Piriformis syndrome is a musculoskeletal condition where the sciatic nerve is sensitised around the Piriformis muscle at the greater sciatic notch.
Piriformis syndrome is estimated to account for 6% cases of low back pain and it can be described as primary or secondary. Primary Piriformis syndrome has an anatomical cause, with variations such as a split piriformis muscle, split sciatic nerve, or the path of nerve path runs through the muscle (depicted in the adjacent image). Among patients with this condition, fewer than 15% of cases have primary causes. Secondary piriformis syndrome occurs as a result of a precipitating cause, including injury, repetitive motion, maintaining positions leading to local ischemia (blood flow restriction). It is commonly reported that prolonged: sitting; climbing stairs; walking; cycling or running can increase symptoms.
Surgical Options (In severe cases where conservative management has been unsuccessful).
Fishman, L. M., Dombi, G. W., Michaelsen, C., Ringel, S., Rozbruch, J., Rosner, B., & Weber, C. (2002). Piriformis syndrome: diagnosis, treatment, and outcome—a 10-year study. Archives of physical medicine and rehabilitation, 83(3), 295-301.
Hopayian, K., Song, F., Riera, R., & Sambandan, S. (2010). The clinical features of the piriformis syndrome: a systematic review. European Spine Journal, 19(12), 2095-2109.