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Conference vmszoo::medical

Title:MEDICAL questions and answers
Notice:Please read notes 1.11, 1.27 and 624.*
Moderator:IJSAPL::ANDERSON
Created:Mon Jan 26 1987
Last Modified:Wed May 28 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:2054
Total number of notes:15270

2032.0. "PERIFORMIS SYNDROME/SCIATIC LEG PAIN " by ABACUS::MANNI () Mon Jan 27 1997 11:26

    PERIFORMIS SYNDROME/LOW BACK-LEG PAIN
    
    Looking for any information on low back pain radiating into legs. Have
    had for 1 year and no diagnosis/help with xrays etc. One possible clue
    given by a neurologist last week may be Periformis muscle problems.
    If anyone has had any experience with this elusive muscle I would be
    interested in hearing from you.
    
    MKOTS4::MANNI  381-6455
    
T.RTitleUserPersonal
Name
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2032.1exercises that work for meCAM::JOHNSONimagine... sharing all the worldTue Jan 28 1997 21:3443
>>    PERIFORMIS SYNDROME/LOW BACK-LEG PAIN
>>    Looking for any information on low back pain radiating into legs. Have
hi,

i don't have a clue what PERIFORMIS is... however...

i had severe low back pain into my leg only on the right side...
doctor said it was sciatica, but no amount of anti inflammatories worked...

paid lots of $$ to see a chiropracter, whose exercises and therapy did not do
much...

i was living with it when i went to see a fascia specialist for plantar
fachitis, and mentioned it... she gave me 1 exercise that has helped
greatly, though some pain is still there...

she said it was probably disk material pushing out the back side on a nerve....
the disks work like hydrolics, so you heve to work on the other side to 
suck the material back in...

now, every morning, i lie on my stomach (pillow under stomach to get
a reverse curve in spine) w/ arms streched straight over head, and legs
straight...

1-at-a-time, lift each limb by itself off the ground only about 6 inches
for a count of 2 (i do 3 sets of 8 lifts per limb)

then do opposite arm/leg at the same time, then both arms, then both
legs, then all 4 (again, i do 3 sets of 8 lifts per group)...

this takes 5-7 minutes, and has worked for me...

good luck.

sarah

BTW... i was poking in here to see if there wer any notes to differentiate
the pain of a cracked rin vs a pulled muscle under the rib cage...

if anyone has any info on that, it would be greatly appreciated.

thanxk,
sarah
2032.2IJSAPL::ANDERSONLike to help me avoid an ulcer?Wed Jan 29 1997 05:45178
    I stated looking yesterday morning. The word Periformis was not in any
    of my reference books or known to the medical note file. However Alta
    Vista did have two references, neither of which was much use.

    However this morning one of the two did actually prove to be useful as
    it was a bit about anatomy. Tracing the nerve back to my anatomy book I
    found the correct spelling for the muscle was pyriformis.

    Your neurologist is quite right it is a rare condition I could only
    find 3 references with abstracts attached in the entire database. 
    I have included them here and added at the end the names and location
    of 2 doctors who seem to have some experience on the subject which I
    dug up from the web using Alta Vista..

    The information may be of more use to your neurologist than it will be
    to you.

    Jamie.

    -------------------------------------------------------------------

ANDERSON,JAMIE
COMPUSERVE, INC.
WED JAN 29,1997 3:11 AM

PaperChase provides 9,380,751 references -- all references found in the
following databases of the National Library of Medicine and the National
Cancer Institute*.  You are searching all four databases simultaneously.

  Database    Indexing Began    Updated     Current through
   MEDLINE        1966          weekly       March 1997 Update, Part 3
   HealthSTAR     1975          monthly      December 1996 Update
   AIDSLINE       1980          monthly      December 1996 Update
  *CANCERLIT      1980          monthly      January 1997 Update


LIST                    REFERENCES   
 A) PYRIFORMIS                1037    
 B) SYNDROME                169281    
 C) ABSTRACT ONLINE        4545302
 E) *ON A&B&C                    3

*** <IN PaperChase Core Journals> ***


*****ARCHIVES OF SURGERY*****

(REFERENCE 1 OF 3)
76205056

Mizuguchi T  
Division of the pyriformis muscle for the treatment of sciatica.
  Postlaminectomy syndrome and osteoarthritis of the spine.

In: Arch Surg (1976 Jun) 111(6):719-22

<Muscles/SU> <Osteoarthritis/SU> <Sciatica/ET/SU> <Spine/SU> 

<Adult> <Aged> <Human> <Laminectomy/AE> <Lumbar Vertebrae/RA> 
  <Middle Age> <Myelography> <Postoperative Complications/SU> 
  <Sciatic Nerve/PA> <Spinal Diseases/SU> <Syndrome> <Medline File> 

Division of the pyriformis muscle at its tendinous insertion was
  employed for the treatment of sciatica in 14 patients with
  postlaminectomy syndrome and osteoarthritis of the spine. Of these
  patients, 85% had satisfactory results. It is logical that the
  pyriformis muscle can play an important role in the production of
  sciatic associated with intraspinal lesions. Tension on the sciatic
  nerve, which passes in close approximation to the pyriformis muscle
  anteriorly, can be relieved by division of the pyriformis muscle.


