Neuro

Piriformis Syndrome

search

Piriformis Syndrome

  • See Also
  1. Sciatica
  2. Hip Pain
  • Definitions
  1. Piriformis Syndrome
    1. Sciatic nerve impingement by the piriformis Muscle (subset of Deep Gluteal Syndrome)
  • Causes
  1. Anatomic variant (sciatic nerve passes through piriformis Muscle in 15% of patients)
  2. Decreased core Muscle Strength (buttocks)
  3. Sacroiliac Joint Dysfunction
  4. Local Trauma to piriformis Muscle
  5. Pressure from wallet in pocket
  • Symptoms
  1. Posterior Hip Pain and buttock pain
  2. Pain worse with sitting
  3. Sciatica
    1. Burning pain radiating down posterior leg
  • Signs
  1. Pain on Internal rotation of hip against resistance
  2. Seated piriformis stretch may exacerbate pain
  • Diagnostics
  1. Consider MRI or electrodiagnostic nerve testing to identify entrapment location in refractory cases
  • Management
  1. Local measures (e.g. ice or heat)
  2. NSAIDs
  3. Core Muscle StrengtheningExercises (see resources below)
  4. Correct comorbid conditions (e.g. Sacroiliac Joint Dysfunction)
  5. Local Corticosteroid Injection
  • Resources
  1. Piriformis Syndrome Stretches (Cleveland Clinic)
    1. https://health.clevelandclinic.org/piriformis-syndrome-stretches-exercises
  2. Piriformis Syndrome Exercises (Bob and Brad)
    1. https://www.youtube.com/watch?v=DsHvuYMt45g
  • References
  1. Chamberlain (2021) Am Fam Physician 103(2): 81-9 [PubMed]