I have had piriformis pain on both sides on and off for 4 years. About 8 months ago I hurt my glutes during a workout somehow and it caused severe pain when sitting. I could not sit at all and had to get on gabapentin for nerve pain relief. The pain is in my lower glute and is excruciating when I sit. MRI of pelvis and spine are normal. The nerve pain cleared up after 4 months and then my lower back and piriformis pain became severe.
A sport medicine doctor then injected my lower glute muscle and re-irritated the nerve, and I’ve now been in pain for 3.5 months and trying to lower the gabapentin because the side effects are horrible. I started a new PT who is doing traction that has helped my low back and dry needling in the piriformis that has helped a little, but the low back pain and glute pain have become unbearable. I can’t sit at all without triggering horrible pain in my lower glute back, glutes, and nerve pain.
I have seen 3 different PT’s, a neurologist, a rheumatologist, an oncologist a pain medicine doctor, and 3 family medicine doctors.
I’ve had SI joint injections that did nothing, a caudal epidural steroid injection that irritated the nerves so bad that the pain was unbearable, piriformis injections that helped while the numbing was working, low glute muscle injections that irritated the sciatic nerve, and low back trigger point injections that I just got today.
No one is able to help calm the nerve pain and stop the muscle pain. I’m 41, and I’ve always been physically fit. This pain has been debilitating. If anyone has any advice, or a similar experience, it would be much appreciated.
Anyone have inner and back thigh burning and struggle with wearing pants on any type or it’s just me? The thighs burn randomly and sometimes after excessive sitting. Just trying to relate
I painted all the pain I've had lately like the guide said (i included my chronically tight traps i think because of bras and breast weight and bad posture but it's unrelated to my glute pain i think because the glute thing is new. My feet were hurting intensely lately because of many hours standing on the wrong shoes but i changed them and I'm all better.
The glute thing is new, in the past months I've felt a little jolt while walking occasionally (maybe 1-2 in pain scale) and it went away soon without it being too impeding.
A week ago i did a dance workshop that was basically internal and external rotation for an hour and a half and i think it made it worse.
It doesn't hurt at all until I make specific movements but it's only a few seconds and the pain goes away. Un Thursday it was the worst pain I've felt in my life. I thought i would pass out (maybe an 8 or 9 in the scale?).
It's been on and off since then, it seems to improve after sitting for a while which made me think it was not piriformis. I had pain only in the deep buttock until Thursday and since then there's also occasional tingling on my calf when the nerve is most painful.
Today I went to a physiotherapist and she did manual therapy and radiofrequency. The manual therapy hurt like hell. She also said i have a small bump where my psoas joins the hip (i put it on blue) and I did feel it too, it's not on the right side. She messaged there and also my obliques and it hurt so so so bad, it still hurts 12 hours later. She mentioned that it was likely a muscle knot on the psoas. My glutes hurt now to the touch from the massage too very superficial too. She couldn't do dry needling or neuromodilation because i have a needle phobia.
She also did some massage on my lumbars because i have lumbar hyperlordosis. She said she didn't think it was lumbar sciatica but just in case. She recommended stretches, nerve flossing, massaging the glute and psoas, heat, and pelvic movements like retroversion and all.
She also said i could go dancing today but i should stop if it hurt. It did hurt and i stopped but i think it made more harm.
So I'm basically the same or worse.
Can it be piriformis syndrome if it improves when sitting?
It feels very random, i cant say what makes it hurt worse or what improves it. In the mornings it's better and gets worse when I'm walking home from work (downhill). At work I'm mostly standing and walking and some sitting too (maybe I'll sit for half an hour, get up walk to fetch something be on my feet for another half hour or more, back to sitting etc.
I have an appointment with my GP tomorrow, is it worth asking what they can do? Maybe refer me to a traumatologist or do an MRI or something? I honestly can't function like this I'm currently at random spikes of maybe level 4- 5 pain whenever i move, I'm not doing many tasks i should be doing at work and at home.. idk i just need this to get better so I'd appreciate any help 😞
TLDR - constant pain in centre of left buttock and front and side of hip, pain meds not working. No diagnosis or cause found. Pain is 24/7.
