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Your Lower Back Pain Or Sciatica Might Actually Be Piriformis Syndrome

April 13, 2010 by  

Your Lower Back Pain Or Sciatica Might Actually Be Piriformis Syndrome

How often do you hear yourself saying things like: “I have hip pain,” “My lower back hurts,” “Pain is shooting down my leg,” “There’s numbness and/or tingling on the top of my foot,” “I have sciatica,” and so on…

Well, you’re not alone. In fact, these are frequently recited phrases in doctors’ offices, physical therapy clinics and healing centers the world over. When patients present their symptoms to me they offer many of those descriptions and curative measures they’ve been instructed to carry out. Their physician has told them to take anti-inflammatory drugs, such as ibuprophen, or to use ice. Sometime the doctor recommends physical therapy, wherein the therapist designs a series of strengthening exercises to solve the problem.

By the time the problem reaches my office, the patient has already swallowed the over-the-counter pills and gone through a lengthy course of physical therapy or chiropractic care… all with little lasting effects. Sometimes the problem has become worse.

When I hear phrases like those mentioned above, I already know what the person has “tried” prior to seeing me. I also know that they will tell me the problem is not “fixed.” If it was they would not be here. The first thing I do is perform a series of orthopedic tests on their piriformis, a muscle largely overlooked by the mainstream medical community.

The Piriformis MuscleThe piriformis muscle originates at the front of the sacrum (the part of the spinal column that is directly connected with or forms a part of the pelvis). It passes out of the pelvis through the greater sciatic foramen. It inserts into the upper border of the greater trunchanter (ball) of the femoral shaft (thigh bone). It is used to rotate the thigh laterally when such a motion is called for.

What this means is that this one muscle, if dysfunctional, has the ability to negatively affect a number of places on the hip, low back, legs and feet. Since the piriformis attaches the femur to the sacrum, if it is hypertonic (tight, contracted, in spasm) it can cause the foot to splay. That is, the foot of one or both legs will tend to point outward when walking. And this causes pain in the hip.

If the piriformis is contracted it can compress the sciatic nerve, thus causing what is described as “shooting leg pain.” Often, those who are diagnosed with sciatica actually have piriformis syndrome. Sure their X-rays may show some disc herniation, and the doctors will tell the patient that is the cause and recommend surgery. But this is not necessarily the case.

People live the entire lives with disc herniations and have no pain from them. So the presence of herniation uncovered by magnetic resonance imaging (MRI) when sciatica is present is a correlation and not necessary a cause and effect situation.

When the piriformis tightens it can also cause the hips to rotate either to one side or diagonally, thus causing the pelvis to be askew, which can be a cause of both lower back pain and hip pain.

On the other hand, if the piriformis is too loose or flexible (hypotonic), it will cause slack in the connection of bones and allow play to occur. This can irritate nerves and muscles and cause severe pain.

So how does the piriformis become too tight or too loose? Well, the most common cause is sitting for prolonged periods of time. The human body was designed to stand and walk, not sit with 90-degree flexion at the hips and knees. When sitting, the muscles, tendons and ligaments in the front of the pelvis become hypertonic (shortened), and those on the rear become hypotonic (elongated). Elongated muscles tend to contract naturally as a defense against poor posture and this results in spasms.

Sitting for prolonged periods at a desk or while driving a car also reduces the amount of blood and body fluids moving through the contracted areas of the waist. In Chinese medicine we call this “stasis” or blockage of blood, fluids and energy. And where there is no free flow there is pain. Conversely, where there is free flow there is no pain. If you want to get rid of the pain you need to release the tension and allow flow.

I see hypotonic (hyperextended) piriformis in some yoga practitioners who are either too eager in the stretching exercises or are under the misguidance of an unqualified teacher. Muscles should be stretched only within their normal range of motion. When stretched too far they can become torn or slack and this causes pain and injury.

And while strengthening exercises such as those used in physical therapy are good, strengthening a muscle that is hypertonic is asking too much of it while in its dysfunctional state. It is better to go through a regimen of stretching, Thai yoga massage, muscle energy technique or tui-na Chinese bodywork to first work out the hyper tonicity before strengthening the muscle.

The next time your low back, hip, buttocks, leg, shin or foot is bothering you, ask your physician/healer/therapist about the possibility of the piriformis being the culprit. It just might be, and getting a jump on it early on will shorten the healing process and prevent the problem from becoming chronic.

