These emails culminated in Matt flying in to see us one week later ---- on Thursday, February 2nd. Unbeknownst to me at the time, Matt had already scheduled a Piriformis Release Surgery (Piriformisectomy) for later this month --- a surgery whose results are a known to be a total crap shoot --- more likely to leave you worse than better. Here is our email conversation as per permission from Matt.
I'm a XX [thirties] year old male, and was very active prior to my chronic pain. About 5 years ago I was running about three miles 3-4 times per week on a treadmill, as well as Yoga and Pilates. One afternoon as I was doing Pilates I suffered an injury to my right inner thigh. The exercise I was doing at the time was an advanced variation of the Ball Roll. The variation I was doing calls for the arms to be placed inside the legs, legs spread apart, with the hands clasping the outside of the shins.
I had immediate intense pain in my right inside groin for days; most flexibility in my groin’s right side was gone for 3-4 months. I slowly got it back over the course of a year. Still to this day after I golf the right side groin pain returns for 2-3 days after I play 18 holes of golf (and I’m right-handed).
Sometime during the year following the groin injury I had what felt like a pulled right hamstring. I stopped running for 6 months to give it time to heal and continued stretching. Sometime later in the same year I noticed that I started having right buttock pain. The buttock pain was triggered by sitting upright such as in my office chair or in my car. The pain reaches 8 out of 10 every day.
Now, four years later, and after many images, medications and treatments, my pain is in my right buttock daily, and often travels down into my right hamstring. After golfing 18 holes, my pain will reincarnate in my groin for up the three days.
I wake up every day at a 2/3 on the pain scale. Sitting in an office chair or in a car cause my pain to rapidly increase from a 2/3 to an 8/9. When I say rapidly I mean 10 to 30 minutes. My right butt muscles spasm randomly every day from one spasm episode to multiple episodes lasting anywhere from 1 to 10 seconds. The spasms do not trigger painful sensations. I take Baclofen to stop the spasms but the pain is not relieved.
Over the past four years, here’s my medical history: I’ve had several MRIs (with and without contrast) of my lower back, right hip and hemi-pelvis, x-rays of lumbar spine, ultrasound of ischial bursa area, and whole body bone scans.
1/14/2008 – MRI LUMBAR OF THE LUMBAR SPINE – SLMC - L4-L5: minimal posterolateral disk bulges are identified bilaterally. There are no focal significant disk herniations or evidence of central canal stenosis. There is mild narrowing of the neural foramina bilaterally; L5-S1: There is a small broad-based posterior central disk protrusion at this level. There is no evidence for compromise of central canal or nerve roots. There is no significant foraminal narrowing.
3/10/10 – MRI HIP WITHOUT AND WITH CONTRAST – Negative MRI of the right hip and hemipelvis.
10/13/10 – MRI OF THE LUMBAR SPINE WITHOUT CONTRAST – Mild posterolateral disk bulges at L4-L5 which contribute to mild bilateral foraminal narrowing; Small broad-based posterior central disk protrustion without evidence of central canal stenosis or compromise of the nerve roots.
10/13/10 – WHOLE BODY SCAN WITH SPECT CT SCAN – Intense activity in the region or right sphenoid sinus of questionable etiology. Correlation with CT scan and/or MRI may be obtained; Normal uptake within the lumbar spine.
Epidural steroid injection in L4 and L5, and S1 - SLMC: Relieved the pain for 6 months.
Epidural steroid injection in L4, L5, and S1 - SLMC: Relieved the pain for 3 months.
Epidural steroid injection in L4, L5, and S1 - SLMC: Relieved the pain for 2 weeks.
3/23/10 – CT-GUIDED RIGHT PIRIFORMIS STEROID INJECTION – WFH - Relieved the pain for 2 months.
5/17/11 – CT-GUIDED RIGHT SI JOINT INJECTION – WFH – No pain relief.
6/1//10 – CT-guided Ischial bursa injection – WFH – 2 days of relief.