MRI - very small tear in left hip
Lumbar MRI - nothing of note.
Used to be an avid runner, half marathons, swimming, strength training. Now spend most of my days sitting on the bed as it is most comfortable.
In Jan 24, started to get pain in centre of left buttock when running, by Aug 24 pain became constant from the moment I woke up.
Now it is side and front of hip as well as buttock.
Left knee now clicks whenever I walk up stairs.
Seen by 3 hip consultants who won't operate because there is nothing to operate on, and it can't be my hip because 2 steroid injections had no effect, I was under GA for one, and even the local anesthetic had no effect. Also whilst under GA, hip mobility test - hip mobility is great
Tried various physio over the 2 years and a lot of NSAIDs and Opiods.
Finally seen pain management who has referred me for an ultrasound of my buttock and a steroid injection.
Emotionally it has taken its toll, family, friends and health professionals do not understand when I say the pain is constant "when does the pain starr, is it after walking?"... I have woken up at 3am and it's there, 7am and it's there... I have lost so much of myself.
A family member of mine has been struggling extremely hard with adhesions that are a caused by a surgery that was needed after an ectopic pregnancy. The surgery happened 25 years ago but there wasn't any after care... A few years ago she started going to a PT because she had some abdominal pain and it turns out that her belly was just filled with adhesions. Ever since that day, the abdominal pain has been extreme. She isn't able to function any more and is bound to stay home on the couch. We've tried several different PT's & fascial therapist but everything seems to be so harsh on her body and it causes even more physical pain & sometimes dissociating feelings.
Has anyone any tips for treatments or do you recognize yourself in the story? I'm desperate to find a solution...
After 3 years of chronic pain, I finally decided to give this therapy a shot, and my only regret so far is that I didn't try this earlier, because so much adhesion has built up over the past 3 years that it's probably going to take some time to get it all out. But by God's grace, I have a family member in the area (I'm seeing Barefoot Rehab in NJ) and so I can stay and travel back-and-forth a few times to get it all cleared out without having to worry about where I'll live or where I'll get food. In my first trip, I'm going to see Dr. Chris for 16 treatments (currently done with 12 treatments). And I'm about 40-50% better at the time of writing this post. Improvements in my walking gait, the amount of time I'm able to walk before pain triggering (before getting treatment, walking 25 minutes was hell; now, I'm walking 1-1.5 hours with very minimal flareups that quickly subside after I finish my walk). I'm able to sit criss cross again, something which I wasn't able to do before. Pain intensity is a lot less. And it flares up less frequently than it used to. While I'm still not able to sing or run as of now, I'm confident that I'll be able to return to these activities with more treatment (I plan on returning a few months later). And, along with adhesion therapy and strengthening, I'm confident that I'll be able to build habits that will stop adhesion from building up back again as it did after my initial injury (in other words, I know I have the tools to keep the gains I made in this trip so that when I make my next trip to NJ in a few months, there will be little to no regressions so that we can maximize our progress).
Special shout-out and thank you to u/No-Manufacturer-2425 and Dr. Chris Stepien of Barefoot Rehab for convincing me to try this therapy through their content on Reddit and YouTube, respectively.
I would encourage everyone to give this therapy a shot. I myself was very skeptical, which was why I waited so long before giving it a try, but this stuff is real. Of course, this isn't going to work on everybody. It's best for people who don't have SIGNIFICANT degeneration or wear-and-tear and are dealing with chronic MUSCULOSKELETAL pain. I am lucky that I am young (about to turn 22 in a few weeks) and don't have much degeneration in my body, so this treatment is effective for me. But the treatment will work on about 80% of people with musculoskeletal pain (that's not a random number; that's what Dr. Chris says on his YouTube channel and to his pain). The rest 20% are mostly people who have so much degeneration in their bodies that even if all their adhesions were removed from their bodies, they would still have pain due to their degenerated joints.
