Pain relief for acute Piriformis

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.

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.  

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.

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.

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.

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