I have suffered with what I was told was Myofascial Pain Syndrome, did I only this past spring '06 get diagnosed with Pirifornis... what a difference that made in my life. A diagnosis... a treatment, a diagnosis to a human being, without fibromyalgia..or Myofascial. I still have pain upon rest with my piriformis. But at least I know what I am dealing with. I am totallyh disgusted with most Doctors. Only one treated me like a human being, and actually examined me, and I almost lost my job as a nurse, but thanks to this Dr. I can deal with what I have.

Ugh!!! No cortisone! Have you had an MRI of your spine? You could have herniated disk involvement. But, whether you do or do not, your body has set up a chain reaction of tightening up many muscles in an effort to protect one or more that are either weak or overtightened.

I, too, had piriformis syndrome, but that was the result of a tight QL and weak glute medius.

I would strongly recommend 3 non-invasive procedures:
1. Get an MRI. It would be good to at least rule out disk issues.
2. Find a good SPORTS massage therapist. Not fluff 'n buff. Someone who knows the muscles and can help work out the tightness you have.
3. Buy one or both of the books: The Trigger Point Therapy Workbook and Trigger Point Therapy for Myofascial Pain, read and start hunting (with your massage therapist) for trigger points.

It can take awhile to find out which muscle is the root cause of all your issues, but you still need to work on the acute issues.

You DO need to stretch your left side more than your right until you figure this out. It's nice your chiro told you your left hip is high, but the reason for that is probably because the muscles on your left side are tight. This can also be exacerbated by a number of things. You are left-handed, correct? You probably stand with your left hip hitched up. Stop doing that. You probably also lay on the floor on your right side. Stop doing that. Do you run on roads? Camber can affect this as well.

It concerns me that you are having neck involvement, which is why I think an MRI might be in order. Even if there is a disk issue, you will still need to address all the muscular tightness that has been created in your body's effort to protect your spine.

Be optimistic! If you get on a good stretching program right away (and remember you need to work on your left side twice as much), and begin working out your acute trigger points, you might start to see some relief in just a few weeks. When I had the alleged piriformis syndrome and I began stretching my right side extra and working on triggers, I was noticeably better in 2 weeks. But it's work--I was stretching twice a day (sometimes 3 if I could sneak it in) and getting a good sports massage once a week.

The reason I said no cortisone is that often cortisone shots are given in LAST muscle in the chain to experience issues. For example, piriformis syndrome is often not caused by the piriformis itself (in my case it was the QL). So to inject that muscle doesn't cure anything. Also, cortisone injections can give the feeling of "cure," but they are just masking the root cause.

You have some work ahead of you, but you can get through it.

The short leg is probably "functional", i.e., it's caused by the tilted pelvis. You would have to have a bone scan in order to measure your femur, etc. to prove that you have a PHYSICAL leg length issue.

Good to hear you are making some progress. X-rays are not conclusive in ruling out disk issues. Maybe you need to find a different chiropractor? Or perhaps go see a good physical therapist?

You need a medical care partner who will look at you holistically and assess your muscle strengths and weaknesses, postural problems, etc., and then help you do the appropriate strength exercises to supplement your stretching and trigger point work. If you can find a chiropractor that will do this (sorry, but I am skeptical about them), great, if not, keep looking.

If you have had the high hip for several years, it is not going to go away quickly necessarily, so you need to be patient. You need to be conscious of how you stand, how you sit, how you sleep. You need to stand with weight on both feet equally. You need to sit NEVER CROSSING YOUR LEGS. Sleep on your back is best. I think the trigger point books talk about this.

Are you getting massage? The more of this you can get to add to your stretching and self-work, the faster you will get to the root of the problem.

Also tpmassageball.com has good toys to help work on yourself, but I assume you already have those.

I'm not a doctor or PT. You ultimately need to make the decisions about the severity of your issues and whether to press for MRI or to just be patient and continue your good habits.