— Dr. Mark Wiley

Dr. Mark Wiley

is an internationally renowned mind-body health practitioner, author, motivational speaker and teacher. He holds doctorates in both Oriental and alternative medicine, has done research in eight countries and has developed a model of health and wellness grounded in a self-directed, self-cure approach. The Wiley Method provides a revolutionary way of providing recovery and prevention of chronic pain, illness and disease. Grab your FREE COPY of Dr. Mark Wiley's "The 3 Secrets to Optimal Health" HERE.

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  • Ken Roberts

    Medical massage would be a help if I understand this article and then getting the muscle out of a bad state of health before doing exercises. I have what is called bursitis of the hips my hips actually burn when I walk . I had better times when I worked because I walked about 4 to 7 miles a day during my work shift. Walking would be a good thing for this condition I think because I did not have as much problem then as I do now

    • Dr. Mark WIley

      Hi Ken, You are right: walking is a great way to ease and prevent sciatica and other kinds of lower back, hip and leg pain. You are also right about the massage. The problem is that often the pain is so great that people cannot walk. However, taking the time to stretch properly and/or receive a corrective massage to release the area (not merely ‘relaxation’ massage)will free the are, create an environment for fresh blood, nutrients and oxygen to nourish the muscles and sinews. Also doing range-of-motion movements like hip and other joint rotations (slowly and small movements at first) will warm the area, release the synovial fluid and also help ease the pain. Walking will then be less painful, and will allow better overall range of motion, body heath, muscle release and pain reduction.

  • Casper Weiss

    Thanks for the information and this fits my problem to w tee. I hve been going through this for two years and complaining tht they may not be addressing the right problem. Unfortunately I am older, retired and tied into a HMO. Can you recommend tome a type of practicioneer that I can see if I go out side my HMO?
    Right now I have availabe to me through my primary physcian a pretty good pain medication, so i haven’t been complaining too much although they had me convinced that we have done all.

    Thank You, Casper

    • Dr. Mark WIley

      Hello, Casper, I am sorry to hear of your suffering. If you can find a ‘bodywork therapist’ that would be terrific. This is a broad term for someone who practices hand-on bodywork, that is not just for relaxation. So a ‘relaxation’ massage therapist will not be of much help. However, a porson skilled in Tui-Na, Rolfing, Muscle Enegergy Technique, Positional Release, Deep Tissue… or other modalities should be equipped to help you get over the hump in anywhere from 2-6 visits… afterwhich you can do stretching and walking on your own.

      An oon-line search will help find that person… Best of luck!

      • RAe DePauw

        I surely do not wish to miss your recommended exercises when you publish them

    • Paula

      This condition was suggested as the cause of chronic hip pain. Learned the exercise and do several sets a few times a month and viola!–no excruciating hip pain. Usually do the piriformis stretch in conjunction with knee to chest back stretches. The piriformis stretch is done slowly and gradually and you can literally feel the stretch. I give myself about 3 minutes to ease it out for each one. Do three sets at a time alternating sides. Don’t rush it!!!!!

  • Tom Konopinski

    I have been there and done this with all the muscle relaxers, anti inflammatory pills, physical therapy, x-rays and chiropractic. As Dr. Wiley stated, with little or no long lasting results. I will be checking in to Dr. Wiley’s regimen of stretching.I have tried everything else, short of surgery. Stretching each day and walking certainly sound better to me than surgery. Thanks for the article.

    • Dr. Mark Wiley

      Hello, Tom. I am sorry for your extended suffering. Natural, non-invasive methods of rebalancing the body are always a best first choice when dealing with health issues. I am working on the video and others, and we hope to have the exercises up next Tuesday to go with this piece. We weren’t prepared to do these, but see there is a great need. I am happy to help and thank everyone for their interest in these simple exercises and for their patience in getting them up.

