fatigue in all extremities for 4 months. an mri showed disc protrusion in l3-l4/ l4-l5 & abutment on exiting nerve root. could symptoms be related to this or possibly ms?

Anything is possible: Your piriformis symptoms would be an uncommon presentation of MS. More likely is involvement from the nerves in the lower back, or locally in the piriformis muscle. A more thorough history and physical exam are necessary to see if the MRI findings actually correlate to your symptoms. General fatigue and four extremity numbness/tingling can be many things, but are not likely from the lower back.