6/10/10 – PHYSICAL THERAPY – ULTRASOUND & MASSAGE. Psoas muscles spasms, especially the left.
6/11/10 – CT-GUIDED RIGHT PIRIFORMIS STEROID INJECTION – WFH – 2 weeks pain relief.
7/12/10 – RIGHT PIRIFORMIS NEUROLYSIS AND BOTOX INJECTION – WFH – No pain relief.
6/13/11 – NERVE ROOT BLOCK – L5, S1, S2 – WFH – 2 weeks pain relief.
7/19/11 – MEDIAN BRANCH BLOCK – T11, T12, L1, L2 – WFH – Six weeks pain relief.
2009-2011 – CHIROPRACTIC MANIPULATION – Gait scan showed dropped arches, now wear ortho inserts daily.
9/6/11 - RF Ablation of T-11 through L2 –Buttock pain relief for 1 month.
12/2/11 – RF Ablation of T-11 through L2 – No pain relief.
DR RUSS: WOW! I feel for you Matt. I honestly do not know if this is purely a Piriformis Syndrome issue or not. Part of it screams yes, part of it says maybe not. Let me tell you what I would do if I were you. I see so many people with Piriformis Syndrome, and my opinion is that the medical community is for the most part doing a terrible job with them; so you are going to have to step outside of the box. Not sure where you live, but if you can get to Mountain View, I will schedule you at a time when we can spend whatever time we need to spend. I will check you for FASCIAL ADHESIONS / TENDINOSIS, and see where that takes us.
All I can tell you is that if what I do is going to help you, there will be a substantial difference after one treatment. If not, I'm not sure what your problem could be or if it may require surgery. There is always a chance that the disc issue could be bigger than it appears to be. In that case, maybe Spinal Decompression Therapy might help.
I'll try and get our newest Video Testimonial up this morning. It just happens to be about Piriformis Syndrome. I've only been doing these Video Testimonials for about two months, but a few days ago, we shot a video of older farmer / framing carpenter (retired) who has absolutely suffered with Piriformis Syndrome for over 30 years (although he had never heard the term before). He was about 80-90 percent better after just one treatment. It would be really cool if that were you. I would suggest that you do not do the "Release Surgery" without trying this first.
Russ Schierling DC
I have been in hell four the last five years. If I didn't have a family that needed me, I wouldn't see a need to continue living with this pain everyday. I'm done with this suffering...mentally and physically. This last year has really taken its toll on me, and I don't know why. It almost destroyed my marriage and it is actually making me dumber (or perhaps that's the medication).
I came across your website because most nights all I do is research Piriformis Syndrome in search of a cure. I emailed you on a whim and you replied that you may be able to provide me 80-90% relief in one visit that may last a couple of hours?! Just writing that sentence brings tears to my eyes. I've watched all your videos and you come across as an honest Christian man so I want to believe you, but you must see it from my point of view.
Please explain what we're going to do during the visit based on my history. I read about the Tissue Remodeling on your site, and need to understand this better please. When I read the content from your site it sounds like you have the technology to scan my pain areas (butt, groin and leg), detect injuries, and then treat the damaged tissues. And, based on what you've said, a single treatment would heal the injured areas. Please understand that from my point of view this sounds like the miracle cure I've been searching and praying for for years.
I have a BRUISING PAGE on my site to show how intense this treatment can be. Mind you, I never do more than what you can tolerate. However, I have learned that with this form of treatment, you are either breaking scar tissue and adhesion ---- or you are not. If I am not crossing the threshold and breaking adhesion, I am really not doing you any good. Lots of sub-threshold treatments add up to a whole lot of nothing.
I will not scan you with anything electronic Matt. However, if and when I find scar tissue, I will do my best to break it up. I would never hope to say that one treatment will completely heal areas of chronic Fascical Adhesion. What I will tell you, however, is that if what I do is going to help you, you will know it in just one treatment. No maybe it helped me, or I'm not sure if it helped me or not. You will know within a couple of days whether or not we are on the right track. Most people with PS see the change immediately if there is going to be a change.
