Piriformis syndrome – anatomical causes. Diagnosis and treatment

Abstract

Introduction and Objective. Sciatica is a clinical condition characterized by pain radiating along the roots of the sciatic nerve, extending from the lumbosacral spine and buttock, through the posterior surface of the thigh and lower leg down to the foot. One of the frequent cause is piriformis syndrome where the sciatic nerve is compressed by the piriformis muscle. There are many diagnostic tests and imaging studies available, but the most crucial aspect is to exclude other causes of sciatica. The aim of the review is to present the literature describing causes, diagnosis and treatment of the piriformis syndrome. Review Methods. The review is based on 46 papers found in PubMed and PubMedCentral databases using key words: ‘piriformis syndrome’ and ‘anatomical causes/diagnosis/treatment’, published between 1947–2023. Brief description of the state of knowledge. The variability in the course of the sciatic nerve and anatomical variations of the piriformis muscle have different impacts on the onset of piriformis syndrome. The diagnosis of this condition primarily aims to exclude other causes of sciatica, as there are no precisely confirmed diagnostic criteria. The preferred treatment is non-operative. When this is unsuccessful, surgical intervention may be considered. Summary. There are numerous causes of piriformis syndrome. There is a discrepancy in the results of various studies regarding the impact of different anatomical variations of the sciatic nerve on the onset of symptoms of this condition. The primary goal of research should now be to conduct a large, representative study on patients diagnosed with sciatica, focusing on the presence of anatomical variations.