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European Spine Journal

, Volume 19, Issue 12, pp 2095–2109 | Cite as

The clinical features of the piriformis syndrome: a systematic review

  • Kevork Hopayian
  • Fujian Song
  • Ricardo Riera
  • Sidha Sambandan
Review Article

Abstract

Piriformis syndrome, sciatica caused by compression of the sciatic nerve by the piriformis muscle, has been described for over 70 years; yet, it remains controversial. The literature consists mainly of case series and narrative reviews. The objectives of the study were: first, to make the best use of existing evidence to estimate the frequencies of clinical features in patients reported to have PS; second, to identify future research questions. A systematic review was conducted of any study type that reported extractable data relevant to diagnosis. The search included all studies up to 1 March 2008 in four databases: AMED, CINAHL, Embase and Medline. Screening, data extraction and analysis were all performed independently by two reviewers. A total of 55 studies were included: 51 individual and 3 aggregated data studies, and 1 combined study. The most common features found were: buttock pain, external tenderness over the greater sciatic notch, aggravation of the pain through sitting and augmentation of the pain with manoeuvres that increase piriformis muscle tension. Future research could start with comparing the frequencies of these features in sciatica patients with and without disc herniation or spinal stenosis.

Keywords

Piriformis Sciatica Diagnosis Systematic review 

Notes

Acknowledgments

We thank Mrs Wendy Marsh, Head of Knowledge Services, Ipswich PCT for assistance with retrieval, and Prof. Milos Jenicek and Prof. Paul Glasziou for comments on the assessment of case studies. The study was partly funded by a grant from the Scientific Foundation Board of the Royal College of General Practitioners. The authors are independent of the funding body.

Conflicts of interest statement

None.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Kevork Hopayian
    • 1
    • 3
  • Fujian Song
    • 1
  • Ricardo Riera
    • 2
  • Sidha Sambandan
    • 1
  1. 1.School of Medicine, Health Policy and PracticeUniversity of East AngliaNorwichUK
  2. 2.Department of the MedicineUniversidad CaraboboValenciaVenezuela
  3. 3.AldeburghUK

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