Piriformis syndrome is a neuro-muscular disorders that occurs , when the sciatic nerve is compressed or irritated by the piriformis muscle.

Piriformis muscle is present in gluteal region and it is located within pelvis and posterior to the hip joint. The sciatic nerve runs either through the piriformis muscle as it leaves the spine.

What are the symptoms to patients?

• Location of pain is often imprecise, but it is often present in the hip, coccyx, buttock, groin and distal part of leg
• Pain with sitting
• Pain and paresthesia , radiating from buttock , down to posterior aspect of the thigh, usually stopping above knee.
• Pain increases from sitting position
• Difficulty in walking, or patient may have antalgic gait or foot drop
• Tingling or numbness in lower limb.

How your doctor will test you?

Your pain physician will stretch the irritated piriformis muscle , your Doctor will apply pressure over this muscle , while hip is flexed.  Your Pain Physician will examine you by doing FAIR test, ( flexion, adduction and internal rotation of hip),

What investigation doctor will advise?

MRI of lumbar  spine, ultrasound, EMG, NCV study may help to rule out othe pathologies.

Treatments:

• It includes , medications, interventional procedures and rehabilitation.
• Medication include, anti-inflammatory drugs, analgesics and muscle relaxants to reduce inflammation, spasm and pain.

Intervention procedure:

Piriformis injection

• We give this piriformis injection , when patients do not respond with conservative medications.
• With the use of ultrasound and fluoroscope , we inject local anesthetic plus methyl-prednisolone  into piriformis muscle. So it will reduces pain and swelling.
• Along with injection, abnormal biomechanics caused by posture, pelvic obliquities and leg length inequalities need to be corrected.
• Physical therapy involves stretching of the piriformis muscle with flexion, adduction, and internal rotation of hip followed by pressure applied to muscle.
• Core muscle strengthening to reduce strain on piriformis muscle is advised.