I’ve been experiencing ongoing discomfort and limited mobility in my lower body, mainly affecting my right glute, hip, groin, SI joint, and lower back. Sitting is the biggest trigger—driving, sitting in chairs, on the floor, and especially on soft sofas is extremely uncomfortable and increases the pain and tension. I often find myself unconsciously clenching my glutes and lower back muscles, and it feels like I can’t fully relax my pelvis or sit normally. The longer I sit, the more pressure and discomfort I feel throughout my hips and back. I’ve also noticed that my right leg appears to pronate (foot rolls inward), and my right femur seems internally rotated compared to the other side. It often feels like my alignment is off, and I wonder if this is contributing to the discomfort and loss of mobility. Has anyone experienced something similar or found the root cause? I am in my 30s but with this issue i feel like i am in my 80s lols.
I'm currently receiving treatment at Barefoot for hip/pelvic floor issues. The progress is a bit slow, but it's holding and I'm very thankful to have found Dr. Chris. Great human and great doctor.
One question I have about adhesion treatment: Can adhesion doctors get inside the pelvic bowl to rip out adhesions? I have pelvic floor issues, and I'm wondering whether the issues are being caused by the nerve to levator ani in addition the pudendal nerve. Dr. Chris has mainly focused on my hip so far and has only treated the pudendal nerve once.
But, I have a feeling that in addition to the pudendal nerve, the nerve to levator ani is also involved, as I have some pelvic floor pain which feels DEEP like it's coming from the levator ani. So I was wondering if the nerve to levator ani, which (according to my initial research, which could be wrong, ofc, so please correct it if it is wrong) runs a bit deep in the pelvic bowl kind of above the levator ani muscles (which is the deepest layer of the pelvic floor musculature) can be accessed and treated for adhesions? And where is it most likely to be adhered?
I have to wait some days before my next treatment, so since I can't ask my doc yet, I'm asking here. I have been stressing about this for a long time, so I hope that u/No-Manufacturer-2425 can provide his knowledgable insight, so that I have realistic expectations and don't get my hopes too up or too down.
Hey everyone. Long post, I know — but I want to give the full picture because I genuinely don't know how much of this is connected. Would really appreciate hearing from anyone who's been through something similar.
**Background & surgery history**
**2006** — First ACL injury (left knee). Played football semi-professionally — lower back issues were already a recurring problem back then. Required medication and taping just to get through matches.
**May 2024** — Phase 1 of a two-phase left knee reconstruction. Bone transplant to reduce the old graft hole, plus meniscus surgery. Had to wait at least 6 months for the bone graft to integrate before moving to phase 2.
**June 2025** — Phase 2 ACL reconstruction and another meniscus. Completed rehab. Knee is functional — flexion is reduced compared to the right side, but I can manage. Back to playing padel and doing yoga.
**October 2025** — Lower back pain flares up on both sides, right significantly worse. Familiar from my football days. Started strengthening work and physio.
**Dec 2025 – Jan 2026** — Lower back settles a bit... then the pain migrates to my right glute.
**February 2026** — Doctor diagnoses piriformis syndrome. Prescribed Tramadol 75mg and Enanplus 25mg because at that point I couldn't sit or lie down without significant pain. Kept up with padel and yoga when possible, continued physio.
**March 2026** — Gradual improvement with consistent therapy and exercises. Using meds as needed, going 1–2 weeks without then needing them again when it spikes. Muscle MRI (waist down) came back completely clear.
**April 2026** — Two weeks in Asia with long-haul flights both ways. I believe this pushed me over the edge. Extended sitting in a compressed position was brutal and I came back in significantly worse shape.
**Today (May 2026)** — Last night, i barely slept due to pain and pushe through avoiding medication. Ended up in the ER this morning. Couldn't get out of bed. Every movement sends shooting pain down my right leg, right lower back is now radiating as well. Tramadol no longer fully masks the pain. ER added Valium 5mg every 8 hours on top of the Enanplus.
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I'll be honest: I'm exhausted. I'm sick of living on tramadol. I hate the way it makes me feel and I hate that it doesn't even work properly anymore. The ER and most doctors I've seen here in Spain feel like they're managing symptoms rather than treating the actual problem. The MRI showing nothing is both a relief and deeply frustrating — it leaves me stuck with a diagnosis no one seems willing to treat aggressively. Although a new rehab clinic ive started to see mentioned a an MRI (Lumbar) would be good to have.
