Sciatica?: Herniated Disc VS Piriformis Syndrome
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- Опубликовано: 30 сен 2024
- Are you struggling with sciatica (sciatic nerve pain running down the back of the leg) and are not sure what's causing it? Wondering how to tell if the sciatica is from a herniated disc or piriformis syndrome? In this video, I share an in-depth flowchart to help you navigate the self tests you can do and the questions to ask yourself to ID whether your sciatica pain is coming from a problem in the back (like a herniated or bulging disc) or from deep in the butt/glute (like piriformis syndrome).
And for a more comprehensive guide to help you pinpoint the source of your back, butt, hip, or leg/sciatica pain using simple self movement tests & a step-by-step approach without needing expensive images or a specialist... Grab my FREE “Better Than an MRI DIY Diagnostic Guide” here: www.drcharliej...
#drcharliejohnsonpt #sciatica #piriformissyndrome #herniateddisc
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• Sciatica?: Herniated D...
![Stop All Back, Piriformis & Sciatica Pain Exercises! [Until You Watch This]](http://i.ytimg.com/vi/2uKFN0pKxP0/mqdefault.jpg)
Thanks so much for watching! Want to pinpoint the source of your back, butt, hip, or leg/sciatica pain without needing expensive images or a specialist? 🔥Grab my FREE “Better Than an MRI DIY Diagnostic Guide” here 👉 www.drcharliejohnsonpt.com/diyguide
Hi! Just downloaded the guide and watched this video. Been in agony for the last 5 months. Ortho specialist said it was PS but no signs of it in the MRI. Went to chiro, did PT and dry needling and nothing has worked. Pain management Dr also said he thinks it’s PS and gave me a steroid shot in the PS muscle a week ago. I didn’t want to go that route but I was desperate. And it still doesn’t feel much better. After watching your video I tried the straight leg test and could barely lift my good leg without it hurting my bad leg, which you said is 95% herniated disc. I also can’t sneeze or cough without being terrified of the pain. I don’t feel much back pain tho. I mostly feel it in my butt and down my leg to my foot. I’m just so confused. Based on your video it seems obvious it’s a herniated disc but they are convinced it’s PS. I’m so frustrated because this ha completely halted my life. Any thoughts or suggestions would be so appreciated!
@@SarahMae-jd6xi hey! Thanks for watching my video and checking out my guide. Sorry to hear about what you’re dealing with. Does sound disc related and I have a hunch but would need more details.
No pressure, but are you open to potentially working together?
I’d be happy to review your case and see if/how we can help and what’s going on. No pressure, but if you’re interested- please visit www.drcharliejohnsonpt.com/apply and select a time to chat with us.
Okay?
Hang in there Sarah!
Thank you!
Dear Dr. Charlie Johnson,
I’m a bit confused. I’m trying to diagnose whether it’s PS (piriformis syndrome) or a disc problem.
I don’t have pain in my lower back or in my back in general,
the pain doesn’t move from one side to the other,
when I sit for about 20-30 minutes, I have a small issue when I get up, but it’s not in my back, rather I feel more tightness in the gluteal area and leg,
when I cough or strain myself or sneeze, I generally feel a very mild discomfort in the gluteal or piriformis area, but not in my back,
my back isn’t crooked,
I can move my back forward, backward, left, and right without pain.
Also, the exercises you showed during the piriformis test were positive for me because when I lie down and place my right leg (the one that hurts) over my left, and start pulling it towards my shoulder, I feel tightness and pain in the piriformis. Additionally, my biggest issue is sitting, because when I sit, I feel pain in the piriformis but not in the lower back, and after sitting for a longer time, the pain spreads down the thigh and calf all the way to the ankle and heel, and I often feel tingling in my heel when sitting for too long.
If you ever get a chance to see my comment, I would be very grateful if you could briefly reply whether you think my issue is related to the piriformis or a disc problem.
P.S. When I warm up my lower back and gluteal area with a wool belt, I notice it feels better, as well as when I do stretching exercises.
My comment has nothing to do with the video. I am perplexed by the staircase that seems to go nowhere.
LOL
I couldn’t hear anything else he said after I read your comment 🤦🏽♀️😂
@@relaxbeenatural Roflololol. He hearted the comment, but gave zero explanation.
Me too😂😂
Well... You have great observations
I’ve been watching your videos for like 3 hours now. I am beyond frustrated with my medical care, was complaining of low back pain for years and years and now I have excruciating hip pain when hiking and walking, greater trochanter area pain. I need a diagnosis and a plan of action. It’s impacted everything in my life and my super active work and lifestyle!
Sorry to hear! Appreciate you checking out my content! Are you open to a different approach?
Would love to see if/how I can help.
No pressure, but if you're interested, I'd love to review your case and see if I can help... you can schedule a time to chat here- www.drcharliejohnsonpt.com/apply
Very educational and understandable. you made it so easy, thank you
You're welcome!
Back.
But wow I could have sworn I had PS, even my PT suggested that, but stretching the muscle didn't help.
In your test I found all three bending backwards tests caused my butt and back leg pain (down S1 zone).
But neither of the PS tests caused the pain
Time to go back to checking disc.
Thanks so much for pointing me in the right direction!!
You got it Lord! Glad i could help- let me know if you have other questions. Good luck!
@@drcharliejohnson You are a life saver!! Doing my PT exercises for bulging disc reversed my sciatica pain!!
Can't thank you enough WOW
@@lordw9609 awesome! So glad I could help. Yeah- can be tricky. Way to watch and apply 👊🏼
What about a compression on my traversing left L4 nerve root? Could that be causing my band of pain down the front of my left thigh and inner left knee and inner left leg shin and outside area of my inner left foot?
Burn pain left thigh muscle, joint, left side back above glute. Relief walking bent over at waist. Lift rt leg seated=left area pain. Can touch pain at disc area above glute. Believe its disc. Help?
💡 moment thank you
What if the burning is in my thigh not my hamstring. I'm 99% comfortable in my hamstring but the burning goes down my leg into my quad. ON FIRE. UGH.
Brilliant! Putting it all together on a diagnostic flowchart simplifies things, prevents useless anxiety, avoids unnecessary tests and saves a lot of time and expense. May your tribe increase, Dr. Charlie Johnson!
Thanks a million!
