The Piriformis syndrome causes and diagnosis - Everything You Need To Know - Dr. Nabil Ebraheim
This educational animated video describes the condition know as piriformis syndrome, the signs and symptoms, etiology, diagnostic tests, and the treatment options.
The sciatic nerve is compressed by the piriformis muscles in the buttock. piriformis syndrome may be associated with lower lumbar-radiculopathy similar to spine pathology. Some patients may have spine surgery without improvement.
Symptoms
•Occasionally develops from blunt trauma to the buttock.
•Localized buttock pain increased by sitting or driving.
•Pain increased by bicycling or running in young individuals.
•Radicular symptoms with pain and paresthesia, however it is not common.
•Pain may present when palpating directly into the area of the greater sciatic notch.
Provocative test
Lasegue’s maneuver
•Reproduction of the pain by the hip is flexed to 90 degrees and the knee extended.
The sciatic nerve is compressed by the piriformis muscle, fibrous bands or by vascular anomalies.
Be aware of possible anatomical variation of the sciatic nerve ( Four types of variations).
The sciatic nerve is composed of the tibial and peroneal divisions which are usually bound together but sometimes may divide as they pass the piriformis muscle.
Relation of the sciatic nerve to the piriformis muscle
1-A normal relationship with the sciatic nerve passing beneath piriformis muscle.
2-Piriformis divided into two parts with the peroneal division of the sciatic nerve passing between the two parts of the piriformis muscle.
3-Peroneal division of the sciatic nerve passes over the muscle and the tibial division passes beneath the undivided piriformis muscle.
4-The entire nerve passes through the divided piriformis muscle.
Diagnosis
•High index of suspicion
•Patient history and exam
•EMG and bone scan are not very helpful
•MRI:
a)enlarged piriformis
b)anomalies of the vessels
c)compression of the nerve.
Diagnostic injection is helpful.
Treatment
•Aquatic therapy
•Physiotherapy
•NSAID medication
•Injections.
•Surgical release of the piriformis muscle and decompression of the sciatic nerve is the last resort.
Consider possibility of piriformis syndrome when treating trochanteric bursitis or patient with sciatica especially after a failed spine surgery.
Patient with sciatica will have pathology in the lumbar spine as shown on MRI such as disc herniation, lumbar stenosis, or degenerative changes.
Patient with piriformis syndrome may not have symptoms or MRI findings related to the lower back.
High index of suspicion in a patient with buttock or leg pain in the absence of lumbar pathology.
This pain is increased while sitting with minimal or no back pain.
Piriformis syndrome is a hidden cause of sciatica.
Тэги:
#piriformis_syndrome #piriformis_test #piriformis_stretch #piriformis_muscle #piriformis_exercises #piriformis_syndrome_test #piriformis_syndrome_treatment #sciatica #piriformis_syndrome_diagnosis #piriformis_muscle_anatomy #piriformis_syndrome_examination #sciatic_nerve_anatomy #piriformis_stretches #piriformis_pain #piriformis_syndrome_pain_relief #piriformis_syndrome_symptoms #piriformis_syndrome_or_sciatica #piriformis_syndrome_causes #piriformis_syndrome_surgeryКомментарии:
Thank you so much. Have had this for far too many years but have never heard it explained so well.
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Does working out help, glute muscles
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Thank you so much. I m going through a confusion, whether my sciatica is due to Piriformis or disc bulge.
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You do not mention spinal stenosis?
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I got the injury while dancing i a bboy… I can twist feeling the pain 😢
ОтветитьThank you so much 🙏❤️❤️❤️❤️
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Thank you for making this video. This is very helpful.
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I get this pain only while driving. What would you advise?
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دكتور انا عملت الاشعة الرنين والدكتور يقول انزلاق غضروفي طبعاً قالي تحتاج الى عملية انا رفضت وقلت اخذ ابر الستيرود وبعد مافادتني لكن بعد فترة الاحظ ان الالم اكثر في اسفل الارداف اذا جلست على سطح صلب يصير عندي تنمل . فهل الي اعاني منه متلازمة الكمثري .
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Very helpful, well put together
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Useful video
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I'm only 20, why am I experiencing this?? 😭😭
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Anyone here who overcame this? I need to know how'd you do it?
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Thank you!!! This has helped me to understand the pain I've been having for many years. I appreciate the time and effort you have taken to explain this!
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This was the best video for people who are trying to figure out what is causing the source of the pain for the appropriate treatment.
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Mine start to hurting when im standing longer then 5 minutes from the buttock down to knee, sometime ankle.
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Accrding to this video my doctor in Sweden SHOULD consider the POSSIBILITY that my sciatica and walking difficulties are caused by a piriformis syndrome. As I am almost sure is the case. But no... In Sweden´s FREE public health care the preferred diagnosis is hip arthritis and no attention at all is given to piriformis syndrome. The doctors tells me that "oh no, the piriformis is a very small muscle and can not cause a serious sciatica, your problem is severe hip arthritis"... well I KNOW I have hip arthritis now and I am SURE it is because I have had a piriformis syndrome with sciatica for many years. Now I will pay a private physioterapeut specialist what is needed to investigate this problem further. If I can cure the piriformis syndrome maybe my hip will heal to some degree.
These videos by Nabil Ebraheim are very good indeed and the public health care in Sweden is severely corrupt.
Thank you So!! Much! Doc! For being detailed and explaining everything so simple. This information will help my conversation with the orthopedic physician.
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Does a person here know if, or not that iritation causes a reaction to the muscles?
Small, or even greater iritation levels?
Please, and thanks in front.
And thank you again Sir for spending your time in making another video to teach.
Oh.
Does a person also know if the human lungs emit its own body chemicals?
Is all human chemical production just hormonal production?
My hip muscles are melting, what should I do?
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Fantastic, very clear and transparent showing knowledge, great visualisation, thank you Dr. Nabil Ebraheim.
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Tank u so mch veri hejpful
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👍
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سلمت الانامل بروفيسورنا الغالي.. انا اسمي هذا الشرح بالمختصر الوجيز... ارفع لك لك القبعة لك ولعلمك.. بارك الله فيك. تحياتي واحترامي لشخصكم الكريم.
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Good morning sir
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Wonderful as usual our prof
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🙏🌈🙏
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Thank tou so much. Your videos help me to better understand my issues. And avoid waking them up in my Pilates class!
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