AS and Piriformis Syndrome
Has anyone noticed any correlation between Ankylosing Spondylitis and Piriformis Syndrome?
I am on day 41 of an AS flare. The length of this flare is highly unusual for me and the type of pain is as well. In addition to my left SI joint pain, my rheumatologist suspects I have Piriformis Syndrome, but she also said the two may not be related.
This is conflicting information for me. I have had the left Piriformis pain almost as long as I've had the left SIJ flare. The pain seems cyclical. When the Piriformis flares, the SIJ flares, and vice versa. To me, they have to be connected but I can't find any data to support that.
I'm very curious to know if others have had a similar experience and if yes, what treatment you found helpful in addressing the Piriformis Syndrome.
Pain and stiffness wise good, but skin getting worse…
I wonder if you have been in to see your dermatologist? I have really benefited from seeing mine over the years.... rick (moderator)
so I had Piriformis Syndrome as my initial diagnosis, before they decided it was the AS. I had physical therapy, active release, acupuncture… But I have enthesitis of the gluteal muscle attachments that seems to be more in line with the whole mess….the AS society was super informative in my initial education on what the heck was going on with me, and I read research papers to go deeper. I was a PA, retired at 60 when my symptoms started, and my rheumatology prof taught us that naming the condition is not as important as going to the root of the symptoms for treatment. So I am better described as having nonradiographic axial spondylitis….so I hurt in my soft tissue, and that’s where the inflammation is, that’s the target we treat. But everything comes and goes, weeks, months or days….pain moving around is not unusual. It’s a pain in the butt…if you can excuse the pun?! yes! It seems like some exercises set it off! The chiropractor was trying the active release which should have worked on a typical muscle issue, but I just was worse…he finally said” I think something else is going on here”;so I called my Dr and asked for the rheum panel…everything else was ok but CRP was very high…that was my ah ha moment! I started with prednisone just to feel better, kinda wish I hadn’t, took a bit to get off it! Do you find this is a recurring issue for you or has it been one long go? Have not found that Vimovo, Meloxicam or Celebrex (all the typical NSAIDs) have assisted whatsoever with the muscle pain. Tried prednisone for dermatitis back in the day. That worked but I don't know if I'm fussed to take it agian... That said, if it helps, it helps! Do you have any longterm care plans for this issue if it's something reoccurring?
I could only find one study that addressed this issue directly. I imagine there are more but my cursory review did not turn much up. The main discussion I found was the Piriformis syndrome is exclusionary. Meaning if one has it pretty much excludes other SI joint issues. Here is a smattering of chapters about Piriformis syndrome.
https://www.sciencedirect.com/topics/medicine-and-dentistry/piriformis-syndrome
Here is the one small study I found that addresses the issue directly.
https://www.ehealthme.com/cs/ankylosing-spondylitis/piriformis-syndrome/
I hope these might help..................... rick (moderator).Thanks so much for your help, Rick. That's very thoughtful of you. These reports do have me wondering whether the two at once are unrelated (just unlucky), but I still have my doubts given the piriformis muscle's relationship with the sacrum. Too much mystery for me. 🙁
