Frequency of Piriformis Syndrome:Does the Presence of One Pathology Rule Out the Other?

Study Overview
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Brief Summary
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The purpose of the investigators is to determine the frequency of priformis syndrome in patients presenting with hip and/or leg pain and to investigate the association of Priformis syndrome with other pathologies of the lumbar spine and hip.

Detailed Description
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Priformis Syndrome is a neuromuscular disorder characterized by compression or irritation of the sciatic nerve under the piriformis muscle, tenderness in the piriformis muscle, and back, hip, and leg pain. The pain may radiate along the sciatic nerve trace in the gluteal region and posterior thigh. Diagnosis is based on clinical symptoms, specific physical examination findings, and positive response to local injection. The diagnosis of piriformis syndrome is usually made only after lumbar spine pathologies are excluded. This traditional approach leads to underdiagnosis of piriformis syndrome. More than one cause may coexist in hip and/or leg pain.The existence of one cause does not exclude the other.Priformis syndrome should not be a diagnosis of exclusion. In the differential diagnosis of hip and/or leg pain, physical examination to exclude piriformis syndrome and injection of local anesthetic into the piriformis muscle is much less invasive than surgery to confirm lumbar spine pathology and can be performed as an outpatient.Thus, early diagnosis and appropriate treatment process is accelerated. If there is an unfavorable response to the local injection, investigation for lumbar vertebral pathologies can be initiated. The purpose of the investigators under this information and justifications is; To determine the frequency of Priformis syndrome in patients presenting with hip and/or leg pain and to investigate the association of Priformis syndrome with other pathologies of the lumbar spine and hip.

Official Title
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Frequency of Piriformis Syndrome in Hip and/or Leg Pain: Does the Presence of One Pathology Rule Out the Other?

Conditions
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Chronic Pain

Intervention / Treatment
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* Drug: Priformis intramuscular injection with %2 lidocain


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients presenting with unilateral hip and/or leg pain Exclusion Criteria: no

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: patients with unilateral hip and leg pain<br>Musculoskeletal system examination, neurological examination, visual analog scale (VAS) score and DN4 (Douleur Neuropathique 4 Questions) of patients presenting with unilateral hip and/or leg pain, 3 tests frequently used in the diagnosis of priformis (Freiberg test, Pace sign, FADIR) ) will be applied. Patients with suspected priformis syndrome will be given an intramuscular injection If the pain intensity decreases by 50% or more after the intramuscular injection, the diagnosis of piriformis will be made. | Drug: Priformis intramuscular injection with %2 lidocain<br>* Priformis intramuscular injection will be administered with 5 cc 2% lidocaine, accompanied by a nerve stimulator under ultrasound guidance<br>* Other names: pyriformis intramuscular injection or diagnostic test with local anesthetic;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To determine the frequency of Priformis syndrome | Change in Pain Scores on Visual Analogue Scale scores at 24 hours before and after Priformis muscule injection | 1 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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piriformis syndrome, myofascial pain, ultrasound guidance, trigger point injection