Hamstring & Piriformis Tightness/Pain

[Husker95]

Hi, this is my first post so if I am in the wrong sub-forum please re-post or let me know.

I am looking for some treatments for persistent, hamstring and piriformis muscle tightness and pain in my wife. She was diagnosed with MS about 12 years ago and we did very well for about 10 years. About 2 years ago she started suffering moderate pain in her hip and buttock. We started the diagnosis process and tried to mitigate the pain with massage, stretching and PT. She had 2 surgeries to remove bone spurs and repair her labrum in 2014 which has helped range of motion but she still suffers from the tightness and pain in the buttock area.

Can anyone offer some advice in this area? I really want to help her relieve some of the pain and regain some mobility. Thank you.

Husker

[Kimba22]

Hi Husker,

Welcome to MSWorld! We're glad you joined us, and thanks for looking for answers to help your wife. I'm sorry to hear about her pain.

I'm not a doctor and am not familiar with your wife's labrum tear/ repair except what I just read when I googled it. So whether or not her tightness/ pain is a direct correlation to that or not, I'm clueless.

But there is a word that describes the tightness (and pain) many of us with MS experience - Spasticity. Here's a link to the National MS Society for you: http://www.nationalmssociety.org/Sym...oms/Spasticity.

You might want to ask your wife's neurologist about it and see if one of the medications helps to relieve her symptoms.

Good luck!

[Husker95]

Kimba,
Thanks so much for your reply. We have seen her neurologist and he has tried a few things. In 2013 he gave her a shot of botox into the piriformis in the hopes it would relax the muscle. That treatment didn't work. We continue to explore other alternatives. Strangely enough, what seems to be working the best so far is acupuncture, or what they call "dry needling" out here. We've only started that but it seems to relax things a little which is what she really needs.

Interested in finding out other treatments/strategies others have tried and the results. Again thanks so much - I really appreciate it.

Husker

[Kimba22]

HHusker,

Your very welcome. Botox was what I was I found in my Google search that might help, sorry to hear it didn't and neither did the other things her neurologist tried. Must be o frustrating. I'm glad she's now found something that is offering her some relief, and hope it only continues to get better. I'd never heard the term "dry needling" before.

Acupuncture is actually recommended by the NMSS as a CAM therapy that might help some of our symptoms, and spasticity is one of them. http://www.nationalmssociety.org/Tre...es/Acupuncture. There are some others mentioned in the box on the upper left. I don't know if any of them are options you've already explored.

I hope someone has other suggestions for you. Good luck!

[Husker95]

Kimba,
Is there any way to tell if muscle tightness and pain is from spasticity or is a symptom of something greater like simply the hip injury she has been going through?

That's one of the most frustrating things is not knowing if the symptoms are MS caused or the result of a hip problem un-related to MS.


Husker95

[Marco]

In addition to what Kimba said

My right hamstring has been a mess for years so I can definitely relate.

A few things to consider (you do not have to respond, especially without her consent).

Has any therapy provided any help?
Does anything seem to aggravate it? (stress, heat, fatigue, etc.)
What medications have been tried? Baclofen, Tizanidine, Soma, Diazepam, Clonazepam?
Is she on any medications for nerve pain (possibly Gabapentin, Lyrica or Cymbalta?)
Is she on any other pain medications?
Was this a single botox injection or multiple injections during one treatment?


For me, I saw many doctors, including multiple neurologists, but basically made no progress until I saw a Physical Medicine & Rehabilitation (PM&R) doctor. Personally, I would look for a PM&R doctor in your area and have them evaluate her. Neurologists look at the brain towards the muscles while PM&R doctors typically look at the muscles towards the brain. My PM&R doctor has been a godsend.

• You can also see if they have Neurological Physical Therapy in your area and get a referral (any doctor). They can help evaluate any gait issues, develop a customized exercise program and teach her how to properly stretch.
• Strengthening opposing muscle groups may also provide some benefit.
• Massage (trigger point or other) may also help. For me, it only provided brief relief.
• Have you tried heat/cold? Cold works better at reducing the pain, but different people prefer heat.
• Some people find relief from a TENS unit and your insurance just might provide one.

That's about all I can think of at the moment. I really hope she gets some relief, once the spasticity gets out of control it just cycles between pain and spasticity until you want to bash your head into the wall. Thank you for looking out for your wife -- it's refreshing.

[Kimba22]

Hi Husker,

Marco lists some good points to consider, and I second his suggestion about being evaluated by Physical Medicine/ Rehabilitation doctor (aka physiatrist). They may be able to determine whether or not her pain/ tightness is from spasticity. Something I learned from my Google searching was an EMG (electromyogram) can help determine if it is spasticity. But, since I'm not a doctor, I don't know how reliable or conclusive that test would be for someone who has MS.

Not all physiatrists are familiar with spasticity, so I recommend finding out whether or not one is before making an appointment with him/ her. Some actually specialize in spasticity, the physiatrist that finally helped me was a Spasticity Specialist. You may be able to find one here: http://www.baclofenpump.com/living/p...ator/index.htm (A neurosurgeon is on the list in my area, because he performs surgery for a therapy for severe spasticity, a baclofen pump.)

Cold therapy helps with my pain, too, and does gives me some short term relief from the spasticity I still experience in my back, despite having a baclofen pump. (I'd never seen that in print anywhere before, until recently when I stumbled on it in a booklet from MSIreland called "Spams and Stiffness.") But cold can also increase spasticity for some people and make it worse. (It's also important to know how to use it correctly, because people with MS can have impaired sensation.) It all depends in the person, and like Marco mentioned, some people benefit more from heat.

If all else fails, there is a surgical option that may help your wife's pain, called a neurostimulator.

Best wishes to you both, I hope she finds relief from her pain.

[Temagami]

Have the same pain- I eat very little sugar, stretch poses that help are the pigeon pose in yoga, lying on your back and pulling a bent knee to the chest- alternate for a set of 10 reps than hold one leg at a time in that pose for a longer spell. Other pose- lie on back, feet flat, knees bent, arms out to the sides. slowly drop knees to the side with the goal of keeping your back flat. Come up slowly, drop to opposite side. Repeat.