Piriformis Syndrome Flashcards
What is responsible, on a patho level, for the muscle spasm?
Abnormal gamma motor neuron stimulation elicits the stretch reflex and maintains the spasm
What is the general idea of nociception theory of facilitation?
Facilitation is the enhancement of the response of a neuron once it is stimulated.
Once an impulse from the spinal cord reaches the motor neuron, there is a release of peptides in the peripheral tissues that causing inflammation. This lowers the pain receptor threshold causing more signals to the spinal cord, hence a spasm because of continues signaling and lowering of threshold.
What does sympathetic stimulation, vasoconstriction, and NE do to pain threshold?
Lowers it, so amplifies the pain response
So basically, what does inflammation do for pain?
It causes facilitation. Lowers threshold, so you don’t need as large as a stimulation to get a pain response.
2 functions of the piriformis?
When leg is straight, ER
When leg is flexed, abductor
What is the most common relationship between piriformis and sciatic nerve?
Sciatic nerve leaves inferior to the muscle
What is the most common cause of piriformis syndrome?
Micro trauma to the butt
Trauma, inflammation, muscle spasm, nerve compression
Wallet neuritis
How is the sacrum, lumbar spine and ipsilateral leg affected by piriformis syndrome?
Forward torsion away form the side of the piriformis
Lumbar spine rotates away from the forward torsion and to the affected piriformis
Ipsilateral short leg of the piriformis
4 special tests for piriformis syndrome And explain them?
Straight leg
Freiburg - pain during IR of hip
Pace - pain during hip abduction while seated
Fair test - flex, IR, Adduct of affected hip and causes pain
Strengthening which muscles of the hip as proven effective for piriformis syndrome?
Adductors
