age 46, 5"9', 160, occupation - administration



Hello,



I am a healthy individual, but about 3 years ago I hurt my back while putting down a pile of firewood and turning to my left side. I felt immediate hot sensation over my right back and buttock region. This was the first time I ever experience this type of lower back pain; otherwise, healthy back.



In addition, I am an avid runner. I run usually 3-4x/week for 2-3 miles.



Seen by Orthopedist, with symptoms of right SI joint pain, right buttock pain, right hip and right medial knee pain with intermittent numbness and tingling of right foot. Diagnosed as "Piriformis Syndrome."



NOT affected by straight leg raise, sneezing, coughing or bowel movements. I have bowel movements one per day.



Worse with prolonged sitting with legs placed underneath the chair and crossed and with driving, touching the brake and accelator pedal. Also when having a bowel movement and reading a magazine and placing my right elbow over the right knee for support.



It is not the lower back pain, but the intermittent tingling of my right foot. It is not specific to one area, sometimes at the big toe, others at the lateral foot or sole of the foot. It feels like the symptoms are moving around depending upon the day.



Better with standing, walking, and lying flat on the ground. Sleep is not an issue, in fact, I feel better with sleep, but upon waking feel stiffness of the back or no symtoms at all.



Test/TX - xrays (normal), anti-inflammatory, PT, Chiropractic, Exercise.



Medication is temporary, whereas, the manipulation and and PT seems to help.



Throughout the years, the condition seems seasonal; meaning, I will be totally asymtomatic for many months, I go back to training (running), and symtoms appear again. The main issue is the tingling of the right foot. I do stretch, yoga, and mediate on a regular basis.



One month ago (2011), I injured my back while doing a prone exercise for the back. Few days prior to this incident, I ran. Again, evaluated by ER, General MD, and receiving PT. X-Rays are normal, medication are temporary, PT producing slow results. I have strong bilateral muscle strength.



My main thing is the right foot tingling, which is low-grade, comes and goes, aggravated by prolonged sitting. I was informed that I do NOT exhibit symptoms of discogenic disease. Just as I began writing this "on-line request", I had the symptoms, but now they are gone????



Most of the time, I do NOT have lower back pain if I do it is localized to the right SI joint. I am taking multi-vitamin, apply external ointment with necessary. Strangely, the right foot tingling is gone when I place the right foot over the left foot, as opposed to, right foot over the left knee.



At times, I fell twitching of my right buttocks. When the muscle spasms, the tingling disappears. I have done many exercises for the piriformis and when done correctly the muscle is painful.



I feel that I could manage my condition through rest, exercise and avoiding exacerbating movements. I have been swimming almost daily. My main goal to totally eliminate the symptoms of right foot tingling.



Is it the lower back, lower extremity or both? Foot entrapment? Where is the re-current flare ups coming from? Your suggestions are deeply appreciated!