Piriformis Syndrome Case Solution & Answer

Piriformis Syndrome Case Solution

Table of Contents

  1. Introduction. 5

1.1 Etiology. 5

1.2 Epidemiology. 6

  1. Piriformis syndrome. 6

2.1 Symptoms of Piriformis Syndrome. 7

2.2   Diagnosis of piriformis syndrome. 7

2.2.4 Pace sign. 8

2.2.5 Palpations. 9

2.2.6 Hughes test 9

2.2.7 Hip Abduction. 9

  1. Treatment of piriformis syndrome. 10

3.1 Muscle stretching. 10

3.2 Piriformis stretches. 10

3.4 Physical Therapy. 11

3.4.1 Ice casket and massage. 11

3.4.2 Heat Treatment 11

3.4.3 Massage therapy. 11

3.5 Exercise. 11

3.6 Medications. 13

3.7 Steroids. 13

3.7.1 Piriformis injection. 13

3.7.2 Botox injection. 13

3.8 Electrotherapy. 13

3.9 Surgery. 14

  1. Differential diagnosis. 14
  2. Prognosis. 14
  3. Complications. 15
  4. Literature review.. 16
  5. Pearls And Safety Measure. 21
  6. How to evolve awareness among people?. 22
  7. Outcomes. 23
  8. Conclusion. 23


Piriformis syndrome (PS) is neuromuscular disorder produced by the compression and spasm of piriformis muscle. The piriformis muscle is a flat, spindle shaped muscle present at the buttock region. The spasm caused in the muscle irritates the nearby sciatic nerve and causes pain. The patient suffering from this syndrome may feel pain at the bottom of the back and legs. Study has shown that this syndrome is more likely to be found in women as compared to men. This syndrome can be diagnosed through several techniques such as MR-imaging, Medical history and physical test. Once the syndrome has been detected, the patient undergoes through several treatment procedures which ultimately depends upon the patient’s condition. The possible treatment procedures for this syndrome might include exercise, physical therapy, exercise, injections and surgery. The time span for each of the therapy may vary. However, it has been shown that physical therapy along with injections, has more efficient and promising results in treatment procedure than surgery. The patients are suggested to visit to the experienced health professionals to avoid any complications.

Key words: piriformis muscle, MR-imaging, Physical therapy, muscle spasm, PS.

1. Introduction

PS is a medical constrain that develops from the piriformis muscle. It is a standard, belt-like muscle arranged in sequence by the sciatic nerve present in the pelvic region. This muscle is significant for lower body growth because it measures the hip joint and turn the thigh apart from the body. This allows us to move, to shift our weight from one foot to the next, and to maintain balance. It is widely used in sports including lifting and rotating thighs. In general, these muscles are very important in lower extremity movements and motions.

The sciatic nerve is a broad and long nerve in the body. It crosses near or close by the piriformis muscle. It goes at the bottom of the back and leg, and finally goes down into the inferior arteries ending at the feet.

Piriformis syndrome is a rare neuromuscular disorder,which is caused by the compression of sciatic nerve. This condition makes the person feels uncomfortable in walking and in sitting. It causes pain in back when sitting or sleep in one position for a long period of time. However, this condition is painful but it can be treated through different therapies and medications. The treatment procedure and duration may varies from the person to person. In some cases this condition can be resolved rapidly whereas in some, it takes a long time rehabilitation for treatment and pain inhibition.

1.1 Etiology

Sciatic Nerve is enveloped anteriorly to the piriformis muscle and posterity to the gamelli-obturator internus at the ischial tuberosity. This muscle can be over-stressed because of the poor body motion and rotation of lower back and hip. There are several anatomic conditions that compress the nerve such as invasion of tumor, bipartite piriformis etc.(ZF, 2018)

1.2 Epidemiology

Study has shown that almost 6% of the cases of back pain is due to sciatic nerve compression. About 40 million of people suffers from this syndrome annually.(ZF, 2018)

This syndrome is most commonly be found in middle-aged.

2. Piriformis syndrome

Piriformis syndrome is a neuro-muscular disorder brought by the spasm of piriformis muscle. After the contraction, it causes irritation and shivering along the back and foot.(TO, 2018)

Causes of piriformis syndrome

The suspected induces for the syndrome are:

  • Muscle can be contracted by either the disturbance created by the p(John Revord, 2012)iriformis muscle or the nearby structures
  • Compressing or blistering of muscle due to specific wound or spasm
  • Bleeding nearby muscle

The above stated causes or the combination of these causes may fabricate the piriformis muscle and adjacent schiatic nerve.

Study has shown that this syndrome is more likely to be found in women than it is found in men. The ratio is illustrated below:

2.1 Symptoms of Piriformis Syndrome

The patient suffering from piriformis syndrome might have acute sensitivity in buttock and sciatic-like pain at the lower back and foot. Typical symptoms for this syndrome may include:(revord, 2012)

  • Buttock Ache.
  • Sciatic-like ache at the lower body back and foot.
  • Increased affliction after delayed sitting.
  • Decreased scope of movement of the hip joint.
  • Pain when going upstairs.

It has the chances of getting worse after protracted sitting or walking and can be relaxed by sitting or stretching out at the back.

2.2  Diagnosis of piriformis syndrome

The piriformis syndrome can either be diagnosis through physical tests, patient’s medical history and by diagnostic exam.(revord, 2012)

 Physical Tests

The physical examination is one of the easiest test to observe the PS. This test will identify if the patient is experiencing pain along the lower body back and leg by increasing the lower extremity. This test will also be helpful in ruling out other body pain, such as: tenderness and muscle strength.

  • Patient’s Medical history

The patient’s medical history is one of the confined measures in the treatment of any disease. The health professionals may review the patient’s Medical history before suggesting any medications and treatment. The medical history is very important and plays an important role in judging patient’s medical conditions. It will also include a review of ailment found in patient’s family such as: arthritis.

2.2.3 Diagnostic Exam

X-beams and other spinal imaging contemplates can’t decide if the sciatic nerve is aggravated in the piriformis muscle. In any case, demonstrative tests, (for example, X-beams, MRI and nerve conduction tests) can be executed to preclude different conditions that may cause manifestations like piriformis disorder.

2.2.4 Pace sign

Pace sign is a diagnostic test. It can be judge by the weakness and pain the patient’s felt when moving the hip rotation-ally in external position. It has shown that the 46.5% of the patients diagnose with PS due to the pace sign test…………………………..

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