Excruciating piriformis pain is a very uncommon occurrence, since most symptoms are annoying and even physically limiting, but tolerable. Excruciating pain describes symptoms that are debilitating and prevent living normally. Many patients with these severe manifestations cannot work, perform family responsibilities or even take adequate care of their own basic needs.
When we hear the word excruciating attached to any musculoskeletal pain condition, we usually immediately think of ischemic causation. Typically, the structural presentation of the condition is not extraordinary or in any way explanative for the extreme nature of the pain. Additionally, treatment for these ultra-severe forms of piriformis pain is usually unsuccessful, regardless of what type of therapy is used, including drugs, surgery and exercise. All of these factors, plus our extensive experience in clinical practice, support the idea of mindbody causation in the majority of these debilitating expressions. However, there are exceptions to this rule.
This discussion delves into very severe examples of piriformis syndrome. We will explain the types of symptoms experienced, the effects on the patient and provide insight based on our experience as to the true nature of many of these disorders.
Excruciating Pain in the Piriformis and Lower Body
Excruciating pain means intolerable and intractable. Patients who endure this degree of suffering simply can not function at a normal level. Additionally, most patients will also demonstrate related disorders including preoccupation with their pain, depression or pre-depression states, insomnia, fatigue and generally poor health.
Severe piriformis pain is rare, since the structural mechanism of the condition is typically self-limiting. Most patients can function relatively well with piriformis syndrome, despite having pain and some degree of physical limitation. It is almost unheard of for a disability claim to be approved for piriformis syndrome.
Excruciating Piriformis Pain Consequences
When a person is obsessed with their pain and can not function, their entire life is compromised. These patients usually immediately suffer work restrictions and many cannot keep their jobs with such severe pain preventing them from functioning physically and cognitively.
Family responsibilities are often shirked, especially when they involve physical care for younger children, driving and other difficult tasks that might exacerbate symptoms.
General health suffers, since most patients will not get adequate exercise. Some usual consequences on health include poor circulation from extended time periods spent in bed, slow metabolism, weight gain, obesity, diabetes and high blood pressure.
Cognitive and psychoemotional states will deteriorate and some patients might become depressed, suffer the inability to sleep, suffer restless leg syndrome and possibly even resort to alcohol or illicit drugs to provide relief from their torment, particularly if care providers view them as risks for opioid abuse based on current or past history of poor pharmacological product management.
Origins of Excruciating Piriformis Pain
It is possible that some patients have purely structural compression of the sciatic or pudendal nerves based on severe injury or some other mechanical causation. However, we have yet to see such a case in over 15 years of working in the chronic pain education and advocacy sector and many more years in clinical practice.
In our collective experience, most cases of intractable chronic pain are of mindbody nature, including excruciating piriformis symptoms. Ischemia makes much more sense from a scientific perspective, since it can not only cause the piriformis muscle to clamp down of affected nerves, but it can also affect the nerves themselves, as well as the spinal nerve roots providing the sciatic with its CNS origins. The most severe manifestations of regional ischemia can be unbearably torturous and easily explain why the pain is so severe, as well as why treatment typically fails when it follows the Cartesian philosophy of care.
For these intractable cases of piriformis syndrome, we universally recommend knowledge therapy and have seen many cases resolve using our own proprietary program. If you need help right now, you can get it 24/7 from anywhere in the world. Learn more about our pain relief program here.