There is no simple diagnostic test for piriformis
syndrome causing irritation of the sciatic nerve.
The condition is primarily diagnosed on the basis
of the patient’s symptoms and on a physical
exam.
Symptoms of piriformis syndrome
Most commonly, patients describe acute tenderness
in the rear and sciatica-like pain down the back
of the leg. Typical symptoms of piriformis syndrome
may include:
- A dull ache in the mid-rear
- Pain down the back of the leg (a radiculopathy or sciatica)
- Pain when walking up stairs or inclines
- Increased pain after prolonged sitting
Symptoms of piriformis syndrome often become
worse after prolonged sitting, walking or running,
and may feel better after lying down on the back.
Physical exam to diagnose piriformis syndrome
The physical exam will include examination
of the hip and legs to see if movement causes
increased low back pain or leg pain (sciatica
pain). Typically, motion of the hip will recreate
the pain.
X-rays and other spinal imaging studies cannot
detect if the sciatic nerve is being irritated
at the piriformis muscle. However, diagnostic
tests (such as X-rays, MRI and nerve conduction
tests) may be conducted to exclude other conditions
that can cause similar symptoms to piriformis
syndrome (such as a disc herniation).