  • Darlene

    I had back surgery 4 years ago, but my back pain has only got worse with time. I have had shots in my back several times, and on one of those times the Dr. “tapped” me. It was one of the worst things that has ever happened to me, I thought I was going to die, I suffered for 4 days before he finally took me into his office and did a “Blood Patch”, but what I guess he didn’t think about was he had given be extra pain meds for the Headache. So when he put me under for the blood patch they couldn’t wake me up! They were begining to panic and called my husband back there and asked him to call out to me, long story short I’m here, but I’ve been through hell. I have developed Epidural Fbrosis, which is Scar Tissue in my Epidural cavity yet there are those who want me to continue to take shots that do not work!! I have 2 Rods in my back plus a Cage, now have C2&C3 that are Bulging, my God what am I going to do?!
    Are they right? Is there nothing anyone can do for me? I had the Back Surgery because I could barely walk, I believed it would help me, I wanted it to help me so badly!!!
    The Dr. that did the Surgery said it looked like a “Bomb had gone off in my back,” yet here I am still in pain and some days the pain is worse than before the surgery.
    Please tell me, is there any hope for me?

    • Dr. Mark Wiley

      Darlene, I am sad to hear of your suffering. Like so many of us have experienced, over-zealous surgeons and practitioners can lead us down a harrowing path with their limited health views. This goes for all practitioners, not just allopathic MDs.

      I am not sure what to tell you here, given the limitation of my role and this message board. I will say, however, that there is always hope for change toward betterment in health. Please give me some time to think about a more detailed reply. I do not wish to “shoot from the hip” here. More soon…

    • Richard Pawley

      I can’t add much to what Dr. Wiley has said. I am fortunate never to have had an operation since my tonsils were taken out at age six. However, having been in several auto accidents my physical body has been thrown around to the max. Nothing broken but “Oh, my!” I find that if it take six tart cherry tablets available from for about $15 for a 120 that the pain of inflammation is usually relieved. Only on rare occasions do I have to take this more than twice. I take these because I don’t want to put stress on my liver or cause other problems that I don’t have. On the occasions when the cherry doesn’t work I use a combination of aspirin, acetaminophen, and caffeine, the only pain reliever that years of experience has shown me works for me. I occasionally go to a chiropractor but I don’t think that would be for you. I would also suggest prayer as it has even been proven (scientifically) to have benefit although those who hate God will not admit this and those who think they are somehow unworthy won’t try it. (Big secret: All are unworthy but God loves us anyway). I’ve said a pray for you and all I can think to say is don’t give up and enjoy what you can of life as much as you can. It will get better but sometimes that takes more than time. May God bless you.

  • Suzanne

    Hello,I am now 47. This information is a god send. I was hit from behind by a pickup truck about 11 years ago. Within 36 hours I was in extreme pain, in my neck & back with many spasms. I had all kinds of tests and have been to many specialists since then looking for pain relief. I have cronic lower back pain ranging from an 8 to 10 and off the chart some days. I take regular narcotics because my pain management doctor cannot control it any other way. I have many herniated dics, etc. and no neurosurgeon will operate on me. I have all of the symptoms you described and I am not getting any better. I hate taking these medications but if I don’t I cannot function to take care of my family. What type of specialist would you go to for a reliable exam of the piriformis? Also, as a woman would this condition cause extreme pain in the lower back,etc when I have my period? Thank you.

    • Lower Stomach Pain

      We’re a gaggle of volunteers and starting a brand new scheme in our community. Your web site provided us with useful info to paintings on. You have done an impressive task and our entire group will be thankful to you.

  • Kristin

    Does this correlate to sacroilliitis in any way?

  • Karen

    What you’re describing here is exactly what i have been experiencing for a couple of years now. Changed jobs and was spending a great deal of time at a desk and it came. Even now, sitting for any period of time can aggravate it. The pain keeps me up at night for about an hour or so, but when i wake up, i am pain free until i start moving around, then it comes back. My Chiropractor has told me it is coming from my sacro-iliac joints so is partially right and visits to him generally help but can’t afford to go all the time. Please include some exercises and stretches to help this so i can get on with my life. Thank you!!!

  • Greg

    Yes, I know about this muscle. Is there any definitive way to test and tell if it is the problem? Also, we need some videos or photos , etc., that show how to do specific stretches or exercises for this muscle problem. Thanks for the info!


    • Zach Luce

      It is very sad that so many people are hurting so many and have been bounced around so much in our health care system. I’m a Physical Therapist and I have a Board Certification in Orthopedics. Everyone should look for a Physical Therapist that specializes in Orthopedics and uses Manual Physical Therapy techniques. These techniques involve most of the types of things that were describe as work that is done by a “Bodyworks Therapist”. The PT should then give you specific exercises based on their clinical assessment using “Orthopedic Special Tests” etc. Some exercises will have to be modified based on the individual impairments that different people will have so just having pictures of exercises may or may not be effective. Drugs should only be used to control the pain so that the individual can tolerate the exercise and get back to normal movement.
      Best of luck to all of you in your quest to get back to normal life.

