owwwww helppp
July 2, 2012 12:14 PM Subscribe
I've had chronic sciatic pain due to an inflamed piriformis muscle for about a year now. Physical therapy basically did nothing, so I'm considering accupuncture. Can anyone help me find a reputable place for this kind of procedure? Other piriformis advice is also welcome.
I'm in the Cincinnati area if anyone knows of a good place there, but even just advice for things to look for when looking into an accupuncture place is more than welcome.
I am also totally open to other advice, but my budget is really, really low and previous, long-term physical therapy did not really help.
I'm looking into accupuncture because, basically, I'm a bit desperate. My former trainer had mentioned that a patient he had previously treated had a similar, very stubborn piriformis inflammation and he had gone the route of accupuncture, which cleared it right up. Unfortunately, that trainer has since moved on and no one can get me in contact with him to learn where that patient got accupuncture treatment.
More details:
- I am 28, female, and relatively physically fit, although I am in a pretty high-stress environment (grad school).
- I don't know why the sciatica started, but pain levels have varied steadily from a 1 to an 8 or 9 (physically debilitating--standing up required that I bend over for a few seconds to deal with the pain for a while). Pain's mostly in the butt but on the worst days shoots down the back of the leg to the knee.
- I went to physical therapy for it for about four months before the insurance money ran out, but to be honest there was only a little progress during PT and on some days it seemed to make it worse.
- Both of my trainers attributed the sciatic symptoms to an inflamed piriformis (butt) muscle, and that's quite apparently right due to the stubborn knots of tension there.
- We tried everything I've read of: constant anti-inflammatories (all over-the-counter, ibuprofen etc.), various exercise routines, stretching, icing at home and at training, electronic muscle stimulation, massage. Again, most of it helped to some degree but it really only mitigated the pain. For a couple of months it was okay (pain level 1 or so) but now it's back with a vengeance.
I'll be happy to offer any further details on request. Really hoping someone here can help me out. I acknowledge that none of you are my doctor, though.
I'm in the Cincinnati area if anyone knows of a good place there, but even just advice for things to look for when looking into an accupuncture place is more than welcome.
I am also totally open to other advice, but my budget is really, really low and previous, long-term physical therapy did not really help.
I'm looking into accupuncture because, basically, I'm a bit desperate. My former trainer had mentioned that a patient he had previously treated had a similar, very stubborn piriformis inflammation and he had gone the route of accupuncture, which cleared it right up. Unfortunately, that trainer has since moved on and no one can get me in contact with him to learn where that patient got accupuncture treatment.
More details:
- I am 28, female, and relatively physically fit, although I am in a pretty high-stress environment (grad school).
- I don't know why the sciatica started, but pain levels have varied steadily from a 1 to an 8 or 9 (physically debilitating--standing up required that I bend over for a few seconds to deal with the pain for a while). Pain's mostly in the butt but on the worst days shoots down the back of the leg to the knee.
- I went to physical therapy for it for about four months before the insurance money ran out, but to be honest there was only a little progress during PT and on some days it seemed to make it worse.
- Both of my trainers attributed the sciatic symptoms to an inflamed piriformis (butt) muscle, and that's quite apparently right due to the stubborn knots of tension there.
- We tried everything I've read of: constant anti-inflammatories (all over-the-counter, ibuprofen etc.), various exercise routines, stretching, icing at home and at training, electronic muscle stimulation, massage. Again, most of it helped to some degree but it really only mitigated the pain. For a couple of months it was okay (pain level 1 or so) but now it's back with a vengeance.
I'll be happy to offer any further details on request. Really hoping someone here can help me out. I acknowledge that none of you are my doctor, though.
I tried accupuncture and I went in as a skeptic. I suffer from arthritis in my spine, so I have muscle spasms accompanied with chronic pain.
Well, I have to say, it certainly put me in a better mood, and had an overall positive effect. I am anti fufu stuff, and generally all about scientific explanations, but from my experience it was good. There is no harm in trying it, its safe, relatively inexpensive, and if it works great!
/accupuncture for me was really relaxing, and reminded me a meditative state. I left my first appointment feeling high, like drug induced. It was unique and quite nice.
posted by handbanana at 12:34 PM on July 2, 2012
Well, I have to say, it certainly put me in a better mood, and had an overall positive effect. I am anti fufu stuff, and generally all about scientific explanations, but from my experience it was good. There is no harm in trying it, its safe, relatively inexpensive, and if it works great!
