Piriformis syndrome

Is it painful for you to sit on a solid? And foot to foot? Is it easy to get out of the car? No, I’m not exploring your habits, I’m looking for symptoms.

Frequent pathology, but I rarely see this diagnosis made. Increasingly “osteochondrosis” and use https://pillintrip.com/ru/medicine/boxagrippal🥴 …

Piriformis syndrome is manifested by aching pulling pains in the gluteal region, sacrum region, hip joint, and with involvement of the sciatic nerve – “long” pains along the back of the leg with burning and numbness.

Characteristically: the pain intensifies when sitting on a firm ground for more than 20 minutes in a leg-to-leg position (the patient is down), it is difficult to get up from a chair, pain at the beginning of walking, in a standing position, squatting, when leaving the car, when taking out the sore leg first.

Pain relief occurs in the supine position, sitting with legs spread apart, in the process of a short walk, after stretching the piriformis muscle.

When tapping in the projection of the piriformis muscle, a typical pattern of pain arises, pain during palpation of the attachment points of the muscle-greater trochanter and the lower third of the sacrum, with compression of the sciatic nerve (direct Lasegue test is often positive), a “long” pain occurs when raising the leg from ~ 30 to ~ 60 degrees.

Bonnet syndrome is characteristic: the patient lies on his back; when trying to bring and rotate inward, the leg bent at the knee and hip, there is a typical long pain characteristic of sciatica as a result of tension on the nerve passing under / through the piriformis muscle. Pace’s symptom is positive.

Trigger points in the piriformis muscle are often activated during movements associated with forced rotation on one leg, falls, with excessive strength training with insufficient recovery period, with unsuccessful i / m injections, with prolonged strong abduction of the legs in the hip and flexion in the knee joints during performing gynecological and urological manipulations.

An important role in treatment is played by timely diagnosis (piriformis muscle spasm +/- compression of the neurovascular bundle), blockade with anesthetic and glucocorticosteroids, NSAID and muscle relaxant therapy, cancellation of power loads and stretching, post-isometric relaxation, myofascial release, soft manual techniques, physiotherapy.

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