Had gone to so many chiropractors, PTs and massage therapists but bar none, you are the most common sense and articulate doctor out there both in real life and on the internet. Been telling everyone I know to check your channel. Thank you.
indeed
💯💯💯🎯🎯🎯
I had a slipped disc serious bulge at L4 L5 and I tried everything physio therapy massage everything that I could throw it's way I did full diet change and I was still using 4 to 6 gabapenton per day I flew to Thailand and had to do business class because of the length of flight to see a recommended Thai lady I have been here for 8 days now I'm staying for 6 weeks and I've seen this lady every day I am now free from gabapenton use I use 1muscle relaxer and 1 pain killer Thai medicine each day,she identified my problem as being in a totally different place although the MRI showed the disc prolapse she said it has been caused by extremely tight fascia in my right leg mainly in the location of the hamstring she did the most painful therapy I have had which left me bruised basically from knee to hip give or take a few places but the results are amazing I am confident that before I fly back this issue will be sorted,I feel the western way of dealing with things is treating the problem but that will present again unless you treat the cause.
Cobra hurts like a son of a bitch. This doesn’t mean it’s my back though because that move also involves tightening of the the periformis as does the standing backbend move. So I’m unsure what is causing my sciatic nerve irritation. I do know that I cannot do any glute exercises as this totally kicks the pain into high gear. I’m at a loss. Maybe I have both a lower back issue & a tight periformis
PIRIFORMIS but not sure. The 'good leg' caused pain when doing the lying on the floor with knee flexed and raising the 'bad' leg? Also, just recently did a lot of moving and lifting of heavy boxes with no physical help and started the 10,000-plus steps daily. hard to move around for repositioning in bed. Standing and bearing full weight on the right(bad) side is painful. Going to stop the typical stretching after the walking ; ; any suggestions for that other than the 2 you show in your "stop stretching" video? Your videos are so easy to understand and informative. Thank you for taking the time to help those of us who simply do not wish to go the 'other' route.
Absolutely brilliant and you've helped me differentiate what has been extremely baffling with my hip, buttock and sciatica pain. I guess I'd hoped it was piriformis syndrome but all the tests point to a herniated disc. You've been more helpful than the MDs, Chiropractors and massage therapist---and I've been to many. Thank you Dr. Charlie
Thanks Cheryl! Glad I could help you so far 👍. Now just gotta get you up to full speed! 💪🏻. Hang in there!
I have not so much upper back pain. I have left leg back side numbness and numbness on the bottom of foot to my toes. The real problem is cramping which wakes up at night and cramps so hard I can't stand up. I believe this piriformis problem. I have gone to a back doctor he says that L4 to L5 are herniated disc's and that they have healed. But numbness continues with cramps. I started exercises and it has helped a lot. But still numbness. I want know if I am on the right track.
I thought my problem was piriformis syndrome, and flowchart and tests confirmed that. Thank you for the clear explanation!
Hey Leslie! Thanks for watching- glad it helped!
What are you currently doing for treatment?
No clue for me, I'm too freaked out by the STAIRS TO NOWHERE that nobody else seems to see!!
I saw that too!
Great and informative video. I’ve had the hardest time figuring out what is wrong with my back. Now I’m 99% sure it’s a herniated disc. Thank you for your help Dr. Johnson. Now that I know the problem maybe now I can fix it. Going on 6 months of constant pain from sciatica
That guy sure can raise his leg!
Thanks so much for watching! Want to pinpoint the source of your back, butt, hip, or leg/sciatica pain using simple self movement tests & a step-by-step approach without needing expensive images or a specialist?
🔥Grab my FREE “Better Than an MRI DIY Diagnostic Guide” here 👉 www.drcharliejohnsonpt.com/diyguide
i'd very much appreciate your input. i'm having mild back pain and a bit more intense sciatica in my piriformis. the pain in my leg basically ends in the glutes even though it seems like my right calve muscle is cramping bad (my hamstring doesn't seem to bother me and it's only in my right leg). Nothing in my toes. seems to be affected by coughing. i had a portion of my l5/s1 cut out about 5 years ago. back then my pain never left or improved at all. it was intense. i basically wake up now sore with my piriformis tight but my back can feel fine, walking and moving feels better than sitting. there's moment's when i almost have no pain at all and sometimes the pain goes to the side of my lower back (maybe where a SI joint might be) and my piriformis feels fine. been 6 weeks so far. but i can also do the leg raise fairly easy. any advice is appreciated.
I think mine is low back. I really thought that it was PS, but I noticed pain on both sides on Yoga movement we did this morning and I also feel pain on the right along the spine just above the right dimple.
@@1321FunnyGirl sounds like back to me! What have you tried to solve it?
@@drcharliejohnson Chiropractic adjustments, yoga, only to find I am usually more messed up after Yoga. Chiro gave me stretches to do, I.e. Arm & Shoulder, Pigeon-Towd deep knee bend,Knee to Chest Stretch, Spinal Extension, Circular Neck Rotation (have lots of neck shoulder issues), Neck Rotation with Flexion Extension, Deep breathing and Postural Side Bending.
@@1321FunnyGirl oh no- sorry to hear. Would you be interested in working with me directly? No pressure- but sounds like current approach is not working.
If so, first best step would be to set up a time to chat to see if/how I can help…
Would you would be open to this?
I think I have a sciatic butt pain rather than a performing pain
Herniations in l4 l5s1 can’t get comfortable
Hi.Dr Charlie, where are you located? I'm hoping somewhere in Ontario Canada 🤞lol. If not, do you do Skype or zoom consults??
Hey Jennifer! Thanks for watching. Do not live in Canada but do consult with people worldwide. If you’re interested, feel free to shoot me an email at charliejohnsondpt@gmail.com 👍
Where can my husband find someone like you? He has been to 4 different clinics and multiple injections, Accupunture, chiropractor, PT, everything.
Hey Kimberly! Sorry to hear about your husband… not fun.
Is he open to help virtually where he can learn how to solve this himself (with some help of course)?
I do consult with folks internationally.
No pressure- but if he is, first step would be to set up a time to chat to see if it’s a fit and I can review his case. He could do that by visiting:
www.drcharliejohnsonpt.com/apply 👍
I have piriformis syndrome type symptoms and related neck and shoulder pain, all on the left side. Ever heard of this? Thanks!
