Piriformis syndrome | |
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Other names | Deep gluteal syndrome[1] |
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Location of piriformis syndrome within the body | |
Specialty | Orthopedics, sports medicine |
Symptoms | Buttock pain that is worse with sitting[2] |
Duration | Long-term[3] |
Causes | Trauma, spasms, overuse injury[2] |
Diagnostic method | Based on symptoms[4] |
Differential diagnosis | Herniated disc, kidney stones, SI joint dysfunction[3][2] |
Treatment | Avoiding activities that cause symptoms, stretching, medications[3][5] |
Medication | NSAIDs, steroids, botulinum toxin injections[2] |
Frequency | Unknown (2017)[4] |
Piriformis syndrome is a condition which is believed to result from nerve compression at the sciatic nerve by the piriformis muscle.[2][5] It is a specific case of deep gluteal syndrome.[6]
The largest and most bulky nerve in the human body is the sciatic nerve. Starting at its origin it is 2 cm wide and 0.5 cm thick. The sciatic nerve forms the roots of L4-S3 segments of the lumbosacral plexus. The nerve will pass inferiorly to the piriformis muscle, in the direction of the lower limb where it divides into common tibial and fibular nerves.[7] Symptoms may include pain and numbness in the buttocks and down the leg.[2][3] Often symptoms are worsened with sitting or running.[3]
Causes may include trauma to the gluteal muscle, spasms of the piriformis muscle, anatomical variation, or an overuse injury.[2] Few cases in athletics, however, have been described.[2] Diagnosis is difficult as there is no definitive test.[5][4] A number of physical exam maneuvers can be supportive.[3] Medical imaging is typically normal.[2] Other conditions that may present similarly include a herniated disc.[3]
Treatment may include avoiding activities that cause symptoms, stretching, physiotherapy, and medication such as NSAIDs.[3][5] Steroid or botulinum toxin injections may be used in those who do not improve.[2] Surgery is not typically recommended.[3] The frequency of the condition is unknown, with different groups arguing it is more or less common.[4][2]
that is presumed to be a compression neuropathy of the sciatic nerve at the level of the piriformis muscle