Piriformis syndrome and low back pain: a new classification and review of the literature

Papadopoulos, E.; Khan, Safdar N.

doi:10.1016/s0030-5898(03)00105-6

Cited by 207 publications

(151 citation statements)

References 46 publications

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“…Reported prevalence of PS among patients with LBP varies widely from 5 to 36% [3,12,13]. In our study, the prevalence of PS among patients who visited the pain clinic for LBP with/without lower leg pain was 13.7% (317/2,320).…”

Section: Discussionmentioning

confidence: 53%

Piriformis syndrome after percutaneous endoscopic lumbar discectomy via the posterolateral approach

Kim

2011

Eur Spine J

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Percutaneous endoscopic lumbar discectomy (PELD) can be performed under local anesthesia with intravenous analgesics. To define the incidence of piriformis syndrome (PS) after PELD via the posterolateral approach under local anesthesia compared to that of general patients presenting with low back pain with/without lower leg pain. The incidence and time of occurrence of positive FAIR test after PELD within a 3-month follow-up period were evaluated retrospectively, and compared with the prevalence of general patients who visited the pain clinic for LBP with/without lower leg pain. Factors that may increase the incidence of PS after PELD were also evaluated. There was no patient with positive FAIR test immediately after PELD in the operation room and before walking. The prevalence of PS in general patients was 317/2,320 (13.7%); however, the incidence of PS after PELD within a 3-month follow-up period was 61/151 (40.4%), peaking at 32 days. High anxiety scale scores during operation led to increased incidence of PS after PELD. PELD under local anesthesia with high level of anxiety may increase the incidence of PS after walking, peaking around the first month, compared with the results for general patients with low back pain with/without lower leg pain.

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Section: Discussionmentioning

confidence: 53%

Piriformis syndrome after percutaneous endoscopic lumbar discectomy via the posterolateral approach

Kim

2011

Eur Spine J

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“…Secondary PS occurs as a result of a precipitating cause, including macrotrauma, microtrauma, ischemic mass effect, and local ischemia [19,[25][26][27][28]. Among patients with PS, fewer than 15% of cases have primary causes [19,23]. PS is most often caused by macrotrauma to the buttocks, leading to inflammation of soft tissue, muscle spasm, or both, with resulting nerve compres-Aggarwal Pawan Kumar, Agarwal Nidhi.…”

Section: Discussionmentioning

confidence: 99%

“…Stretching of the piriformis muscle and strengthening of the abductor and adductor muscles should also be included in patient treatment plans [30]. A manual medicine approach may combine muscle Gebauer's spray, stretch technique, soft tissue, myofascial, muscle energy, and thrust techniques to address all somatic dysfunctions in the patient with PS [20,23,25,26]. If the patient does not respond adequately to manual treatment, then acupuncture and trigger point injection with lidocaine hydrochloride, steroids, or botulinum toxin type A (BTX-A) may be considered [23,[31][32][33].…”

Section: Discussionmentioning

confidence: 99%

“…A manual medicine approach may combine muscle Gebauer's spray, stretch technique, soft tissue, myofascial, muscle energy, and thrust techniques to address all somatic dysfunctions in the patient with PS [20,23,25,26]. If the patient does not respond adequately to manual treatment, then acupuncture and trigger point injection with lidocaine hydrochloride, steroids, or botulinum toxin type A (BTX-A) may be considered [23,[31][32][33]. If all the pharmacologic and manual medicine treatments fail, the final treatment option is surgical decompression [9,18,20,23,24].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of PS in patients with low back pain has been reported to vary widely from 0.33% to 36% [19][20][21][22][23][24]. It may be the reason that difficulties arise in accurately determining the true prevalence of PS because it is frequently confused with other conditions.…”

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confidence: 99%

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Piriformis Syndrome: A Case Report

Kumar¹,

Agarwal²

2017

IJPR

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Assistant Professor, Maharaja Agrasen College of Physiotherapy, Agroha District Hisar (India).Piriformis syndrome is a clinical condition of non-discogenic sciatica caused by compression of the sciatic nerve by the piriformis muscle and its patho-physiology is not fully understood. It has variable etiologies. The major etiology known includes spasm, edema and inflammation of the piriformis muscle, and sciatic nerve compression by the muscle later on. Patients can be diagnosed immediately with a comprehensive clinical examination and early diagnosis which makes the treatment much easier. A case of piriformis syndrome diagnosed in a patient who presented with radicular low back pain is reported in this study. Differential diagnosis of the piriformis syndrome, a very rare cause of low back pain, should be thoroughly made with the exclusion of other conditions.

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