Hey Marc. Sure, not super uncommon to have multiple aches and pains at once. back pain + migraines... neck + back/butt pain etc. What are you currently doing to treat it?
Following your scheme, it would be my back not my pelvis/SIjoint, but then:WHAT DO I DO?!?? 😢
Hey Lily! Thanks for watching. Sorry to hear about what you’re dealing with- but glad you could narrow it down a bit.
Honestly hard to give you a clear plan without knowing more details. Not sure even if I can help you yet, but would you be open to submitting details of your specific case and setting up a time to chat so that I can confirm either way.
No pressure- let me know 👍
Dr., Thanks for posting your many videos. I especially appreciated your "decision tree" guide. I"m a 67 year old malel that has had 3 lumbar laminectomies since 1990 to deal with herniated discs (L3/L4, L4/L5, L5/SI). I was miserable prior to surgery for all 3, and pain free for many years after each of the 3 surgeries. Two weeks ago I began having pain in my right hip/groin, no back pain, and no pain at/lower than my knee. Your decision tree w/ "does it hurt to do this exercise vs. that excercise?") helped me identify 2 possible sources: SI Joint or Hip Arthritis. Have appointment with a well-recognized pain MD in a few days to confirm the problem and suggest treatment strategies. I'll be able to walk into the appointment with better insights into my pain that I can share w/ the MD. At this point I want to hear a medical Dx, but I will continue to review your resources. Thanks again. Greetings from Pawleys Island, SC.
Hey Rob! Thanks for watching- sorry to hear about what you're going thru...
Would love to hear how the appointment goes- if you're willing to update!
Thanks
OMG I HAVE A HERNIATED DISC!!! Thanks Doc 😃
hi, dr johnson. a little bit longer, so sorry for that. according to your algortihm i have piriformis syndrome at left. but i have also l4 l5 disc hernitaion at left. i feel buttock, groin pain and rare leg pain. besides i have no pain on my back and buttock with any movement. finally i want to ask that the groin pain can be caused by piriformis? why do i feel pain while i feel pain my buttock? disc herniation or piriformis ? thank you so much doctor. best regards.
PS will NOT cause groin pain. L4 disc problem can absolutely refer pain to the groin. Hip joint issues also commonly refer pain to the groin. Sound like, based off what you've provided, that back is most likely referring pain to groin/causing everything. Make sense?
What are you doing for treatment?
@@drcharliejohnson Firstly, thank you so much for the answer. I have understood that exactly. My hip MR is clear. Actually, i have suffered from that (l4-l5 protrusion @left) about for 10-15 years. I did go to physical thearpy for 3 times. The last one (1 monts ago) is mainly focused on trigger points on my buttock, because i don't feel back pain. I really feel better now. But the pain is not gone completely. Interestingly, i feel so much buttock and groin pain(left bottom abdominal) in rest, at weekend, in cold weather and after long sleeps, but i feel little pain while i am working without long sitting. I did also go to Manuel Therapist. It didn't work. The therapist told me that your problem is hip stability not disc herniation and added continue to exercises. My neurosurgeon suggesting not surgery for pain. So i dont want to go the surgery and searching the another ways. Now i am plan continuing to exercies and go to PT session after 6 monhts. I am confused with what to do. The pain is decreasing so slow..
I am really grateful for your support and patient.
@@FinansalTeknik glad it made sense.
Sorry to hear about what you’re dealing with. No pressure, but are you open to some help? This is my specialty. Would love to chat to see if/how I can help.
If interested, best first step is to set up a time to chat - www.drcharliejohnsonpt.com/apply
I think i have piriformis from a fall injury on my right hip two years ago.(was black from knees to my waste band both sides of my body, my feet went numb.& fought it for 2 years-- today some tingeing today but vastly improved) .... the only deviation i notice is both of my hip bones hurt ( i use a massage gun) but the right hurts far worse and with daily use of massage gun on hips, butt-ox and down the outer legs(both sides) the left side goes quiet, the right never goes away but reduces)
i get about three days relief when my chiropractor puts me on a table that rolls up and down my spine.... then he moves me to another table and places electrodes on my hips and lower spine(15-+ minutes) and with the current turned up and pulling i request higher and higher settings and i find temporary relief about 3 days and then its back..
Hey! Sorry to hear. Appreciate you sharing your story! What else have you tried to resolve this?!
Dr. Johnson. Very helpful information. My wife has on-going pain in the Lumbar-Sacrum area that her doctors haven't been able to determine the cause. I suspect Piriformis Syndrome. And what's going on with the stairway in your video background that seems to go nowhere?
HAHA- stairs to nowhere! FIREWALL between commercial and residential- so they are blocked off... just go strait to ceiling... weird I know.
Sorry to hear about wife- appreciate you watching my stuff. For sure a tricky area. Most of my clients have seen many other providers and still can't crack the code...
Are you guys (you/your wife) open to help? No pressure, but would love to chat to see if/how I can help your wife (this is my specialty... literally all I treat).
If so, you can set up a time to chat at- www.drcharliejohnsonpt.com/apply
Thanks Chris!
Let me know if ya have other questions!
Great explaniation of the 3differences..Thank you so much.i dont know what i have yet going to extray on whensday.but i think is Sciatica pain it burns so muchat the frant can wear shoes or pants. I will se your explanation igen it is so good like so Thanks very much.
Welcome! thanks for watching!
This is somewhat confusing to me, I can bend down when seated with no pain, twist my spine on both directions, bend back centre and sideways and no pain, but my low back feels stiff there is some discomfort in it although it does flare up separately from my leg pain, the only sign of sciatica due to disk that I have is having pain while straining on the toilet but maybe because I’m sitting on my buttock and the glute muscles might fire up during straining as well but I do not have pain coughing or sneezing esp when standing
Hey Mohamed! Thanks for sharing man. No worries if things aren't 100% clear... they rarely are and honestly, don't need to be diagnostically if you're looking to use your mind and movement as medicine. Sounds like we need to do some more detective work and shift from diagnosis to solution. You've got some good awareness and insights... now lets move towards resolving it... studying your response to given inputs and collecting data to get clarity on the best path forward. You got this!
