prevalence of piriformis muscle among individual with low back pain

prevalence of piriformis muscle among individual with low back pain research presentation

1. Supervisor:
Dr. Laila NiazKhan
Submitted by:
RabiaArif
MohsanMubarak
Sidra Amjad

2. Department: Doctor of Physical Therapy
Session: 2018-2023

3. Thepiriformisisasmallmuscledeepinthebuttock,behindthegluteus
maximus.Itrunsdiagonallyfromthelowerspinetotheuppersurfaceof
thefemur,withthesciaticnerverunningunderneathorthroughthe
muscle.Thepiriformismusclehelpsthehiprotate,turningthelegandfoot
outward.(Koziołetal.,2022)
Thearterialsupplyofpiriformismuscleisfromtheinferiorgluteal,superior
gluteal,andinternalpudendalarteries,allbranchesoftheinternaliliac
artery.Thenervesupplyofpiriformisissuperiorglutealnerve(C.Changet
al.,2022)

4. Lowbackpainisdefinedaspainanddiscomfort,localisedbelowthecostal
marginandabovetheinferiorglutealfolds,withorwithoutlegpain..
(Mughal,Ahmad,&binMalik,2020)
ThemostcommonmusclesthatareresponsibleforLowBackPainarethe
Iliopsoas,QuadratusLumborum,theGlutealsandtheMultifidusmuscles.
Theyarethemusclesthatattachinandaroundyourspine.TheIliopsoasis
actuallytwomusclesthatmeetatthefrontofyourhip.(Payton,
Khubchandani,Thompson,&Price,2017)

5. Thisstudywasconductedin2022byKhanetal.thiswasacross-sectionalstudyat
LadyReadingHospitalinPeshawar,Pakistan,toregulatetheregularityof
piriformissyndromeinpatientrolebypostdecompressionlumbarsurgical
procedure.Studyincluded60patientsselectedthroughsimplerandomsampling.
Theanalysisrevealedthattheoccurrenceofpiriformissyndromeamongaffected
rolewithpost-decompressionlumbarsurgerieswas36.5%.However,nowasfound
betweenpiriformissyndromeandthesurgeries.(khanetal.,2022)

6. In2023Othmanetal.publishedintheInternationalJournalofHealthScience
Research,researchersaimedtorecognizetheprevalenceofpiriformistightnessin
inactivepeople.Thestudyincluded200subjects,whowerecarefullyevaluatedand
screenedconstructedandexpressinclusion,andexclusioncriteria.Theassessmentof
piriformismuscletightnessinvolvedtheuseoftheboththeestablishedpiriformis
stretchmedicaltestandthepiriformisstretchtest.Thefindingsrevealedthat159
subjects,accountingfor79.5%ofthesample,exhibitedpiriformistightness.The
studyconcludedthatthereisahighprevalenceofpiriformistightnessintheinactive
people,particularlyamongadults,whichmayrisethedangerofemergingpiriformis
syndromeandsubsequentlowbackpain.(Othmanetal.,2023)

7. AuthorMughaletal.conductedacross-sectionalstudytodeterminethefrequencyof
piriformisstiffnessamongstbankersasaresultoftheirextendedsittinghours.The
studyusedaconvenientsamplingtechniqueandincluded190subjects.Thepiriformis
stretchtestwasperformedtoconfirmthepresenceofpiriformistightness.The
resultsshowedthatapproximately65.4%ofthesubjectshadapositivepiriformis
stretchtest,indicatingtheprevailingprevalenceofpiriformistightnessamongthem
(Mughaletal.,2020)

8. This study set out to ascertain whether people with low back discomfort were more
susceptible to piriformis muscular disorder. The purpose of this study is to increase
knowledge about piriformis muscle disorder as well as low back discomfort in the
research groups along with healthcare professionals.

