Piriformis syndrome, diagnosis and treatment.
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.
Kirschner
Jonathan S
JS
Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey- New Jersey Medical School, Administrative Complex Building 1, 30 Bergen Street, Newark, New Jersey 07101-1709, USA. jkirschnerMD@gmail.com
Foye
Patrick M
PM
Cole
Jeffrey L
JL
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D005081:Exercise Therapy; D006801:Humans; D009135:Muscular Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D009408:Nerve Compression Syndromes / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D039781:PubMed / Q000706:statistics & numerical data; D012585:Sciatica / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local; D001905:Botulinum Toxins