    • Dr. Mark Wiley

      Yes, Greg, there are indeed specific orthopedic tests that will show if the muscle is the culprit. An old-school osteopath or skilled chiropractor or physical therapist will be able to do these assessments. However, it seems in the US such are becoming a lost art.

      For a true assessment, you should see a practitioner. Just call around to offices and ask if they perform these tests. If yes, then book an appointment. Regardless, the exercises on the forthcoming video are simple and will help, even without the actual assessments.

  • http://PersonalLibertyDigest Kam

    I am a dance instructor and have been plagued with this problem for a very long time. The sciatic, or should I say piriformis, is a common problem in my industry, so any stretches or exercises that you can post would be beneficial to ALL of us! Mostly, our problem stems from turnout and flexibilty. Can you differintiate between the tight vs. loose piriformis and if the exercises would differ for the two? Much appreciation!

    • Dr. Mark Wiley

      Good question and insight, Kam. I see hip and lower back issues amongst ballet and yoga practitioners all the time! Too much stretching and holding postures that are outside the normal (healthy) range of motion are the culprit. Yes, dance is fun and the skill can be inspiring to watch, but it is not healthy on the physical structure of the body. The same goes for yoga, as we in the West practice it.

      There are indeed simple orthopedic tests to see if the muscles are hypertonic or hypotonic and easy exercises to ‘fix’ the issues. However, it would take several articles and video to show and describe them all. For this one, I have discussed piriformis syndrome and shot a video of easy stretches and exercises to correct. It should be posted next Tuesday. Future articles will discuss other muscular syndromes, too.

  • Barry Bailey,

    Thank you Dr. Wiley for confirming what I have been telling my Massage clients for years. I treat the piriformis (and other hip rotators) regularly using a technique I call Soft Tissue Active Recovery Technique (STAR Tech(R))which is based on European Orthopedic techniques. Stretching is a major part of my treatment and is also the maintenance I give my clients to do at home.
    Sitting is one of the worst things we do to our bodies.
    I have also been using STAR Tech(R) succesfully treating athletes and stroke patients.
    Barry Bailey, MS, LMT
    Maynard, MA

    • Zach Luce

      What is the difference between the “STAR Tech(R)” techniques and PNF/Contract Relax techniques?

  • George McGarity

    I went for 30-years with similiar pains in the back/hips/groins…a number of neuro surgeons told me that the MRI’s or CT’s did not detect anything that would explain the level or type of pain I was experiencing. Early this year I found a group of doctors who used a procedure that uses an instrument called the AccuraScope…they insert a small camera and laser into the spinal canal at the lower end of the tail bone. The diagnosis was nerves teathered/adhered to old scar tissue at several lumbar levels. Scar tissue from lumbar surgeries performed in the mid 70′s. During a 45-minute surgery, they were able to relieve 90% of my pain with the laser. The procedure was quick and without discomfort. This may not apply to everyone, but I wanted to share this experience with fellow back/hip/groin sufferers.

  • Anita wright

    I was given steroid shot in lft hip it hurt by evening in grt pain next day couldn’t walk . That was 8mnths ago . Had therapy and now back surgery . Doc responsible for shot denies it was that. I was fine before even walked into his office with no pain or back problem. I believe they hit pyroformis causing my sciatica nerve to crink up as surgeon said it was. Have you known any one else experience this?

  • jo

    Now that you have identied the problem, can you please provide exercises and/or other curative instructions?

  • Terry

    Wow!! Finely an answer that sounds logical. I’ve had 6 surgeries over the past few years (discectomies&lamenecomies), the last was a fusion w/fixations. I can’t walk more than thirty feet freely. Sharp Lower back pain and feels like scalding liquid running across and down from my hips with numbness in thighs and burning,numb feet and toes. I have to use a walker and a wheelchair to do anything. I’m going to print this and bring this up at my next Dr.’s visit. Thanks So much. Feel that I have new ammo for an old Gun !!