9. Thepurposeofthisstudyistodeterminetheprevalenceofpiriformismuscle
syndromeamongindividualswithlowbackpainwhospendalotoftimesittingdown
andbeingsedentaryatworkandtogeneratethefrequencyofpiriformismuscle
syndromeamongindividualswithlowbackpain

10. 3.1StudyDesign:
Itwasacross-sectionalstudy.whichanisobservationalstudythatanalyzesdatafroma
populationorarepresentativeatspecificpointintimethatiscross-sectionaldata.
3.2StudySetting:
DatawasgatheredfromServicesHospital,Lahore.Joharinstituteprofessionalstudyandbank
3.3StudyDuration:
Thestudywascompletedinsixmonthsfollowingtheethicalcommittee'sapprovalofthe
summary.
3.4Samplingtechnique:
Forthisstudy,nonprobabilityconvenientsamplingtechniquewasused.
3.5SampleSize/collection:
Thesamplesizeofmyresearchwas210.
3.6 Sample Selection:
The following criteria were used to choose the sample.

11. 3.6.1 Inclusion criteria:
Sample within the age group of 30-50 years was a part of this study.
Both gender are included
Other symptoms including sciatic nerve compression, association of low back pain
is also found positive
Low back discomfort, above the age of 30.(A. Chang et al., 2023)
patients included office worker, prolonged bad rest of hospital, and institute
3.6.2 Exclusion Criteria:
The following were among the criteria for exclusion:
Injury to lumber during a traffic accident
Spinal fusion surgery
Disc degenerative disease
Lumbar disc discomfort (Koli& Anap, 2018)
3.7 Data Collection Procedure:
This study was conducted by selecting subjects based on inclusion criteria from
different setting . A questionnaire was used for the collection of demographic data.
To diagnose piriformis syndrome and low back pain FAIR Test and visual analogue
scale were used

12. 3.8DataCollectionTool:
Theinformationwasgatheredfromeveryparticipantaftertakingconsent,
afterbriefingthemregardingourstudyanddatacollectionprocedure.During
ourtestingprocesswefollowedsocialnorms.Wecollecteddatausingthe
visualanaloguescalequestionnaireandanoutcomeassessmenttoolthat
includesquestionsabouteverydayactivitiestofindprevalenceofpiriformis
musclesyndromewithlowbackpain.
3.9EthicalIssues:
Thesubjectwasfullyinformedbeforetheinterviewandthereasonfor
conductingthesurvey.Allinformationgatheredbythesubjectwaskept
confidentialandwasnotsharedwithanyoutsidesourceforpublicdisplay.
Thesubjectwasfreetocompletethequestionnaireortowithdrawatany
stage.

13. 3.10DataCollectionProcedure:
Patientswithconfirmed210casesoflowbackpainwere
added,andmusculoskeletaltests(FAIRtest)andquestions
regardingtheirpainbasedontheVAS(visualanalogscale)were
administeredtothepatients.Datawasgatheredusingaself-
madequestionnaire.

14. 3.11DataAnalysis:
TheStatisticalPackageforSocialSciences(SPSS)16versionwasusedto
analyzethedata.Tocheckeachfactor,thefrequencyofeachitem's
responsewasexaminedindividually

15. Figure1:Ageofparticipant
Thisfigureshowstheagedistributionofparticipantsas66.7%arebetweenthe
agesof30to40,andtheremaining33.3%fallwithinthe41to50agerangewith
ameandeviationof1.3333±47253.

16. Figure 2:Gender of Participants
This figure shows the gender distribution of participants, majority of 57.6% are female,
while 42.4% are male with the frequency of 121 and 89 and mean standard deviation1.5762±.49534.
0
20
40
60
80
100
120
140
male female
Frequency

17. 0
10
20
30
40
50
60
70
80
Office worker Housewife Teacher
Frequency
Figure 3:Occupation of participant
This figure shows the occupation distribution of participants as 35.7% was an office worker,
29.1% was a housewife, and 35.2% was a teacher, with a mean standard deviation of 1.9952±.84433.

18. 0
20
40
60
80
100
120
140
Positive Negative
Frequency
FAIR Test
Figure4:FAIRTestofparticipant
ThisfigureshowstheFAIRtestvaluesamongparticipantsas59%positiveand41%
negativewithameanstandarddeviationof1.4095±.49292.