I have pain in My buttock outer hip and down both legs ,the pain is alternating between left and right.I have been diagnosed with gluteal tendinopathy,,can it csuse pain in both sides ,how long does physiotherapy take to work
Hey Billy! Thanks for watching! I guess it's possible to have tendinopathy on both sides... but likely rare. Not to mention... tendinopathy is a chronic degeneration/change within the tendon- meaning it wont randomly or suddenly go away... it wont randomly shift sides or alternate. Does NOT sound like glute tendinopathy at all given what you've shared and in my experience.
Motion/physio or the right treatment should work very quickly. Goal for me when I work with folks is to see IMMEDIATE changes when we find the approach that works best for folks. Don't guess- test!
No pressure, but are you open to some help? Would be happy to review your case and see if/how I can help.
If you're open to that- visit www.drcharliejohnsonpt.com/apply and select a time to chat
Hang in there!
The leg raise is a very very positive test for me, but I don't have any tingling or numbness in my leg. I have pain in the butt to the back of the leg behind the knee but it typically stops there and it's mostly achy or shoots when I make the wrong movement etc. Can that still be sciatica?
Hey! Yes- sounds like it could absolutely be sciatica! Might be some other things to tease out - but sounds consistent with some form of nerve irritation.
What are you currently doing for treatment?
If I do the sitting on the chair and leaning forward test and my sciatica is activated, could it also be bc that stretch activates the piriformis? I made sure to sit on the edge of the couch, and I had my symptoms activated which makes me think it’s a herniated disc. But I also know the piriformis is connected to the hips, so I can’t be sure!
Hey Tara- try dropping your leg to the side/off the chair so your knee is pointing the to ground while seated. Then bend forward. Could be back or PS/sciatica. Hard to tell based off what you’ve supplied. Either way- what are you doing for treatment?
Whatever leg I raise I feel the pain in my buttocks and there is limited range to where I can raise my leg. It feels better to do it lying down then I don't feel any pain just a little strech on the hamstrings. Doctor if it's possible can you please help me with this?
Could be many things- but definitely sounds like your sciatic nerve is angry.
What if it’s both? I have a bulged disc at L4-5 but the PT said it’s my poriformis
Hey Melanie! Thanks for watching. Highly unlikely that it’s both (statistically and in my experience) If you can move your back and reproduce your butt pain- it is your back.
Hope this makes sense!
Let me know if ya have other questions or are looking for a different approach! Hang in there 👊🏼
Great video! I've had horrible buttock/left leg pain for many months and my doctor says it's a disc problem after seeing results from my MRI. But I'm not convinced because I have absolutely no back pain and after watching your video, my symptoms are all PS, not herniated disc. So doc says disc but your video says PS...do you have any comments on how I should treat my aching piriformis? My daily pain level is a 9!
Hey! Thanks for watching!
Honestly (and I hope you can understand)- difficult to give specific recommendations without knowing more about your specific case.
What caused your pain?
Are you open to my help?
No pressure- but if you’re interested, I’d love to see if/how I can help.
Best first step to do that would be to set up a time to chat 👉🏻 www.drcharliejohnsonpt.com/apply
Thanks again for checking out my channel! ❤️
what if I can't elevate my leg from the floor even 1 inch? It doesn't hurt and I'm pretty athletic but my hips are very tight
Hey Nikita! Good question... so, I'd need some more info here. Have you checked out my complete DIY Diagnostic Guide? I just revamped it and it's killer (a bit biased of course)- you can get your free copy here... www.drcharliejohnsonpt.com/DIYGuide
I know it will be super valuable for you!
Quick question… what if I raise my good leg and feel it on my left glute but not my legs? Is that still sciatic nerve or disc issue ?
sounds mostly consistent with disc issue!
I believe I am suffering from piriformis and herniated disk pain... piriformis is worse right now.
Herniated disc causes pain to be felt in piriformis area... not the other way around. So DISC would be primary pain source- causing referred or radiating pain into buttock.
Great video, Can one have both issues ?! !! I believe I do. The only thing that helps me is walking or lying flat on floor
Good question. Yes, anything is possible- but when it comes to diagnostics- the most upstream problem is the most likely source of pain and should be considered the cause of any downstream problems (until proven otherwise). So, if back issue is present- it can cause and should be considered the primary source of the buttock pain as well!
Make sense??
Great video thanks!
Just one question .. how come your staircase doesn’t lead anywhere?? 🙄
hey doctor i just wanted to find out is piriformis relatively rare ? is it like a really easy to get condition? and if the piriformis is inflammed due to a trauma do the strenthening exercises help or should one wait for the inflammation to come down and then strengthen ? would love a reply
thanksss
The seated leg test for sciatica causes a terrible pain in bottom of my foot at my heel. It feels like it's tearing. Most times I flex my foot it's terrible pain but more if I raise my straight leg, either sitting or lying. All other symptoms seem to be lumbar disc problem or S1. Six weeks now. Any advice please? No luck with physiotherapist or doctor.
Hey Suzanne! Sounds like you might be right with the disc issue... if you're not sure- feel free to check out my DIY Diagnostic Guide > www.drcharliejohnsonpt.com/diyguide
If you are correct and given I don't know too much about what you're dealing with- here are a few things to consider...
1. Disc induced sciatica takes on average 3-6 months to resolve- sometimes longer... evidence suggests 75% of folks (majority) of people will have symptoms that resolve within this time frame... so, 6 weeks is still early on.
2. Not sure what your physio is doing- but the first step to healing is to OPTIMIZE your healing environment- paying careful attention to how you're moving and positioning your body so that you're not aggravating the problem- AND paying attention to thoughts of fear and worry that come to mind (if you're not careful, overtime you'll become "afraid" of certain movement and train the brain that movement = pain... this is an issue because life = movement.
3- Once the environment has been optimized- it's time to use some gentle PAINFREE motions to reduce symptoms... there are many possible motions- so hard to give a specific exercise... point being- do NOT push into pain.
Does this help?
For some more tips- feel free to check out my workshop...
www.drcharliejohnsonpt.com/freeworkshop
I tried to get you guide twice now and I'm not receiving it. It isn't in my spam folder either.
Hmm… odd- looks like it was sent. can you shoot me a personal email at charliejohnsondpt@gmail.com?
Sometimes it goes to promotions or spam/junk- so check those too!
After completing several test I've confirmed that I have a back issue for sure. Excellent job
Definitely Piriformis. Location and movement test confirm that. Thank you for this video, Charlie!
