CASE REPORT
Manual therapy in the diagnosis and treatment of piriformis syndrome – a case study
 
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1
Dział Rehabilitacji SPZOZ Parczew; Zakład Rehabilitacji i Fizjoterapii Uniwersytetu Medycznego w Lublinie
2
Zakład Rehabilitacji i Fizjoterapii Uniwersytetu Medycznego w Lublinie
CORRESPONDING AUTHOR
Kamil Zaworski   

Polna 65/20, 21‑200 Parczew
 
Med Og Nauk Zdr. 2015;21(2):215–220
KEYWORDS
ABSTRACT
Introduction:
Piriformis syndrome was first described by Robinson in 1947 as the collection of symptoms of pain in the region of the lumbar spine or buttocks, radiating to the lower limb. This pathological entity may cause chronic pain, scarring around the sciatic nerve and, in severe cases, even paralysis.

Objective:
The paper presents a case of study of 46-year-old female patient suffering from long-lasting piriformis syndrome.

Material and Methods:
The functional tests included: Freiberg`s test, Pace`s test, Beatty`s test, FAIR tests, compression of the sacroiliac joints test, the Lasègue test and Thomayer`s test. The severity of pain was assessed using the Visual Analog Pain Scale (VAS). The following manual therapy techniques were applied: joint mobilization and functional soft tissue treatment.

Results:
After 10-day treatment and four months after treatment, Freiberg`s, Beatty`s, and Lasegue`s tests, along with the SIJ compression test, were negative. Immediately after completion of treatment, the pain complaints decreased from 7 scores to 1, according to the VAS scale. Four months after treatment, the patient reported light pain symptoms (2 acc. to the VAS scale), only during prolonged sitting (over 30 minutes).

Conclusions:
Manual therapy may be an effective method for the diagnosis and treatment of piriformis syndrome. The techniques used are safe and impose no burden on the patient. Follow-up treatment in home conditions may result in long-lasting effects of the treatment.

 
REFERENCES (13)
1.
Jonathan S, Kirschner MD, Patrick M, et al. Piriformis syndrome, diagnosis and treatment. Muscle Nerve 2009; 40: 10–18.
 
2.
Shacklock M. Neurodynamika kliniczna. Wroclaw: Elsevier Urban & Partner; 2005.
 
3.
Kuncewicz E, Gajewska E, Sobieska M, et al. Zespół mięśnia gruszkowatego. Ann Acad Med Stetin 2006; 52(3): 99–101.
 
4.
Jorritsma W. Anatomia na żywym czlowieku. Wrocław: Elsevier Urban & Partner; 2010.
 
5.
Lee D. Obręcz biodrowa. Warszawa: DB Publishing; 2001.
 
6.
Bochenek A, Reicher M. Anatomia człowieka. Tom 1. Warszawa: Wydawnictwo Lekarskie PZWL; 2013.
 
7.
Boyajian O’Neill LA, McClain RL, Coleman MK, et al. Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach. J Am Osteopath Assoc. 2008; 108(11): 657–664.
 
8.
Tachibana S. Surgical therapy for entrapment neuropathy. Rinsho Shinkeigaku 2012; 52(11): 840–843.
 
9.
Mayrand N, Fortin J, Descarreaux M, et al. Diagnosis and management od posttraumatic piriformis syndrome: a case study. J Manipulatice Physiol Ther. 2006; 29(6): 486–491.
 
10.
Chapman C, Bakkum BW. Chiropractic management of a US Army veteran with low back pain and piriformis syndrome complicated by an anatomical anomaly of the piriformis muscle: a case study. J Chiropr Med. 2012; 11(1): 24–29.
 
11.
Tonley JC, Yun SM, Kochevar RJ, et al. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. J Orthop Sports Phys Ther. 2012; 40(2): 103–111.
 
12.
Grgic V. Piriformis muscle syndrome: etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy. Lijec Vjesn. 2013; 135(1–2): 33–40.
 
13.
Michael F, Decavel P, Toussirot E, et al. Piriformis muscle syndrome: diagnostic criteria and treatment of a monocentric series of 250 patients. Ann Phys Rehabil Med. 2013; 56(5): 371–383.
 
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