Piriformis syndrome - Revision history

Rossdonaldson1: /* References */

2021-01-12T16:46:18Z

References

2021-01-12T16:45:46Z

Management

← Older revision		Revision as of 16:45, 12 January 2021
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	**[[NSAIDs]] +/- [[gabapentin]] if patient has neuropathic pain		**[[NSAIDs]] +/- [[gabapentin]] if patient has neuropathic pain
	*May benefit from referral for steroid or botulinum toxin injection <ref>Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.</ref>		*May benefit from referral for steroid or botulinum toxin injection <ref>Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.</ref>

			==Disposition==
			*Outpatient

			==See Also==

			==External Links==

	==References==		==References==
	<references/>		<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]

2021-01-12T16:45:17Z

Management

← Older revision		Revision as of 16:45, 12 January 2021
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	**Avoidance of contributory activity (e.g. running, cycling, heavy lifting)		**Avoidance of contributory activity (e.g. running, cycling, heavy lifting)
	**Physical therapy		**Physical therapy
	**NSAIDs +/- gabapentin if patient has neuropathic pain		**[[NSAIDs]] +/- [[gabapentin]] if patient has neuropathic pain
	*May benefit from referral for steroid or botulinum toxin injection <ref>Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.</ref>		*May benefit from referral for steroid or botulinum toxin injection <ref>Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.</ref>

2021-01-12T16:43:51Z

Background

← Older revision		Revision as of 16:43, 12 January 2021
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	==Background==		==Background==
			[[File:Piriformis syndrome.jpg\|thumb\|Piriformis muscle in relation to sciatic nerve.]]
	*The piriformis muscle acts as an external rotator, weak abductor, and weak flexor of the hip		*The piriformis muscle acts as an external rotator, weak abductor, and weak flexor of the hip
	*It originates from the anterior sacrum and inserts on the greater trochanter of the femur		*It originates from the anterior sacrum and inserts on the greater trochanter of the femur

2020-12-14T17:08:04Z

Background

← Older revision		Revision as of 17:08, 14 December 2020
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	==Background==		==Background==
	*~~Irritation~~ of the sciatic nerve ~~from~~ the piriformis muscle		*The piriformis muscle acts as an external rotator, weak abductor, and weak flexor of the hip
			*It originates from the anterior sacrum and inserts on the greater trochanter of the femur
			*The sciatic nerve typically exits the greater sciatic foramen deep along the inferior surface of the piriformis muscle, but in approximately 20% of people, the sciatic nerve pierces the piriformis muscle <ref>Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP. Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach. J Am Osteopath Assoc 2008;108(11):657–664.</ref>
			*Local inflammation of the piriformis can cause muscular compression or irritation of the sciatic nerve causing local or radicular pain

	==Clinical Features==		==Clinical Features==

2020-12-14T15:06:55Z

Management

← Older revision		Revision as of 15:06, 14 December 2020
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	**Physical therapy		**Physical therapy
	**NSAIDs +/- gabapentin if patient has neuropathic pain		**NSAIDs +/- gabapentin if patient has neuropathic pain
	*May benefit from referral for steroid or botulinum toxin injection		*May benefit from referral for steroid or botulinum toxin injection <ref>Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.</ref>

	==References==		==References==
	<references/>		<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]

2020-12-14T15:03:51Z

References

← Older revision		Revision as of 15:03, 14 December 2020
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	<references/>		<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]
	~~Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.~~

2020-12-14T15:01:44Z

References

← Older revision		Revision as of 15:01, 14 December 2020
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	<references/>		<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]
			Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881.

2020-12-14T15:00:55Z

Management

← Older revision		Revision as of 15:00, 14 December 2020
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	==Management==		==Management==
	*Conservative		*Conservative
			**Avoidance of contributory activity (e.g. running, cycling, heavy lifting)
			**Physical therapy
			**NSAIDs +/- gabapentin if patient has neuropathic pain
			*May benefit from referral for steroid or botulinum toxin injection

	==References==		==References==
	<references/>		<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]

2020-12-14T14:52:56Z

Evaluation

← Older revision		Revision as of 14:52, 14 December 2020
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	*Provocative testing with Freiburgs test: placing hip in extension and internal rotation, and then resisting external rotation		*Provocative testing with Freiburgs test: placing hip in extension and internal rotation, and then resisting external rotation
	**Pain or sciatic symptoms yield a positive test		**Pain or sciatic symptoms yield a positive test
			*Consider XR or outpatient MRI to rule out other causes of gluteal and sacroiliac pain

	==Management==		==Management==