Glad it was helpful, Ramona!
Could a person possibly have both, PS and a herniated disc?
HIGHLY unlikely. Treat upstream first. Disc problem most likely cause referred “piriformis” pain downstream
Hello Dr. Charlie. I got injured on my lower left back side because of a seated cable row exercise in the gym. Is there a way to contact you online. I have been experiencing pain in the left side for 3 months since I got injured and I'm getting confused from watching so many videos. Please let me know how can I contact you or book an appointment online? Thank you
Hey! Thanks for watching- appreciate it. Sorry to hear- for sure, best first step would be to set up a time to chat to see if/how I can help. Easiest way to do that is to visit my calendar - www.drcharliejohnsonpt.com/apply
Sound good?
Hang in there!
@@drcharliejohnson thank you very much for the quick response. I already booked an appointment and now I'm going to apply the instructions. Thanks again Dr. Charlie 🙏
Hello, Great information and videos. Im new yo your channel and I am new to this pain. Ok, here is my issue. I just turned 50. My pain began about a few monthes ago in my right butt cheek and right thigh. It mostly hurt while in bed and turning from lying flat position to either side. After about 2mos it went away. It's been about 3mos or more free of pain. Now, this past Saturday I felt pain in my lower back about waistline slightly more to the right of my lower back, then it went away. Then the next day, Sunday I have excruciating pain in my my right butt cheek and runs down half way through my right thigh. All day I have this pain. Last night in bed it was painful to sleep on my back and right side. I woke up today this morning with the same pain in my my right side buttcheek my thigh and now my calf and lower right side of my back.
The calf pain feels like a cramp wanting to come on but no cramp. I was able to lay on my right side with moderate pain this morning as well. So what is going on, do I have a sciatic nerve issue?
Thank you.
Where does that staircase go?
Hello Dr Charlie, please keep bringing videos for treatment of different orthopedic issues
I have to ask... who has stairs that lead to the *ceiling* ??? (Behind you) I’ve been suffering for 7 WEEKS of mind-numbing pain that began on the left of low back then moved to the right, then on the side of thigh & *front* of thigh. 🥵 Just beginning to stand/sit/walk after 7 weeks. After watching here it’s definitely herb. disc(s). Chiro has no idea how to fix. Ultra sound/tens. Can’t take much more of this pain. Can’t sit/stand/walk. Was literally in BED for 6 weeks. If I COULD run I think I’d run into traffic 😩.
Oh no! sorry to hear... I have stairs that go to nowhere- HA.. duplex- bottom is commercial top is residential- firewall! what are you doing to solve it?
Dr. Charlie Johnson, PT trying a Chiro. but they seem clueless. They just do ultrasound (improperly, very quickly..) & tens with *slight* table-dropping adjustments, 2-3x’s a week. I will have a day of *slight* improvement, where I can slowly walk to my kitchen/bath., then the next day back to almost no movement/can’t straighten up. Sitting about 10-15 min then back to bed w/ice. Cannot take much more of this pain, can’t take pills either so I get to feel every bit of this.
Very useful, however all the tests and my belief now that I have heard about PS for the 1st time in 35 years of back problems. Point to a PS PROBLEM However it does give me a crocked back.
I have had what I feel is a muscle in spasm in my right buttock for 2 years. Chiro’s have ‘corrected ‘my back but never got rid of my muscle in spasm. On a trip to the UK I saw a well respected Phsio who never mentions PS and had me lying on my back on the floor with my legs on a chair for hours per day for 2 weeks to try an reduces inflamed nerves. Then a senior surgeon who felt it was a disc problem L2-L3 which was indicated in a MRI. However I had a split flight from the UK back to the Philippines of over 14 hours sitting in the plane.. I assumed I would be struggling to walk comfortably after that however to my surprise with the exception of slight uncomfort in bed and getting up the muscle spasm had gone and over 2 weeks I started to get my balance and strength back.
However for some unknown reason it came back when I was out shopping. This is when researching my problem I came across PS
I AM CERTAIN. My muscle goes into spasm when I sleep in bed. Or lying on my back for treatment . I am planning to try and replicate my flight back to see if I can fix it again. Any pointer welcomed
Hey Clive! Sorry to hear man. Thanks for watching. Appreciate you sharing your story. Have you watched my other content on PS? May find something there…
Otherwise, hopefully you can understand that it’s difficult to solve this with a quick recommendation without knowing more specifics and troubleshooting stuff.
No pressure, but would you be interested in chatting with me to see if/how I can help?
If so, please visit www.drcharliejohnsonpt.com/apply and set up a time to chat 👍
Sound good?
@@drcharliejohnson hi does sound good and I am expecting and want to have a private appointment post the free chat but so as not to waste our time I would like to know your rates upfront if you don’t mind.
Thanks regards Clive
I believe I have both. As every one of these chart descriptions is what I deal with, It's just the severity that may differ at times. Is that possible?
Do you have a neck video as well? As I have C3/4 C5/6 and C6/7 disc bulging, numbness, tingling and the feeling of being stabbed with a knife in my right trapezius muscle, headaches (top of skull, front and temples) and pain at base of skull mostly right side for all of these issues.
Hey Tania! Not likely to have both... more likely one thing causing both (most upstream) back issue being highest probability. My exclusive specialty is helping people with unresolved back, butt, sciatica pains- so, no do not have any current neck videos... but I do have some much older ones buried inside my channel!
Hope this helps!
@@drcharliejohnson Great! Thankyou for taking the time to reply. Ill check out your other vids. 👍
Wait I’m confused! I’ve have read dozens of articles and seen a couple of videos where they say periformis syndrome CAN cause lower back pain and stiffness and also be Painful on both sides ! 😊is this not true?
Hey John- if you can move your back and reproduce the pain in your butt.. It's not your Piriformis. Is this clear?
@@drcharliejohnson yes 🙌🏻 but what I was asking is can periformis syndrome also cause lower back pain ? I have seen it mentioned before ! And they confuse it with lower back disc sciatica because there is lower back pain present but in reality it is periformis syndrome causing back pain !
where do those stairs go? you must live in m. c. escher's house :)
To nowhere! 🤣🤣
Well the bend to the right fires the pain off - my butt then the outside of my ankle and foot. I've dealt with this since the beginning of the year. A month or so of excruciating pain while trying to walk (sitting brings relief but lying down does not so sleep disturbance is a problem) and then it gradually goes into remission only to come back after a month or so. MRI shows a variety of issues - disc bulges, stenosis, arthropathy, synovial cyst(?). Oddly, and thankfully, riding my bike is virtually pain free. I appreciate your thorough and matter of fact approach.
