Piriformis syndrome
Piriformis syndrome (PS) is a sciatic neuropathy condition caused by compression of the sciatic nerve by the piriformis muscle.
Epidemiology
The prevalence of PS in patients with low back pain was reported by Bernard et al. as 0.33%, Pace and Nagle as 6% and Parziale as 5% 1) 2) 3).
PS is more prevalent in women than men and this situation was evaluated to be due to the wide angle of the quadratus femoris in the pelvis 4).
Etiology
Usually depends on individual predisposition or congenital anomalies. However, trauma such as falling in the sitting position or heavy lifting can also trigger the condition. The mechanism here is internal rotation of the hip or sciatic nerve impingement under the tendinous portion of the piriformis muscle due to spasm of the muscle 5) 6).
It has been classified as primary and secondary. While the primary condition is caused by intrinsic pathology originating from the piriformis muscle such as myofascial pain or myositis ossificans as a result of trauma, the secondary condition is caused by other causes of hip pain due to pathology of adjacent structures of the sciatic notch 7) 8).
Pathophysiology
Is not fully understood. The major etiology was known to be the spasm, edema and inflammation of the piriformis muscle and sciatic nerve compression of the muscle later on.
Diagnosis
Patients can be diagnosed immediately with a comprehensive clinical examination and early diagnosis makes the treatment much easier. Diagnosis of the piriformis syndrome, a very rare cause of low back pain, first requires that this syndrome is remembered, and then a differential diagnosis should be performed 9).