/accupuncture for me was really relaxing, and reminded me a meditative state. I left my first appointment feeling high, like drug induced. It was unique and quite nice.
posted by handbanana at 12:34 PM on July 2, 2012
I just restarted yoga (actually kind of against the advice of my PT) and my butt is super happy. Regular stretching of piriformis muscles plus deep core exercises are together making a huge difference. The twice weekly almost debilitatingly painful ass massages from my PT are also pretty rad. Also I do the "sit on a tennis ball and roll around" thing a couple of times a day behind the closed door of my office because everyone already thinks I am weird enough.
posted by elizardbits at 12:51 PM on July 2, 2012 [3 favorites]
posted by elizardbits at 12:51 PM on July 2, 2012 [3 favorites]
I'd try massage again, with a therapist who'll focus on the muscles surrounding the piriformis.
posted by Iris Gambol at 12:56 PM on July 2, 2012 [4 favorites]
posted by Iris Gambol at 12:56 PM on July 2, 2012 [4 favorites]
I am a little troubled by the fact that one of the two reviews of this place on Yelp says the reviewer was seeking acupuncture for weight loss, but if you want to try acupuncture for minimal cost, this place might be an option in your area: Tiny Needle. Looks like they offer a sliding scale as well.
To be clear, I know nothing about them myself, but I do know a good way to save money is to check out "community acupuncture," where you receive treatments in a comfy room full of recliners with other people. The practitioners can be inserting needles in other patients during the time you're chilling out with the needles in you, so it costs much less. Acupuncture is not for me and my chronic migraines, but I do know friends who have acupuncture done regularly, and they like the community acupuncture model just fine.
posted by adiabat at 1:03 PM on July 2, 2012 [1 favorite]
To be clear, I know nothing about them myself, but I do know a good way to save money is to check out "community acupuncture," where you receive treatments in a comfy room full of recliners with other people. The practitioners can be inserting needles in other patients during the time you're chilling out with the needles in you, so it costs much less. Acupuncture is not for me and my chronic migraines, but I do know friends who have acupuncture done regularly, and they like the community acupuncture model just fine.
posted by adiabat at 1:03 PM on July 2, 2012 [1 favorite]
ALSO I use a heating pad at the highest setting for about 30 minutes first thing in the morning (which often leads to unfortunate nap attacks) and for about 30 minutes around bedtime. Aside from the general enjoyment of a toasty butt, this really seems to be relieving a lot of tension that I'd been so used to having that noticing its absence was a goddamn revelation.
posted by elizardbits at 1:11 PM on July 2, 2012
posted by elizardbits at 1:11 PM on July 2, 2012
I've had acupuncture for piriformis caused sciatica and it definitely helped. I did take more than one visit for it to totally go away though.
My first time having acupuncture was due to desperation in a foreign country. Since then I've found my acupuncturists (multiple because I moved) by looking at the list of practitioners my insurance would cover, or who I would get a discount from, and picking someone close. I would not repeat my visit to a teaching school where I was treated by acupuncture students.
posted by kbuxton at 1:11 PM on July 2, 2012 [2 favorites]
My first time having acupuncture was due to desperation in a foreign country. Since then I've found my acupuncturists (multiple because I moved) by looking at the list of practitioners my insurance would cover, or who I would get a discount from, and picking someone close. I would not repeat my visit to a teaching school where I was treated by acupuncture students.
posted by kbuxton at 1:11 PM on July 2, 2012 [2 favorites]
Have you been evaluated for piriformis syndrome? Maybe see a kinesiologist or sports medicine doc about that, because if you do have that variation, you'd need a special sequence of PT and in face the regular PT for piriformis pain might be counterproductive.
I had good success with acupuncture for bursitis, pretty much zero success with acupuncture for joint pain.
posted by Sidhedevil at 2:12 PM on July 2, 2012
I had good success with acupuncture for bursitis, pretty much zero success with acupuncture for joint pain.
posted by Sidhedevil at 2:12 PM on July 2, 2012
Have you tried Skelaxin? Cheap prescription, completely non-drowsy, worked immediately for me. I got the prescription from one of those walk-in clinics (RediClinic).
posted by Houstonian at 2:31 PM on July 2, 2012
posted by Houstonian at 2:31 PM on July 2, 2012
Seconding yoga and 'sitting on a tennis ball and rolling it around'.
I am similar age to you and am succesfully dealing with simliar pain. Going to yoga classes (twice a week to begin with, down to once and practising at home now) taught by someone who actually wants to share their knowledge of anatomy helped me diagnose and treat it (before yoga I tried acupuncture, PT and chiropractors, none of which worked for me) and also just learning how to use your brain to deal with pain is useful too (try the book 'Full Catastrophe Living' by Jon Kabat-Zinn).
