Piriformis syndrome

1. Piriformis Syndrome By Laura Sandve & Andy Coleman

2. Sciatica symptoms due to an involvement of the piriformis muscle Often referred to as “Wallet Sciatica” or “Fat Wallet Syndrome” Entrapment of one or more nerves Sciatic Pudendal Pathophysiology

3. Tightness or spasms of the piriformis Trauma to the piriformis Weak gluteals Sitting on thick wallet for long periods of time Possible Causes

4. Higher incidence in females 6:1 ratio Total hip arthroplasty Excessive pronation Strengthening without stretching Sciatic nerve passing through the piriformis About 15-30% of the population Risks

5. Sciatic Entrapment Pain, tingling, numbness Buttocks, posterior thigh, hip, leg Radiating Tenderness in the area of the sciatic notch Signs and Symptoms

6. Pudendal Entrapment Pain, tingling, numbness Coccyx, groin May cause bowel and/or bladder incontinence Signs and Symptoms

7. Beatty Maneuver Freiberg Test Pictured Pace Test Muscle injections Usually an anesthetic and C ortizone Diagnosing

8. Generally very easy to treat Surgery is rarely recommended but is generally very successful Patient’s whose sciatic nerve runs through the piriformis muscle are more susceptible to repetitive piriformis syndrome Prognosis

9. Non-operative Modalities Massage, Ultrasound ice, heat Gait training Stretching Piriformis, e xternal rotators, IT band Strengthening Gluteals, Adductors, Abductors NSAID’s Treatment

10. Operative Not common Surgical release of the piriformis Generally a posterior approach WBAT post surgery for 2 weeks Treatment

11. Bibliography Kisner , Carolyn. Colby, Lynn Allen. Therapeutic Exercise : Fifth Edition. Philadelphia: F.A. Davis Company, 2007 Mid-Tennessee Bone & Joint Clinic P.C . 2006. 22 November 2010 < http://www.mtbj.net/pdf/PiriformisSyndrome.pdf > eMedicine : Piriformis Syndrome. 31 March 2010. 22 November 2010 < http :// emedicine.medscape.com/article/308798-overview> Piriformis Syndrome. 9 November 2010. 19 November 2010 < http:// en.wikipedia.org/wiki/Piriformis_syndrome>