“Secret

Piriformis
Syndrome
Treatment”
A Clinical Guide to Back &
Buttocks Pain Relief

By Author, Lecturer &

Back Pain Specialist
Dr. Barry L. Marks, DC
MEDICAL DIRECTOR
ORANGE SPINE & DISC REHABILITATION CENTER

FORMER ASSOCIATE CLINICAL PROFESSOR

 ”Secret Piriformis Syndrome Treatment”
A Clinical Guide to Back & Buttocks Pain Relief

Dr. Barry L. Marks, DC

LEGAL NOTICE:

 You Do NOT Have the Right to Reprint or Resell this Report!

 You MAY NOT Give Away, Sell or Share the Content Herein

All Rights Reserved

No part of this book may be reproduced, stored or transmitted by any
means, electronic, mechanical, photocopying, recording or otherwise
without the expressed written permission from the author.

 2008 Dr. Barry L. Marks, DC

Abundant Health Publishing

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 Table of Contents

PIRIFORMIS SYNDROME SURFACE ANATOMY............................................4

PIRIFORMIS SYNDROME IS…..........................................................................6

HOW CAN I TELL IF I HAVE PIRIFORMIS SYNDROME?............................9

SECRET PIRIFORMIS SYNDROME TREATMENT REVEALED… ..................11

WHAT DOES FAILURE OF THE SECRET PIRIFORMIS SYNDROME

TREATMENT MEAN… .......................................................................................16

SPECIAL OFFER FOR READERS OF THE SECRET PIRIFORMIS

SYNDROME TREATMENT PROGRAM.............................................................18

“ABOUT THE AUTHOR” ...................................................................................19

MORE FROM DR MARKS .................................................................................20

CONTACT DR. MARKS.....................................................................................21

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 Piriformis Syndrome
Surface Anatomy

“Doctor, my…

…hip
…bottom
…behind
…tush
…culo
…gluteus
…bum
…really low back
…etc.

…is killing me…”

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Sound familiar?

When I hear those words, my mind immediately starts to race…what do they

mean? Is it really their hip? Or is their sacroiliac? Or as is often the case, do they
mean their buttocks?

Let’s get something clear right away…

Doctors don’t really know where you hurt when you

use vague or confusing terms. Hey we’re human. So
the diagram on this page will give you a little anatomy
and medical terminology so that we can all
understand each other.

Back: the area from the top of your shoulders down

to your waist. You can divide it into upper, middle and
lower regions. The low back is called the lumbar
region.

Buttocks: yep, the butt. It’s the area on the backside

below your wait that you sit on. As a doctor, I don’t
care what you call it, but I call it a butt or buttocks.

Sacroiliac: this is a joint between your pelvic bone

and your tailbone. You can find one on each side by
putting your hands on your waist and reaching your
thumbs in and down. There you’ll find a hard knobby
bone inside of a depression or dimple above your butt.

Hip: this is the actual leg bone connected to the

pelvic bone. This is the joint that allows your leg to
move up and down. This joint is on your side at about
the level of your wrist as you are standing with your
arms hanging down. In the front, your hip joint forms a
crease in your groin area on lifting your thigh up.

Thigh: the area of your upper leg between the

buttock and knee on the backside and the groin and
knee on the front.

So now you should have a clear understanding of the

basic surface anatomy of the area. It’s now time to dig
in and see what this Piriformis Syndrome thing is all
about.

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 Piriformis Syndrome is…

…a neuromuscular, anatomic, physiologic

malfunction…

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Now that that’s crystal clear…

Let’s cut through the medical jargon

gobbeldy gook and breakdown what that
means and what Piriformis Syndrome is.

Neuromuscular:
Neuro pertains to nerve and muscular
obviously pertains to muscle.

Sp the condition involves nerves and

muscles. Most notably, the Sciatic nerve
and the Piriformis muscle are involved.

Anatomic:
Anatomic refers to the structure of the
body. In this case, there are certain
anatomic relationships that lead one to be
more prone to Piriformis Syndrome than
others.

The anatomy of the sciatic nerve and the

path it takes in relationship to the physical
characteristics of the Piriformis muscle is
key.

