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<p>Totally agree with this. I’ve had great luck with physical therapists.</p>
<p>This is a great stretch for the piriformis
[Lying</a> Piriformis Stretch - How to Stretch the Piriformis Muscle and Open the Hips](<a href=“http://sportsmedicine.about.com/od/flexibilityandstretching/qt/Lying-Piriformis-str.htm]Lying”>Essential Piriformis Stretches)</p>
<p>piriformis syndrome or sciatica from what I understand is very similar thing
Be so careful taking muscle relaxers because you could damage it even more-</p>
<p>I don’t know what an xray would show- mine showed I cracked my sacrum, but perhaps they are looking for vertebral misalignment. ( I had a bad fall on ice- but it didn’t start causing me problems for a long time- although it hasn’t been that long ago & since I have osteoporosis now, it is kinda interesting that I didn’t do more damage)</p>
<p>Ive gone to a PT an, chiropractor & a LMT. The PT taught me exercises to focus on the intrinsic muscles involved but to feel better, I would recommend a massage therapist.
<a href=“Massage Today | The Massage Profession's Digital News Source”>http://www.massagetoday.com/mpacms/mt/article.php?id=13771</a></p>
<p>Two years ago I had disabling sciatica caused by a herniated disk and the narrowing of the hole in the spinal column where the nerves go–all this created agonizing pressure on the nerves in my back and legs, and muscles that cramped so severely that sometimes I could not bend my body to get into my car, or to sit down. I remember having to take an airplane flight during this time–fortunately my teenage daughter was with me and could get my shoes back on me after security, because there was no way I could have done it myself.</p>
<p>My GP was pretty dismissive–most back pain tends to resolve by itself–but my oncologist sprang into action, afraid that my cancer had metastasized. She ordered an MRI, which showed that it wasn’t cancer but pinpointed the cause of the problem. I ended up in a specialty spinal clinic and finally got decent prescription meds–neurontin for nerve pain, flexeril (a muscle relaxant), and a strong anti-inflammatory. I also had two cortisone shots into the inflamed area–they were agonizing, especially the first one, but they did help.</p>
<p>My spine doctor recommended the book “Pain Free” by a guy named Ergoscue–it’s a bunch of exercises and stretches to align your body and to strengthen your core. I started doing them religiously. They took awhile to work, but work they did, and over the course of about a year my back pain completely disappeared. I’m now able to run in road races, do Pilates, etc. with no problems. However, I keep doing those core exercises, and I have also become much more aware of my body alignment and posture. My back problems occurred after I’d had a radical mastectomy, which numbed one side of my body and threw my balance off. I realized this when I saw a snapshot of myself–I was standing on a slant.</p>
<p>I had breakfast with a friend this morning who gave me the name of a PT that she uses and raves about. I plan on giving her a call this week. I haven’t heard the results of my xray yet, but I am feeling somewhat better after a day on the steroids/muscle relaxers.</p>
<p>Jingle - your comment about having your balance thrown off and that causing your pain: My friend this morning reminded me that just a couple of months ago, my right foot was in a “boot” for 3 weeks due to a stress fracture; maybe that could have started something from walking off balance? Also, thanks for the name of the book; I’ll look into it. It sounds like it really helped you.</p>
<p>A physical therapist cannot diagnose anything. You have to have a physicians referral and prescription for treatment by a PT. That being said, the PTs I have seen over the years (I have had two back surgeries) have been excellent at getting to exactly what needs to be done to treat and strengthen weakened areas.</p>
<p>it sounds like you have a disc pressing on a spinal nerve. An x-ray probably will not show anything, but that is always the first step. Next will be an MRI, most likely. </p>
<p>Until you know what is going on medically, I would NOT go to a chiropractor. See what the medical tests reveal and go from there. </p>
<p>good luck with this.</p>
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<p>Okay, let me rephrase this-- a PT can evaluate and assess the injury. Better? They are often much better than the primary physician who is just going to order tests or give out drugs. Did you know that probably about 85-90% of us have a problem with at least one of our intervertebral disks? And how many of those do not produce symptoms? </p>
<p>Also, the requirement for having a prescription depends on the state. In some states, physical therapists are allowed to see patients without going through a physician. And finally, most physical therapists I know would evaluate the injury directly and refer you to the physician if needed.</p>
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<p>With my current back/leg issue, I just told my family doc what was going on and asked him for a PT referral. He was fine with that. He didn’t diagnose my problem at all - the PT did.</p>
<p>The nice thing about going the PT route first is often you can avoid expensive MRIs and other imaging…especially if you’re not exhibiting serious symptoms such as numbness or dragging a foot or leg or not being able to walk due to the pain. You can always have the tests done if PT fails to eliminate the pain or increase mobility.</p>
<p>My hospital just opened a spine center. The first line of treatment is nearly always PT and pain management. Some people have imaging studies done first, some don’t. Every case is different. I did a lot of research on this prior to us opening the center (it’s part of my job). Approximately, 80% of all adults will experience a back issue at some point in their lives. Less than 10% of back problems require surgery.</p>
<p>PLease understand: I think seeing a PT first is a FANTASTIC way to go. In my experience, they definitely know more about the functional situation because of the time they take with their patient and the hands-on (very literally!!) techniques used. I worked in a rehab hospital for a time as a therapist (speech/language) as part of an interdisciplinary team including PTs, and, at least at that time and in that particular state, there was no way to see a PT without a doc’s referral. My more recent personal experiences with PTs have been that they are more comfortable treating for issues that were not included in the initial referral/'script than I remember them being back in “the day”. But I am pretty sure that my insurance would not cover physical therapy services without a physician’s prescription.</p>
<p>According to my yoga teacher, piriformis syndrome is when the butt muscle (piriformis is one of the butt muscles) gets tight or strained (like from climbing up and down chairs all day hmmmmMMMmm???) and then pinches (because it’s swollen or spasming tight) the nerve that runs basically perpendicular to the muscle and under the muscle, down the butt and into the leg. To unpinch the nerve the muscle has to get loosened up. My yoga teacher gives 2 moves:</p>
<p>1) Lay yourself down on your bed on your belly. Bend the hurtin’ side leg so the thigh is perpendicular to your body and bend the knee so your shin is parallel to the body (bend at the hip and knee). Rest here thoroughly, until the muscle unspasms (relaxes). This can take a few minutes, and after about 2 minutes you’ll feel your whole body subtly relax. This is an UNSTRETCH - the opposite of stretching. It puts the muscle in slack. Lets it unspasm.</p>
<p>2) Lay down with your back on the floor (not a cold floor!!! use blankets or carpet) and put both leg up on your bed, again bend at the hips and knees. Stay here for around 10 minutes and relax the sacrum. This relieves the SI joint (sacroiliac joint).</p>
<p>Also - important - if you are at all deydrated (which you probably are from running around all day like the crazy woman we all are this time of year) in a heated house, you must drink lots of water. Dehydration tightens muscles and exacerbates injury. Drink hot tea with yummy lemon all day long.</p>
<p>GOOD LUCK! Low back pain is a big pain in the you know where!!!</p>
<p>Oh yes and my book recommendation is The Trigger Point book [Amazon.com:</a> The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition (9781572243750): Clair Davies, Amber Davies, David G. Simons: Books](<a href=“http://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Treatment/dp/1572243759/ref=sr_1_1?s=books&ie=UTF8&qid=1292938025&sr=1-1]Amazon.com:”>http://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Treatment/dp/1572243759/ref=sr_1_1?s=books&ie=UTF8&qid=1292938025&sr=1-1) Others on these boards have found this book helpful.</p>