Piriformis surgery on 9/8/09

Rob Wilson · #1 (**permalink**) 10-24-2009, 08:04 PM

I have waited to write about my recent left sided piriformis surgery until I felt that I could report concrete results. My surgery was performed by Dr. Henry Bohlman of University Hospital in Cleveland, Ohio on 9/8/09. I believe that he has performed well over 100 of these surgeries. I was very sacred to have this surgery but felt I had little option if I was going to rid myself of my continuing sciatica pain, butt pain, hip pain and leg cramping. I even had low back pain and upper back tightness (opposite side due to body compensating). I had many diagnostic tests (SI joint injections, selective nerve root blocks, foramen injections, prolotherapy of various SI ligaments, RF ablation of the L4, L5, S1, S2, S3 medial branches) to rule out other issues. I had many different types of treatment including trigger point massage therapy, chiropractic, prolotherapy, and ART (active release technique). Once I felt comfortable it was piriformis syndrome and that all my conservative measures would not get me where I wanted to be I made a visit to Dr. Bohlman. I also consulted with a number of people that Mark Mintzer provided who had this same surgery and surgeon. Dr. Bohlamn determined that I had piriformis purely by exam and the fact that I had already had ADR at L4/5 and L5/S1 and decompression of the L5 and S1 nerves and the aforementioned diagnostics. I proceeded with surgery soon thereafter. It entailed separating the gluteal maximus muscle down to the piriformis muscle, removing the entire piriformis muscle, and decompressing any fibrous tissue and arteriovenous abnormalities around the sciatic nerve. The surgery only took ~ 45 minutes and I walked out of the hospital with no aid. Very very sore. I was out of work for ~ 2 weeks and then gradually began back to work beginning with 4 hours a day. Now I am 6 ½ weeks out of surgery and have seen steady improvement. My major cramping is gone. The low back pain is gone. The upper back tightness is gone. I still have some sciatica and pain but it is slowly improving. I continue to hope that I will have great results once my body has fully healed. This could take a long time but I am very happy I had this surgery so far.

I have something similar going on with my right side but MUCH less than the left side. The ART is helping.

dshobbies · #2 (**permalink**) 10-25-2009, 02:20 AM

Rob,

Sounds like a good diagnosis and treatment. A lot of testing went into and you apparantly made the right decision witht he right doctor.

I hope you continue to improve and the right side issues resolve themselves once you loosen up. What is active release technique?

Dale

ans · #3 (**permalink**) 10-25-2009, 10:03 AM

Congratulations for a permanent "fix". I suspect piriformis syndrome; if this is what I have, the pain is tormenting. Good work!

Rob Wilson · #4 (**permalink**) 10-25-2009, 07:21 PM

Sciatica and ART

Thanks for the encouragement. If you have a bad case of pirifirmis, it certainly can be life changing. Difficult to sit, drive, work and sleep. I took a long (3 hour drive yesterday) and now my opposite side is bothering me in the same piriformis type symptoms. Oh well. I just need to be thankful for my improved surgery left side.

ans · #5 (**permalink**) 10-29-2009, 07:09 AM

Hi. This may sound incredibly stupid but I think I do have piriformis syndrome as I responded to an S-I injection given yesterday (no hip pain).

Here's stupid: Did you stretch your piriformis for a long time and also have Botox injections? The reason I ask is that your surgery seems intense and I"m not sure what you lose in terms of motion from this.

If I do have this pain, it is utterly maddening.

My very best ~ ans

Maria · #6 (**permalink**) 10-29-2009, 02:00 PM

Rob,
Thanks for posting your surgery and results to date. After my 2nd discectomy I had piraformis pain that was horrific and it lasted quite some time (years). I never had much diagnostic testing beyond multiple MRIs post failed discectomy but had nerve root blocks at S1 nerve root that didn't help.

Piraformis stretching used to feel good while stretching but I don't know that it helped as I did this for years...

Again, not really sure what alleviated the pain that was deemed "piraformis syndrome" for me but I was soooo extremely glad to be rid of it as it was terrible whatever the cause.

Another type of pain that has left me over the years has been the terrible tailbone pain I had for so many years post failed discectomy as well.

I really don't know what was related to what but somehow I feel that time seemed to heal things but if there's a way to not wait *forever* and have to stop working/living while waiting for perhaps things to heal.. then it's ever so good to read about a physician skilled in diagnosing this problem and treating it surgically.

Hope you continue to improve daily!

Rob Wilson · #7 (**permalink**) 10-29-2009, 07:55 PM

These issues are so difficult diagnose. It could be due SI joint, hip, various SI ligaments, various muscle dysfunction (of which piriformis is included). Many have similar symptoms and many are the cause or symptom of the other. All of a sudden I have SI joint or pirifirmis on my opposite sie. It is all very complicated but get agood pain managment person and they can really help to figure it out.

Ans - it is a little early to make any rash judegments re my surgery but I do not anticipate any significant loss in strength or flexibility in the long term.

ans · #8 (**permalink**) 10-31-2009, 12:58 AM

I wish you well in your brave decision. You certainly have been thru the mill and yes, it seems so hard to sort out these intense diffuse pains.

You really thought this one out. Hope this is the good final fix for you.

Best ~ Allan

wilsonrob · #9 (**permalink**) 12-22-2009, 07:14 PM

3 1/2 month update for left piriformis surgery to remove muscle and decompress the sciatic nerve. Most of my leg cramping and sciatica is gone. Unfortunately it seems to have been replaced by some numbness in my butt and rear thigh. I was hoping I would see some decrease in the numbmness by now but it is still significant. I did not have this before the surgery. Oh well. I am going to see a pain management specialist who does CT guided injections in the piriformis area. Maybe a little injection might calm things down. We shall see what he says. Maybe it could make things worse though. Anyone have any suggestions. Thanks

CraigT · #10 (**permalink**) 12-22-2009, 08:10 PM

Rob,

I am 1 month post op for bilateral piriformis release surgery however they didn't remove the muscle they cleared the entrapments. My right side has a large softball size numb region that tingles on the outer edge and this happened after my surgery. My doctor says it should heal with time so perhaps this is a common occurrence?

Craig

wilsonrob · #11 (**permalink**) 12-22-2009, 08:45 PM

I would love to exchange experiences. If you email me I can give you my cell.
rob.wilson@lubrizol.com

wilsonrob · #12 (**permalink**) 03-04-2010, 06:43 PM

6 month piriformis surgery update

The piriformis surgery that completely removed the muscle has been somewhat successful. It rid me of most of the terrible cramping and pain. However, I have numbness in my butt and all the way down the back of my thigh that was not there before surgery. I also have a lot ot tightness in my butt and leg still though better that before.

dshobbies · #13 (**permalink**) 03-04-2010, 07:03 PM

Rob,

Some good news along with a little bad, sounds like a typical recovery. Glad that most of your pain is gone. The numbness and tightness may just be a part of the healing process. What does your doctor say about them?

Please keep us posted as you continue to heal. My best to you, Dale

wilsonrob · #14 (**permalink**) 03-04-2010, 07:46 PM

You know how doctors are. The surgeon says the numbness will go away with time but the pain management says it is here to stay.