REVIEW – March 2020

Piriform muscle syndrome: a review and physiotherapeutic approach

Authors: Kirkke Reisberg, Getter Lindre

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Abstract

The commonest clinical features of PS have been reported as follows: buttock pain, pain aggravated on sitting, external tenderness near the greater sciatic notch and pain on any maneuvre that increases piriformis muscle tension. The PS is usually a diagnosis of exclusion, where back, pelvic and hip disorders have to be excluded. Based on clinical features and provocative maneuvres (stretching tests and muscle activation), we can identify many important features of PS and discriminate it from sciatica caused by radiculopathy. The PS can be treated with medications and/or physitoherapy; there is some evidence about their co-effect, as well as about the effectiveness (pain reduction, improved lower limb function) of sciatic nerve mobilization and stretching exercises. The kinesiotaping method seems to be ineffective and considering the small number of trials/limitations in research quality, it is not possible to draw conclusions about their effectiveness or ineffectiveness. In case conservative treatment has failed, injections and surgery may be considered.