We will do whatever we can do to reproduce your pain before I treat you. After I treat, we will retest to see if there is any change taking place. We may go thru this process dozens of times. I have been doing this so long that I recognize many patterns and see them over and over and over. But there is not a week that goes by that I do not find something new and different (our VIDEO TESTIMONIALS are proof of that).
I go to a small family-integrated home church that is full of powerful men of God. We will pray for you tomorrow that God will grant me the knowledge to figure this thing out. Often, it is like figuring out a complex 3-D puzzle.
My goal is not to lead you or anyone else on --- or give people false hope (HERE). I think that most people can see from my transparency, as well as the fact that I am willing to come in on my day off so that I can have uninterrupted time to work (not to mention our ridiculously low fees), that I am all about getting sick people well.
Fascia is such crazy unique tissue. It is not only the most potentially pain-sensitive tissue in your body, in most areas it will absolutely not image on MRI (or anything else for that matter). This is a terrible combination. Rest assured that I will do everything in my power to help you Matt. For me, it's not about money ---- it's about helping people avoid crappy surgeries, dangerous drugs, and a living hell. This work is my life. God bless Matt.
I am asking for prayer. Matt is coming to see me on Thursday from long distance. I have had several email conversations with Matt and would ask for prayer that I can be instrumental in solving this problem that has literally ruined his life. I am almost positive that he has PIRIFORMIS SYNDROME brought on by a GROIN PULL -- something I have seen several times previously.
Fortunately, I treat lots of this stuff and am more than familiar with it ---- it's literally an American Epidemic. Just pray that God will grant me the wisdom and ability to solve Matt's problem. Thank you for your prayers.
MATT: Dr. I just got this email. I was out and about and my phone was dead. I am working on my travel arrangements to try and be at your office by 10AM on Feb. 2nd. I'm hoping that if for some reason my travel plans are not ideal your schedule is a little flexible that day. I will do my best to be there on time. You know how badly I want to get better, and how much this visit means to me. The airfare alone could be up to 10x the cost of your office visit and I'm not really well enough to make the drive.
Also, I want you to know that I pray too. I pray not for a miracle but for me to find someone that has the knowledge to fix me. I hope that person is you. The trick to prayer is faith. You have to have faith. I have never given up on faith that I could be cured if I kept looking for it. At my worst times I have wondered why I choose to continue to suffer with this pain everyday and I look at my children and I see my answer. I hope for them I can be a happy, healthy father and not a sick, depressed father. Perhaps you're the answer I've been praying for.
MATT FED-EXD HIS MRI'S TO ME.
MY RESPONSE TO MATT.
I ran a quick Blog Article on PIRIFORMIS SYNDROME on my Spinal Decompression Site. Make sure you check out my PIRIFORMIS VIDEO PAGE while you are at it. I just put up a video from Ike Reese yesterday. You'll appreciate this guy. He's my kind of people --- a no-nonsense never-go-to-the-doctor-unless-I-am-dying hard working kind of guy. Although he had never heard the term before and had no idea what it was, he had struggled with Piriformis Syndrome for over 30 years, and actually was forced to quit work because of it. He was 90% better after his first treatment. The video was shot after his second treatment and he is not scheduled to have another for this particular problem.
MATT: I've arrived in St. Louis. Be in Mountain View in about 4 hours.
When Matt came into the office, he was in a pain-induced daze. I told him that we were going to do whatever it took to solve this puzzle and figure out why muscles were misfiring and nerves were in a constant state of severe irritation. We started about 11:15 and finished an hour later. By the time that I had finished, Matt looked (and felt) like he had been run over by a Mack Truck. Since he needed some time to recuperate and rest before heading back to St. Louis to catch his flight, I invited him over to the house for a sandwich.
