Piriformis syndrome, diagnosis and treatment

Jonathan S. Kirschner, Patrick M. Foye, Jeffrey L. Cole

Research output: Contribution to journalReview articlepeer-review

111 Scopus citations

Abstract

Piriformis syndrome (PS) is an uncommon cause of sciatica that involves buttock pain referred to the leg. Diagnosis is often difficult, and it is one of exclusion due to few validated and standardized diagnostic tests. Treatment for PS has historically focused on stretching and physical therapy modalities, with refractory patients also receiving anesthetic and corticosteroid injections into the piriformis muscle origin, belly, muscle sheath, or sciatic nerve sheath. Recently, the use of botulinum toxin (BTX) to treat PS has gained popularity. Its use is aimed at relieving sciatic nerve compression and inherent muscle pain from a tight piriformis. BTX is being used increasingly for myofascial pain syndromes, and some studies have demonstrated superior efficacy to corticosteroid injection. The success of BTX in treating PS supports the prevailing pathoanatomic etiology of the condition and suggests a promising future for BTX in the treatment of other myofascial pain syndromes.

Original languageEnglish (US)
Pages (from-to)10-18
Number of pages9
JournalMuscle and Nerve
Volume40
Issue number1
DOIs
StatePublished - Jul 2009

All Science Journal Classification (ASJC) codes

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

Keywords

  • Botulinum toxin
  • Myofascial pain
  • Nerve compression syndromes
  • Piriformis syndrome
  • Sciatica

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