The Importance of Gluteus Maximus Muscle in Patients With Preliminary Diagnosis of Piriformis Syndrome
Condition: Piriformis Muscle Syndrome; Myofacial Pain Syndromes; Piriformis Syndrome
MeSH terms: Facial Neuralgia; Piriformis Muscle Syndrome; Syndrome; Facial Pain
Study type: Interventional

Summary: 
      Literature shows different pathologies or combination pathologies can cause gluteal region
      pain and it can be difficult to diagnose. Piriformis syndrome is one of the cause of gluteal
      region pain, symptoms of myofascial pain syndrome affected gluteus maximus muscle may
      masquerade as piriformis muscle syndrome or both syndrome can be seen together. The aim of
      this study is diagnosis myofascial pain syndrome of gluteus maximus muscle and piriformis
      syndrome by physical examination, special clinical tests and ultrasound guided diagnostic
      injection test in patients presenting with gluteal pain and evaluate the coexistence of both
      syndromes.
    

Detailed description: 
      Piriformis syndrome is a painful clinical picture caused by entrapment of the sciatic nerve
      by the piriformis muscle at the exit of the pelvis, which causes pain in the gluteal region.
      It is characterized by symptoms of pain and numbness radiating from the thigh to the leg
      along the hip and sciatic trace. Compression/irritation of the sciatic nerve in or around the
      piriformis muscle constitutes the neuropathic component of the syndrome. Myofascial pain of
      the piriformis muscle is the primary cause of the somatic component of the syndrome. Various
      causes have been reported: congenital anomalies of piriformis muscle or sciatic nerve,
      trauma, overuse, muscle hypertrophy, shortening of the muscle, infection within the muscle,
      and leg length discrepancy. History, physical examination and ultrasound guided diagnostic
      injection test are key elements for the diagnosis.

      Another cause of pain in the gluteal region is myofascial pain syndrome of gluteus maximus
      muscle. Myofascial pain syndrome is a largely underdiagnosed and undertreated entity.
      Prevalence varies from 30 to 93% among the persons with musculoskeletal pain. Myofascial pain
      syndrome is a syndrome characterized by acute or chronic regional pain originating from
      localized trigger points in the muscle and fascia. Traumatic events, muscular overloads,
      psychological stress, and systemic pathology may lead to development of one or more palpable
      bands or trigger points. Myofascial pain syndrome affecting the gluteus maximus muscle causes
      pain in the medial and lower parts of the muscle; It is characterized by pain that usually
      radiates throughout the hip and sometimes into the coccygeal region. The diagnosis of
      myofascial pain syndrome is based on a pertinent history and physical examination.

      The purpose of the study is; to evaluate the myofascial pain syndrome of gluteus maximus
      muscle and piriformis syndrome with physical examination, special clinical tests,
      ultrasonographic examinations and, to confirm the presence of myofascial pain syndrome of
      gluteus maximus muscle accompanying piriformis syndrome with the evaluation of clinical
      findings after the gluteus maximus and piriformis muscle diagnostic injections.
    

Intervention name(s): Ultrasound guided piriformis muscle and gluteus maximus muscle lidocaine injection
Intervention type(s): Diagnostic Test
Intervention description(s): Ultrasound guided piriformis muscle (piriformis syndrome) and gluteus maximus muscle 5 ml %1 lidocaine injection
Other intervention name(s): Ultrasound guided piriformis muscle (piriformis syndrome) and gluteus maximus muscle (myofacial pain syndrome of gluteus Maximus muscle) diagnostic lidocaine injection
Intervention MeSH terms: Lidocaine
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Diagnostic
Keywords: Piriformis Muscle Syndrome; Myofacial Pain Syndrome; Ultrasonography; Gluteus Maximus Muscle