Sciatica/Piriformis Syndrome

[zhogbin]

For the last year and a half, my fiance has been suffering with severe pain that radiates from her hip/buttock down her right leg. She has lately even been complaining about her right foot feeling cold. She has had multiple MRIs of her lumbar, pelvis, and hip that all have been inconclusive in finding any sort of problem. She has had nerve blocker injections that have not worked. She had an SI joint injection that helped for 3 weeks and then after physical therapy and another SI joint injection, the pain returned. Her pain management doctor even did a lumbar epidural on her which mimicked her pain and she felt fine after standing. But 3 hours later she was in terrible pain in her lower back. She went to see a neurosurgeon for a second opinion but this was unhelpful as her MRI shows nothing abnormal in the spine. Her symptoms are that of sciatica and piriformis syndrome. One of her MRIs says this:

Sciatic nerve: Symmetric size. Mildly asymmetrically increased T2/STIR signal intensity within the right-sided nerve just distal to the right ischium, likely artifactual. The posterior femoral cutaneous nerves are symmetric in size and signal intensity.

I don't really understand this, but her doctors don't seem to think it is of any concern. She has scheduled an appointment with an orthopedic surgeon for yet another opinion, but she can't get in for 3 weeks and her pain has been increasingly worse lately. She cries on a daily basis. Can anyone lend any advice or point us in the right direction? Has anyone had a similar experience? This has affected every aspect of her life and mine.

I would greatly appreciate some advice on this.

[TheMadMan]

This procedure is called Radio Frequency Ablateration. It burns the nerves which can cause pain. I have had this done to my SI area including S-1,S-2 and S-3 area of my pain issues. I have had this procedure done with success. Attn: the nerve does grow back but for the time the nerve is dead, I have had relief. This procedure is not for everyone. I have heard horror stories but depending on your health and doctor, this procedure can work but again, it is not for everyone. Ask your doctor.

[zhogbin]

Thank you for the response. I believe she has already had this procedure. I didn't specify what injection it was. It only helped for 3 weeks and physical therapy made it worse. I will look into it and see if it was actually RFA.

[TheMadMan]

sciatica, piriformis, Piriformis Syndrome
The symptoms you describe are similar to the same issues I have called Piriformis syndrome. Look this up on the web and you will see exercises AFTER TREATMENT. I have been suffering with this for YEARS and the only thing that helps me is called RFA Radio Frequency Ablateration. It is the burning of the nerve in the SI area. Stay away from steroid injections, they are only a temporary fix and do no good (at least for me). I have had the same experience you have had. Go to see a pain management doctor that does this procedure called RFA. It burns the nerve related to the SI area and helps better than anything else I have tried. Only settle for the RFA, nothing else. Most doctors will increase drugs, muscle relaxers etc. They some time help but a pain management doctor that is familiar with piriformis syndrome will know how to treat this. THEN the exercises will help.
This is the best advise I can offer that works for me. I hope the same for you.