eMedicine Specialties > Sports Medicine > Hip

Piriformis Syndrome: Follow-up

Author: Shishir Shah, DO, Consulting Staff, Comprehensive Woundcare, Banner Baywood Hospital
Coauthor(s): Thomas W Wang, MD, Consulting Staff, Department of Occupational Medicine, Kaiser-Permanente
Contributor Information and Disclosures

Updated: Apr 28, 2009

Follow-up

Return to Play

Athletes with piriformis syndrome may return to play when they demonstrate full pain-free range of motion and strength of the affected side and can perform their sport-specific activities without discomfort. Patients must adhere to the aforementioned stretching exercises and perform a liberal warm-up before the activity. The duration for return to play varies with each individual and the type of treatment rendered. The longer an athlete ignores the problem before seeking treatment, the longer his or her rehabilitation will take.

Prevention

Recurrence of pain in the piriformis muscle can be prevented by continuing the stretching exercises and by avoiding risk factors.

Prognosis

Most patients with piriformis syndrome progress well after a local trigger-point injection. Recurrences are uncommon after 6 weeks of therapy. After surgery, patients treated with piriformis release return to their activities in an average of 2-3 months.

Education

Patients with piriformis syndrome should modify their activity habits. For example, patients are recommended to adhere to the following: avoid prolonged sitting, perform the suggested stretching exercises 2 or 3 times a day and before participating in a sports activity, and avoid direct trauma to the gluteal region.

Patient education should be an ongoing process throughout the course of rehabilitation. Physical therapists and occupational therapists are valuable members of the team for teaching the patient strategies used to recover from this syndrome and also to prevent recurrences. Patients should be informed of the importance of their routine compliance with an individualized home exercise program.

Miscellaneous

Medicolegal Pitfalls

  • The authors' review did not reveal any medicolegal issues related to piriformis syndrome.
  • As with the management in any back pain, other causes must be excluded before piriformis syndrome can be diagnosed.
  • In particular, the physician must be highly sensitive to the possibility of acute cord syndromes, fractures, neurologic deficits, and vascular compromise.
 


More on Piriformis Syndrome

Overview: Piriformis Syndrome
Differential Diagnoses & Workup: Piriformis Syndrome
Treatment & Medication: Piriformis Syndrome
Follow-up: Piriformis Syndrome
References
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References

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Further Reading

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Keywords

piriformis syndrome, hip pocket neuropathy, sciatic neuritis, wallet neuritis, lower back pain, low back pain, LBP, periarthritis of the anterior sacroiliac joint, piriformis muscle, piriformis hypertrophy, sciatic nerve entrapment, herniated nucleus pulposus, muscle spasm due to chronic or overuse injury, sciatica, Morton foot, spinal stenosis, nerve entrapment syndromes

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Contributor Information and Disclosures

Author

Shishir Shah, DO, Consulting Staff, Comprehensive Woundcare, Banner Baywood Hospital
Shishir Shah, DO is a member of the following medical societies: American Academy of Family Physicians, American Medical Association, and American Osteopathic Association
Disclosure: Nothing to disclose.

Coauthor(s)

Thomas W Wang, MD, Consulting Staff, Department of Occupational Medicine, Kaiser-Permanente
Thomas W Wang, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Medical Editor

Joseph P Garry, MD, FACSM, FAAFP,, Director of Sports Medicine and Sports Medicine Fellowship, Associate Professor of Family Medicine and Exercise and Sport Science, Department of Family Medicine, East Carolina University Brody School of Medicine
Joseph P Garry, MD, FACSM, FAAFP, is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Heart Association, American Medical Society for Sports Medicine, and North American Primary Care Research Group
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Russell D White, MD, Professor of Medicine, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center Lakewood
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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