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KMID : 0948920160150010009
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Clinical Pain
2016 Volume.15 No. 1 p.9 ~ p.12
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Piriformis Muscle Syndrome: Differential Diagnosis for Sciatica
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Park Jung-Hyun
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Abstract
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Piriformis muscle syndrome is a nondiscogenic cause of direct muscular pain or piriformis muscle or sciatica from compression of the sciatic nerve around the piriformis muscle. Patients typically have buttocks pain with/without sciatica, and pain is worsening with sitting. They usually show normal neurological examination results and positive results of provocation test such as Flexion, adduction, and internal rotation (FAIR) of the hip, Freiberg sign, Pace sign. Direct tenderness is noted in palpation of the piriformis muscle and the symptom may be reproducible. Imaging and electrodiagnostic studies are typically normal and are used to rule out other causes of sciatica. Magnetic resonance neurography can be used for evaluating pathology of the sciatic nerve. Conservative treatment, including medication and physiotherapy, is usually helpful and should be considered first. For intractable cases, corticosteroid and botulinum toxin injections may be attempted. Ultrasound or fluoroscopic guidance injection can improve accuracy. Tenotomy of piriformis muscle can be done for those who do not respond to decompress the sciatic nerve.
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KEYWORD
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Piriformis muscle syndrome, Sciatica, Buttock pain
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FullTexts / Linksout information
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Listed journal information
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