The most amazing transformation took place. This person across the table from me who was just an hour ago in a fog of pain, was conversing with me normally. His eyes looked different. I asked how he was feeling, and he was not in pain despite the fact that he was sitting on a wooden chair. Although I could tell that he wanted to say more, he was almost afraid to believe that this could possibly be working. We talked a bit, I had Matt stretch for ten or fifteen minutes, and he left for St. Louis.
It was such a beautiful day here in the Ozarks that I took the kids ON A HIKE. By the time I got home, curiosity had gotten the better of me, so I emailed Matt.
DR RUSS: Hello Matt, How did you handle the drive back to St Louis? Super curious. Russ
Matt: Not there yet because I keep stopping to stretch. The drive has been wonderful... I think I'm in shock. Thank you so much. Ill check in with you tomorrow.....
MATT A COUPLE HOURS LATER: I'm so happy right now. Can't wait to see how tomorrow goes.
When Matt arrived at my office, he was literally in a daze from the pain of traveling. His situation was even worse than I had imagined, or he had described --- and what he had described was a living, breathing, nightmare. However, I immediately put him on OXYGEN and we went to work. I started checking things that doctors much smarter than I had not thought to check, and in the end, even though Matt looked like I had beat him with an axe handle (some of you know exactly what I am talking about), the change was immediate. We finished up with the COLD LASER to promote the healing process and were finished.
I invited Matt over to eat lunch with our family before he headed back to St Louis to catch his flight. He was a different person. I could immediately see a clarity in his eyes that was not present when I first met him --- CHRONIC PAIN DOES BAD THINGS TO YOUR BRAIN. One of the things that would set off his pain was sitting. Matt sat thru the entire meal and could not believe the fact that he was not hurting --- he was what you might call, "Cautiously Optimistic".
All I can say is that it is great to know true men and women of prayer! Again, God bless all of you for caring enough to pray for a person you have never met.
By the way, for those who are interested, I actually sat down this morning and created a BLOG ARTICLE about the specifics of what I believe was going on in Matt's body to cause this problem. It is a pattern that while not something I see everyday, is something that I have seen previously. In a nutshell --- a strain of his right Adductor Magnus (a groin pull) compounded by a history of a repeatedly pulled right hamstring, caused a pelvic destabilization that led to chronic dysfunction and FASCIAL ADHESIONS of his same-side PIRIFORMIS MUSCLE.
I love you guys!
I WAS SO EXCITED FOR MATT, THAT I CREATED A BLOG ARTICLE BASED ON THE PARTICULARS OF HIS CASE
THEN I EMAILED MATT TO FIND OUT HOW HE WAS DOING
MATT'S RESPONSE TO ME ON FRIDAY MORNING FOLLOWING HIS TREATMENT ON THURSDAY: Russ, I'm tearing up as I write this email. What I put my body through yesterday should have left me both mentally and physically depleted...to the point where I would have asked myself how can I wake up and do this yet another day. I cant drive for more than 30 minutes without reaching a pain level of 8/9 out of 10 (which some say is close to labor pains). I drove a total of over 6 hours and took a flight of 1 hour mixed in with wheelchair assistance at the airport on my way to you. By the time I got to you for treatment I was DONE!
Post-treatment, followed up by lunch at your place, which I did while sitting on a hard chair for another 30 minutes and then a round of stretching I turned right around and did the trip all over again (minus the wheelchair because I felt good enough to walk). For me that's a suicidal day. I drove the last hour of my 18 hour journey yesterday without any pain. I crawled into bed (after one final round of stretching), kissed my wife, and laid there waiting for "my pain" to come. It never came. I rolled over one my side, "my pain" never came. I had the best night of sleep in the last 1,500 days of my life, and for the first time in as long couldn't wait to see what the next day was going to bring.
I woke up this morning and was sore, but it's not "my pain", it's different and not nearly as severe. As soon as I stretched the pain abated. I kissed my kids, and my wife and sent them on their way. Thank you for giving them their daddy and husband back. I'll keep you posted my friend. Yes, whether you like it or not you're now my friend because you can't have an impact like this on someone's life and then just shake their hand and send them on their way. You're stuck with me now.