The main stretch that helps me is lying on your back, put one ankle on the other knee, then use your hands to gently pull the 'foot down' leg towards your chest (foot comes off the floor), while pushing the knee of the leg with the ankle up away from you. The key is doing it for about a minute to allow the piriformis to relax.
Consider getting a foam roller too. I had never used one but it stretches out your IT band which can help with piriformis syndrome. Youtube has loads of videos for how to use it (and the tennis ball).
posted by atlantica at 2:47 PM on July 2, 2012 [2 favorites]
I am similar age to you and am succesfully dealing with simliar pain. Going to yoga classes (twice a week to begin with, down to once and practising at home now) taught by someone who actually wants to share their knowledge of anatomy helped me diagnose and treat it (before yoga I tried acupuncture, PT and chiropractors, none of which worked for me) and also just learning how to use your brain to deal with pain is useful too (try the book 'Full Catastrophe Living' by Jon Kabat-Zinn).
The main stretch that helps me is lying on your back, put one ankle on the other knee, then use your hands to gently pull the 'foot down' leg towards your chest (foot comes off the floor), while pushing the knee of the leg with the ankle up away from you. The key is doing it for about a minute to allow the piriformis to relax.
Consider getting a foam roller too. I had never used one but it stretches out your IT band which can help with piriformis syndrome. Youtube has loads of videos for how to use it (and the tennis ball).
posted by atlantica at 2:47 PM on July 2, 2012 [2 favorites]
Try massage again, with someone who knows what they are doing and, very importantly, who advises you how to treat yourself at home. You should continue doing stretches, and do self-massage, with tools such as a foam roller, tennis ball, and/or trigger-point tool.
Piriformis syndrome, if that is what you have--and it sounds like it is--is not something that is likely to be helped by acupuncture. Much, much more likely you'll get real help from a good massage therapist.
If you really can't get a cure after that, there is potentially surgery. But you probably won't have to go there.
posted by parrot_person at 4:22 PM on July 2, 2012 [1 favorite]
Piriformis syndrome, if that is what you have--and it sounds like it is--is not something that is likely to be helped by acupuncture. Much, much more likely you'll get real help from a good massage therapist.
If you really can't get a cure after that, there is potentially surgery. But you probably won't have to go there.
posted by parrot_person at 4:22 PM on July 2, 2012 [1 favorite]
I had very bad sciatic pain when I was pregnant, I'm talking shooting pains down my legs that would make my legs buckle underneath me so I collapsed. While I was pregnant, I used a combination of physiotherapy and massage and once the baby was here and I'd recovered from the csection, I started Pilates. Pilates has been a miracle. He's 8 months old now, my core is so much stronger and not only has the pelvic and sciatic pain completely gone, I no longer have the shooting pains from scoliosis I've had my entire life. I can't recommend it enough as a long term solution. I go once a week and as long as finances permit, I always will.
posted by Jubey at 5:07 PM on July 2, 2012
posted by Jubey at 5:07 PM on July 2, 2012
You say you've been dealing with this for awhile, so I imagine you've tried this before. But, since you didn't specifically mention it, and in the off chance that it's helpful here's a visual for the figure 4 stretch. You can also do this sitting upright in a chair, which is helpful on particularly tight days, or for people who are not very flexible.
I would like to second the recommendation to see another massage therapist. It's possible to find one who has a sliding scale, and/or accepts insurance. Have them work the surrounding muscles, thigh muscles, IT band, and also the SI joint.
A lot of my personal issues with piriformis stem from sleeping on my side without proper support under my knee/lower leg. This stretches the crap out of your hip, not in a good way. I learned that I need to support my leg so it's at the same height as my hip joint, which is a good two feet of pillows to prop under there. It's a lot awkward at first, but you get used to it.
posted by purpletangerine at 5:26 PM on July 2, 2012 [1 favorite]
I would like to second the recommendation to see another massage therapist. It's possible to find one who has a sliding scale, and/or accepts insurance. Have them work the surrounding muscles, thigh muscles, IT band, and also the SI joint.