Physiologic:
Physiology means how the body or a
specific structure or organ functions.
Normal physiology means that an organ or
body system is working as it is intended to. Abnormal physiology can be termed
malfunction.

So, Piriformis Syndrome is…

A condition in which the Piriformis muscle has tightened up and therefore
become thicker, which causes it to put pressure on the sciatic nerve as it travels
under, through or around it.

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 The Piriformis muscle is located underneath your gluteus
maximus muscle. It attaches to the side of the sacrum or
tailbone and inserts into the top of the femur or hipbone.
Its purpose or action is to rotate your leg outward. The
Piriformis muscles shape varies from person to person.

The largest nerve in the body is the sciatica nerve, which

is a bundle of nerves that arises from he spinal cord at
about the L4, L5, S1, S2, S3 and S4 levels. I say about
because this nerve varies from person to person. Some
people have branches that being as high as L2 or L3. Skin
sensation and muscle strength of the thigh, lower leg and foot are supplied by the
sciatic nerve.

Variations of Piriformis Muscle and Sciatic Nerve

In many people the sciatic nerve passes under the
Piriformis muscle and then branches off into two parts to
supply different parts of the leg.

In others, the nerve may branch before the Piriformis

muscle and overlap parts of it.

Another variation is where the Piriformis muscle is split in

two parts with the sciatic nerve passing between the
muscle branches.

In Piriformis syndrome the muscle contracts and thickens

due to spasm in response to a strain, injury or chronic
postural stress. When it thickens it squeezes the sciatic
nerve causing the characteristic pain from the buttocks to
the thigh or lower leg.

It is theorized that for people with the latter two variations,

chronic Piriformis Syndrome is most prevalent. Reportedly,
15% of the population has one of these variations.

Chronically relapsing symptoms of Piriformis Syndrome

may also indicate an underlying disc issue where the
nerves are being slightly irritated by the disc bulge and
then again by a tight Piriformis muscle. The resultant
“double crush” of the nerve causes sciatic pain. Both the
disc and the muscle must be treated for complete
resolution. An MRI of the back will help diagnose this
condition.

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 How Can I Tell If I Have
Piriformis Syndrome?...

…a simple 5 second test…

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Piriformis Syndrome Self-Test:
This is a simple 5-second test that will tell you if your sciatica is caused by your
Piriformis muscle.

1. Locate Piriformis muscle

Locate the area of your Piriformis muscle
by finding the part of your hip bone on the
side of your leg that sticks out. Slide your
fingers back and up at a 45 degree angle
towards your tailbone. You should be over
the Piriformis.

2. Apply deep pressure

Put firm deep pressure with a thumb or
fingers into the buttocks over the Piriformis
area at 3 different points along the muscle.

3. Interpret results
You Do Have Piriformis Syndrome if…
you experience numbness, tingling and/or
pain radiating down your leg or out towards
your hip region

You Probably Do Not Have Piriformis Syndrome if…

you have only localized pain with no radiation. Your problem is one of the other
causes of buttocks pain and/or your sciatica such as a lumbar disc bulge or other
condition. If this is the case, go here for more info:
www.orangespinaldecompression.com

What to do about Piriformis syndrome:

In the following section, I will reveal the “secret” Piriformis Syndrome treatment I
use in my Orange, California Spine & Disc Rehab Center…

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 Secret Piriformis Syndrome
Treatment Revealed…

…a program to relieve buttocks and leg

pain due to piriformis spasm and
inflammation…

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Secret Piriformis Syndrome treatment revealed…

This is the protocol I use in my office daily for people I have diagnosed with
Piriformis Syndrome. I have experimented with many different forms of therapy
and have found that the therapy modalities listed and at the exact same
parameters I suggest are the most effective. Deviating from these parameters
may or may not work.

Go ahead and share this information with your chiropractor or therapist. If they
are open minded and are interested in relieving your pain, then they should have
no problem with trying this out on you. After all, if you’ve ordered this report, then
it is obvious you are still looking for a solution.

Initial Care
The initial goals of treatment are to reduce inflammation around the nerve and
reduce spasm of the Piriformis muscle.

