Further Outpatient Care

See the list below:

Piriformis syndrome usually is treated effectively with conservative measures. Please refer to the Treatment section for a discussion of treatment recommendations.

Further Inpatient Care

See the list below:

Inpatient care is necessary only if surgical intervention is warranted. Surgery is the last-resort treatment for severe cases of piriformis syndrome.

Deterrence

See the list below:

No method of preventing piriformis syndrome has been demonstrated. The best means of prevention is to maintain biomechanical balance through the restoration of a more physiologic weight-bearing distribution; this necessitates a level pelvis/sacral base and equal leg lengths, which can be achieved by using heel-lift therapy if necessary. This treatment approach also prevents recurrences of piriformis syndrome, especially if the underlying etiology is a leg-length discrepancy. The patient also must engage in a general stretching program that includes the bilateral piriformis muscles.

Complications

See the list below:

The most significant complication of piriformis syndrome is a failure to recognize, diagnose, and treat this painful condition. If left untreated, a patient may undergo unsuccessful back surgery for a disk herniation; however, a coexisting occult piriformis syndrome can result in a failed back syndrome.
Another complication is inadvertent direct injection of the sciatic nerve, which usually results in a nondisabling and temporary sciatic mononeuropathy.

Prognosis

See the list below:

The prognosis of piriformis syndrome depends on early recognition and treatment. Because it is a soft-tissue syndrome, the condition has a tendency to become chronic, usually due to late diagnosis and treatment (which lead to a less favorable prognosis).

Patient Education

See the list below:

For conservative measures to be effective, the patient must be taught, via an aggressive, home-based stretching program, to maintain piriformis muscle flexibility. He/she must comply with the program even beyond the point of discontinuation of formal medical treatment.

Questions

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Media Gallery

Nerve irritation in the herniated disk occurs at the root (sciatic radiculitis). In piriformis syndrome, the irritation extends to the full thickness of the nerve (sciatic neuritis).

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Author

Milton J Klein, DO, MBA Consulting Physiatrist, Heritage Valley Health System-Sewickley Hospital and Ohio Valley General Hospital

Milton J Klein, DO, MBA is a member of the following medical societies: American Academy of Disability Evaluating Physicians, American Academy of Medical Acupuncture, American Academy of Osteopathy, American Academy of Physical Medicine and Rehabilitation, American Medical Association, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, American Pain Society, Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

Chief Editor

Ryan O Stephenson, DO Associate Professor of Clinical Practice, Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine; Medical Director of Polytrauma and Brain Injury (Polytrauma Network Site), Department of Physical Medicine and Rehabilitation, Eastern Colorado Veterans Affairs Medical Center

Ryan O Stephenson, DO is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

Additional Contributors

Rajesh R Yadav, MD Associate Professor, Section of Physical Medicine and Rehabilitation, MD Anderson Cancer Center, University of Texas Medical School at Houston

Rajesh R Yadav, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.