Pyriformis syndrome: Myth or reality?

Abstract

Pyriformis syndrome is theoretically caused by compression of the sciatic nerve by the pyriformis muscle. Patients with pyriformis syndrome often report shooting, burning, and numbness in the buttock and down the leg along the sciatic nerve. Sitting, standing, and walking can worsen the symptoms. The diagnosis of pyriformis syndrome is made only after ruling out other causes of pain in the buttock or leg. Therefore, it is a diagnosis of exclusion. These clinical features are like those of L5 or S1 radiculalgia due to spinal disorders such as herniated lumbar disc (HLD) and spinal stenosis (SS). Lumbosacral radiculopathy can be misdiagnosed as pyriformis syndrome and diagnostic confirmation of pyriformis syndrome is difficult.