A lot of my personal issues with piriformis stem from sleeping on my side without proper support under my knee/lower leg. This stretches the crap out of your hip, not in a good way. I learned that I need to support my leg so it's at the same height as my hip joint, which is a good two feet of pillows to prop under there. It's a lot awkward at first, but you get used to it.
posted by purpletangerine at 5:26 PM on July 2, 2012 [1 favorite]
Yes, I agree, a good massage therapist, a really good one that also might know Shiatsu. They'll also put you on a stretching routine to do on your won and work on your trigger points. In my case, physical therapy actually made things worse and I didn't start to get somewhat better until a couple of weeks after I stopped. I don't know about the Yoga, there are some good things, but possibly some stretches that may aggravate things as well. There are some decent videos on YouTube for treating this properly and you'll have to be diligent.
posted by mdrosen at 6:11 PM on July 2, 2012
posted by mdrosen at 6:11 PM on July 2, 2012
> We tried everything I've read of
Your list did not have ultrasound. When I had a pulled periformis a few years ago,
the orthopedist I saw first did not make an accurate diagnosis;
fortunately the physical therapist he sent me to figured out it was a periformis pull and she treated it with ultrasound--around five treatments over a three week period.
That is a very tricky little muscle so the best avenue might be to get second third fourth & fifth opinions from the most expert specialists you can find. Good luck. I have had few injuries as frustrating.
posted by bukvich at 6:17 PM on July 2, 2012 [1 favorite]
Your list did not have ultrasound. When I had a pulled periformis a few years ago,
the orthopedist I saw first did not make an accurate diagnosis;
fortunately the physical therapist he sent me to figured out it was a periformis pull and she treated it with ultrasound--around five treatments over a three week period.
That is a very tricky little muscle so the best avenue might be to get second third fourth & fifth opinions from the most expert specialists you can find. Good luck. I have had few injuries as frustrating.
posted by bukvich at 6:17 PM on July 2, 2012 [1 favorite]
Response by poster: Thanks so much for all the options, guys.
Just to clarify, I have been doing stretches (figure 4 especially) throughout this period. I also do one where I put my feet flat against the wall, legs straight, and lift my head up, press it down, do side to side, supposedly to stretch out nerves and muscles and etc. I do also do the tennis ball trick and I have a foam roller. It seems to both hurt and help.
I did indeed go to sports medicine/physical trainers, and the words 'piriformis syndrome' were indeed tossed around quite a lot, although I can't remember anyone specifically saying 'you have it'. But basically, that's the likely scenario.
As per most of your advice... I suppose I probably won't go the acupuncture route. I'm really hoping to manage a minimum time investment in this because I've already wasted so much time on no results and the money just doesn't exist.
Considering yoga (for a few weeks... I can afford that time and money wise I hope) and if I don't see improvement I'll look into massage therapy with perhaps a more experienced/knowledgeable practitioner.
Again, I really, really appreciate the advice. This thing has just been killing me and I can't believe it's been going on as long as it has despite significant effort on my part.
posted by six-or-six-thirty at 8:54 PM on July 2, 2012
Just to clarify, I have been doing stretches (figure 4 especially) throughout this period. I also do one where I put my feet flat against the wall, legs straight, and lift my head up, press it down, do side to side, supposedly to stretch out nerves and muscles and etc. I do also do the tennis ball trick and I have a foam roller. It seems to both hurt and help.
I did indeed go to sports medicine/physical trainers, and the words 'piriformis syndrome' were indeed tossed around quite a lot, although I can't remember anyone specifically saying 'you have it'. But basically, that's the likely scenario.
As per most of your advice... I suppose I probably won't go the acupuncture route. I'm really hoping to manage a minimum time investment in this because I've already wasted so much time on no results and the money just doesn't exist.
Considering yoga (for a few weeks... I can afford that time and money wise I hope) and if I don't see improvement I'll look into massage therapy with perhaps a more experienced/knowledgeable practitioner.
Again, I really, really appreciate the advice. This thing has just been killing me and I can't believe it's been going on as long as it has despite significant effort on my part.
posted by six-or-six-thirty at 8:54 PM on July 2, 2012
You may need to see an orthopedist, they can give you a shot in the piriformis muscle to paralyze it and relive your symptoms. Additionally, in the most severe cases, they can operate and sever the muscle. There are options. Also, have you just tried rest, for a couple of weeks at least? I'm sorry that you're suffering and I wish you the best of luck.
posted by mdrosen at 3:54 PM on July 3, 2012
posted by mdrosen at 3:54 PM on July 3, 2012
I have a neurological disorder that can put me in crippling pain at times -- my neurologist sent me to Mimi Tagher with Synergy Holistic -- she changed my life.
Feel free to message me for more information.
posted by caveat empress at 5:04 PM on August 30, 2012
Feel free to message me for more information.
posted by caveat empress at 5:04 PM on August 30, 2012
(btw, Mimi does accupuncture and craniosacral work on me.)
posted by caveat empress at 5:05 PM on August 30, 2012
posted by caveat empress at 5:05 PM on August 30, 2012
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Sorry I have no advice on acupuncture :(
posted by katypickle at 12:33 PM on July 2, 2012