Damage to the piriformis muscle vs bulging L4/5 disc?
In April 2007 I overexerted myself walking (long strides) and the next month was an endless string of emergency room visits, Demerol, Oxycodone, and ultimately oral steroids. I had a lumbar MRI done in May 07 and it showed I had a "slight" problem with a bulging L4/5 disc that "may cause some discomfort". I would have laughed if it hadn’t hurt so bad. One doctor ran a little picky wheel over my foot and it indicated to him a problem with the sciatic nerve. He was of the opinion some pressure was being put on it by the bulging disc but he also didn’t think I was a candidate for surgery because I hadn’t lost any motor skills or bowel control. My right leg has been numb since May 07. My hips and lower back ached all the time but most likely from lack of use… I was afraid to do much because I thought I’d make it worse.
In April 08 I had another MRI done and the report stated my discs actually looked better than in 07. Good news, but the numbness was still there. I bought an inversion table and found it to be helpful overall. I use it twice a day at 30 degrees. My most important revelation however, is that I kept reading about the piriformis muscle. My overexertion walking (which nobody ever addressed) could have strained, pulled, or otherwise damaged the piriformis muscle on the right side and also put pressure on the sciatic nerve, leading me (and apparently everyone else) to believe I had sciatica due to bulging discs. I have been doing deep stretching exercises for the piriformis and the numbness in my right leg stays away for 8 hours or so. I am now of the belief that there is scar tissue on the piriformis and I must continue stretching it many times a day to ward off numbness and pain. I have copies of the 2007 and 2008 MRIs and I would like to know if there is any way to determine damage to the piriformis from those MRIs?
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NO! The MRI is selective, insofar as they are imaging the vertebrae and surrounding tissue, while the piriformis muscles originates from the anterior (front) part of the sacrum, the part of the spine in the gluteal region, and from the superior margin of the greater sciatic notch (as well as the sacro-iliac joint capsule and the sacrotuberous ligament).
It exits the pelvis through the greater sciatic foramen to insert on the greater trochanter of the femur.
So hip area which is not imaged! On my MRI I can see my boob and my nicely formed excrement but the rest is a blur as they imaged the spine, dissected it longways several cuts and then honed in on my lumbar vertebra, dissected them each several times. Unless you ask for a MRI or CT Scan of the muscle, you will not see it. My boob was operated on, lump removed and I thought I might see some scar adhesion tissue but no. Best of Luck
Actually, you can get an MRI of wherever, it’s totally the technician’s discretion. Just talk to the doctor, and they’ll hook you up.