Prevalence estimates suggest that between 40 and 70% of adults will experience some form of lower back pain during their lifetime. Of these, epidemiological studies suggest that between 5-36% have lower back pain that is attributable to piriformis syndrome.Piriformis syndrome is relatively uncommon, though many believe that current estimates are skewed, and that piriformis syndrome is actually more common than studies report, due to the fact that so many cases of piriformis syndrome are thought to go undiagnosed.
In terms of pharmacotherapy, there are a number of medications available. Specifically, non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen; oral analgesics, including acetaminophen; as well as anti-depressants are recommended and have received some support in terms of their effectiveness in relieving pain associated with piriformis syndrome. Additionally, gabapentin, a drug frequently used to treat neuropathic pain, has also received some support as providing relief from pain associated with piriformis syndrome.
For chronic piriformis pain, a non-surgical nerve block procedure is recommended to provide patients with significant, and often complete, relief from pain. Located within the buttocks, the sciatic nerve is a bundle of nerves whose job is to transfer pain information from the legs to the spinal cord and brain. Thus, the sciatic nerve block is a non-surgical procedure to anaesthetize the sciatic nerve bundle and thereby prevent the transmission of pain information. Additionally, there is some indication that patients can experience a significant reduction in pain with spinal cord stimulation. This procedure involves implanting a device near the spinal column that delivers electrical impulses to control the transmission of pain signals from the nerves within the spine. Trigger point injections have also received some support in relieving pain related to piriformis syndrome.
Biofeedback training has received support for helping individuals manage their symptoms of pain. This non-pharmacological technique assists patients with recognizing symptoms in order to help them learn skills to control them. During this training, individuals are taught relaxation and coping skills, thereby allowing the patient to gain some control over their symptoms of pain.
Piriformis syndrome is a relatively uncommon pain condition affecting the piriformis muscle and sciatic nerve within the lower back and buttocks. Many believe that prevalence rates of piriformis syndrome are much higher than those reported owing to misdiagnosis of lower back pain. There are a number of treatment options available for managing the pain associated with piriformis syndrome. Patients with piriformis syndrome are encouraged to speak with their physician about the possibility of using corticosteroid injections to help relieve their symptoms of pain.
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