{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:54:29Z","timestamp":1791456869758,"version":"4.3.4"},"reference-count":40,"publisher":"Galenos Yayinevi","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Turk J Phys Med Rehab"],"abstract":"<jats:p>Objectives: This study aims to investigate the presence of piriformis syndrome (PS) in patients with clinically diagnosed lumbosacral radiculopathy (LR).\nPatients and methods: In this prospective, cross-sectional study, 39 patients (14 males, 25 females; mean age: 48.2\u00b112.2 years; range, 26 to 69 years) with evidence of L4, L5, or S1 radiculopathy and localized tenderness at the ipsilateral piriformis muscle (PM) were enrolled between February 2022 and August 2022. All patients received a 5-mL ultrasound-guided injection of 2% lidocaine into the PM. The patients whose pain resolved at least 50% from the baseline after the injection were diagnosed as having PS. Thirty-nine patients completed the one-month follow-up period.\nResults: Piriformis syndrome was diagnosed in 33 (84.6%) patients with LR. The mean percentage reduction in symptoms at 1 h, one week, and one month after the injection were 66%, 57%, and 71%, respectively. Compared to baseline, all pain parameters showed statistically significant improvement at the one-month evaluation (p&lt;0.05).\nConclusion: Piriformis syndrome should be regarded as a potential coexisting condition rather than an exclusion criterion in patients with LR. In patients with LR and PS, ultrasound-guided PM injections provide short-term benefits, facilitating early return to daily activities.<\/jats:p>","DOI":"10.5606\/tftrd.2026.17346","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:59:16Z","timestamp":1781161156000},"source":"Crossref","is-referenced-by-count":0,"title":["Piriformis syndrome and lumbosacral radiculopathy:  An overlooked coexistence"],"prefix":"10.4274","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3028-0720","authenticated-orcid":false,"given":"Ya\u015far Burak","family":"Top\u00e7u","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2811","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1. Reus M, de Dios Berna J, Vazquez V, Redondo MV, Alonso J. Piriformis syndrome: a simple technique for US-guided infiltration of the perisciatic nerve. Preliminary results. Eur Radiol. 2008;18:616-20. doi: 10.1007\/s00330-007-0799-3.","DOI":"10.1007\/s00330-007-0799-3"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. Misirlioglu TO, Akgun K, Palamar D, Erden MG, Erbilir T. Piriformis syndrome: comparison of the effectiveness of local anesthetic and corticosteroid injections: a double-blinded, randomized controlled study. Pain Physicia.n 2015;18:163-71.","DOI":"10.36076\/ppj\/2015.18.163"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. Cass SP. Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep. 2015;14:41-4. doi: 10.1249\/JSR.0000000000000110.","DOI":"10.1249\/JSR.0000000000000110"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. Bateman EA, Fortin CD, Guo M. Musculoskeletal mimics of lumbosacral radiculopathy. Muscle Nerv.e 2025;71:816-32. doi: 10.1002\/mus.28106.","DOI":"10.1002\/mus.28106"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5. Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Cli.n 2007;25:387-405. doi: 10.1016\/j.ncl.2007.01.008.","DOI":"10.1016\/j.ncl.2007.01.008"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6. Geler Kulcu D. Deep Gluteal syndrome: an underestimated cause of posterior hip pain. Turk J Phys Med Rehabil 2024;70:4-16. doi: 10.5606\/tftrd.2024.14668.","DOI":"10.5606\/tftrd.2024.14668"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. Misirlioglu TO, Palamar D, Akgun K. Letter to the editor involving the article 'Piriformis muscle syndrome: a crosssectional imaging study in 116 patients and evaluation of therapeutic out-come'. Eur Radiol. 2018;28:5354-55. doi: 10.1007\/s00330-018-5554-4.","DOI":"10.1007\/s00330-018-5554-4"},{"key":"ref7","unstructured":"8. Niu CC, Lai PL, Fu TS, Chen LH, Chen WJ. Ruling out piriformis syndrome before diagnosing lumbar radiculopathy. Chang Gung Med J. 2009;32:182-7."},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. Cassidy L, Walters A, Bubb K, Shoja MM, Tubbs RS,Loukas M. Piriformis syndrome: implica-tions of anatomical variations, diagnostic techniques, and treatment options. Surg Radiol An-at. 2012;34:479-86. doi: 10.1007\/s00276-012-0940-0.","DOI":"10.1007\/s00276-012-0940-0"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10. Zhang W, Luo F, Sun H, Ding H. Ultrasound appears to be a reliable technique for the diagnosis of piriformis syndrome. Muscle Nerve. 