Abstract
Piriformis syndrome manifests as buttock pain; it can also induce sciatic pain due to compression of the sciatic nerve by the piriformis muscle. Among patients with sciatica, 5–6% present with piriform syndrome. The most common symptom of piriformis syndrome is ipsilateral buttock pain with or without sciatica. It tends to be exacerbated by prolonged sitting. The diagnosis is based on clinical symptoms, i.e., tenderness over the piriformis muscle and the effectiveness of piriformis blocking. Conservative treatment consists of oral medication, physiological therapy, and piriformis blocks. Piriformis muscle stretching is easy and useful for pain control. In most patients, conservative treatment helps to control pain; surgery is indicated when conservative therapy is ineffective. As the symptoms of piriformis syndrome and lumbar spine disease are similar, and as lumbar spine disease may be co-present, patients with sciatic pain accompanied by buttock pain must be diagnosed carefully.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Jankovic D, Peng P, van Zundert A. Brief review: piriformis syndrome: etiology, diagnosis, and management. Can J Anaesth. 2013;60(10):1003–12.
Halpin RJ, Ganju A. Piriformis syndrome: a real pain in the buttock? Neurosurgery. 2009;65:197–202.
Martin HD, Kivlan BR, Palmer IJ, Martin RL. Diagnostic accuracy of clinical tests for sciatic nerve entrapment in the gluteal region. Knee Surg Sports Traumatol Arthrosc. 2014;22:882–8.
Vassalou EE, Katonis P, Karantanas AH. Piriformis muscle syndrome: a cross-sectional imaging study in 116 patients and evaluation of therapeutic outcome. Eur Radiol. 2018;28(2):447–58.
Fishman LM, Wilkins AN, Rosner B. Electrophysiologically identified piriformis syndrome is successfully treated with incobotulinum toxin A and physical therapy. Muscle Nerve. 2017;56(2):258–63.
Kirschner JS, Foye PM, Cole JL. Piriformis syndrome, diagnosis and treatment. Muscle Nerve. 2009;40:10–8.
Rues M, de Dios Berna J, Vazquez V, Redondo MV, Alonso J. Piriformis syndrome: a simple technique for US-guided infiltration of the perisciatic nerve. Preliminary results. Eur Radiol. 2008;18:616–20.
Hanania M, Kitain E. Perisciatic injection of steroid for the treatment of sciatica due to piriformis syndrome. Reg Anesth Pain Med. 1998;23:223–8.
Waseem G, Boulias C, Gordon A, Ismial F, Sheean G, Furlan AD. Botulinum toxin injections for low-back pain and sciatica. Cochrane Database Syst Rev. 2011;(1):CD008257.
Benson ER, Schutzer SF. Posttraumatic piriformis syndrome: diagnosis and results of operative treatment. J Bone Joint Surg Am. 1999;81:941–9.
Filler AG, Haynes J, Jordan SE, Prager J, Villablanca JP, Farahani K, McBride DQ, Tsuruda JS, Morisoli B, Batzdorf U, Johnson JP. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine. 2005;2:99–115.
Isu T, Kim K, editors. Numbness and pain that are treated by surgery. Diagnosis and surgery for peripheral nerve entrapment neuropathy. Osaka: Medica Shuppan; 2016.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Morimoto, D. (2021). Piriformis Syndrome. In: Isu, T., Kim, K. (eds) Entrapment Neuropathy of the Lumbar Spine and Lower Limbs. Springer, Singapore. https://doi.org/10.1007/978-981-33-6204-8_7
Download citation
DOI: https://doi.org/10.1007/978-981-33-6204-8_7
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-33-6203-1
Online ISBN: 978-981-33-6204-8
eBook Packages: MedicineMedicine (R0)