Piriformis syndrome

1. How is the piriformis usually injured?
2. What are the clinical symptoms of piriformis syndrome?
3. What is the provocative test for piriformis syndrome?
4. What is the treatment?

Answers:
1. Poor body mechanics, forceful hip internal rotation. (Sciatic nerve may be involved.)
2. Pain in lateral buttock, posterior hip and prox posterior thigh, SI joint, with tenderness over the muscle belly going from the sacrum to the greater trochanter. It is exacerbated by walking up stairs.
3. Pain with internal hip rotation, adduction, and flexion.
4. Stretching, NSAIDs, US, local cortisone injection.