Prevalence of piriformis syndrome among the cases of low back/buttock pain with sciatica: A prospective study

Abstract

Aim: The aim of this study was to find out the prevalence and causes of piriformis syndrome in patients with complain of low back pain/buttock pain with sciatica attending Regional Institute of Medical Sciences (RIMS), Imphal. Materials and Methods: All the patients in the study group attending Orthopedic and Physical Medicine and Rehabilitation Out-patient Department in RIMS, Imphal were examined. Those with increased symptoms on sitting, localized significant tenderness on palpation of the muscle, presence of one or more of the following tests: Freiberg, pace, beatty, and FAIR (Flexion , Adduction and Internal Rotation) maneuvers with negative X-ray, ultrasound, computed tomography and magnetic resonance imaging findings were subjected to piriformis muscle injection of lidocaine (2%) 2 ml and methyl prednisolone 2 ml (40 mg) for confirmation of diagnosis. Result: Out of 2910 patients, 182 cases (M: 28, F: 154) in the age range of 19-75 years with a mean age of 43 years were clinically diagnosed as piriformis syndrome. Prevalence of piriformis syndrome was 6.25%. Conclusion: Piriformis syndrome is one of the differential diagnoses of low back/buttock pain with Sciatica. Individuals of all activity levels can be affected. Females are more affected than males. Causes are overuse, prolonged sitting, trauma, and vigorous massage. Diagnosis is by exclusion of other causes. Simple injection with local anesthetic and steroid in the piriformis muscle is both therapeutic and confirmatory of diagnosis. Early diagnosis and treatment with injection of piriformis muscle can prevent further complications and risks of surgery, which is also not 100% curative. With proper care, piriformis injection can be carried out without any complication. Long-term study is needed to evaluate the recurrence after injection treatment.