Question
QUESTION: I've been having this problem for 2 months now..not sure
what triggered it but i started to get a pain shooting down
my left leg basically the sciatic nerve. I'm ok when i sit
but when i stand and walk i get the sharp pain in my pelvis
and down to the front of my knee. now after going though a
bunch of different doctors my chiropractor finally
diagnosed what the problem is . it is my piriformis muscle.
but instead of it being inflamed it is the opposite  it is
completely flaccid on my let side. he's suggesting
acupuncture to try and have it activated I'm not sure what
to do. any suggestions would be greatly appreciated

ANSWER: Dear Jerry,

Hi.

Sciatic pain goes down the back of the leg, not the front.  Sciatic pain is a nerve impingement, so a flaccid muscle can't cause it.

My first piece of advice:  ask your chiropractor to explain how a flaccid piriformis muscle causes pain down the front of your knee.

Second:  have him/her examine your quadriceps and psoas muscles for heightened tension.

The pain you describe, pain in your pelvis, sounds like the iliacus muscles, which means your psoas muscle is likely involved -- in contraction and sore.  A twist through the pelvis, caused by unbalanced tensions between the two legs, also causes pelvic pain.

You may read my articles on sciatica and on the psoas muscles at somatics.com/page4b.htm.

with regard,
Lawrence Gold

---------- FOLLOW-UP ----------

QUESTION: thanks for your insight on this matter but how does this
explain the spasms in the left buttocks/left pelvis? and
does the psoas muscle cause the pirformis muscle to be
flaccid??

Answer
It doesn't explain the spasms in your left buttock.  That's another issue.

Muscles don't cause each other to be tight or flaccid.  The brain regulates muscles, so the brain causes tightness or flaccidity.  It's a matter of conditioned reflexes, where the conditioning is commonly caused by the shock and pain of injury (an incident preceding, but not necessarily causing, the pain in that particular region).

Spasm is the opposite of flaccidity.  Spasm in your left buttock is contraction of the buttock muscles, of which the piriformis is one.  That might cause "piriformis syndrome" sciatica, but your sensations are not those of sciatica because they're in the wrong location for sciatica.  

It sounds like both the muscles that go down the front of the thigh and your buttock muscles are contracted.  That happens, sometimes, again, due to some injury-incident.  My guess is that the injury occurred to your buttock, and the muscles got so tight that the front muscles of the hip joint and thigh had to overtighten to overcome the other muscles, in movement.  Hence, the knee pain.

So, again, I might suggest that you read the articles I suggested, for more understanding and a course of action.  Where knee pain is involved, tight hamstrings are often also involved, so I point you to the article on hamstrings and knee pain, as well.

with regard,
Lawrence Gold