Hey Chris - thanks for watching. Are things getting any better?
What are you currently doing to solve this?
Best informational video, thank you sir
Welcome! 👊🏼👍
I been going to chiropractor and pt for like 3 months now. I still have light sciatica but my back pain has been going away basically its very light tingling and not as bad as it was . Also it's not consistent sciatica. Sitting to long is the major cause . Does it sound like my situation is improving I heard it's supposed to centralize in the back last but for me it's the opposite.
Hey! So, honestly- centralization doesn’t always occur, and while it can be a sign that things are “healing” I wouldn’t be too concerned at the moment. Doesn’t mean things are “going the wrong way or getting worse.” Keep making modifications to your sitting… finding as much comfort as you can.
Let me know if ya get stuck and need help! Keep it up.
@@drcharliejohnson hey Charlie Thanks for the reply 👍
What about the s.i joint? Can s.i joint issues cause piriformis tightning and therefor cause sciatica?. Or can s.i joint alone cause sciatica? My sciatica came gradually over months , my but and sidebut and hamstring is so tight and the sciatic pain was for 2 months only to my back of knee,but last 5 weeks its been down in my calf and tingling and spasns and burning , and foot is tingling ,and also the muscle in my but spasms in horrible pain ,sleepin has been hard as my leg is pulsating like i have growth pain times a 100.. Sitting is my best releaf. Spesially sitting with crossed legs on the hard floor.. or squatting.
Unfortunately there’s a huge shortage when it comes to si joint specialist !!
@@alkarim5890 i have notised. Have .M.R.I on 1.oct. i called them to ask them to check it..i found this guy the other day tho.
hey Mayliss - I think maybe it would help if you checked out a couple of my other videos...
"Five Signs that SI Joint Problems Are Causing Your Back, Buttock or Hip Pain" ruclips.net/video/4jU2h1i9Esc/видео.html
OR this one, "Is It A Back, Sciatica, SI Joint, Hip, Or Piriformis Problem That’s Causing Your Pain? Watch & Learn" ruclips.net/video/KeT3v1OHhi8/видео.html
@@maylissbjerke9204 also- I'd highly recommend you check out my DIY Diagnostic Guide- should help bring clarity to this question. Download it for free here 👉www.drcharliejohnsonpt.com/DIYguide
@@drcharliejohnson . Watched So many videoes ,and all yours about s.i joint and what else that can cause sciatica,but i seem to have it all when i do the tests and so i dont get any wiser🙈.. yet..BUT i will watch them again, and also check out what you sendt me ... thankyou Charlie i apritiate it.
Have, seemingly performing, daughter is a pilates expert, been getting deep tissue massage, knee issue, pain, on same side as aching butt cheek, after massages, seems to help, but aggravation for days, this last massage Monday, she worked heavily on lower back and performing, felt good, knee relief, yesterday I bent over and wrenched lower back. Could barely walk. Seemed better after taking ibuprofen and arnica cream, but too much movement, now I am hurting and it concerns me, a other issue is when I bend over or lift in the past, I would feel tired in the lowerback girdle area, would radiate all in lower back, and be painful, would have to sit down, but not had this lower back pain like this, where I can't walkwell, noticed that it it is directly related to the right side issue, that happens ago with a hike a d afewdays later, after driving, sitting would be in excruciating pain all down the right side from butt cheek to foot, my life has never been the same. I am also off balance and use to fall easily on my knees, was walking more, in a quandary? I feel right now a slight ache on right side inner lower back next to the butt crack.
My pain is on my right side. I can't switch my pain on with most of these tests. When I turn right and lean back, my pain goes on full blast so I guess it is back.
Hey Vince! I know we chat soon- but yes... in this case- BACK!
@@drcharliejohnson Yes, you must have a photographic memory. I have no pain in my back which is weird. Only when I twist. All other pain is glute, knee, calf, foot. My nerve is getting crushed.
can you have both? because that what I think I have....
Hey Sarah! Thanks for watching. I’m sure it’s possible- but not highly likely- if both- then disc or spine is most likely culprit causing pain downstream. That being said- disc is the #1 cause of sciatica. So yes- can have disc issue causing sciatica (in which case sciatica is really a symptom of disc problem).
Make sense?
No pressure- but are you open to some help?
I’d love to review your case and see if/how I can help…
great video, I fell on my back/hip area, martial arts training 5 days ago, I instantly felt sciatica symtoms and left class early. When my sciatica symptoms really flare up (butt, back of leg and calf) the only thing that relieves pain is when I stretch my glute muscles (figure 4 stretch) and stretch my hamstrings. Reproducing pain can give direction to PS vs spine issues, how about what reduces pain? Can glute and hamstring stretches reduce sciatica symptoms from a disc problem? Or Only PS?
thanks!
Charlie I have pain climbing stairs and uphills and pushing trolley and pain relieves when I put a pillow behind my back sitting in the car cause it hurts when I push the clutch pedal .outside hip pain sore on external rotation of the hip and lower back pain
Hey Nicola! Thanks for sharing... so, sounds like your back for sure has something to do with your symptoms. What are you currently doing treatment wise to solve it?
@@drcharliejohnson thanks for getting back Charlie 🙏💞. much appreciated your shortening of the piriformas muscle and another herniated disc video seems to give some pain relief but legs still feel heavy on uphills and stairs .their seems to be a bump out I can roll it under my finger it's at the lumbar area left side it's at the top of my bum where the crack of the bum is and out left about an inch then if you draw a line diagonally up from the bum crack about 4 inches I can feel something bump out when I roll my fingers over it and its painful if I do squat exercise the other video I'm doing is Jessica valant herniated disc
What’s up Doc 🥕 🐇 … hi I went out a run few months back didn’t stretch or anything and then I ended up completely paralysed had this really deep sore pain in my buttock it goes away for a few days then flares right back up it’s where my Piriformis muscle is in my left buttock I can’t work or even move most days went to physio they told me more than likely a muscle spasm which I don’t believe can you please help me this is starting to affect my mental health so bad thank you 🙏
I have SI joints problem. No ‘disc-type’ material left. No disc material left at L5/S1.
