Pain relief for acute Piriformis

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I have acute pain under left buttock but now spreading down left leg and the pain is staring to affect my right lower buttock area. Had total hip replacement over 1 year ago/ Currently prescribed Voltorol Gel, Dihydrocodeine for pain with no relief whatsoever. Am 66 and stretches are not a good idea due to the amount of damage inflicted on Femur by a fall.

Please can anyone advise more suitable pain relief. Am in agony.

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10 Replies

  • Posted

    I have found Voltorol Gel, Dihydrocodeine to be is worthless. I use a OTC called Penetrex instead. What about Tylenol, etc., Have you tried physical therapy. If you can find a good physical therapy practice they might do you a lot of good. Don't just take whoever your doctor recommends. Interview them first.

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    • Posted

      i agree as far as medication is concerned but i am hoping to have injections to ease the problems I am having with severe pain. Do you know much about those?
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  • Posted

    I’m sorry when you said you were using the Gel I assumed it couldn’t be a really severe pain. I can’t believe anybody would be given Gel for severe pain.

    But I’m not clear what kind of injections you are referring to. During my first knee operation I roomed with two guys who had lost part of their legs and they were on opioid drips. Stopped the pain cold. My mother used cortisone for her knees and that worked well for immediate relief. But there can be long term consequences to both of these. Whatever you do find something that stops the pain at least temporarily, and then you need to deal with the problem that caused it.  

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    • Posted

      Yes, I was prescribed Voltarol and now Co-codamol! The injections are Cortisone. Now another GP has told me I should have Physio - totally fed up and just need to reduce pain level for some quality of life
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  • Posted

    Try the cortisone, get some pain relief and then do the physio. Don't get stuck on the cortisone as the long term side effects can be nasty. Try to get physio at least two days a week an hour a day, you need to do at least this much to make good progress.

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    • Posted

      Thanks very much for your advice. I had heard about the side effects of cortisone so shall query that option and perhaps just go for the Physio. My pain has now spread to the other side of my butt!
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  • Posted

    Hopefully just the physio helps. You may need some sort of pain relief for the physio to work efficiently, but the PT can advise you on that. I hope you get a good PT, I've had very good ones, I don't think I would have made it though some of the things I went through without them.

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    • Posted

      You are not going to believe this, but my pain has eased a little today and I have learned that if I really try to concentrate to relax the affected muscles throughout the day it helps. However, being a very active person is not helping; movement yes, but don't go around like a bull in a china shop. Will continue to go to referral (23 week wait, can you believe that).

      As long as I need pain meds I will take them.

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  • Posted

    It sounds like it might be Piriformis Syndrome (aka Deep Gluteal Syndrome.) Sometimes Piriformis Syndrome can be caused by scar tissue building up on the sciatic nerve after hip surgery. I too believe I have Piriformis Syndrome (PS) but mine is not caused by an injury or surgery. There are three primary treatments for Piriformis Syndrome: 1) ) Physical therapy on the piriformis muscle. This tends to work well for people with mild symptoms. 2) A series of Botox injections into the piriformis muscle. A pain specialist or radiologist would do the injections. 2) Piriformis Release surgery. This surgery is done to free the entrapped nerve and/or remove scar tissue. This is usually done by a hip specialist, but some nerve surgeons can complete the surgery as well. Piriformis Release surgery has the best overall long-term outcomes.

    The difficulty is finding someone who can diagnose and treat PS. I have found five surgeons in the US who have experience with PS surgery. Alternatively, many pain specialists can give you botox injections for PS. I am interviewing 2 surgeons at the end of Oct to see if they can perform surgery. I also have two pain doctors/radiologists lined up to try injections, if I decide to go that route instead.

    That said -- I can't know for certain that you have PS. But it sounds like it might be a strong possibility.

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  • Posted

    Thanks for your useful comments. I am sure it is the Piriformis muscle and Sciatic Nerve problem. I am waiting to to hear how long I will have to wait for an Outpatient appointment. Now, 2 different Doctors have given me conflicting methods of treatment advice; but they are not Specialists

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