Piriformis syndrome is a entrapment neuropathy that occurs with pain, numbness, paresthesia and weakness in the areas of the sciatic nerve. Compression of the sciatic nerve by the piriformis november as it passes through the sciatic notch the result is formed. The november function of the piriformis muscles is to rotate the thigh bone externally in the hip joint, which november innervated by the sacral plexus. The symptoms of piriformis syndrome are usually sacroiliac and it begins after a direct trauma to the gluteal region. Sometimes, the syndrome is the result of repetitive hip and lower limb movements or repetitive pressure on the piriformis november and the underlying sciatic nerve.
Symptom and signs
The first symptoms include severe pain in the buttocks, which can spread to the lower extremities and feet. Patients suffering from Piriformis syndrome have concomitant sacroiliac, back and hip pain, which can confuse the clinical picture it may indicate an altered gait, which leads to Physical manifestations include tenderness over the sciatic notch. Novemberpation of the piriformis muscle shows tenderness and a swollen, hardened november body. From Piriformis syndrome in most patients suffering from it, lifting or bending in the waist and hips increases the pain.
The initial treatment of pain and functional disability associated with Piriformis syndrome includes a combination of nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors and physical therapy. Locally the application of hot and cold can also be useful. Any repetitive activity that may aggravate the patient’s symptoms should be avoided. If the patient is decumbent, putting a pillow between his legs can help. The patient is important if he suffers from paresthesias, gabapentin may be added. For patients who have not responded to these methods of treatment, an injection of local anesthetics and methylprednisolone into the sciatic nerve region at the level of the piriformis november is reasonably next step. Rarely, surgical release of the trap is required to achieve relief.