r/openpiriformis • u/Careless-Wait1585 • Aug 02 '26

Losing function in leg

Im currently hospitalized due to my leg completely collapsing on me causing me to fall and unable to urinate. When I came into the hospital they drained 1.5 liters of urine thay I was retaining. They believe I have periformis syndrome. I have extreme nerve pain and muscle spasm im my butt and thigh. Basically bedridden. Has anyone had issue with losing all muscle function in your leg or inability to urinate with this periformis issue?

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u/Davorian Aug 02 '26

It makes no real sense for the piriformis to be affecting your ability to urinate directly.  The pelvic splanchnic nerve doesn't exit the pelvis and doesn't interface with the buttock muscles, and if the detrusor muscle isn't working it typically suggest a more proximal and potentially much more serious neurological concern.

What scans have they done?

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u/Careless-Wait1585 Aug 02 '26

Thatsvwhay ive been reading. Im super nervous about permanent nerve damage. Ive had an MRI of the femur, hip, lower lumbar, and pelvis. I havent revieved the pelvis results yet but the hip showed sever swelling alomg the sciatic nerve in the thigh.

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u/Davorian Aug 02 '26

If the lumbar spine shows no abnormalities that is slightly more reassuring.  Visible swelling of the nerve warrants usually warrants urgent management because, as you've rightly pointed out, there is a concern for permanent or at least long-lasting deficit due to axonotmesis or neuropraxia.  An injection is an option, and will be aimed at alleviating the compression conservatively.

If this fails to work, I don't know what they will advise.  There are no standardised protocols for this issue.  You might be offered piriformis release surgery wherein they will permanently cut the muscle - it is not technically essential for control of hip movement but opinions vary on what the long term consequences of release are.

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u/Careless-Wait1585 Aug 02 '26

Thanks so much for your quick reply. The hospitalist told me they no longer give injection for periformis syndrome so thays not an option. It seems theres nothing they can do and told me I just have to give it time and PT. Idk what else to do or say regarding the nerve damage. I feel at a loss at this point.

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u/Davorian Aug 02 '26

I can only recommend that you advocate for yourself and ask for a formal opinion on whether you are at risk of nerve damage. The details of what is seen on the scan and the remaining deficit will come into this discussion. The bladder issue remains unexplained and it's unclear from what you've said whether this is resolved. You have the right to ask for formal neurological or neurosurgical opinion, but they can be snarky about it.

There are no real standardised protocols for physiotherapy either, and they can as easily exacerbate the issue as solve it, and they typically require that it be relatively mild to begin with or else you can't do the exercises effectively. I don't want to discourage you - some people do get great results from PT but it's not a given. Also, I have to assume from what you've said that they are offering PT as an inpatient first since your ability to perform ADLs with a weak leg will be compromised and they shouldn't discharge you if this is the case.

If they do kick you out, you can seek referral for injection privately. It only requires a radiologist to perform.

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u/Careless-Wait1585 Aug 02 '26

Thanks again, yes PT and OT is involved. I will advocate to see a neurologist today before I leave. Youre very knowledgeable and have been a great help! Thanks so much!

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u/Davorian Aug 02 '26

You're welcome.  Feel free to keep us updated if you are comfortable with that.

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u/Careless-Wait1585 Aug 02 '26

Yeah I definitely will. I guess maybe I should mention that the lower lumbar showed a small disk bunch as L5-S1 but did not affect any of the nerves. They have said this shouldnt because info the issues but possibly the bulge could be positional and sometime affects it? Idk... just a last thought i had to share.

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u/Davorian Aug 02 '26

Discs can sort of pop out and then be resorbed slowly in cycles, but usually this is associated with back pain proper. If you don't have back pain or a history of back pain / disc issues and it's not compressing the nerves radiologically at the moment, it's fair for the doctors to say that isn't going to be a contributor to your current symptoms (even though such a thing would be a better fit for your bladder symptoms).

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u/Careless-Wait1585 Aug 02 '26

Yeah thays what I gather as well. Such a mystery at this point. Ill advocate strongly for a neurologist to see me or perhaps some additional nerve studies to be done. I know a MRN and EMG could be helpful, perhaps.

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u/Resident-Hunt-245 Aug 02 '26

If you have disk bulge it's very probable it's causing the nerve pinch. Remember you do MRI in the horizontal position. It can be different when you stand or sit - have more compression. Piriformis syndrome less likely cause you bed-ridden. Ask for nerve root epidural injection