i too have been dx with ps, also have myofascial syndrome as well i have recieved injections in piriformis which is similar to the si joint.

I have had 2 surgeries for SI Dysfunction....I feel worse now than I did before the surgery. I was checked for Piroformis Syn by a nerve study. I had no evidence of this being the problem.

However, my doc still wanted to do the surgery to release the pirformus muscle...

Not happening. He says the only way to treat it is to cut the muscle away and from what I understand, this is a really tough surgery to recover from.

How did they diagnose you?

I had a trapped pyriformis on top of disc problems, had laser spine surgery which helped the stenosis but exacerbated the pyriformis muscle, horribly painful and couldn't stand up. .Shots helped briefly. Lyrica and hot pads helped but basically incapacitated for months. Doctor only prescribed pain meds, surgeon wanted to operate further at a different level, massage therapist and chiropractor said muscle can grow into bony support around the hip (sort of like chicken leg/thigh tendons) trapping nerves. i finally got relief from stretching exercises. Water exercise is good because takes the weight off the leg. My problem is complicated because of a weird balance problem but after months of rest and gentle stretching (I found strong exercise unbearable and unhelpful) the pain is gone. There is hope but i have to say my traditional doctors didn't offer it nor anything other than pain meds. I think my problem originated with improper posture, bearing weight unevenly on the body frame over years.

I've not heard of Piriformis Syndrome...but know what the Piriformis muscle can do to your pain level...as a massage therapist I deal with it all the time...my clients alternatly hate me then love me...ha...
I agree with Norak...gentle stretching...perhaps some beginner yoga...START SLOWLY..."gentle" is a key word here...you might also try alternating ice and heat packs...do this after the stretching...it helps the blood and lymph flow to the area which will promote healing...the other thing I'd try is Trigger Point Needling...it hurts like a bear when it's happening...but the results are amazing and almost immediate...it worked beautifully for my TMJ...I went from being able to open my mouth about a half inch to being able to open it all the way after one treatment...BE SURE TO FIND SOMEONE IN YOUR ARE WHO HAS BEEN CERTIFIED TO DO THIS...ALMOST ALWAYS A DOCTOR... http://www.painmanagementsolutionsinc.com/tpn2.html here is a site that explains it...and of course...find a good massage therapist that knows Trigger Point Therapy...again...not a fun thing...but once the therapy/pain is over...can be extremely effective...
ANY time you have any type of work/stretching/etc. done...be sure to spend at least an hour alternating your heat and ice to promote healing...
Other than those ideas...when any pain I have from my fibro is just too much to bear and I can't control it or can't get to the doc that particular day...a Lidoderm Patch is usually enough to at least help some...
Sorry for your pain...hope this helps...

As a physical therapist I often deal with patients suffering from piriformis syndrome. The best results are achieved when the treatment includeds trigger point injections (done by pain management specialist - ie. physiatrist, spine orthopedist) followed immediately by visit to physical therapist that performs a protocol for trigger point treatment (total of 30 minutes of specific modalities followed by deep tissue mobilization to the site), followed by daily stretches (gentle yoga) as well as massages (weekly preffered but whatever you can afford will help).

I'm so glad this topic has come up!! What kind of protocol could be tried for someone w/complicated, treatment resistant, chronic-for-nearly-a-decade piriformis syndrome?

If you have tried all conservative measures, stretching, massage, heat, cold, anti-inflammatory meds, physical therapy, trigger point injections, etc... then you can still try Botox injections and finally, piriformis release (surgery). Please be sure that this is the true diagnosis. In order for you to be sure, you should have at least had an MRI of the lumbar spine and maybe of the hips. An EMG and MR neurography may also be helpful.

Amoebatt,
Hi there! I just noticed you resurrecting some old threads on piriformis syndrome and mentioning that you were considering surgery for the condition. At one time, I myself had TERRIBLE, persistent piriformis spasms on both sides of my butt. However, these spasms were caused by an instability in my sacroilaic joints, which was in turn caused by weakness/injury to my sacroiliac ligaments. I received many months of a treatment called prolotherapy to the ligaments of my pelvis to stabilize my sacroiliac joints, hips, and pelvis. Of course, the awful piriformis syndrome went away completely - once these muscles were no longer being recruited to stabilize my pelvis. So - that's my story.

I was wondering - have you had an MRI -N? Did it show any abnormalities? I am curious because, although I'm familiar with a "pseudo piriformis syndrome" with a root cause in an instability of the sacroiliac joints, I haven't ever spoken with someone who has what I refer to as a "true" piriformis syndrome, where the problem truly originates from an abnormality in the piriformis muscle/sciatic nerve. I've read about this type of piriformis syndrome, though, and have seen example MRINs that confirmed the condition. I'm really interested in hearing about your problem!
With lots of caring,
Orchid