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Piriformis Syndrome in Fibromyalgia

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Piriformis syndrome in fibromyalgia: clinical diagnosis and successful treatment.


Piriformis syndrome is an underdiagnosed extraspinal association of sciatica. Patients usually complain of deep seated gluteal pain. In severe cases the clinical features of piriformis syndrome are primarily due to spasm of the piriformis muscle and irritation of the underlying sciatic nerve but this mysterious clinical scenario is also described in lumbar spinal canal stenosis, leg length discrepancy, piriformis myofascial pain syndrome, following vaginal delivery, and anomalous piriformis muscle or sciatic nerve.

In this paper, we describe piriformis and fibromyalgia syndrome in a 30-year-old young lady, an often missed diagnosis. We also focus on management of the piriformis syndrome.

Source: Case Reports in Rheumatology, 2014. By Md Abu Bakar Siddiq, Moshiur Rahman Khasru, and Johannes J. Rasker.

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14 thoughts on “Piriformis Syndrome in Fibromyalgia”

  1. misslingan says:

    had a back injury 14 yrs ago at work and had been previously diagnosed with fibromyalgia after the back injury and seeing a few Drs I saw a physical medicine specialist who diagnosed me with piriformis syndrome . Is I sit too long or stand too long I get the deep gluteal pain which also goes into the hip and down my leg to my knee and when really severe it seems to go into my ankle bone and pains like a toothache the only relief I get is from the heating pad, bed rest and sometimes Flexeril and ibuprophen.. Is there a cure or any other suggestions to help with this …. Thanks…

  2. seshmet9 says:

    Been going to doc and ER both none of them knew what the pain was that i was having in the pelvic deep inside, kinda felt like my insides was falling out all i was told it might be your fibro guess they are right i did not know this syndrome all i am getting now is new symptoms belonging to fibro just getting so tired of everything being blamed on it or is it. Wish they would find a cure or at least something that works. I seem to have tried everything.

  3. donaldjeffrey says:

    I Have Fibromyalgia for over 20 yrs in cold weather is worst time of year I take Lyrica & I use hand warmers & I tape them to my underwear. My Fibromyalgia is in my Groin & down my right leg I had prostrate surgury in 1992 and pain ever since hope this help someone T/Y Dj

  4. hamhock62 says:

    I just had a series of xrays done to see if I had arthritis in my pelvic bones. Didn’t. I have had sciatic type pains in my groin area for a number of years but no doctor has ever been able to determine the cause. This sounds right – and my medicine for regular sciatica appears to be helping the groin pain too. I probably won’t be able to convince any of my doctors but at least this appears to be an explanation and to give me hope that my medicine (Gabapentin) will continue to help.

  5. LCordero says:

    I am new to the Fibro world, diagnosed in Sept 2014. I have been having groin pain for years at night. I’m a nurse and never thought to ask a Doctor what it was. I figured it was a pinched nerve or something. Now as I look back over the last several years, I have been having symptoms for quite some time, but didn’t know it. I just attributed them to working out to hard, being on my feet too long, getting older etc. It is all coming together now. I live in Michigan, currently we have ten inches of snow and the wind is whipping out there. I can’t move my shoulders…I guess this is what is referred to as a “flare”. I am so sensitive to medications that I am only taking Tramadol for pain. I tried Lyrica and it almost killed me. I am thinking about Cymbalta, but because of all the problems I’ve had with even benign medications, I’m afraid to take it. I take 3000mg Turmeric…not sure if it helps. Nights are the worst for the pain…my hands, elbows and shoulders, and of course the sciatic pain that I just learned about. Not gonna lie, this sucks. But it’s my life now. I am on disability and that has helped a lot. I find emotional stress to be a bigger trigger than physical stress. Being a surgical nurse was impossible. I also have venous insufficiency, so blood pools in my lower legs and feet. I sound a mess, but I look great…

    1. emziemer says:

      I am convinced I have this. Worse in winter and when it is stormy. Non-chemical partial relief: I bought in a Thriftstore one of those HomeMedics chair massagers for office chair or car. During “that” time of year, I lay it flat in my bed. Both the cradling shape when on my back, and the heat help. Down-side: 20 minutes auto shut off safety feature that I don’t know how to bypass. But often just one or two rounds of 20 minutes while I am emailing on iPad (like now) make a huge difference. The best $10 ever spent in a Thriftstore – and they show up there pretty regularly :-). Good luck!

    2. emziemer says:

      Sorry to read your sad tale. Sad for you, and sad for all of us for having lost a good surgical nurse to fibro! I understand your hesitation to trying Cymbalta, though I couldn’t do without that stuff. You may wish to discuss off label use of Gabapentin with your doc: longer on the market and better known, easier to dose, cheaper, and for you most importantly, faster in and OUT of your system, if you have adverse reaction. Wishing you the very best — especially a doc who listens and truly works with you!

