II. Definitions
- Piriformis Syndrome
- Sciatic nerve impingement by the piriformis Muscle (subset of Deep Gluteal Syndrome)
III. Causes
- Anatomic variant (sciatic nerve passes through piriformis Muscle in 15% of patients)
- Decreased core Muscle Strength (buttocks)
- Sacroiliac Joint Dysfunction
- Local Trauma to piriformis Muscle
- Pressure from wallet in pocket
IV. Symptoms
- Posterior Hip Pain and buttock pain
- Pain worse with sitting
-
Sciatica
- Burning pain radiating down posterior leg
V. Signs
- Pain on Internal rotation of hip against resistance
- Seated piriformis stretch may exacerbate pain
VI. Diagnostics
- Consider MRI or electrodiagnostic nerve testing to identify entrapment location in refractory cases
VII. Management
- Local measures (e.g. ice or heat)
- NSAIDs
- Core Muscle StrengtheningExercises (see resources below)
- Correct comorbid conditions (e.g. Sacroiliac Joint Dysfunction)
- Local Corticosteroid Injection
VIII. Resources
- Piriformis Syndrome Stretches (Cleveland Clinic)
- Piriformis Syndrome Exercises (Bob and Brad)