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Piriformis Syndrome is often a misdiagnosed cause of Low Back Pain and Sciatica secondary to sciatic nerve entrapment in Piriformis muscle at the greater sciatic notch. Abnormal condition of the Piriformis muscle such as hypertrophy, inflammation, or anatomic variations may lead to this condition.

1 Piriformis Syndrome occurs most frequently during the fourth and fifth decades of life and affects individuals of all occupations and activity levels.

2- 4Reported incidence rates for Piriformis Syndrome among patients with low back pain vary widely, from 5% to 36%.4,5 Piriformis Syndrome is more common in women than men, possibly because of biomechanics associated with the wider quadriceps femoris muscle angle (i.e., “Q angle”) in the os coxae (pelvis) of women.

6 Barr’s work correlating clinical features with operative and histological findings, the dominant opinion for decades on the cause of sciatica was nerve root compression by a herniated intervertebral disc. An alternative cause, compression of the nerve trunk by the piriformis muscle, was proposed by Freiberg and Vinke and developed by Robinson, who is credited with coining the term Piriformis Syndrome.

7 ANATOMY OF THE PIRIFORMIS MUSCLE AND THE SCIATIC NERVE: The Piriformis muscle originates from the anterior surface of the S2–S4 sacral vertebrae, the capsule of the sacroiliac joint, and the gluteal surface of the ileum near the posterior surface of the iliac spine. It runs laterally through the greater sciatic foramen, becomes tendinous, and inserts into the piriformis

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