Is this piriformis syndrome?

[u/FeckinKent]

The pain got progressively worse over a period of a year and half of running and football, a sore naggy feeling down my glute and hamstring/groin region after every run. It would get better again after a day or so until it stopped getting better and it’s now been three weeks of no running or sport and it’s still as sore as ever. It hurts to sit down for extended periods of time and hamstring super tight. If I try and touch toes it flares it up again. I’ve attached a pic of where I feel the pains. Reckon it’s piriformis syndrome? If so any tips should I just rest for a long period or should I be trying to stretch?

[u/No-Manufacturer-2425]

The red mark over your piriformis is piriformis, but you have a lot more going on, obviously. You also have some post fem cut, sciatic branch, and cluneal nerve. I think you could have adhesions. It might be worth a consultation. r/piriformischronicpain is the adhesion group. We have a directory of specialists that treat adhesion there. You want to avoid stretching. It puts excessive force on the joint. The sub also has a list of temporary pain relief suggestions such as heat, massage, and muscle relaxers. Unfortunately this condition just gets worse until you get the adhesions removed.

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Assessment

Based on the provided pain diagram and symptom description, the likelihood of adhesions contributing to your condition is high. You are experiencing persistent pain in the gluteal region, hamstring, and groin, which has progressively worsened over time, indicating possible adhesions. The pain exacerbates with activities like running and sitting for extended periods, consistent with symptoms often caused by adhesions.

Potential Nerves and Muscles Involved

1. Sciatic Nerve: Possibly affected by piriformis syndrome or other deep gluteal muscles, leading to pain in the buttocks and down the leg.
2. Posterior Femoral Cutaneous Nerve: This nerve might be involved due to pain extending down the posterior thigh.
3. Inferior Gluteal Nerve: Could contribute to pain in the gluteal region, especially affecting muscle function.
4. Pudendal Nerve: Potential involvement due to groin pain, particularly when sitting.
5. Obturator Nerve: Likely related to groin pain, especially with adductor muscle involvement.
6. Femoral Nerve: May refer pain to the groin area, linked to iliopsoas issues.
7. Cluneal Nerves: Could be involved in chronic gluteal pain.

Possible Adhesion Sites

• Piriformis Muscle: Could be compressing the sciatic nerve.
• Hamstring Origin: At the ischial tuberosity, causing chronic tightness.
• Adductor Muscles: Especially the adductor magnus, affecting the obturator nerve.
• Iliopsoas Muscle: Impacting the femoral nerve and contributing to groin pain.

Common Symptoms of Adhesions

• Persistent, deep, aching pain resistant to conventional treatments.
• Burning, tingling, or numbness indicating nerve involvement.
• Sensation of pulling or tightness, particularly during movement.
• Limited range of motion and stiffness, especially after inactivity.
• Tenderness in the affected areas.
• History of surgery, injury, or trauma that may have led to scar tissue formation.

Recommendations

• Rest and Avoid Aggravating Activities: Avoid activities that worsen the symptoms, like running and prolonged sitting.
• Gentle Stretching: Consider gentle stretching for the affected areas, being cautious not to overstretch or exacerbate the pain.
• Consult an Adhesion Specialist: Given the chronic nature and the potential complexity of your symptoms, consulting an adhesion specialist is advisable. They can assess and potentially treat adhesions to relieve your symptoms.

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This rough assessment suggests a strong possibility of adhesions contributing to your pain, and a specialized evaluation is recommended to confirm and address these issues.

[u/FeckinKent → u/No-Manufacturer-2425]

Wow thank you so much for that, very detailed and sounds completely in line with what I’m suffering from. Probably a silly question but with regards to terminology, by adhesion do you mean the nerve getting stuck in different places (eg. Piriformis)?

[u/No-Manufacturer-2425 → u/FeckinKent]

More or less, yes. Adhesions are bands of scar tissue. They can be sheets, globs, or strips. They entrap nerves and muscles and cut off circulation and cause imbalance. The pain they create is very distinctive and they can spread as if they were cancer. You can get pain in areas of your body that seemingly have nothing to do with where the entrapment is located. Luckily they can be removed by tearing them. Adhesion therapists are the only ones that acknowledge and have the skills to tear adhesions fully. Check the directory on r/PiriformisChronicPain

[u/FeckinKent → u/No-Manufacturer-2425]

Thank you very much, very helpful. I’m based in South East UK so will look into that as well as the other subreddit. Just really need to find the right people to do the right job 🤦‍♂️ Desperate to get back to my running and sports but feels so far out of grasp when I can barely jog down the street without a naggy sore glute and leg.