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.