Not all Low back pain with Radiation are Disc Problem(   Piriformis Syndrom )

Not all Low back pain with Radiation are Disc Problem( Piriformis Syndrom )

iriformis syndrome is difficult to diagnose and resistant to therapy. The existence of piriformis syndrome has been doubted for years, but with the power of the Internet the reality of this syndrome has finally reached a tipping point. Previously, it was not even considered as a diagnosis, in others it was quickly ruled out. In others the symptoms are ascribed to "sciatica" or some other cause, even if the piriformis is considered as a possible cause. Often the patient has considered the possibility before the physicians, trainers, therapists and others have.

Piriformis syndrome may overlap with a variety of other problems including what McCrory et. al. have called a "deep buttock" syndrome. This includes pain in the buttock region, possibly pain in the hamstrings, occasionally pain in the back of the leg that is difficult to locate.

These symptoms of the piriformis muscle dysfunction may be caused by other clinical entities that include gluteus medius dysfunction, herniated or bulging disks, "sciatica", pelvic stress fractures and other musculoskeletal problems in this area. Scant information is available on the piriformis syndrome in lay publications, and only a little more in scientific publications. The functioning of the muscle has not been clearly defined and examined in the literature. The location of the muscle does not allow for surface EMG (electromyographical) study. It is quite difficult, if not impossible to place a deep electrode in the muscle for study purposes also.

The anatomical position of the muscle leads one to conclude that it functions in some ways similar to that of the gluteus medius. The major portion of origin of the piriformis is the anterior lateral portion of the sacrum and the insertion is on the upper portion of the femur.

The sciatic nerve passes immediately below the piriformis muscle.

Dr. med. Masyar Rahmanzadeh

Leiter: Gelenkzentrum Berlin/ Vivantes Klinikum am Urban Berlin: Sektion Endoprothetik (Hüfte/Knie)/Sektion Fu?chirurgie

9 年

In an anatomic cadaver-study it was shown that in almost 20% of the specimen the pirformis mucle or tendon gets pierced directly by the sciatic nerve. In these cases pseudoradicular symptoms are even more probable....this is in fact what I can confirm from my daily experience when performing hip resusurfacing surgery (McMinn, BHR) from the posterior approach...

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