{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:32:32Z","timestamp":1791495152587,"version":"4.3.4"},"reference-count":71,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T00:00:00Z","timestamp":1563753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Piriformis syndrome is a form of sciatica caused by compression of the sciatic nerve by the piriformis muscle. It is a relatively uncommon, but not insignificant, cause of sciatica. The diagnosis of piriformis syndrome is complicated by the large differential diagnosis of low back and buttock pain with many diagnoses having overlapping symptoms. This narrative review highlights the relevant anatomy, history, physical exam maneuvers, electrodiagnostic findings, and imaging findings that are used to diagnose piriformis syndrome. Also discussed are posterior gluteal myofascial pain syndromes that mimic piriformis syndrome. The review then outlines the different treatment options for piriformis syndrome including conservative treatment, injections, and surgical treatment. In addition, it provides the reader with a clinical framework to better understand and treat the complex, and often misunderstood, diagnosis of piriformis syndrome.<\/jats:p>","DOI":"10.1002\/pmrj.12189","type":"journal-article","created":{"date-parts":[[2019,5,18]],"date-time":"2019-05-18T03:49:29Z","timestamp":1558151369000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment"],"prefix":"10.1002","volume":"11","author":[{"given":"Daniel","family":"Probst","sequence":"first","affiliation":[{"name":"Division of Physical Medicine and Rehabilitation, Department of Neurology Washington University School of Medicine  St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Stout","sequence":"additional","affiliation":[{"name":"EvergreenHealth Sport &amp; Spine Care  Kirkland WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devyani","family":"Hunt","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine and Rehabilitation, Department of Orthopaedics Washington University School of Medicine  St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318183a4a2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.1983.11698378"},{"key":"e_1_2_6_4_1","first-page":"1119","article-title":"The relation of arthritis of the sacroiliac joint to sciatica","volume":"2","author":"Y W","year":"1928","journal-title":"Lancet"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(47)90345-0"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnv029"},{"issue":"3","key":"e_1_2_6_7_1","first-page":"686","article-title":"The sciatic nerve and the piriformis muscle: their interrelation a possible cause of coccygodynia","volume":"20","author":"Beaton LA","year":"1938","journal-title":"J Bone Joint Surg"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000145121"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)90208-9"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-008-0538-0"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-013-1180-7"},{"key":"e_1_2_6_12_1","first-page":"126","article-title":"Sciatica and the sacro\u2010iliac joint","volume":"16","author":"Freiberg AHVT","year":"1934","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199706000-00016"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199403000-00018"},{"key":"e_1_2_6_15_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/00003086-199101000-00029","article-title":"The appearance of the piriformis muscle syndrome in computed tomography and magnetic resonance imaging. A case report and review of the literature","volume":"262","author":"Jankiewicz JJ","year":"1991","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"e_1_2_6_16_1","first-page":"647","article-title":"Sciatica caused by piriformis muscle syndrome: report of two cases","volume":"91","author":"Chen WS","year":"1992","journal-title":"J Formos Med Assoc"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.02.017"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10195-006-0129-6"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.2.2.0099"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200212000-00009"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1504-9"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10483"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(91)90029-4"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10482"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-015-2124-6"},{"key":"e_1_2_6_26_1","volume-title":"Functional Anatomy of the Limbs and Back","author":"Jenkins DB","year":"2009"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20893"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5447-6"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-006-0169-x"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00045-9"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2005.00039.x"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1937.01190080138007"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2002.30622"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000335788.45495.0C"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-017-2031-8"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.32098\/mltj.03.2016.16"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2015.11.001"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453678108991762"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2758-7"},{"issue":"6","key":"e_1_2_6_40_1","first-page":"435","article-title":"Piriform syndrome","volume":"124","author":"Pace JB","year":"1976","journal-title":"West J Med"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2006.07.258"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-199927040-00005"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100015298"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.183.1.1830063"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2001.21971"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-008-0486-8"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.10.1469"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2009.04.015"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000376"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2018.04.002"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu275"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.4103\/JMU.JMU_6_17"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(03)00105-6"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21318"},{"key":"e_1_2_6_55_1","volume-title":"Mobilisation of the Nervous System","author":"Butler D","year":"1991"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2013.04.003"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2008.27.8.1157"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-199823020-00020"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-011-0185-z"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.5301\/hipint.5000219"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.14366\/usg.14039"},{"issue":"2","key":"e_1_2_6_62_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.36076\/ppj\/2015.18.163","article-title":"Piriformis syndrome: comparison of the effectiveness of local anesthetic and corticosteroid injections: a double\u2010blinded, randomized controlled study","volume":"18","author":"Misirlioglu TO","year":"2015","journal-title":"Pain Physician"},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000113404.35647.D8"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.27.5.657"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25504"},{"key":"e_1_2_6_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2014.02.015"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000104669.86076.30"},{"key":"e_1_2_6_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-012-0940-0"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000110"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199907000-00006"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-001-0319-z"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hny018"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpmrj.12189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.12189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmrj.12189","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.12189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T07:46:15Z","timestamp":1694245575000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.12189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,22]]},"references-count":71,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1002\/pmrj.12189"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.12189","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,22]]},"assertion":[{"value":"2019-07-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}