  • Sandy

    This discription discribes my husban to a tee.Right now we have appointmnt with doctor coming up. Are there any test or xrays that would confirm?
    Any natural herbs and you said chiro didn’t help much.
    He has been going to one for awhile now.
    What kinda of therapy would be the best? We have acupnture doctor would that be better?

    Can Lyme mimmic this?
    Any info would be helpful

  • lemie mcgarity

    What you have described in your article is exactly what I am being treated for right now with cordozone shots into my L4 & L5 which has caused some relief, and I have been using traction to take the pressure off my sciatic nerve. I even have pain when lying down and right in the hip area.

    After reading your article and thinking back about my problem I am beginning to think that I might need to rethink the whole process of treatment prescribed for me by my doctors.

  • Ted Ferguson

    This is precise with my problem. I have had these symptoms for three years and there are times where the pain is almost unbearable. However, to quit is not in my vocabulary, so I go on with my life. If there is something I could do rather than ibuprophen and Chiropractic visits? I am 72 years of age and I am very active and want to stay that way. I drive approximately 30,000 miles each year, take care of 20 acres of property, play golf and more. Let me know if you have knowledge of someone who could possibly diagnose this problem.

  • Dr. Mark WIley

    Hello, Jo. I will see if I can shoot a quick video of these this week and post on this site. I will also try and see if I can shoot some pics of the exercises and post them… Keep an eye out for these!

  • Dr. Mark WIley

    I love it, Terry. Often bio-pharma based physicians overlook what is simple and non-invasive and go straight for the big guns. It’s almost like they think (or at least act like), “you natural guys are quacks, with your little stretches and herbs. Step back and watch what we can do with a knife!” Rediculous!

    Knowledge is power, and every person should know about their health issue and available treatments before they see their primary care, then put them on the table for discussion and debate.

  • http://donthaveone Beberoni

    I think I have this exact thing, as I never had back pain until I “graduated” into a desk job. After 2 and half years of sitting when I wasnt used to it, I have had this exact problem, and what you say about the front muscles relaxing and the back ones stretching seems right. I had such acute pain a month ago, I started seeing a chiropractor, who through just stretching my legs downward while on my stomach and dropping out the mid section of table has made the pain go away, I have the constant fear of this pain returning as it was excruciating. So short of not sitting at my job, which is impossible, how do I combat this? Just by excersizing the stomach muscles or what? Please advise.

  • Davida Stocklan

    Please advise what to do about a tight piriformis muscle. What exercises and stretches will help? What is the best way to sit?

  • Dr. Mark WIley

    Hello, Sandy. I can hear your frustration in your post here. I am sorry for it.

    The first thing you need to know is that the scans and imaging only tell a piece of the story. They show correlation, not cause and effect. If there is a scan that shows herniated discs, it it no way means the disc bulge is the ’cause’ of the pain or problem. Most people live their entire lives with bulging/herniated/slipped discs and NEVER have symptoms of pain, tingling, cold limbs. The disc ‘could’ be a reason, but it not ‘necessarily’ the reason. Muscle contraction, leading to skeletal imbalance is more likely the cause of sciatica, lower back pain, and so on.

    No, there is no x-ray or scan that can show this. However, there are numerous orthopedic tests that can be done to show which muscles are in limited range of motion, and which are in extended range of motion. Then a therapy of releasing the constricted muscles while strengthening the looser ones will, over time, bring them and the skeletal system back into balance. This should prevent the pain, because the underlying cause of it is corrected.

    A bodywork therapist who knows these tests is who you need to see, even if you have to pay out of pocket for the visit. Old-school Osteopaths have this orthopedic assessment knowledge, a very few physcial therapists and only a small fraction of massage therapists… I would do an online search for terms like “bodywork therapy” and “othopedic assessments” for your location, makes some calls and see who is around… before ANY surgery or regimine of ling-term pain meds.

    Best of luck!

  • Dr. Mark WIley

    That sounds like a great plan, Lemie. Read some of my replies above for more information to help you. Best of luck, I am thrilled that this information is useful to you!

  • Dr. Mark WIley

    Hi Ted, you are so active and full of life! What you need to find is someone who can do “manual orthopedic assessments.” This will show, for your body specifically, where the imbalances are in musculature. Then, find a practitioner who can release the area manually (with their hands), such as someone trained in tui-na, muscle energy technique, positional release, deep tissue, Rolfing. After you have an assessment, and help with the initial bodywork release, then you can do stretches and slow walking to keep the ares in motion and heated, which brings pain relief and helps return the body to balance.

