Photo Credit: Doucefleur

The following is a summary of “Prevalence of priformis syndrome in sciatica patients: Predictability of specific tests and radiological findings for diagnosis,” published in the May 2024 issue of Pain by Yürük et al.

Due to limitations in definitively diagnosing piriformis syndrome (PS), current practice relies on excluding other causes of sciatica, potentially leading to unnecessary imaging and delays in treatment.

Researchers conducted a retrospective study to assess the prevalence of piriformis syndrome (PS) using a novel injection technique targeting the piriformis muscle, moving away from the traditional exclusion-based approach.

They involved patients with PS who had sciatica, tenderness on palpation of the piriformis muscle, and a minimum of 50% pain relief from a local injection. Age, sex, pain duration, piriformis muscle tenderness, Freiberg test, PACE sign, FADIR, Visual Analog Scale (VAS) score, Douleur Neuropathique 4 Questions (DN4) score, and radiological findings were compared between those who responded and those who did not respond to the piriformis injection.

The results showed that out of 110 patients with sciatica, 66 with piriformis muscle tenderness received local injections. In 27 of these 66 patients (40.9%), the Numerical Rating Scale (NRS) score decreased by more than 50%, confirming a PS diagnosis. No significant differences were found in age, sex, pain duration, PACE sign, FADIR test, radiological findings, NRS, and DN4 scores. However, Freiberg test positivity was significantly higher in patients diagnosed with PS.

Investigators concluded that injecting the piriformis muscle to identify tenderness offered a valuable tool for diagnosing PS, potentially reducing reliance on traditional exclusion methods.

Source: journals.sagepub.com/doi/10.1177/20494637241254349