piriformis syndrome
Introduction
Introduction to Piriformis Syndrome Piriformis syndrome is a common disease that causes acute and chronic sciatica. It is generally believed that the common branch of the common peroneal nerve branches out from the piriformis muscle bundle or the sciatic nerve passes through the piriformis muscle. When the piriformis is damaged, congestion, edema, spasm, adhesions, and contractures occur, the muscle gap or the muscles and the lower hole become narrow, and the nerves and blood vessels that are interspersed between them are squeezed, and a series of clinical symptoms appear. And body disease, known as piriformis injury syndrome. basic knowledge The proportion of illness: 0.025% Susceptible people: no specific population Mode of infection: non-infectious Complications: muscle atrophy
Cause
Cause of piriformis syndrome
Piriformis injury (30%):
Mostly due to the internal rotation of the thigh, the lower jaw suddenly stands, or the waist bends forward and straight, once the rotation occurs, the piriformis is excessively pulled and damaged. It can also be when the left hip is twisted. The hip joint is sharply externally rotated, and the piriformis muscle contracts violently, which can also cause the muscle damage.
Sciatic nerve variation (28%):
Some cases have only overworked or cold at night, resulting in hip pain. The outside of the calf and the back side are numb. Symptoms and physical symptoms such as pain, or total nerve palsy, which may be related to sciatic and piriformis injury variations.
Prevention
Piriformis syndrome prevention
1. The patient takes a standing position or a sitting position, presses the ring jump with the fingertip of the thumb of the affected side, and supports the acupuncture point. A is a point, and each hole is pressed for 10-20 seconds to feel the degree of soreness.
2. The patient's position is as before, and the piriformis is plucked 6-10 times with the thumb of the affected side of the thumb.
3, if the disease is treated with the correct method as soon as possible, its curative effect is very good, sometimes it can be cured several times or even once.
4, the patient should avoid re-injury in the daily work, and should avoid the cold and invade, so as not to aggravate the condition.
Complication
Piriformis syndrome complications Complications muscle atrophy
Complications of this disease are rare, but those with long-term disease may have muscle atrophy, and other diseases are reported less.
Symptom
Symptoms of Piriformis Syndrome Common Symptoms Lower Limb Feelings, Muscles... Lower Extremity Swelling and Weak Lower Extremity Radiation Pain Sleep Disorder
Pain is the main manifestation of piriformis syndrome. The pain is mainly on the buttocks and can be radiated to the lower limbs. In severe cases, it is impossible to walk or walk for a long distance and the pain is severe. It takes a short break before walking. The patient can feel the pain position is deep, mainly to the posterior or posterior lateral side of the ipsilateral lower extremity, and some may be accompanied by numbness of the lateral leg and perineal discomfort. Severe pain can be said that the buttocks have a "knife-cut" or "burning-like" pain, difficulty in flexing the legs, lying on the knees, and difficulty sleeping at night. Defecation, coughing, sneezing, etc., can increase the abdominal pressure and increase the pain of the affected limb.
Examine
Examination of piriformis syndrome
Straight leg raising test
Straight leg elevation was positive before the 60° pain.
2. Piriformis tension test
It is a method to check the damage of the piriformis. The specific steps are as follows: the patient is lying on the examination bed, and the affected limb is straightened, and the internal rotation is performed. If the sciatic nerve has radiation pain, the patient will be abducted and externally rotated. The pain is then relieved, which is positive for the piriformis tension test, and is a commonly used test for piriformis syndrome.
Diagnosis
Diagnosis and differentiation of piriformis syndrome
Differential diagnosis
The main manifestation of piriformis syndrome is hip pain and radiation to the affected side, that is, the sciatic nerve compression symptoms. There are various diseases that cause sciatic nerve compression symptoms in the clinic. Therefore, it is necessary to exclude the sciatic nerve caused by other diseases when the piriformis syndrome is diagnosed. Pain, mainly sciatic neuritis and root sciatica.
1. The onset of sciatic neuritis is more urgent. The pain along the sciatic nerve is transmitted from the buttocks to the back of the thigh, and the fossa is released to the distal side of the calf. The pain is persistent dull pain and can be exacerbated or burnt-like tingling. Pain relief when standing.
2, root sciatica mostly due to disc herniation, spinal osteoarthritis, spinal bone tumor and ligamentum flavum thickening and other spinal and spinal lesions, the incidence is slow, a history of chronic low back pain, sitting pain Obviously, the pain in the lying position can be relieved or disappeared, and the symptoms can be repeated. The skin on the lateral side of the calf and the back of the foot is reduced or disappeared. When the foot and toe are flexed, the flexor strength is weakened, and the tendon reflex is weakened or disappeared. Tablet examination to assist in diagnosis, in addition, piriformis syndrome should be differentiated from other diseases that cause dry sciatica, such as hip abscess, sciatic nerve sheath tumor and other diseases.
In addition, the following two diseases need to be identified:
1. Lumbar disc herniation: There is pain in the lower extremities, and the straight leg height test is positive. The higher the height of the straight leg, the more severe the pain.
2, hip fracture: femoral neck fracture, femoral trochanteric fracture, have a history of obvious trauma. Most occur in the elderly, hip pain after falling, can not stand and walk, the affected limbs have more hip flexion and knee flexion, the heel longitudinal slamming positive, x-ray film mostly shows fracture line.