In Office
This treatment is given in the office 3 times each week for 4 weeks

 Hydroccolator moist heat pack with Dynatron Interferential Current 1-

150Hz x 12 minutes over the affected area

 Erchonia Cold Laser (630 Nm) 9, 16, 26, 42 x 180 seconds over the
affected area

 Chiropractic manipulation of the sacroiliac and sacral base as indicated by

palpation (often find opposite side sacral base is posterior with inferior
ilium on affected side)

 Deep ischemic muscle goading of Piriformis

 PIR stretching of piriformis, glute and hamstring muscles with Erchonia

Cold Laser at 4, 9, 33, 60

At Home
Home care is done every day.

 Moist heat (hot shower, bath, Jacuzzi, hot towels, moist heat pad) x 15
minutes

 Stretching of Piriformis, glue and hamstring muscles

In most cases the pain levels will be reduced by about 70-80% after this initial
treatment period, at which time it is appropriate to commence rehabilitative care.

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Rehabilitative Care

In Office
This treatment is given in the office 2 times each week for 4-8 weeks with re-
evaluation of symptoms and objective exam findings every 4 weeks.

 Hydroccolator moist heat pack with Russian Isoelectronic Rehabilitation

2500Hz on 10:30 timing cycle x 12 minutes with active contraction of
muscle

 Erchonia Cold Laser (630 Nm) 9, 16, 26, 42 x 180 seconds over the
affected area

 Chiropractic manipulation of the sacroiliac and sacral base as indicated by

palpation (often find opposite side sacral base is posterior with inferior
ilium on affected side)

 Erchonia Cold Laser neurological upgrade protocol for lumbar spine at

4,9,33,60

 PIR stretching of piriformis, glute and hamstring muscles with Erchonia

Cold Laser at 4, 9, 33, 60 as indicated by tight or weak muscles on testing

At Home
Home care is done every day.

 Moist heat (hot shower, bath, Jacuzzi, hot towels, moist heat pad) x 15
minutes

 Stretching of Piriformis, glue and hamstring muscles

 Strengthening exercises

1. Bridge
Lie flat on your back with your knees bent and
feet flat on floor. Push down with your feet
while lifting the buttocks off the floor. Hold the
pose while tightening your buttocks for a few
seconds then lower. Repeat 10-20 times.

2. Donkey kick
Assume a hands and knees position on floor.
Lift one leg up and extend up and out. Hold
for a few seconds then lower and lift the other
leg. Repeat 10-20 times each leg.

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 3. Side Planks
This variation works the lateral hip and back muscles.

Beginners use the modified plank using a bent

knee and propping up on your arm. Hold 10-20
seconds then lower yourself. Repeat for several
repetitions or one long exercise. Repeat for the
opposite side.

Advanced version is to rest on your

outstretched foot and hand as shown. Hold
position for 10-20 seconds then lower
yourself and repeat.

Expectations
What can you expect with the Secret Piriformis Syndrome Treatment program?

 In the first 1-2 weeks you may feel worse. Your condition involves
inflammation and muscle spasm both of which cause pain. As the
treatment commences inflammation may actually rise slightly. Once the
modalities begin to cause physiologic changes however, you will notice
less and less pain.

 By the end of 4 weeks you should feel approximately 70-80% less

pain. If not, then continue on with initial care modalities on a week to week
basis until you do. If your condition takes 8 weeks to make it through Initial
Care, don’t worry. Many people with Piriformis Syndrome have had their
problem for months or years. For some this means a longer duration of
Initial Care.

 Rehabilitation Care generally takes twice as long as Initial Care. So if

you’ve met the 4 weeks mark in Initial Care, then it’s likely you will
successfully complete Rehab Care in about 8 weeks.

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  At the completion of Rehab Care most people will be fine. It is
recommended to continue the exercises at least 3 times each week to
keep the muscles in good shape and prevent relapse.

But what if my Piriformis Syndrome doesn’t respond well? What if after all this
treatment and 3 months of therapy visits, my butt or leg still hurts? Am I doomed
to suffer?

No.

In the next section I will explain what failure to respond to this program means to
you…

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 What Does Failure of the Secret
Piriformis Syndrome Treatment
Mean…

”Failure is a beginning not an end…”

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What category do you fall under?