2019;59:411-6. doi: 10.1002\/mus.26418.","DOI":"10.1002\/mus.26418"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"11. Probst D, Stout A, Hunt D. Piriformis syndrome: a narrative review of the anatomy, diagnosis, and treatment. PM R. 2019;11(Suppl 1):S54-63. doi: 10.1002\/pmrj.12189.","DOI":"10.1002\/pmrj.12189"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12. Fishman LM, Hosseini M. Piriformis syndrome - a diagnosis comes into its own. Muscle Nerve. 2019;59:395-6. doi: 10.1002\/mus.26417.","DOI":"10.1002\/mus.26417"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"13. Solheim LF, Siewers P, Paus B. The piriformis muscle syndrome. Sciatic nerve entrapment treated with section ofthe piriformis muscle. Acta Orthop Scand. 1981;52:73-5. doi: 10.3109\/17453678108991762.","DOI":"10.3109\/17453678108991762"},{"key":"ref13","unstructured":"14. Freiberg AH, Vinke TH. Sciatica and the sacro-iliac joint. J Bone Joint Surg Am. 1934;16:126-36."},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"15. Beatty RA. The piriformis muscle syndrome: a simple diagnostic maneuver. Neurosurgery. 1994;34:512-4. doi: 10.1227\/00006123-199403000-00018.","DOI":"10.1227\/00006123-199403000-00018"},{"key":"ref15","unstructured":"16. Pace JB, Nagle D. Piriform syndrome. West J Med 1976;124:435-9Martin HD, Kivlan BR, Palmer IJ, Martin RL. Diagnostic accuracy of clinical tests for sciatic nerve entrapment in"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"17. the gluteal region. Knee Surg Sports Traumatol Arthrosc. 2014;22:882-8. doi: 10.1007\/s00167-013-2758-7.","DOI":"10.1007\/s00167-013-2758-7"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"18. Michel F, Decavel P, Toussirot E, Tatu L, Aleton E, Monnier G, et al. The piriformis muscle syn-drome: An exploration of anatomical context, pathophysiological hypotheses and diagnostic criteria. Ann Phys Rehabil Med. 2013;56:300-11. doi: 10.1016\/j.rehab.2013.03.006.","DOI":"10.1016\/j.rehab.2013.03.006"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"19. Charnley J. Orthopaedic signs in the diagnosis of disc protrusion. With special reference to the straight-legraisingtest. Lancet. 1951;1:186-92. doi: 10.1016\/s0140-6736(51)93353-3.","DOI":"10.1016\/S0140-6736(51)93353-3"},{"key":"ref19","unstructured":"20. Dyck P. The femoral nerve traction test with lumbar disc protrusions. Surg Neurol. 1976;(3):163-6."},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"21. Masala S, Crusco S, Meschini A, Taglieri A, Calabria E, Simonetti G. Piriformis syndrome: long-term follow-up in patients treated with percutaneous injection of anesthetic and corticosteroid under CT guidance. Cardiovasc Intervent Radiol. 2012;35:375-82. doi: 10.1007\/s00270-011-0185-z.","DOI":"10.1007\/s00270-011-0185-z"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"22. Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Clin Rheumatol. 2010;24:241-52. doi: 10.1016\/j.berh.2009.11.005","DOI":"10.1016\/j.berh.2009.11.005"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"94","DOI":"10.4103\/0972-4958.121573","article-title":"Prevalence of piriformis syndrome among the cases of low back\/buttock pain with sciatica: a prospective study","volume":"27","author":"Singh","year":"2013","unstructured":"23. Singh US, Meena RK, Singh CAK, Singh AKJ, Singh AM, Langshong R. Prevalence of piriformis syndrome among the cases of low back\/buttock pain with sciatica: a prospective study. Jour-nal of Medical Society. 2013;27:94-9.","journal-title":"Jour-nal of Medical Society"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"24. Hallin RP. Sciatic pain and the piriformis muscle. Postgrad Med. 1983;74:69-72. doi: 10.1080\/00325481.1983.11698378.","DOI":"10.1080\/00325481.1983.11698378"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"25. Kirschner JS, Foye PM, Cole JL. Piriformis syndrome, diagnosis and treatment. Muscle Nerve. 2009;40:10-8. doi: 10.1002\/mus.21318.","DOI":"10.1002\/mus.21318"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"26. Fishman LM, Schaefer MP. The piriformis syndrome is underdiagnosed. Muscle Nerve. 