Piriformis Syndrome: A Cause of Nondiscogenic Sciatica

@article{Cass2015PiriformisSA,
  title={Piriformis Syndrome: A Cause of Nondiscogenic Sciatica},
  author={Shane P Cass},
  journal={Current Sports Medicine Reports},
  year={2015},
  volume={14},
  pages={41–44}
}
  • Shane P Cass
  • Published 1 January 2015
  • Medicine
  • Current Sports Medicine Reports
Piriformis syndrome is a nondiscogenic cause of sciatica from compression of the sciatic nerve through or around the piriformis muscle. Patients typically have sciatica, buttocks pain, and worse pain with sitting. They usually have normal neurological examination results and negative straight leg raising test results. Flexion, adduction, and internal rotation of the hip, Freiberg sign, Pace sign, and direct palpation of the piriformis cause pain and may reproduce symptoms. Imaging and… 
Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment
TLDR
A narrative review highlights the relevant anatomy, history, physical exam maneuvers, electrodiagnostic findings, and imaging findings that are used to diagnose piriformis syndrome and outlines the different treatment options including conservative treatment, injections, and surgical treatment.
Piriformis Syndrome or True Sciatica: Are They the Same or Different?
Sciatica is musculoskeletal pain sensed in the leg along the distribution of the sciatic nerve, which runs from the lower back, through the buttock, to the posterior thigh, and into the
Application of therapeutic massage in the case of piriformis syndrome: A case study
TLDR
Massage can be an effective method of alleviating pain occurring in piriformis syndrome and may constitute an alternative form of conservative treatment.
Sciatic Nerve Variants in Patients Diagnosed With Sciatica: Is There a Correlation?
TLDR
There is strong statistical significance regarding the relationship between sciatic nerve variation and the clinical diagnosis of sciatica and preoperative magnetic resonance imaging can be considered in Sciatica patients to prevent iatrogenic injury in pelvic surgery.
Piriformis syndrome as the only initial manifestation of septic sacroiliac osteomyelitis.
TLDR
A patient suffering from acute pelvic osteomyelitis with piriformis syndrome is reported as the only initial manifestation without fever, which rendered prompt and correct diagnosis difficult.
Laparoscopic surgical approach for the treatment of piriformis syndrome: Intrapelvic decompression technique
TLDR
If the sciatica is refractory to conservative treatments, laparoscopic exploration and decompression surgery of the pelvic nerves and piriformis muscle could be an option.
The Piriformis Syndrome: Evaluation of Seven Cases
TLDR
In 268 cases with conservative method, 100% of cases were cure treatment after 4 months, in contrast to surgery methods after 1 month, the result illustrated the significantly improved between two methods of treatment.
Four symptoms define the piriformis syndrome: an updated systematic review of its clinical features
TLDR
Piriformis syndrome is at a stage previously encountered with herniated intervertebral disc: its prevalence among low back pain and sciatica sufferers and the diagnostic accuracy of clinical features requires cross-sectional studies free of incorporation and verification biases.
Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review
TLDR
Clinicians should consider medical management and conservative management in the initial treatment plan for piriformis syndrome, and the preference of the endoscopic approach over the open approach due to improved outcomes and decreased complications.
...
...

References

SHOWING 1-10 OF 27 REFERENCES
[The piriformis syndrome].
A rare mentioned and therefore and often overlooked cause of low back pain with sciatica. The piriformis muscle arises from the anterior surface of the sacrum and inserts on the superior border of
The Diagnosis and Management of Piriformis Syndrome: Myths and Facts
  • T. Miller, K. White, D. Ross
  • Medicine
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 2012
TLDR
This article explores the various sources of controversy surrounding piriformis syndrome including diagnosis, investigation and management and a proposal for diagnostic criteria which include signs and symptoms, imaging, and response to therapeutic injections.
Abdominal and urogenital diseases can often be the cause of lower back pain and sciatic-like symptoms.
SUMMARY The treatment of lower back pain and sciatic-type symptoms are often not related to spinal cord infringement, but are due to other factors such as urogenital irritation and piriformis
Posttraumatic piriformis syndrome: diagnosis and results of operative treatment.
TLDR
Patients who have blunt trauma to the buttock and then have signs and symptoms that are suggestive of lumbar nerve-root compression may have posttraumatic piriformis syndrome.
The clinical features of the piriformis syndrome: a systematic review
TLDR
The most common features found in sciatica patients with and without disc herniation or spinal stenosis were: buttock pain, external tenderness over the greater sciatic notch, aggravation of the pain through sitting and augmentation of thePain with manoeuvres that increase piriformis muscle tension.
The piriformis muscle syndrome: an exploration of anatomical context, pathophysiological hypotheses and diagnostic criteria.
Piriformis muscle syndrome: diagnostic criteria and treatment of a monocentric series of 250 patients.
Brief review: Piriformis syndrome: etiology, diagnosis, and management
TLDR
The pathophysiology and diagnostic criteria of the piriformis syndrome is provided, an underdiagnosed cause of buttock and leg pain that can be difficult to treat and frequencies of clinical features are estimated in patients reported to have PS.
Botulinum Toxin Type B in Piriformis Syndrome
  • Amy M Lang
  • Medicine
    American journal of physical medicine & rehabilitation
  • 2004
TLDR
Findings suggest the possibility that botulinum toxin type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome.
Piriformis syndrome: diagnosis, treatment, and outcome--a 10-year study.
TLDR
The FAIR test correlates well with a working definition of piriformis syndrome and is a better predictor of successful physical therapy and surgery than the working definition.
...
...