Diagnosis and Management of Piriformis Syndrome
SOURCE: J Am Osteopath Assoc. 2008 (Nov); 108 (11): 657-664 ~ FULL TEXT
Lori A. Boyajian-O’Neill, DO, Rance L. McClain, DO,
Michele K. Coleman, DO, Pamela P. Thomas, PhD
Department of Family Medicine, Kansas City University of Medicine,
Biosciences College of Osteopathic Medicine,
1750 Independence Ave, SEP 358,
Kansas City, MO 64106-145, USA.
Piriformis syndrome is a neuromuscular condition characterized by hip and buttock pain. This syndrome is often overlooked in clinical settings because its presentation may be similar to that of lumbar radiculopathy, primary sacral dysfunction, or innominate dysfunction. The ability to recognize piriformis syndrome requires an understanding of the structure and function of the piriformis muscle and its relationship to the sciatic nerve. The authors review the anatomic and clinical features of this condition, summarizing the osteopathic medical approach to diagnosis and management. A holistic approach to diagnosis requires a thorough neurologic history and physical assessment of the patient based on the pathologic characteristics of piriformis syndrome. The authors note that several nonpharmacologic therapies, including osteopathic manipulative treatment, can be used alone or in conjunction with pharmacotherapeutic options in the management of piriformis syndrome.
From the Full-Text Article:
Piriformis syndrome occurs most frequently during the fourth and fifth decades of life and affects individuals of all occupations and activity levels. [7-12] Reported incidence rates for piriformis syndrome among patients with low back pain vary widely, from 5% to 36%. [3, 4, 11] Piriformis syndrome is more common in women than men, possibly because of biomechanics associated with the wider quadriceps femoris muscle angle (ie, “Q angle”) in the os coxae (pelvis) of women. 
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Difficulties arise in accurately determining the true prevalence of piriformis syndrome because it is frequently confused with other conditions.
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