*** <NOT IN PaperChase Core Journals> ***


*****CLINICAL AND EXPERIMENTAL NEUROLOGY*****

(REFERENCE 2 OF 3)
88027956

Synek VM  
The pyriformis syndrome: review and case presentation.

In: Clin Exp Neurol (1987) 23:31-7

<Nerve Compression Syndromes/PP> <Sciatic Nerve/IN/PP> <Sciatica/PP> 

<Adult> <Buttocks/IR> <Case Report> <Electromyography> 
  <Evoked Potentials, Somatosensory> <Female> <Human> <Syndrome> 
  <Wounds, Nonpenetrating/PP> <Medline File> 

The pyriformis syndrome is a rare entrapment neuropathy in which the
  sciatic nerve is compromised by the pyriformis muscle or other local
  structures. It usually presents with sciatic pain and hypoaesthesia
  and a limp caused by weakness of the gluteus maximus muscle. Peroneal
  nerve innervated muscles and hamstrings are also usually affected.
  The diagnosis relies on the clinical presentation and the EMG
  findings. Other causes of symptoms should be excluded by careful
  examination, detailed x-ray studies of the lumbosacral spine
  (including myelogram), sacro-iliac and hip joints. A case of this
  syndrome occurring in a previously healthy 42 year old woman and her
  follow-up investigations are reported.

Institutional address: 
     Department of Clinical Neurophysiology
     Auckland Hospital
     New Zealand.


*****NEUROSURGERY*****

(REFERENCE 3 OF 3)
89015018

Brown JA  Braun MA  Namey TC  
Pyriformis syndrome in a 10-year-old boy as a complication of
  operation with the patient in the sitting position.

In: Neurosurgery (1988 Jul) 23(1):117-9

<Astrocytoma/SU> <Cerebellar Neoplasms/SU> <Muscular Diseases/ET/PP> 
  <Nerve Compression Syndromes/ET> <Postoperative Complications> 
  <Posture> <Sciatic Nerve/PP> 

<Case Report> <Child> <Human> <Male> <Syndrome> <Medline File> 
  <Cancerlit File> 

We present a case of sciatic neuropathy due to the pyriformis
  syndrome after operation in the sitting position. Neither sciatic
  nerve injury nor the pyriformis syndrome has been reported after
  operation in the sitting position, although a low incidence of common
  peroneal nerve injury has been reported as a complication of
  operation on patients who are in the sitting position. The clinical
  findings of sciatic neuropathy, external rotation of the ipsilateral
  foot in the position of comfort, and a therapeutic response to local
  anesthetic injection into the pyriformis muscle are diagnostic of the
  syndrome. Nerve conduction studies should be performed to aid in the
  differentiation between a common peroneal and sciatic neuropathy. The
  syndrome may occur because of extreme flexion of the hips and
  prolonged pressure while in the sitting position, leading to
  pyriformis muscle trauma, resultant spasm, and sciatic compression.
  The prognosis is for complete recovery after symptomatic treatment
  with nonsteroidal antiinflammatory medication and physical therapy.

Institutional address: 
     Department of Neurological Surgery
     Medical College of Ohio
     Toledo.

Here is the list of doctors

Dr. Brown

Department of Neurological Surgery
Medical College of Ohio
Toledo, OH 43699-0008
E-MAIL: [email protected]
[419] 381-3547
[419] 381-4172

Scientific Papers

Brown JA, Braun MA, Namey TC: Pyriformis syndrome in a 10-year-old boy as a
complication of operation in the the sitting position. Neurosurgery 23:
117-119, 1988

----------------------------------------------------------------------------

    Angela McLoughlin, M.D. of the University of Michigan Department of
    Anesthesiology of the University of Michigan Medical School in Ann
    Arbor, Michigan, USA.


   * Usefulness of caudal injections as an adjunct to physical therapy in
     the treatment of pyriformis syndrome.


Last Updated: August 03, 1996
2032.3In parenting, there are several notes that will reef.NAC::WALTERWed Feb 05 1997 09:2318
    FWIW, I had siactic nerve problems when I was pregnant four years ago. 
    My son would sit on the nerve, so my OB told me and my leg on that side
    would go numb and I would have lower back pain and some leg pain.  
    
    His solution was to go swimming.  It did wonders for me.  It didn't
    hurt when I was in the water and I always felt better after doing some
    laps.  I started out with 20 laps and increased to 40 laps in a normal
    20x40 pool.  If I didn't do it everyday I would try for everyother day. 
    If I went two days in a row without doing swimming, the numbness and
    pain would immediately come back.
    
    Something to think about if you have a membership to a health club with
    a pool.  I was fortunate enough to have this pain in August and
    September so I used my in-laws pool each afternoon. I even got a doctor
    note to leave work early to go swimmin because it helped so much and I
    was useless if I didn't continue the exercises.
    
    cj