19. FIGURE 5: Visual Analogue Scale of Participants
Thisfigureshowstheparticipant’svaluesofthevisualanaloguescaleas38.1%hadnopain,
59%hadmoderatepainand2.9%hadunbearablepain.Theaveragemeanstandarddeviation
oftheparticipant’sVASwas1.1238±.80898.
0
20
40
60
80
100
120
140
No Pain Moderate Pain Unbearable Pain
Frequency

20. Adisorderknownaspiriformissyndromeresultsinpaininthelegandbuttocks
duetoinjurytothepiriformismuscle.Despitethefactthatpiriformissyndrome
cancauselowbackpain,doctorstendtounderestimateitandignoreitmostof
thetimetoassessindividualswithlowbackpainforpiriformissyndrome.An
overallof337patientsstayedinvolvedinthestudy,andtheyhadfourdistinct
physicalexaminationsinordertobediagnosedwithPiriformissyndrome.Fifty-
sixoutofthe111studyparticipants(32.9%)withpiriformissyndromewere
male,whiletheremainingfifty-fivewerefemale.PiriformisSyndromewas
acknowledgedasthereasonoflowbackdiscomfortinoneoutofthreepatients.
ForPiriformisSyndrome,themaletofemaleratiowas3:1.(Haleemetal.,
2021)

21. Piriformissyndromestandsagroupofsignsthensymptomsofpiriformismuscleache
besidesbelocatedcharacterizedbybuttockachingwithvariedsciaticnerve
involvement.Sincethisillnesspresentssimilarlytootherspinepathologies,itis
frequentlyignoredinclinicalpractice.Thelackofdependableimpartialresultsand
theabsenceofasolitaryassessmentthatisspecificallydesignedtodiagnose
piriformissyndromeposeseriouschallengestotheclinicaldiagnosisofthe
condition.Accordingtothefundamentalsofourdiagnosticcriteria,17.2%oflow
backpainaffectedrolehadpiriformissyndrome;entirelyofthesepatientsrole
respondedfavorablytopiriformismuscleinjections;andtherewasnoevidenceofa
causalrelationshipbetweenpiriformissyndromeandspinalillnesses.(KeanChen&
Nizar,2013)

22. Researchers have highly advised consulting the affected role therapeutic past and
determining whether the patient has experienced blunted shock to the gluteal zone,
such as a reduction, in order to diagnose piriformis syndrome, which is the sting of
the sciatic nerve in the deep gluteal cavity. Increased hip rotator activity is
frequently the cause of piriformis syndrome. Long periods of time spent sitting on
hard surfaces may also cause it.Incertain instances, it could also stretch lower the
calf and knee, similar to a classic sciatica condition. Lower extremity exercises like
hip adduction and internal rotation, which stretch the pyriformis strength, might
make sciatica or buttock discomfort worse. But sitting intolerance is the hallmark of
this condition. On the affected side, numbness in a variety of sensory distributions is
typical, but motor faintness in a comparable circulation is uncommon. Sensitivity
and tactual exploration of the larger sciatic cut, as well as the replication of the
discomfort with extreme FADIR of the hip, were the two most reliable physical
examination findings in patients. (Son & Lee, 2022)

23. ourstudyconcludedthatthePrevalenceofpiriformismusclesyndromewithlow
backpainisveryhighamongofficeworkersteachersandhousewives.Alongwith
othersymptomsincludingsciaticnervecompression,associationoflowbackpain
isalsofoundpositive.

24. Limitation
Smallsamplesize
StudywaslimitedtoServicesHospitalLahore
SubjectPerceptionofFatigue
Furtherstudiesshouldhavelargesamplesizes,anddatashouldbecollectedfromdifferent
hospitals.
Recommendations
Forstudypopulations,itisrecommendedthatofficeworkers,teachers,andhousewivesshouldbe
encouragedtoincludeagradedexerciseprogramintheirroutinewithadequaterestintervals.
Sleepmanagement,stressmanagement,ahealthydiet,andseveralrelaxationtechniquesshouldbe
adoptedbyindividualstopreventpiriformismusclesyndromewithlowbackpain.

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(2023).AssociationofPiriformisThickness,HipMuscleStrength,andLowBackPainPatientswith
andwithoutPiriformisSyndromeinMalaysia.Life,13(5),1208.
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