Evaluation of neural therapy effect in patients with piriformis syndrome

Nazlıkul, Hüseyin; Ural, Fatma Gülçin; Öztürk, Gökhan Tuna; Öztürk, Aycel Derya Tanay

doi:10.3233/bmr-170980

Cited by 28 publications

(18 citation statements)

References 18 publications

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“…Also, our findings are similar to those of Nazlıkul et al, who compared the short‐term effect on disability of a local anesthetic injection (as another treatment for PMS) with a control group. However, when comparing our results with those of Nazlıkul et al, our findings related to the reduction in the ODI score had a lower standardized effect size (Cohen d ) …”

Section: Discussioncontrasting

confidence: 47%

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

et al. 2019

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Introduction Piriformis muscle syndrome (PMS) is a disorder that can lead to symptoms of buttock pain and limited hip‐joint mobility, and may have an impact on quality of life. Methods Thirty‐two patients with PMS were randomized to the treatment group, which included three sessions of ultrasound‐guided dry needling (DN) of the piriformis muscle (n = 16), or a waitlist control group (n = 16). The primary outcome was pain intensity measured on the visual analog scale recorded at baseline and then at 72 hours and 1 week after treatment. Results At 1‐week follow‐up, pain intensity was significantly less in the DN group than in the waitlist control group (−2.16 [−1.01 to −3.32], P = .007) by an amount consistent with clinically meaningful improvement. Discussion The findings suggest that DN resulted in clinically meaningful short‐term improvement in pain intensity of patients with PMS.

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Section: Discussioncontrasting

confidence: 47%

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

et al. 2019

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“…Lidocaine has been shown to be useful in the treatment of refractory chronic pain (31). In 2018, Nazlikul et al (32) tested the efficacy of lidocaine injections as neural therapy on reducing pain and improving functionality in patients with piriformis syndrome. The 51 patients in the treatment group received six sessions of lidocaine injections and during each session were given piriformis muscle injections, T11-S2 segmental injections, and a sacral canal injection.…”

Section: Physical Therapymentioning

confidence: 99%

Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review

et al. 2021

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Context: Piriformis syndrome is a solely clinical diagnosis that often eludes the practitioner and goes underdiagnosed. PS is a pain syndrome and for those it affects, causes persistent pain and limits daily activity and work capacity. It is a form of deep gluteal syndrome that needs to be considered on the differential of low back pain as it comprises between 0.3% - 6% of all low back pain cases and is frequently underdiagnosed. Piriformis syndrome may be primary due anatomic anomalies or secondary, though the majority of cases are secondary to some insult. The objective of this manuscript is to provide a description of the epidemiology and presentation of piriformis as well as both non-operative and operative treatment options. We review all of the recent clinical evidence regarding the aforementioned therapies. Evidence Acquisition: Literature searches were performed using the below MeSH Terms using Mendeley version 1.19.4. Search fields were varied until further searches revealed no new articles. All articles were screened by title and abstract. Decision was made to include an article based on its relevance and the list of final articles was approved three of the authors. This included reading the entirety of the article. Any question regarding the inclusion of an article was discussed by all authors until an agreement was reached. Results: Medical management and physical therapy show some promise; however, when conservative treatment fails minimally invasive methods such as steroid injections, botulinum toxin injections, dry needling are all efficacious and there is substantial clinical evidence regarding these therapies. In those patients in which minimally invasive techniques do not result in an adequate relief of pain and return of function, endoscopic release can be considered. Endoscopic release is far superior to open release of the piriformis syndrome given the higher success and lower rate of complications. Conclusions: Piriformis syndrome is an important differential diagnosis in the work up of lower back pain and should not be ruled out with proper examination and testing. Clinicians should consider medical management and conservative management in the initial treatment plan for piriformis syndrome. There are many options within the conservative management and the literature shows much promise regarding these. Physical therapy, steroid injections, botulinum toxin injections, and dry needling are all potentially effective therapies with few adverse effects. Surgical options remain as gold standard, but only when conservative management has failed and the symptoms are significant to affect daily living activities. Endoscopic decompression of the sciatic nerve with or without release of the piriformis muscle has a reported high likelihood of success and a low complication rate. Current literature supports the preference of the endoscopic approach over the open approach due to improved outcomes and decreased complications. Further research is to well define the metrics for the diagnosis of piriformis syndrome and may include a need to develop diagnostic criteria.

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“…This review highlights that sciatic nerve gliding can greatly help reduce lower limb pain and can also be used to monitor the condition of the patient during treatment. Lastly, Nazlıkul et al [10] studied the effect of physiotherapy approaches related to hip neural function, in order to control the functioning of patients with PS. The 102 participants were divided into two groups.…”

Section: Literature Reviewmentioning

confidence: 99%

The effect of physiotherapy in the treatment of piriformis syndrome: A narrative review

Dakou¹,

Iakovidis²,

Lytras³

et al. 2021

Nat. J. Clin. Orthop.

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Piriformis syndrome (PS) is a common sciatic nerve entrapment syndrome caused by muscle spasm or other inflammatory processes in the piriformis muscle area, that lead to compression of the sciatic nerve resulting in the classic sciatica symptomatology. It manifests by pain in the dorsal surface of the thigh that reflects in the leg area, weakness and sensory disorders. The purpose of this review was to search the current literature on physiotherapy approaches to the treatment of symptoms of patients with PS. The PubMed, Science Direct, EBSCO and Google Scholar databases were searched with different combinations of the following keywords: Piriformis syndrome, physiotherapy, rehabilitation. The review included clinical studies, systematic reviews and case studies. From the results of this review, it appeared that there is not a large number of studies on this topic while in the existing studies that were included in this review, the number of participants was very small. The results of this review also show that the various manual techniques have a positive effect on the treatment of PS when combined with pharmacotherapy. In conclusion, the mobilization of the sciatic nerve as well as the strengthening of the muscles adjacent to the piriformis muscle, such as the adductor muscles, contribute significantly to the improvement of the symptoms of the patients, while best results are shown in combination with appropriate medication.

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Evaluation of neural therapy effect in patients with piriformis syndrome

Abstract: After the neural therapy, the patients with low back pain due to piriformis syndrome may have improvement in both pain and functioning.

Cited by 28 publications

References 18 publications

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

Ultrasound‐guided dry needling decreases pain in patients with piriformis syndrome

Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review

The effect of physiotherapy in the treatment of piriformis syndrome: A narrative review

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