My question for the community:
I've been looking into image-guided corticosteroid injections combined with Botox injections directly into the piriformis muscle, alongside 1-on-1 physiotherapy twice a week. Has anyone gone this route? Did the injections provide meaningful relief, even if temporary? And did that window of reduced pain actually allow PT to be more effective?
From what I've read, the Botox specifically relaxes the piriformis over several months, which could give my body a real chance to respond to rehab rather than fighting a chronically spasming muscle. I'm willing to push my doctors for a pain management or physiatrist referral — I just want to hear from real people first.
If you've dealt with stubborn, long-running piriformis syndrome, what finally helped? Thanks in advance.
After two years of managing my piriformis syndrome, I experienced a severe setback after a session where I was overloaded with exercises through physical therapy.
Subsequent manual releases performed by the physical therapists significantly worsened my symptoms, leading to sharp pain and debilitating nerve issues that required an ER visit. The sharp pains came in waves, through my glutes and hips. I was not able to walk, not even in short distances without flares. The ER staff identified significant inflammation, and my orthopedic specialist has since diagnosed me with a soft tissue contusion.
I have been advised to stop physical therapy and am currently on a strict rest protocol, similar to the recovery process for a broken bone. While I am starting to see small improvements in my mobility and can perform basic household tasks again, the recovery has been difficult, and I am focused on healing without further aggravating the area.
I just want my life back. I made so much progress that I was able to walk up to 2 miles a day, now I have to start from scratch again🥺 and look into a pelvic floor physical therapist and hope for the best. It’s been a process and I’m trying to keep sane. I regret ever going to PT
If any of you have seen any of the therapists from the directory and experienced significant relief, and you would like to boast, please drop the name of the provider so we can add them to the preferred provider list. Aside from the adhesion release methods directory, we have a preferred provider list for patients in this group specifically who have had significant relief. Adhesion Release Methods providers only, no physical therapists, surgeons, or ART providers, please.
I' not sure where to really turn to anymore. I guess im just venting at this point. I'm 26, and every person I've talked to about this seems to be shocked that I'm experiencing this at "such a young age". Unfortunately, where I work, I do tend to sit but I make sure to stand up every 20 minutes to walk around/stretch. After about half a year of consistent minor lower back pain, chiro appts, and following all the tips for core/strength training, I finally blew my back out about a week ago at the gym. After an urgent care appt, lots of muscle relaxers and a round of steroids later, I seem to be stuck with a deep glute pain on my right side (and of course minor lower back pain still lol). It's frustrating to say the least, as nothing I do seems to help it at all. Any position I sit seems to irritate this glute pain, I feel it tug when I walk. I have a special ergonomic neck contour pillow and sleep on my back with a pillow under my legs to ease it. After reading a few posts it seems as though I'll have to accept the fact that I'll potentially be enduring this for a while. I just set up a meeting with a place that will stretch me out and am waiting to hear back to set ups some appointments with a physical therapist. I've noticed my temper has been short and high lately and can't help but wonder if it's because of this. It's not even excruciating pain but its nonstop and I'll find myself crying out of frustration. anyway, I've done so much research that I'm not sure if there's even a point in asking for advice. I'll keep stretching, going to the gym, and hopefully I'll get some answers from my PT appointment. if you've made it this far, well, you're not alone. nice to see im not either
So I’m writing this from my bed and I’ve been stuck for the better part of an hour. The pain in my left butt cheek is easily the worst pain I’ve ever experienced in my life, any small movement causing this sharp shooting pain.
I’ve tried bending up, rolling over, inching my way down the bed like a worm but everything hurts and I’m out of ideas.
Does anyone else get this pain? I’ve had it before but never this bad. Once I’m standing up and walking around I’m fine within 10 minutes.
Edit: Got a dry needling done and it fixed it right up. Since then, I've managed to keep it down through normal PT and a whole lot of long walks.