1. Relief with the program, but pain returns periodically.

Chronically recurring Piriformis syndrome may indicate you have a variation
of the sciatic nerve and/or Piriformis muscle in which you are predisposed to
this problem. If this is the case, then you will need to make sure you continue
the exercises and avoid certain postures and/or activities that re-aggravate
your condition.

2. Some relief, but not complete

 You may need more treatment

 Treatment wasn’t properly administered or exercises were not

performed

 Piriformis muscle is only part of your problem… see next section

3. Minimal or no response
If this is the case, then you’re most likely suffering from buttock or leg pain
due to a disc problem. If the discs between the spinal bones begin to
deteriorate or bulge outward, nerves may become irritated sending pain
messages down into the buttocks, hip or thigh.

Buttock pain caused by degenerative disc disease, bulging discs, herniated

disc or stenosis requires a thorough specialized examination and MRI of the
lumbar spine. For more information about diagnosis and treatment of disc
problems or stenosis may be found here:
www.orangespinaldecompression.com

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 Special Offer for Readers of
the Secret Piriformis Syndrome
Treatment Program

“Free Piriformis Syndrome, Back &

Buttocks Pain Severity Evaluation”
“Suffering from back, buttocks or leg pain?”

“Can’t seem to find the solution to your problem

despite treatment?”

Call (714) 938-0575 Now to Reserve Your Free, No-Obligation

Evaluation by the Author, Back Pain Specialist and Former Associate
Clinical Professor, Dr. Barry L. Marks, DC

What Your Free Evaluation Includes:

 Face to face consult to discuss your condition with a true Piriformis
Syndrome and Back Pain specialist, Dr. Marks
 Specialized Back & Buttock Pain Examination… a $125 value
 Space age computerized diagnostic test to painlessly pinpoint the cause of
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This Free Evaluation will tell you everything you need to understand:
 What is causing your problem
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Appointments are first come, first served and are limited each month, to
ensure your Free evaluation, call (714) 938-0575 right now.

Call now, fill out this appointment certificate and bring it with you:

Appointment Date:______________________________ Time: __________________

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 “About the Author”

Dr. Barry L. Marks, DC is the founder of Orange Spine

& Disc Rehabilitation Center, a unique health center
dedicated to the diagnosis and restoration of health
from mechanical injuries such as disc problems,
whiplash, carpal tunnel syndrome and many other
causes. Blending the latest computer technology,
mind-body therapy and old fashioned concern, he is
able to alleviate difficult conditions that have failed
with other methods.

Dr. Marks is a former Associate Clinical Professor at a leading Chiropractic

College and is the author of numerous articles on health and wellness.

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 More from Dr Marks
Self Help E-Books & Audio Programs
by Dr. Barry L. Marks, DC
MyEasyEFT.com
EFT is an amazing mind-body science to uncover and remove hidden mental blockages
to finally realize your potential for abundant health, success, self esteem and serenity.
EFT titles include:

 Emotional Freedom Technique (EFT) for a Healthy &

Pain Free Life
 Emotional Freedom Technique (EFT) for Success
 Emotional Freedom Technique (EFT) for Self Esteem
 Emotional Freedom Technique (EFT) for Serenity

AboutMyHeadache.com
“5 Common Causes of Headaches…3 Steps to Relief”

Uncover the cause of your headaches in this informative, step-

by-step guide and find relief once and for all.

Visit Dr. Barry L. Marks Online

Websites:
www.DrMarks.com
www.OrangeSpinalDecompression.com

Blogs:
www.healthybeyondreason.wordpress.com
www.spinaldecompression.wordpress.com
www.occaraccident.wordpress.com

Free E-Seminars by Dr. Barry L Marks:

7 Days to Abundant Health
www.TruthAboutWhiplash.com

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 Contact Dr. Marks

DR. BARRY L. MARKS, DC

ORANGE SPINE & DISC

REHABILITATION CENTER
2401 W. CHAPMAN AVE #102
ORANGE, CALIFORNIA 92868

TELEPHONE
(714) 938-0575

EMAIL
INFO@DRMARKS.COM

TOUR DR. MARKS’ OFFICE

http://www.drmarks.com/chiropractor_orange_ca_tour.html

REQUEST AN APPOINTMENT
http://www.drmarks.com/same_day_chiropractic_appointments.html

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