2003;28:646-9. doi: 10.1002\/mus.10482.","DOI":"10.1002\/mus.10482"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"27. Hopayian K, Danielyan A. Four symptoms define the piriformis syndrome: an updated system-atic review of its clinical features. Eur J Orthop Surg Traumatol. 2018;28:155- 64. doi: 10.1007\/s00590-017-2031-8.","DOI":"10.1007\/s00590-017-2031-8"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"28. Kean Chen C, Nizar AJ. Prevalence of piriformis syndrome in chronic low back pain patients. A clinical diagnosis with modified FAIR test. Pain Pract. 2013;13:276-81. doi: 10.1111\/j.1533-2500.2012.00585.x.","DOI":"10.1111\/j.1533-2500.2012.00585.x"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"29. Siddiq MA, Hossain MS, Uddin MM, Jahan I, Khasru MR, Haider NM, et al. Piriformis syndrome: a case series of 31 Bangladeshi people with literature review. Eur J Orthop Surg Traumatol. 2017;27:193-203. doi: 10.1007\/s00590-016-1853-0.","DOI":"10.1007\/s00590-016-1853-0"},{"key":"ref29","unstructured":"30. Sari H, Akarirmak U, Uludag M. Active myofascial trigger points might be more frequent in pa-tients with cervical radiculopathy. Eur J Phys Rehabil Med. 2012;48:237-44."},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"31. Letchuman R, Gay RE, Shelerud RA, VanOstrand LA. Are tender points associated with cervical radiculopathy? Arch Phys Med Rehabil. 2005;86:1333-7. doi: 10.1016\/j.apmr.2004.11.023.","DOI":"10.1016\/j.apmr.2004.11.023"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"32. Adelmanesh F, Jalali A, Jazayeri Shooshtari SM, Raissi GR, Ketabchi SM, Shir Y. Is there an as-sociation between lumbosacral radiculopathy and painful gluteal trigger points?: A cross-sectional study. Am J Phys Med Rehabil. 2015;94:784-91. doi: 10.1097\/PHM.0000000000000261.","DOI":"10.1097\/PHM.0000000000000261"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"33. Huang JT, Chen HY, Hong CZ, Lin MT, Chou LW, Chen HS, et al. Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies. Patient Prefer Ad-herence. 2014;8:1105-11. doi: 10.2147\/PPA.S64736.","DOI":"10.2147\/PPA.S64736"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"34. Vas L, Pai R, Pawar KS, Pattnaik M. \"Piriformis syndrome\": is it only piriformis? Pain Med. 2016;17:1775-9. doi: 10.1093\/pm\/pnw037.","DOI":"10.1093\/pm\/pnw037"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"35. Barton PM. Piriformis syndrome: a rational approach to management. Pain. 1991;47:345-52. doi: 10.1016\/0304-3959(91)90227-O.","DOI":"10.1016\/0304-3959(91)90227-O"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"36. Srbely JZ. New trends in the treatment and management of myofascial pain syndrome. Curr Pain Headache Rep. 2010;14:346-52. doi: 10.1007\/s11916-010-0128-4.","DOI":"10.1007\/s11916-010-0128-4"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"37. Laslett M. Manual correction of an acute lumbar lateralshift: Maintenance of correction and rehabilitation: a case report with video. J Man Manip Ther. 2009;17:78-85. doi: 10.1179\/106698109790824749.","DOI":"10.1179\/106698109790824749"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"38. Madani SP, Dadian M, Firouznia K, Alalawi S. Sacroiliac joint dysfunction in patients with her-niated lumbar disc: a crosssectional study. J Back Musculoskelet Rehabil. 2013;26:273-8. doi: 10.3233\/BMR-130376.","DOI":"10.3233\/BMR-130376"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"39. Huang Z, Li G, Deng W, Liu M, Li T. Lumbar disc herniation is a nonnegligible factor for the de-generation of sacroiliac joints. Pain Physician. 2021;24:E357-65.","DOI":"10.36076\/ppj.2021\/24\/E357"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"40. Hopayian K, Heathcote J. Deep gluteal syndrome: An overlooked cause of sciatica. Br J Gen Pract. 2019;69:485-6. doi: 10.3399\/bjgp19X705653.","DOI":"10.3399\/bjgp19X705653"}],"container-title":["Turkish Journal of Physical Medicine and Rehabilitation"],"original-title":[],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:25:49Z","timestamp":1791455149000},"score":1,"resource":{"primary":{"URL":"https:\/\/ftrdergisi.com\/articles\/piriformis-syndrome-and-lumbosacral-radiculopathy-an-overlooked-coexistence\/doi\/tftrd.2026.17346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":40,"URL":"https:\/\/doi.org\/10.5606\/tftrd.2026.17346","relation":{},"ISSN":["2587-1250"],"issn-type":[{"value":"2587-1250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]}}}