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The Diagnosis and Management of Piriformis Syndrome: Myths and Facts

Published online by Cambridge University Press:  02 December 2014

T. A. Miller ,
K. P. White  and
D. C. Ross
T. A. Miller*
Affiliation:
From the Departments of Physical Medicine and Rehabilitation and Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada
K. P. White
Affiliation:
From the Departments of Physical Medicine and Rehabilitation and Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada
D. C. Ross
Affiliation:
From the Departments of Physical Medicine and Rehabilitation and Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada
*
Schulich School of Medicine and Dentistry, University of Western Ontario, St. Joseph's Health Care, Room 066, 21 Grosvenor Street, London, Ontario, N6A 1Y6, Canada. Email: tmiller@uwo.ca
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Abstract

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Piriformis Syndrome (PS) is an uncommon, controversial neuromuscular disorder that is presumed to be a compression neuropathy of the sciatic nerve at the level of the piriformis muscle (PM). The diagnosis is hampered by a lack of agreed upon clinical criteria and a lack of definitive investigations such as imaging or electrodiagnostic testing. Treatment has focused on stretching, physical therapies, local injections, including botulinum toxin, and surgical management. This article explores the various sources of controversy surrounding piriformis syndrome including diagnosis, investigation and management. We conclude with a proposal for diagnostic criteria which include signs and symptoms, imaging, and response to therapeutic injections.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 5 , September 2012 , pp. 577 - 583
Copyright
Copyright © The Canadian Journal of Neurological 2012

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