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piriformis syndrome

Etiology: - entrapment of sciatic nerve by piriformis muscle Epidemiology: rare Pathology: - occurs when the piriformis muscle compresses or irritates the sciatic nerve Clinical manifestations: 1) see sciatica 2) pain/paresthesias in the buttocks & along the sciatic nerve, often down to the leg 3) pain may worsen as a result of sitting for a long period of time, climbing stairs, walking, or running Radiology: - magnetic resonance neurography can detect abnormality of sciatic nerve near level of sciatic notch & piriformis muscle Management: 1) see sciatica 2) stretching exercises & massage 3) NSAIDs 4) corticosteroid injection near where the piriformis muscle & the sciatic nerve meet may provide temporary relief 5) cessation of aggravating activities 6) surgery in some cases 7) prognosis is generally good

Related

piriformis

General

sciatic neuropathy entrapment neuropathy; nerve entrapment syndrome; pinched nerve

References

  1. Lewis AM Magnetic image resonance neurography in extraspinal sciatica. Arch Neurol 2006, 63:1469 PMID: 17030664
  2. Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
  3. National Institute of Neurological Disorders and Stroke (NINDS) NINDS Piriformis Syndrome Information Page https://www.ninds.nih.gov/Disorders/All-Disorders/Piriformis-Syndrome-Information-Page