Piriformis syndrome, treatment and diagnosis
According to a research conducted by Kirschner, Foye, & Cole (2009), PS or Piriformis syndrome is not a very common sciatica’s cause, and this involves pain in the buttock that refers to a leg. Most of the times, it is much difficult to diagnose the piriformis syndrome, and out of various exclusions, this is one due to less standardized and validated tests for diagnosis.
Taking about the treatment for PS, the authors have stated that historically, the focus has been on modalities of stretching and physical therapy, with refractory patients that are taking corticosteroid and anaesthetic injections into the sciatic nerve sheath, piriformis muscle origin, muscle sheath, or belly. The author has highlighted BTX for the treatment of PS and stated that recently, BTX (Botulinum Toxin) use had gained so much popularity to treat piriformis syndrome and the purpose of BTX use is to give some relief to inherent muscle pain and sciatic nerve compression from the tight piriformis.
Moreover, according to the authors, this treatment is being used mostly for the myofascial pain syndromes, and superior efficacy has been demonstrated by some studies to corticosteroid injection. Last but not least, the authors have concluded in their research that the Botulinum Toxin success in the treatment of piriformis syndrome supports the condition’s prevailing pathoanatomic aetiology by which promising future is suggested for BTX in the other kinds of myofascial pain syndromes treatment .
Piriformis Syndrome Diagnostics
Piriformis syndrome: Diagnosis, treatment, and outcome—a 10-year study
Fishman, Dombi, Michaelsen, & Ringel (2002) conducted a research to validate piriformis syndrome’s operational definition that is based on the H-reflexes prolongation with adduction, internal rotation (FAIR), and hip flexion as well as to evaluate conservative therapy’s efficacy and efficacy of surgery so that symptoms could be relieved and disability could be reduced.
For the design of their research, the authors have used the before-after trial of cohorts method that is recognized by operational definition. For the setting of their research, the authors have utilized offices of 4 physicians and two hospitals’ outpatient departments. The surgery was performed at three different hospitals. The consecutive sample of the research includes 1014 legs of 918 patients and follow-up on 733. For the intervention of research, patients with significant FAIR tests were given physical therapy, injection, and reported disability assessments and pain serially.
The surgery was performed on 6.47 per cent patients i.e. forty-three in number. The Likert pain scale is the main outcome measure of the research. The results of the research have revealed that the FAIR test at 3 SDs had specificity as well as the sensitivity of .832 and .881, respectively. 514 out of 655 or 79 per cent of patients with FTP (FAIR test positive) improved 50 per cent from physical and therapy injection at an average follow-up of 10 months and two weeks. 71.1 per cent was the average improvement. The research has concluded that there exist a good correlation between the FAIR test and piriformis syndrome’s working definition and is a better successful surgery and physical therapy predictor than the working definition .
Fishman, L., Dombi, G., Michaelsen, C., & Ringel, S. (2002). Piriformis syndrome: Diagnosis, treatment, and outcome—a 10-year study. Archives of Physical Medicine and Rehabilitation, Volume 83, Issue 3, 295-301.
Kirschner, J. S., Foye, P. M., & Cole, J. L. (2009). Piriformis syndrome, diagnosis and treatment. Muscle and Nerve, Volume 40, Issue 1, 10-18.