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Piriformis syndrome

MedGen UID:
141601
•Concept ID:
C0458224
•
Disease or Syndrome
Synonyms: Deep gluteal syndrome; Hip socket neuropathy; Piriformis Muscle Syndrome; Pseudosciatica; Pyriformis syndrome; Wallet sciatica
SNOMED CT: Piriformis syndrome (129179000); Pelvic outlet syndrome (129179000)
 
Monarch Initiative: MONDO:0043320

Definition

A condition referring to irritation or compression of the proximal sciatic nerve, secondary to contraction of the piriformis muscle. It results in pain in the hip or the back of the leg mimicking disk-related sciatica. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPiriformis syndrome

Professional guidelines

PubMed

Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment.
Probst D, Stout A, Hunt D
PM R 2019 Aug;11 Suppl 1:S54-S63. Epub 2019 Jul 22 doi: 10.1002/pmrj.12189. PMID: 31102324
Piriformis syndrome, diagnosis and treatment.
Kirschner JS, Foye PM, Cole JL
Muscle Nerve 2009 Jul;40(1):10-8. doi: 10.1002/mus.21318. PMID: 19466717
Diagnosis and management of piriformis syndrome: an osteopathic approach.
Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP
J Am Osteopath Assoc 2008 Nov;108(11):657-64. doi: 10.7556/jaoa.2008.108.11.657. PMID: 19011229

Recent clinical studies

Etiology

Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome.
Danazumi MS, Yakasai AM, Ibrahim AA, Shehu UT, Ibrahim SU
J Osteopath Med 2021 May 31;121(8):693-703. doi: 10.1515/jom-2020-0327. PMID: 34049428
Piriformis pyomyositis, a cause of piriformis syndrome-a systematic search and review.
Siddiq MAB, Rasker JJ
Clin Rheumatol 2019 Jul;38(7):1811-1821. Epub 2019 May 2 doi: 10.1007/s10067-019-04552-y. PMID: 31049761
Epidemiology and etiology of secondary piriformis syndrome: A single-institution retrospective study.
Shah SS, Consuegra JM, Subhawong TK, Urakov TM, Manzano GR
J Clin Neurosci 2019 Jan;59:209-212. Epub 2018 Oct 24 doi: 10.1016/j.jocn.2018.10.069. PMID: 30528358
Spine injuries in dancers.
Gottschlich LM, Young CC
Curr Sports Med Rep 2011 Jan-Feb;10(1):40-4. doi: 10.1249/JSR.0b013e318205e08b. PMID: 21228650
Controversial entrapment neuropathies.
Campbell WW, Landau ME
Neurosurg Clin N Am 2008 Oct;19(4):597-608, vi-vii. doi: 10.1016/j.nec.2008.07.001. PMID: 19010284

Diagnosis

Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment.
Probst D, Stout A, Hunt D
PM R 2019 Aug;11 Suppl 1:S54-S63. Epub 2019 Jul 22 doi: 10.1002/pmrj.12189. PMID: 31102324
Piriformis syndrome: a cause of nondiscogenic sciatica.
Cass SP
Curr Sports Med Rep 2015 Jan;14(1):41-4. doi: 10.1249/JSR.0000000000000110. PMID: 25574881
The clinical features of the piriformis syndrome: a systematic review.
Hopayian K, Song F, Riera R, Sambandan S
Eur Spine J 2010 Dec;19(12):2095-109. Epub 2010 Jul 3 doi: 10.1007/s00586-010-1504-9. PMID: 20596735Free PMC Article
Piriformis syndrome, diagnosis and treatment.
Kirschner JS, Foye PM, Cole JL
Muscle Nerve 2009 Jul;40(1):10-8. doi: 10.1002/mus.21318. PMID: 19466717
Diagnosis and management of piriformis syndrome: an osteopathic approach.
Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP
J Am Osteopath Assoc 2008 Nov;108(11):657-64. doi: 10.7556/jaoa.2008.108.11.657. PMID: 19011229

Therapy

Tendinopathies and Allied Disorders of the Hip.
Sheridan GA, Neufeld ME, Moshkovitz R, Garbuz DS, Masri BA
Orthop Clin North Am 2022 Oct;53(4):393-401. Epub 2022 Sep 15 doi: 10.1016/j.ocl.2022.06.003. PMID: 36208882
Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome.
Danazumi MS, Yakasai AM, Ibrahim AA, Shehu UT, Ibrahim SU
J Osteopath Med 2021 May 31;121(8):693-703. doi: 10.1515/jom-2020-0327. PMID: 34049428
Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space.
Hernando MF, Cerezal L, Pérez-Carro L, Abascal F, Canga A
Skeletal Radiol 2015 Jul;44(7):919-34. Epub 2015 Mar 5 doi: 10.1007/s00256-015-2124-6. PMID: 25739706
Piriformis syndrome, diagnosis and treatment.
Kirschner JS, Foye PM, Cole JL
Muscle Nerve 2009 Jul;40(1):10-8. doi: 10.1002/mus.21318. PMID: 19466717
Diagnosis and management of piriformis syndrome: an osteopathic approach.
Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP
J Am Osteopath Assoc 2008 Nov;108(11):657-64. doi: 10.7556/jaoa.2008.108.11.657. PMID: 19011229