    3. japplebee says:

      I am 21 and I am currently undiagnosed (though some of my drs suggest it may be fibromyalgia), and I have had this particular pain in my hip for YEARS. I started a therapy called Melt Method, it works directly with your muscle, connective tissue, and autonomic nervous system. I encourage anyone and everyone to please try this therapy versus the nasty steroid injections they offer that do little to no good for you or your hip! I have been ill since I was 7, but my hips have been particularly horrible since age 15 and for the longest time they called it “growing pains” until they turned into gut wrenching spasms, and made it unbearable for me to dance, vacuum, sit for longer than 30 minutes, or walk more than 1400 steps a day (4000 spd being average). While my nerve pain is still persistent, as is the hip I’ve been able to manage the pain and gain small increments of my life back for the first time in 15 years. People with joint pain, back, knees, hips, pelvic pain I urge you to at least look into and give it a try. It has also made my periods more tolerable because I literally couldn’t breathe they would get so bad. Sorry this is so much personal info – but I’m trying to share how big of an impact this has had on my overall health and life. I’m still unable to work or walk for much or far, but anytime I have gone without this therapy for even a few days my symptoms come back ten fold and I’m bed ridden. Go to meltmethod.com and at least check this stuff out!

      1. Loriv says:

        I am new to this forum but have had fibromyalgia, spinal stenosis, bulging disks in back and plantars fasciitis since 2013. Tried everything including chiropractic, acupuncture, meds, physical therapy, gentle yoga, etc to no avail. Have severe pain in back, hips, knees and feet. I have been researching the melt method and came across your post. I just bought the balls for hand/feet treatment last week. I’m praying this gives me some relief. Do you use the foam roller or the balls? Your post seems very encouraging as I feel pretty hopeless most days. Please let me know what has helped your hips the most. Thank you and wishing you good health!!

    4. KarenA23 says:

      I have had a fibromyalgia diagnosis for 20 years with endless sciatica into left leg. MRI shows no damage in the low back though the pain is practically unceasing. Any activity of any kind causes flairs. I am positive that this is exactly my issue. The inflamed type pain is coming from that area. I have no doctors that even believe that fibro is real. My pain specialist who I have been with for 9yrs does not. I wonder if he will acknowledge this. I am miserable & truly cannot keep up with normal life in any way. I feel very invalidated and alone in my suffering. How could I get my doctors to understand these are real?

    5. Mom24amazings says:

      I have been suffering with fibromyalgia for the past 3 and a half years and I feel as if I’m getting worse. My body is taking an overall beating from this horrible disease and yet, I try to stay positive for my 4 amazing, patient kids. My husband has taken over alot of the duties that I once did because I can longer do them , as well as, my kids have really stepped up and have helped me out so much! I’m so lucky for them as well as my parents who have helped out as well. This disease doesn’t just affect me, it affects everyone who loves me and I hate that they are all suffering right along with me, especially my kids. They are too young to be dealing with this. We’re all too young for this pain! I take 17 pills a day and I’m still in excruciating pain. Nothing helps. It doesn’t even seem like the Dr’s care. I won’t give up, my family needs me. I’m beaten down , and I may have a smile on my face, but that’s just a mask. I’m dying on the other side.

    6. Truckergirl says:

      Cymbalta is totally a different class of drug than Lyrica. I too cannot take Lyrica as it makes me super sick to my stomach…nor can I take Gabapentin…that stuff was the devil inside me!! But without my Cymbalta, I would not be able to step out of bed in the morning! Zero side effects with my Cymbalta aka: Duloxetine…Cymbalta is an antidepressant and from what my Rheumatologist explained to me, it helps with the leg pains and Fibro symptoms at low doses only…maximum dose of 60 mg per day. I know that Lyrica is not in the same drug class, neither is Gabapentin aka: Neurontin, which I believe is an anti seizure drug but is widely used for nerve pain (neuralgia). If I were you, I would give the Cymbalta a try, if you haven’t already. It has made a HUGE difference in my daily life.

    7. SheraLB says:

      i was diagnosed 2 yrs ago and also have had bad reactions to the meds expecially lyrica….. I’m now taking cymbalta and no bad reaction but only helps my depression

  6. achytwo says:

    I found that taking Protandium one a day and when it is really bad I take 2 has really helped to relieve the muscle aches and stabbing pains that occur all over with Fibromyalgia.

    Could not believe the difference it has made and its really inexpensive compared to many of the meds prescribed. Its about $50 a month for one time a day.

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