  • Pat

    This sounds very much like the pain I have in my hip/lower back. I’ve had an epidural and I am using a Teeter Hanger two or three times a day. I am improved but not completely pain free yet but am hopeful that the ‘hanger’ is helping.

  • Dianne

    I also have had similar troubles. I go to Chinese foot massage. As well as the feet, they give a full body massage through your clothes. Quite a bargain. My “sciatica” was giving me trouble a few weeks ago; and my massage therapist did something he had never done before. He took his pointy elbow and stuck it right in my rear! Looking at the picture above, it looks like he was going for the attachment of that muscle. I did get relief. Due to language (my english, their chinese), I rarely tell where I am having trouble. They always seem to find my trouble spots, though.
    Sure would like to try some stretches, though. I love the noninvasive approach.

  • Chris

    I have this same type of pain. I’m Ok if I sit or stand and walk, however as soon as I get in bed and lay down the pain in my hip, back, and leg begin. I can’t get a good nights sleep. It is very painful each time I have to get up and leave the bed. It takes about an hour each morning to get pain relief. I hate taking pills. I do walk and have a large yard to take care of, it is the nightime that I don’t look forward too. I need advise. Thank you. Chris

  • Joe

    I have been suffering with this for about 7 years now. Although the pain has diminished somewhat from its initial “excruciating” stage, I always have pain in my hip, low back and leg. Had CT Scan, MRI, X-rays and all negative. Saw doctors and Chiropractors to no avail and gave up on medical help. I self-diagnosed Piriformis on the internet but was scoffed at by all in the medical field. I was very active (running and biking) when this first occurred and this is sometimes referred to as “runners syndrome”. I will seek out a specialist as recommended above and hopefully get some relief. Thank you for the article.

  • Ron Dunn

    I have been diagnosed with spondylolisthesis in my lower back in that my right foot will not support my weight on tip toe. It will collapse when I try to stand on it. I had surgery in 2002 to relieve preasure to keep my back from slipping alignment and causing pain. Today I still cannot stand on my tip toe on the right foot but donot have pain. My right foot does not rotate in normal fashion when I walk and this causes me to limp. My orthapediac surgen recommended pins and screws to fuse #4/5 lower lumbar as the condition slipes forward at times but still no pain. Somtimes the limp is really noticeable.Is there anything I can do or someone to see for help? Respecfully ,Ron

  • Paul

    i never had a desk job until Feb 2009. In Oct. 2009 I started getting exactly all these symptoms. It started hurting slowly until one day i could not walk. Had MRI’s that showed bulging and herniated disks and after 2 weeks of physical therapy the back pain went away but the hip, leg and foot pain did not. the intense pain is centered in my hip and the MRI does not show anything wrong with my hip. it is so intense that i have not left the house for months now except to drive to work and home again. I am on Percocet’s but they only help while i am sitting not with walking.
    I will be looking for your excercises when you post them as i am stretching every day but it only helps a little so maybe i am doing the wrong stretches.

  • Fed Up Gal in NM

    Dr Wiley,

    Thank you for this very informative article. I have occasional back pain (usually when I’ve been less active and then start doing projects that require lifting and/or moving things around my house or yard)….so just one more reason to “keep” on moving myself…lol.

    I have a friend however, that suffers from severe back pain due to an injury when she was a child. I’m going to forward her your article; maybe it will help her.

    I’m looking forward to the exercise video you plan to post on the site. Thanks again!

    Fed Up Gal

  • Rose Gold

    This sounds like exactly what I have had for years. I am very very interested in knowing more about what kind of exercises,etc. I see a chiropractor, and have acupunture. I have also had surgery, but it continues to be a problem. I keep thinking I am doing something wrong to provoke the pain. I cannot take any pain medication because I have had ulcers and they make my stomach hurt. Please count me in on anything that would help this situation. Thanks

  • james mcdonald

    please let us know when you have exercise tapes available.

