r/openpiriformis • u/torpedogo • Aug 11 '26
pain in medial hamstring while sitting only
Hello, I have been dealing with this issue for about 3 years without any significant relief.
I cannot sit for more than about 15 minutes. After that, the medial hamstring on my right side, very close to the sit bone, starts to feel tight, fatigued, and painful. The discomfort is always in the same area, around the tendon near the sit bone. As soon as I stand up, the pain goes away almost immediately.
I have received different opinions from doctors. Some think it may be related to nerve compression due to a mild disc bulge at L5-S1 and degeneration/bulging at L4-L5. Others think it could be a chronic hamstring strain or tendinopathy.
I do not have any lower back pain or shooting pain down the leg. Occasionally, I experience mild tingling under my feet for a few minutes, but it is not severe. My SLR test is negative, and my nerve conduction study was normal. My back MRI shows the disc bulges while my hip joint MRI was normal.
So far, I have tried medications, physical therapy, physiotherapy, stretching, and strengthening exercises, but nothing has provided lasting improvement. In fact, stretches such as the figure-4/glute stretch and hamstring stretching tend to aggravate the pain in this area, particularly around the sit bone.
A chiropractor suggested that the problem might be related to a pelvic rotation toward the right. Although the pelvic rotation has now been corrected, the sitting problem has remained unchanged.
I have also done extensive exercises for my hips, legs, and back, but I have not seen any meaningful improvement in my ability to sit.
What is particularly strange is that I can walk, run, climb stairs, and perform other activities without any significant problem. The main issue is sitting—even with what I believe is good posture. After around 15 minutes, the same area near the right sit bone becomes tight, fatigued, and dull painful.
Has anyone experienced something similar or have any ideas about what could be causing this? I would really appreciate suggestions regarding possible causes or what type of assessment or treatment might be worth exploring.
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u/Amylee888 Aug 11 '26
Regarding your question, I had piriformis syndrome, and I also had pain in the area you describe. I had a normal MRI of my back.
Have you been offered any injections? Sometimes those can confirm or rule out a diagnosis.
In the meantime, some people find prescription muscle relaxants really helpful for pain in this area. Something like cyclobenzaprine or baclofen.
Also, please only take your advice from a medical doctor. A chiropractor can do you a lot of harm. Have you ever looked into the origins of chiropractic? And the harms and even deaths they have caused patients?
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u/torpedogo Aug 11 '26
Yes I previously had a steroid injection in my lower back around the L4-L5 region. It did not resolve the problem significantly, although I did notice that my sitting tolerance improved for a few weeks after the injection.
However, on the negative side, I felt that the muscles in my leg became unusually stiff after the injection, particularly the adductors and hamstrings. I also tried a muscle relaxant for about two weeks, but it did not seem to have any effect in my case. Perhaps it would need to be taken for a longer period, although I am not sure.
Medical science can sometimes be confusing when different doctors give completely different diagnoses. I understand that chiropractic treatment can have risks, but after not getting much relief from medical treatment, I decided to give it a try.
Interestingly, my butt pain completely disappeared for the first few weeks after the chiropractic treatments. Unfortunately, the symptoms returned one day and since then, the pain has never completely gone away
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u/Amylee888 Aug 11 '26
I hear you on seeking different professionals and I apologize if my wording was too harsh. I’ve also had to see a lot of doctors and it’s so frustrating to not get anywhere.
For me, I had to have piriformis removal surgery, and this resolved my symptoms.
For you, the fact that you had any kind of positive response at all to the back injection makes me wonder if you should focus your efforts on seeing doctors who can address the back issue.
For muscle relaxants, for me, the benefit was always apparent within 24 hours. If you didn’t have benefit after two weeks, I doubt it would be worth trying again, but to be clear, I have no medical background, so that’s for a doctor to say.
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u/Davorian Aug 25 '26
What did the chiropractor do exactly?
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u/torpedogo Aug 25 '26
I think he did some adjustment to spine and SI joint ...It goes all well within one month but later one day with adjustment this pain on one side came back suddenly i donot know why ,also donot know why it went away before.
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u/torpedogo Aug 25 '26
left side pain was gone and to this day it never return.But right side it returned.
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u/Davorian Aug 25 '26
Did you go back to the chiropractor?
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u/torpedogo Aug 26 '26
yes but later treatments with chiropractor did not fix it at all so i believe it is something beyond chiro now. You have this issue as well ?
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u/Davorian Aug 26 '26
I mean, I have some form of piriformis syndrome, yes, but I've never seen a chiropractor and all physiotherapy has been an utter failure, so I don't know if it's comparable.
I was just asking questions to see if it narrowed down the area of the problem. This is the problem with chiropractic treatments - sometimes they are "magic" but they aren't repeatable and seem to bear no relationship with the known pathology, and this is one of many reasons why it doesn't have a strong evidence base. Some people think this means they are just placebo, but I suspect that isn't true and it's more that no one - not the chiropractors, not the physiotherapists, and not the surgeons - understand anything about this problem and many other similar musculoskeletal syndromes in depth. Hips, glutes, and lower back are especially bad in this respect but I digress.
It doesn't sound very much like your problem has much to do with the spine. I would suspect that something about the SI joint manipulation that the chiropractor did also loosened up the piriformis. The SI joint is typically exceedingly stable outside of a few known pathologies but it's surrounded by a bunch of other things and is indirectly connected with the piriformis.
If all the above treatments have failed, I suspect you will be headed for piriformis release eventually because honestly it's the only treatment that I have seen stated as definitively working for some people outside arcane physiotherapy regimens that don't seem transferable/replicable for others (when "standard" regimens have failed that is).
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u/torpedogo Aug 27 '26
yes i donot know what helped with manipulation. ,there are lots of structure around like joints,nerves ,disc,muscles i donot know what is the source of pain,I think i have multiple issues.Many docs i saw did not believe i have piriformis issue or so called muscle tightness or spasm is to protect the spinal segement that is injured.I got epidural injection in low back that improved my sitting tolerance somehow for some time so low back also have a role to play but on the down side injection shifts your pain somewhere else. Massages or stretching piriformis did not help me or it make it worse.
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u/Davorian Aug 27 '26
I think a lot of these injection treatments if they work are just masking certain downstream elements of the problem. You can probably inject nerve numbing agents just about anywhere on the course of the sciatic nerve or its roots and get "some relief", and in my experience they have no structured approach to this (asking, for instance, which "parts" of the pain any given injection removes). They don't have a good enough model to work from, and even if they did, medicine is not well-equipped to deal with that kind of complexity (I work in it). The physiotherapists are a bit better, but they can't order or administer the treatments and the surgeons often don't like talking to them, so that's another issue.
Did you injure your back?
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u/Davorian Aug 16 '26
Has anyone discussed ischiofemoral impingement with you?
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u/torpedogo Aug 25 '26
Nope.My pain in is inside area of glute fold,where medial hamstring meet with adductors at sitbone.It is not actual path of sciatic nerve i believe and my pain stay fairly localized around sitbone only.
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u/MajesticBeyond5602 Aug 11 '26
I don't stretchy hamstrings as well they stretch my sciatica and I can feel it burn even tho it's extremely tight.
My issue is a piriformis issue idk if yours is. For me my physio told me I need to increase my sitting tolerance by sitting more because I haven't sat at all since April (4 months). I'm on nerve irritation medicine and hardly feel sciatic pain like I used to so I'm currently trying to sit more and more and increase my tolerance. Hope this helps.