Physical Medicine and Rehabilitation for Piriformis Syndrome Treatment

Ph sical Medicine and Rehabilitation for Piriformis S ndrome Treatment & Management
A U :M :M JK , DO, MBA; C E :C TL , MD ... 31, 2010

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PhD Senior Pharmacy Editor. MBA Consulting Physiatrist. Medical acupuncture. Care should be taken to avoid direct injection of the sciatic nerve. It originates at the medial surface of the pubis and passes through the lesser sciatic notch to insert on the greater trochanter. ultrasonographic.[17] These surgical procedures are described as effective. Localization techniques include manual localization of the muscle or localization with fluoroscopic.com/article/308798-treatment#showall 2/5 .[18. sciatica. after localization with a digital rectal examination. American Osteopathic Association. Specialty Editor Board Raje h R Yada . and buttock pain (thereby further clouding the diagnosis). and they do not cause any associated superimposed postoperative disability. including facilitated positional release. local anesthetics.5-inch (8. 21. may be helpful. American Pain Society. [23] Con ib o Info ma ion and Di clo e Author Mil on J Klein. Surgery for this condition involves resection of the muscle itself or of the muscle tendon near its insertion at the superior aspect of the greater trochanter of the femur (as described by Mizuguchi). and electromyographic guidance. Physical examination demonstrates a trigger point that is more caudal than that in piriformis syndrome. American Medical Association.medscape.500 U) have been reported in the literature for the management of piriformis syndrome. can be injected with a 3. Injections with steroids. This disorder is considered to be a soft-tissue problem that presents as low back or buttock pain with sciatica. DO. 19. S gical In e en ion Surgical management is the treatment of last resort for piriformis syndrome. the use of ultrasonography and the spray-'n-stretch myofascial treatment is helpful. Con l a ion Because of the enigmatic nature of piriformis syndrome. 22] No single technique is universally accepted. American Academy of Medical Acupuncture. MD Associate Professor. MD Anderson Cancer Center. eMedicine emedicine. Manual muscle medicine. DO.11/25/11 Physical Medicine and Rehabilitation for Piriformis Syndrome Treatment inferior to the piriformis muscle and is also an external hip rotator. Injection therapy would require direct visualization by fluoroscopy. American Osteopathic College of Physical Medicine and Rehabilitation. 20. including vigorous. can be employed to remove the blockage of so-called chi. Due to the traumatic etiology of most cases. MBA is a member of the following medical societies: American Academy of Disability Evaluating Physicians. and Pennsylvania Medical Society Disclosure: Nothing to disclose. the initial consultation obtained from an orthopedic surgeon or a similar specialist usually is nonspecific. After all of the differential diagnoses have been excluded. Pha mD. direct needling of the piriformis muscle performed in conjunction with the use of traditional meridian acupuncture. and botulinum toxin type B (12. American Academy of Physical Medicine and Rehabilitation. consider piriformis syndrome. due to the small size and location of this muscle.9-cm) spinal needle. MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation Disclosure: Nothing to disclose. University of Texas at Houston Rajesh R Yadav. American Academy of Osteopathy. more proximal causes of low back pain. O he T ea men Prior to physical therapy sessions. piriformis syndrome usually is associated with other. Section of Physical Medicine and Rehabilitation. The piriformis muscle. Heritage Valley Health System-Sewickley Hospital and Ohio Valley General Hospital Milton J Klein. F anci co Tala e a.

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