  • Chris

    I have a herniated disk with sciatic nerve damage which gives me intermitant pain and the family Dr. initially prescribed percocet 5-325 for the pain. then was refered to a nuroligist who prescribed percocet 10-325. i am fully aware of the dangers of adiction to this drug and consider this when taking it I.E. only as needed and may go 3-4 days with only taking an advil…. 40 10-325 percocet’s lasted me 2 months! i went back to Dr. last week and now she refuses to give me a prescription for these. why? and does anyone know of another source that is LEGAL! Thanks

  • Charles D Kowalski

    How may I access the video you mentioned? I have two issues I would like answers for; one is an area in my lower left back at about the belt line. If I press there I can feel what seems like a gelatinous sac. Also I have a DEEP pain in my right groin. Can they be related?

    Thank you.

  • Conrad Collins

    Please add me to your list as well as this sounds more and more like what I also have. After shoveling ice and snow two months ago I had severe pain in my left hip. Two different DC’s weren’t any help after 5 or 6 visits each and the MD had a MRI taken and said it was just ‘age related arthritis’ – I’m 67.

    So I’m very much looking forward to the exercises you mentioned being posted soon as I’m not sure of any of those other experts being available in this area of NC.

  • Harry Newton

    Posting Dr. Mark Wiley’s exercise videos on YouTube would be enormously useful.
    Please. Please

  • Dr. Mark Wiley

    Funny story, Diane. Thank you for sharing. Yes, a good bodyworker will be able to feel the constriction or spasm and know where a trouble spot is even without knowing you have a symptom. Spoken language is not necessary. In Thailand and China alike, the blind masseuse is sought after because their keen sense of physical/orthopedic awareness for finding trouble issues is quite remarkable. They do not need to see to make a difference!

  • Orville D. Hart

    The symptoms described above are very similar to mine. I have had back surgery with numerous MRI,s Cat Scans and X rays but still suffer from foot and back pain. Thanks for you comments.

  • Brian H

    Please try to be more careful in your answers re spelling, etc., especially when recommending searches!! “Otopedic” is not a word, and not a specialty, and not a useful search — unless Google guesses you actually mean “orthopedic”.

  • Brian H

    See? I also misspelled your misspelling!! I meant “othopedic”, and you meant “orthopedic”. ;)

  • Fed Up Gal

    Brian H,

    I worked with physicians for a number of years (20+ years) and it’s always been a joke about them not being able to spell or write legibly. For me, the important thing is whether they have the knowledge, skill and ability to care for their patients.

    Fed Up Gal

  • Brian H

    There are specialty chairs you might consider, too, that keep you mostly upright with knees braced on a pad, called “kneeling chairs” – e.g. A brief walk-around every half hour or so can also help.

  • Dr. Mark Wiley

    The “gelatinous” area in your belt line that is painful to touch sounds like some form of cyst. You can either have it lanced and drained or dissolve it with herbs over a period of time. I have seen so many patients with nerve irritation from cysts in their lower backs and hips… it is no wonder why the spinal adjustments and pain meds don’t help. The issue is the cyst. Speak to your primary care about it and having it drained or dissolved.

    I do not think that is related to the groin pain. The groin pain is perhaps from tight muscles that became contracted as a defense to balance the body from the posture held because of the cyst pain. However, it could also be a hernia. Better to have both areas checked out and then look for the natural relief method to deal with them. Without more information, it is difficult for me to say for certain.

  • Dr. Mark Wiley

    I will do my best, Brian. Thank you for the heads up! I always try my best to respond to as many posts as I can in the margins of my busy schedule… which means typing fast at times. I will be more mindful to double check moving forward. I can see how such a seemingly simple error in typing could possibly lead someone down a wrong path with a search! :)

  • Dr. Mark Wiley

    Davida, I am working on a few videos that we will upload here that will show and explain these essential stretches. I believe next Tuesday they will be available.

  • Dr. Mark Wiley

    Hello Ron, I am sorry for your suffering. Indeed, your specific issue is not so common as others causing lower back pain and loss of muscle strength. Spondylolisthesis can be assessed orthopedically to see how severe the condition is. An Osteopath, Chiropractor or Physical Therapist skilled in orthopedic assessments and corrective exercises can help you. I would advise this before surgery. You should spend a few hrs making calls to local (and perhaps not local) centers to speak with the doc or therapist and discuss his/her knowledge of this issue and their ability to assess and correct it. In the meantime, and during treatment, spend some time each day stretching your hamstrings, as they are one of the culprits in this skeletal imbalance. Stretching three times a day, every day, should become habit for you.

