Piriformis syndrome

Piriformis syndrome
Synonyms	Deep gluteal syndrome
Pronounce
Field	Orthopedics, sports medicine
Symptoms	Buttock pain that is worse with sitting
Complications
Onset
Duration	Long-term
Types
Causes	Trauma, spasms, overuse injury
Risks
Diagnosis	Based on symptoms
Differential diagnosis	Herniated disc, kidney stones, SI joint dysfunction
Prevention
Treatment	Avoiding activities that cause symptoms, stretching, medications
Medication	NSAIDs, steroids, botulinum toxin injections
Prognosis
Frequency	Unknown (2017)
Deaths

Piriformis Syndrome is a medical condition presumed to arise due to the compression of the sciatic nerve by the piriformis muscle. It is characterized by symptoms such as pain, numbness, and discomfort in the buttocks region, potentially radiating down the leg. The intensity of symptoms may be aggravated by activities such as sitting or running.

Symptoms and Signs

Individuals with Piriformis Syndrome commonly experience gluteal discomfort which might radiate down the buttock and leg, often intensified by certain sitting positions or physical activities.<ref name=":0">

Piriformis Syndrome: A Real Pain in the Butt for Runners(link). {{{website}}}.

2013.

Accessed 2023-05-18.

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Etiology

This condition can be triggered by various causes, including gluteal muscle trauma, overuse injury, or spasms of the piriformis muscle. Anatomical variation is also a possible cause. It is worth noting that few cases in athletics have been reported. Diagnosing this condition can be challenging due to the lack of a definitive test.<ref name=":0" />

Diagnosis

Diagnosis of Piriformis Syndrome typically involves the clinical assessment of symptoms and physical examination, including several maneuvers to confirm the diagnosis. Most individuals with this syndrome have normal medical imaging results. Other conditions, like a herniated disc, can present similarly and should be ruled out.<ref name=":1">

Piriformis Syndrome(link). {{{website}}}.

2008.

Accessed 2023-05-18.

</ref> Modern diagnostic tools such as CT scans, MRI, ultrasound, and EMG are primarily useful in excluding other conditions.

Pathophysiology

Piriformis Syndrome occurs when the piriformis muscle, usually due to trauma or overuse, undergoes spasms or shortens, thereby compressing or straining the sciatic nerve beneath it. The condition is a type of nerve entrapment, which refers to a group of conditions that cause neuropathic pain and dysfunction in the peripheral nervous system due to physical compression.<ref name=":1" /> In some individuals, the sciatic nerve passes through, rather than under, the piriformis muscle. Some research suggests that this anatomical variation might not be as critical in causing the syndrome.<ref name=":1" />

Treatment

Treatment approaches typically involve a combination of avoiding symptom-inducing activities, stretching, physiotherapy, and medication, such as NSAIDs. In cases that do not improve with these interventions, steroid or botulinum toxin injections may be considered. Surgery is not usually recommended.<ref name=":0" />

The frequency of Piriformis Syndrome is currently unknown due to conflicting viewpoints on its prevalence.

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