This video is very confusing. I've symptoms of both piriformis and herinated disc. I'm more confused now that which one i have. Not helpful at all
hello doctor. I don't think I have either. I have something closer to piriformis syndrome (none of the disc symptoms match mine, some of the piriformis symptoms match my symptoms, esp carrying a cushion everywhere) but my pain/numbness are on both sides, but the piriformis stretch doesn't aggravate my symptoms. any idea? I can schedule a call on your website if you have ideas.
Also you mention with a disc issues, symptoms are worst when waking up in the morning. I'm the opposite, my symptoms are mildest when I wake up in the morning.
Hey Todd! Thanks for watching. Appreciate you sharing your story. Does not sound like Piriformis syndrome- but something else up in the spine.
Check out my more detailed flowchart here (download it for free): www.drcharliejohnsonpt.com/DIYguide
And yes, I’d love to chat with you if you’re serious about solving this and looking for a plan 👍. To apply to work with me visit:
www.drcharliejohnsonpt.com/apply
I have all the symptoms of PS and non of disk. But it hurts when coughing. But you say coughing is for sure disk problem. Go figure
Does piriformis cause discomfort in calf? How do you relieve the calf discomfort? I’ve been icing it.
This helped me understand a depper understanding on this. I defentily have the disc issue, due to over working out. I got PT but its a very slow process as my PT stated. wooo this pain is bad. When is it time to get a MRI vs XRAY if PT does not solve the issue? Heal time from minor injure could be up to 6 months i hear. Either way thanks for posting this information. Much appreciated.
Hey, doc, awesome video, thank you! In your clinical experience what would be the average recovery period for a PS flare? It seems to be taking weeks and months, no? Also, how can I access the PS exercise you personally recommend - do you have a video on it? Thanks in advance!
I was diagnosed by an Ortho of having a herniated disc, after the diagnosis, I chose to have some treatment with a Chiro and showed my Xray and MRI , the Chiro now is doing to get my disc back or at least get it inside the spine space. Somehow I can still feel the tingling sensation and butt pain on the left cheek, I told them(both the Ortho and Chiro) that I had a seated crunch injury that I felt a tore in it. It subsided after 2mos of not doing anything but after sometime of prolonged walking and standing pain in my left butt is getting painful and unbearable that I needed to see an Ortho. (I always sit down in my job, that I may have forgotten to stretch and still work out in the gym)
Fast forward I signed up for 12 sessions in the Chiro and it is my 4th session now and I can still feel pain in my left butt and tingling sensation on my left leg. I am thinking I may have both since I have an MRI bulge with the L4/L5 and no back pain just painful in the left butt as PS?
I think I may be one of those rare cases of something glute related but on both sides (although one side is worse). Nothing is pointing towards a back problem and I have had no back pain.
Same here, I had a MRI and it came back normal! It's miserable 😩
I must be a strange case.
When I wake up in the morning and I stand up, the back of my leg hurts and also nu butt. After 5 min to 30 min the pain gets less. Still, putting socks on the leg hurts. Driving my bike to work is not painfull but I definately feel my leg. In de at work all pain is gone. Any test I do in your flowchart does not hurt. Only sitting down die longer times reproduce the symptoms. Standing up out of a chair or car hurts because i can 't straighten my leg
Have gone to specialists and have had scans that pinpoint my problem to t11 serious hernia, l4 crushed vertebrae form a fall, and osteoporosis from former medication. Had been a serious weight lifter until the age of 60, when then found the t11 problem, and now at 75 I have helped my gardener remove a heavy mower from his truck resulting in severe pain in lower back, just above the buttocks area (on both sides). No leg pains. Have concluded this is also related to disc/nerve compression and do not want another doctor's visit. Having seen your videos I am impressed with your approach and explanations. Have not tried the exercises tests yet as it has oly been a few days since this accident and am taking ibuprophen to help reduce the pain. Any thoughts here would help.
My butt pain burns a lot when I move my hips back and forth but I don’t have back pain. Basically when I round my lower back the butt pain lights up but I don’t really feel it in my back
I have symptoms of both herniated disc and piriformis. I do not have shooting pain down my leg but when I do the exercises for Piriformis, it definitely is pain in my buttocks. It does not travel or shoot down my leg. How do I treat it or which one do I treat? When I lift my leg, the pain is in the front of my leg in the groin area.
I’m not sure which exercises to do. Many thanks, Rebecca
Can you have both? Seriously?
I’m use it’s possible. But i imagine it’s extremely rare. If you’ve got both pains, then chances are high ONE thing is causing both of them… most likely a spine issue referring to the buttock.
I did the sitting leg raise test and nothing. I can move my back n s e w. Nothing. But when I had my piraformis pain from my left Butt cheek which my massage therapist agreed was spasmed and extremely tight, I was crooked couldn’t stand up straight because my back muscles seem like they were working overtime especially on my left so I was leaning to the side on the left side once she released my piraformis I could stand up straight
Doc, thank you for posting this.
I have the described pain in both legs, so when i do the seated test, each leg i raise hurts in that leg. Thoughts?
Hey Chris! Definitely sounds nerve related. Could be many causes of this (disc could be one).
Are you currently getting treatment for this? No pressure, but would be happy to review your case and see if/how I can help you.
Hang in there!
@@drcharliejohnson thank you for the reply, Doc. I had about a month of treatment via a chiro/PT. Symptoms worsened over that time. Treatment included stretches at home (e.g. ankle over knee and pull leg to opposite shoulder, 90-90 stretches, wall sits) and electro/heat therapy, massage gun and adjustment in the office. Nothing was helping. I just started doing flossing and the hydrogen exercise on my own yesterday. Too soon to tell yet but I'm hopeful.
Where are you located?
@@chriss.3476 hey! Sorry to hear initial PT made ya worse. Makes sense that that approach aggravated the problem. To be clear- it's not too soon to know if what you're doing is working. You should know IMMEDIATELY in the moment if a motion/input is helpful or not- as you should see an immediate improvement in function. But you'll need to follow a process to appreciate this immediate change.
I'm based in Pennsylvania- but am 100% virtual and consult with folks worldwide... so, no barrier there if you're interested.