  • Girl Gone Healthy

    Oh man, upon reading this, now I’m worried if I actually have Piriformis Syndrome, what with my job requiring me to sit in front of the PC all day.

  • Fred

    I have been suffering from this for 6 months now only to be told by Orthopedics that it will not go away until i lose weight and recommended bariatric surgery and then only wanted to give me a cortizone shot (which i refused). I lost 60 lbs on my own but the pain was worse than ever until i read this article, i looked up on the web for excercises and have only been doing it for a week now and the pain is almost completely gone. I have not left my house for 6 months except to go to work but this weekend i am actually going to venture out of my house for a short trip, just taking it slow at first. I wanted to thank Dr. Wiley for this (and You-Tube) for the excercises. While Orthopedic Doctors looked at me like i was lying about the pain (one even dismissed me and left the room) it was the web that cured me. THANK YOU Dr. Wiley.

  • http://?? Joe H.

    careful driving on percocet. if you get stopped for anything and they suspect you can be ticketed for driving under the influence just like drinking!!! Also I am allergic to them and other than giving me migrane strength headaches they actually increase the pain!!

  • http://?? Joe H.

    Doc Wiley,
    I can only agree with you on this as I had L4 and L5 fused a few years back and there is the possibility of buldging discs developing both above and below the fusion! This is my problem as the surgeon told me that this procedure would not limit my movement at all. Well had I taken it a little easier on the discs above and below, I might not have the problems I have now! I will never let them do surgery again on my spine and that includes if I am bedridden!!!

  • Mark

    So, I have been treated for over a year now with multiple injection by a pain doc. I am an avid runner and feel the pain in my piriformis and believe this may be the culprit. My question is what kind of doc do I call for this? Ortho? Neuro? My pain doc keeps saying it is not Piriformis but I am not convinced. Thoughts?

  • http://-- Hans Raible

    The Iron Disorders Institute (IDI) has a list of symptoms of iron overload. Back pain is among them. This is very common in Western societies, and one has calculated that in the US, there are 43 million people suffering from iron overload.

    I lately got back pain (migrating from place to place), and iron chelation is quite useful against it. At present, I am working in our office and have no pain. It also appears to help against tinnitus. The IDI list has 60 items on it, and it is not exhaustive. Hans

  • Linda Perkins

    I think this is what I have suffered from for over 3 years. I tried to copy this for my doctor so he could understand what may be affecting me, but it will not copy. There is no print option either. How can I refer my doctor to this article?

  • libertytrain

    Linda on the right-hand side of the article there’s a large box that says article tools – you can’t miss it – first thing in that large section is “print this article.”

  • Francine

    I believe I have piriforms syndrome
    I have seen a nureologist a rumeotologist and a sports medicine specialist.
    I have chronic bursitis in my left hip and the pain described for piriformis is me to the core. I am being treated for my glute muscle though and i see a physio weekly and have strenghthening exercises.
    i have fortnightly cortisone and i also wear a morphine patch. nothing helps. I am having an MRI tmrw as I was ready to go to hospital with the pain.
    I was on clofen a muscle relaxant but it made me vomit. So that was no help.
    I just want to be better.
    I have been dealing with this for 8mths and it is worse not better

  • knee pain hart

    Hi there, simply was alert to your weblog through Google, and found that it is truly informative. I’m going to be careful for brussels. I’ll appreciate if you continue this in future. Numerous other folks might be benefited out of your writing. Cheers!

  • Martin

    could the groin hurt too? I am trying to figure out why my lower back hurts and I get sharp/shooting pains in my right groin. My physio suggested the piriformis was a trigger point. However my doctor suggests it maybe Osteo-Arthritis in my hip [i'm 37 and have had OA in my knees before]. I go for an xray tomorrow.
    I do a lot of gymnastics and olympic lifting…which may have caused this [heavy lifting or over training]. I’m worried it maybe my discs or nerves around the L1 discs!
    There seems to be a general warm/pain from my lower back through my pelvis and sometimes shooting into my groin, majority on the right side. This has been occuring [getting worse] for over 6 months now. It’s really worrying me.

  • Carmon

    Hello! I just wanted to ask if you ever have any problems with hackers?

    My last blog (wordpress) was hacked and I ended up losing months of hard work due to no back up.
    Do you have any methods to protect against hackers?


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