Prognosis

Electrophysiologically identified piriformis syndrome is successfully treated with incobotulinum toxin a and physical therapy.
Fishman LM, Wilkins AN, Rosner B
Muscle Nerve 2017 Aug;56(2):258-263. Epub 2017 Apr 2 doi: 10.1002/mus.25504. PMID: 27935076
Spine injuries in dancers.
Gottschlich LM, Young CC
Curr Sports Med Rep 2011 Jan-Feb;10(1):40-4. doi: 10.1249/JSR.0b013e318205e08b. PMID: 21228650
Evidence for the use of botulinum toxin in the chronic pain setting--a review of the literature.
Jeynes LC, Gauci CA
Pain Pract 2008 Jul-Aug;8(4):269-76. Epub 2008 May 23 doi: 10.1111/j.1533-2500.2008.00202.x. PMID: 18503628
Anatomic considerations and the relationship between the piriformis muscle and the sciatic nerve.
Güvençer M, Akyer P, Iyem C, Tetik S, Naderi S
Surg Radiol Anat 2008 Aug;30(6):467-74. Epub 2008 May 6 doi: 10.1007/s00276-008-0350-5. PMID: 18458807
Piriformis syndrome: diagnosis, treatment, and outcome--a 10-year study.
Fishman LM, Dombi GW, Michaelsen C, Ringel S, Rozbruch J, Rosner B, Weber C
Arch Phys Med Rehabil 2002 Mar;83(3):295-301. doi: 10.1053/apmr.2002.30622. PMID: 11887107

Clinical prediction guides

Comparing radial extracorporeal shockwave therapy and corticosteroid injection in the treatment of piriformis syndrome: A randomized clinical trial.
Ahadi T, Yousefi A, Sajadi S, Yousefi N, Babaei-Ghazani A
J Bodyw Mov Ther 2023 Jan;33:182-188. Epub 2022 Sep 24 doi: 10.1016/j.jbmt.2022.09.020. PMID: 36775517
Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome.
Danazumi MS, Yakasai AM, Ibrahim AA, Shehu UT, Ibrahim SU
J Osteopath Med 2021 May 31;121(8):693-703. doi: 10.1515/jom-2020-0327. PMID: 34049428
Surgical Treatment of Piriformis Syndrome.
Han SK, Kim YS, Kim TH, Kang SH
Clin Orthop Surg 2017 Jun;9(2):136-144. Epub 2017 May 8 doi: 10.4055/cios.2017.9.2.136. PMID: 28567214Free PMC Article
Piriformis Syndrome and Endoscopic Sciatic Neurolysis.
Knudsen JS, Mei-Dan O, Brick MJ
Sports Med Arthrosc Rev 2016 Mar;24(1):e1-7. doi: 10.1097/JSA.0000000000000088. PMID: 26752779
Piriformis syndrome: diagnosis, treatment, and outcome--a 10-year study.
Fishman LM, Dombi GW, Michaelsen C, Ringel S, Rozbruch J, Rosner B, Weber C
Arch Phys Med Rehabil 2002 Mar;83(3):295-301. doi: 10.1053/apmr.2002.30622. PMID: 11887107

Recent systematic reviews

Efficacy of Botulinum Toxin, Local Anesthetics, and Corticosteroids in Patients With Piriformis Syndrome: A Systematic Review and Meta-analysis.
Hilal FM, Bashawyah A, Allam AE, Lam KHS, El Oumri AA, Galluccio F, AlKharabsheh A, Kaye AD, Salti A, Varrassi G
Pain Physician 2022 Aug;25(5):325-337. PMID: 35901473
Deep gluteal syndrome as a cause of posterior hip pain and sciatica-like pain.
Park JW, Lee YK, Lee YJ, Shin S, Kang Y, Koo KH
Bone Joint J 2020 May;102-B(5):556-567. doi: 10.1302/0301-620X.102B5.BJJ-2019-1212.R1. PMID: 32349600
Piriformis pyomyositis, a cause of piriformis syndrome-a systematic search and review.
Siddiq MAB, Rasker JJ
Clin Rheumatol 2019 Jul;38(7):1811-1821. Epub 2019 May 2 doi: 10.1007/s10067-019-04552-y. PMID: 31049761
Four symptoms define the piriformis syndrome: an updated systematic review of its clinical features.
Hopayian K, Danielyan A
Eur J Orthop Surg Traumatol 2018 Feb;28(2):155-164. Epub 2017 Aug 23 doi: 10.1007/s00590-017-2031-8. PMID: 28836092
The clinical features of the piriformis syndrome: a systematic review.
Hopayian K, Song F, Riera R, Sambandan S
Eur Spine J 2010 Dec;19(12):2095-109. Epub 2010 Jul 3 doi: 10.1007/s00586-010-1504-9. PMID: 20596735Free PMC Article

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