I definitely had a piriformis muscle issue (due to poor protocols in high school sports), then now, I probably have a mix of both due to lifting up a light stand on the film set that totally compressed my spine and herniated it.
Any tips on rehabilitation of the herniated disk, would be very nice and appreciated!
Classic PS I think from getting in and out of a manual transmission pickup feeding cows every day for months. Thanks for the video explaining the difference it was very helpful!! :)
I had a partial herniated disc for more than a decade now, it eventually became more bearable recently until I went cycling with a new saddle about 4 months ago, really hurt my buttocks and my lower back started to flare up and it got worse as the temperature became colder. not sure if I made it worse just by using the wrong saddle?
Hi doctor hi been one year and more those symptoms I saw now on video I have all of them so please make one video specifically for sciatic nerve, pinched nerve I l maybe either I say join to a half left side leg and down the lower back I thought with my finger I feel burning a pain so it’s a nerve little bit more off straight. I feel pain I don’t know what’s going to happen I did want injection like three needles and after that my leg is so bad either the left side the lower back and every day it’s like this I take my prescription especially from the doctor I try couple exercises some good some not I cannot choose so please make on video for me, and all people sick like me early got play see you because you do it work for the people sick thank you very much I’ll need answer because I’m asking like this so many doctors and physiotherapist does it the answer
I do have confirmed Piriformis syndrome but in both buttocks. But here you say its not possible?
My right butt cheek has hurt so bad for months with severe leg pain and electric shock all the way to my foot. Only relief is to sit. And I do say cut my leg off all the time cuz it hurts so bad. Dont have insurance so what can I do? Please advise 🙏
I have watched so many videos on back/sciatica and this is by far the most easily understandable one i have seen yet to make me understand my condition. I had a Sciatica( herniated disc) back late last year that my Shin still bothers me at time , feels like i have shin splints all the time . I wonder if this could be caused from Nerve damage ? I was bed ridden for 6 wks .. i now ice my back 3x a day and it seems to help alot .. Great video
Glad it was helpful! Yeah, “shin splints” likely due to nerve issue
Hi Dr. Charlie...I am a 60 year old housewife and was diagnosed 10 years ago with a Grade 1 Spondy. In 2015 I had a lamenectomy to scrape bone away from my nerve that was giving me extreme back pain. Stenosis. This was great and I have been living with my Spondy and being active and careful. I am a very active outdoors person and as of September 1 I woke up with extreme butt pain that goes down my leg to calf. It hurts like hell and I don’t know what to do. With all this Covid stuff going on I don’t want to go to the hospital and am sitting and crying in silence everyday but still moving. What have I done. I have watched almost all your videos but can’t seem to determine what is wrong. My back doesn’t hurt but my butt is on fire and down my leg and when I sit down it spasms intensely until it calms down about 30 minutes later? Please Help! 😢
That sounds terrible. Did you ever figure it out?
This is fantastic, thanks so much. It's so hard to find clear information like this and there is so much conflicting and muddled information available online, and from various professionals.
As for my story, I have some minor dull low back pain and bad sciatica at the S1 position. i'm positive for all the PS symptoms, plus I have trouble straightening up, really painful to cough or sneeze, I cannot walk without a limp, and I cannot bend forward at the back without reproducing pain. I have my MRI soon but I'm pretty certain it will come up as some form of disc herniation.
What were the results of your MRI? How are you now? What did you do to get better? My story is very similar to yours. Thank you for any details you can share!
@SarahMae-jd6xi my recovery has been a long one. Now I suffer from periods of mild sciatica and back pain, and periods of no pain at all. My mobility is now unaffected. there were periods where I had no symptoms, however I went back to exercise too quickly and put myself back a number of times. Also I have a job which requires I sit all the time, which has massively hindered me. What I would say is give your body time, and don't expect to measure your own recovery against someone else, everyone is unique and everyones story is slightly different. Best of luck on your recovery, I send you best wishes and hope.
@@SarahMae-jd6xi the scan came back l5-s1 disc herniation and l4-l5 disc bulge..
Thanks much Dr. Charlie, your flow chart and video were extremely helpful in diagnosis. I originally thought my sciatica was from PS due to overuse from long distance running, and this really confirms that. I also have a THR in that hip joint, so my flexibility on that side is more restricted. My doctor ordered an x-ray of my spine which showed moderate compression in L5/S1, and unfortunately for me, he is convinced that THIS is the cause and says there 's no way you have PS, it's so rare, you probably have back pain, etc. But disc compression at that spot is apparently a pretty common part of the aging process (I'm in my 50s), so I don't put a lot of weight into his opinion, esp. because I've never had back pain, and the back movements you suggested here did not cause any pain down the leg. I just started seeing a PT who did some functional movement tests and also thought it was PS, not a disc issue.
My doctor wants a spinal MRI (very expensive) to confirm the disc compression and then to get an epidural if the pain continues. I'm definitely against that if it's a PS condition! Though I am reading a lot that a coritisone shot into the P muscle itself can help with pain relief. Will continue with PT exercises for now, thanks again!
ok so I have pain in my lower (mostly left) side of my back. waking gives great pain on the side and the front of the thigh but nothing down below the knee. but doing both leg raises in he chair does not significantly hurt the bad side...where does that leave me?
My back doesn't hurt unless I push down on it but I've been having buttocks pain and leg pain for a couple of years now, only on my right side. I just started to notice leg tingling and numbess on my feet. Would you consider that ps or disc problem because I don't have any back pain unless I push down on it, either laying down or while I'm standing. My doc said I have sciatica and that was it. Went through physical therapy and it didn't help at all. Hoping to get a different perspective. Thank you
Got it. If you haven't check it out yet... I'd recommend you review my thorough "Better Than An MRI DIY Diagnostic Guide" (get it for free here -> www.drcharliejohnsonpt.com/diyguide)... that may bring you more clarity of what's going on.
what did physical therapy look like when you went? (what did they have you doing?)
@@drcharliejohnson thank you. I will definitely check it out. During my visits, my physical therapist had me do stretches, strengthening my core, and laser pain relief.
I'm sorry but you are wrong on so many things. My symptoms is a mix of what you mentioned.
This is such a helpful video. Great explanation of the 3 differences.
Piriformis - awesome video.
Thanks Shallow Hal!