Decisions, Decisions - Piriformis Syndrome

Nothing simple ever happens to Mom.  One side effect has lead to another.  It's called Piriformis Syndrome.  Yup, ANOTHER one of those mysterious conditions.  I love Wikipedia for a quick understanding of this..."Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg."

Basically, it's a pain in the ass (oops...butt).  And leg, and hamstring, and calf, and foot.  It's excruciatingly painful and has really made Mom cry.  She hates crying about pain, but this seems to be different.  This morning, she was making coffee and while the water was boiling, she had to go lie down and stretch the leg THREE TIMES.  She wouldn't even laugh when I stood by her and wagged my tail and acted concerned.  (It wasn't an act...I was concerned.)

Where did it come from?  GUESS!!  Go ahead....GUESS!!

Yup...it came from the Proximal Muscle Weakness caused by the prednisone!!

I don't get it.  How can this happen?  What does it mean for me Mom?

Here's the theory. This proximal muscle weakness (PMW) started sometime in the early summer and crept up all unknowingly.  In the meantime, because Mom is stubborn and loves to walk us, she kept to her routine as much as possible not knowing that she was changing her gait to compensate for the muscle weakness.  Her left foot starting pronating, causing muscle strain, and by the time September rolled around, what she and her doctor thought was just lower back pain turned into a very bad case of Butt Pain (and hamstring and leg, etc...)
Let's fix it!       Turns out it's not so easy to fix because a very difficult choice has to be made.  I can explain it like this:

Squirrel to the left; squirrel to the right.  Which one to go after?  I hope the outcome is the same (eradicating our birdfeeders of these pesky little gray things), but which WAY is better? 

Choice 1:  Mom has to lower the dose of steroids to help resolve the muscle weakness.  (Remember steroids help control inflammation, so she's courting a flare). But, it's possible that the steroids are helping keep the piriformis muscle swelling down a little.

Choice 2:  See a specialist and get an injection into the bursa of the muscle.  What's IN the injection.  Ohhhhhh....just liquid steroids.   

RATS, doesn't that negate the whole "lower the reduce the steroids - to get rid of the muscle weakness -  that led to the change in gait and -  to the strain of the piriformis?" thing? 

What a conundrum.  Let's just sleep on it for awhile.