Piriformis Syndrome Case Solution And Analysis, HBR Case Study Solution & Analysis of Harvard Case Studies

Piriformis Syndrome Case Solution

2.2.5 Palpations

The compression of sciatic nerve can be judge by the sensitivity and palpation at the greater sciatic notch. (Kirschner JS, 2007)

2.2.6 Hughes test

The PS can be judge by performing this test. The Hughes test can be performed by the external isometric rotation of the affected lower extremity.(Kirschner JS, 2007)

2.2.7 Hip Abduction

This test can be performed by abduction of the upper leg. The patient is allowed to lie on the side way with lower leg flexed. Now the patient is asked to abduct the upper leg along the side of the trunk. The measurement and angle of the upper leg can be measured. The normal hip abduction is 45 degree. (Kirschner JS, 2007)

Source: (Kirschner JS, 2007)

3. Treatment of piriformis syndrome

The disease can be treated if the health care professional diagnosis it at early, where as if the disease become acute and diagnosis later, the treatment procedure can become prolong and harder to treat. Piriformis syndrome can be treated through various procedures such as:(revord, 2012)

3.1 Muscle stretching

There are several muscle stretching exercises such piriformis and hamstrings stretches, which can be helpful for the pain degradation. These stretching exercises includes:

3.2 Piriformis stretches

There are many ways to stretch the piriformis muscle, out of which,two simple methods include:

Hold your back by stocking feet level on the floor. Then turn your knees bowed. Now pull the accurate knee to the chest. Hold it with left hand and drag it to the one side of the shoulder by holding the stretch. Repeat the process for each side.
Hold your back with two feet level on the floor and two knees apart. Then relax the lower leg of the accurate leg by putting it over the knee of the left leg. Now drag the left thigh to the chest and hold the stretch. Repeat the process for each side.

.Each extend of the piriformis should be done for 5 seconds at the beginning, and increases upto 30 seconds as time passes. This can be done for at least three times a day.

3.3 Hamstrings stretches

Hamstring is the large muscle present at the back of each thigh. Stretching the hamstring plays a good role in decreasing pain. There are many ways to stretch them such as:

Place two chairs in front of each other. Hold onto one chair by putting the heel of one leg on the other chair. Bend the hip by tilting forward until you feel the stretch.
Hold onto the back by putting both legs straight. Drag one leg up and align it until a mild stretch along the thigh is felt.

Repeat this process for good 30 seconds, 3 or 4 times a day for better results.

3.4 Physical Therapy

Apart from stretching, there are several physical therapies used for inhibiting pain, these are:

3.4.1 Ice casket and massage

Place the ice at the affected and the painful area for approximately 20 minutes. Repeat the process as many times as needed after every 2 to 4 hours. You can also massage the affected area with a large ice for at most 8 to 10 minutes to avoid the frostbite.

3.4.2 Heat Treatment

For the painful areas, you can also use heat pads and place it over your stomach for good 20 minutes to feel better and relaxed. Make sure to avoid using heat pads during sleeping as it can cause skin burn. Take proper safety precautions before doing any such treatment.

3.4.3 Massage therapy

Massage therapy can be useful for the healing purpose. Make sure to take massage therapy by a professional specialist. It decrease the pain by increasing flow of blood and reducing muscle spasm.

3.5 Exercise

There are several exercises that can be helpful in decreasing sciatic pain such as side clam, Extension of hip, supine side stretch and different buttock exercises.(Roy, 2014)

3.6 Medications

The pain engender by this syndrome also produces inflammation in the affected area. This pain can be reduces by taking anti-inflammatory, such as: naproxen, ibuprofen etc.(JB, 1976)

3.7 Steroids

In several cases, the injections can be used to treat the syndrome. These steroids can be helpful in decreasing the pain and swelling of the affected areas.(JB, 1976)

These injections include:

3.7.1 Piriformis injection

The pain and spasm of the piriformis muscle can be decreased by directly injecting the corticosteroid and anesthetic drugs. This injection can be helpful in decreasing the acute pain to get better results.

3.7.2 Botox injection

Botox injection or botulinum toxin is also known as muscle weakening agent. This injection can be helpful in relaxing of muscle. It also helps in reducing the pressure surrounding the nerve and the affected areas.

The main objective of both of these injections is to get better results by decreasing the spasm along with physical therapy and stretching. This will help the patient in getting relaxed for the longer period of time.

3.8 Electro therapy

The transcutaneous electrical nerve stimulator (TENS) or inferential current stimulator (IFC) can be helpful in blocking the pain and reducing the muscle spasm.

In some rear cases, when the person is suffering from acute or delayed pain, the health professionals can cut the piriformis muscle to relief the patient’s pain. The pronging can happen in very rear and prolonged cases.

3.9 Surgery

The surgery can be done in one of a thousand rare cases. Although having a surgery for this syndrome is quite not a good idea for the patient. The surgery can only be done when the patient is suffering from unbearable and excessive pain. The surgery may decompress the nerve reduces the pain at the moment, but the efficient results are not predictable

after a surgery. The person may feel pain and spasm after span of time. In short. In short, It is good to reduce pain and treat this syndrome by doing exercises and medications and avoid getting surgeries.

4. Differential diagnosis

Different diagnosis has been shown when investigating the syndrome, which are:

Injury of hamstrings
Tumor generated surrounding the hip region
Lumbosacral spine injury
Lumbosacral syndrome
Sacroiliac dysfunction
Tumors(L, 2020)

5. Prognosis

The patient suffering from this syndrome may show minor improvement after having injections. However, inoculating of injection along with physical therapies and exercises may help the person in reducing pain successively in a short span of time. (L, 2020)

Individuals who proceed to surgery may get slower or unpredictable results.

6. Complications

Every treatment may produce different complications if not treated well. So, it is a good practice to do research and consult experienced health care professional so that it does not cause any suffering. For this syndrome, it is a good practice to treat it first with rehabilitation exercises and therapies. In some cases medications can also be helpful for the acute pain along with exercises for the sufficient results. However, individual may take proper research guidelines before proceeding into surgeries. Surgeries may cause several complications, are which listed below:

Nerve injury
Injury surrounding the nerve areas
Bleeding
Infections or contamination

Study has shown both manual and physical therapies are more beneficial for the treatment.(A, 2012)........................

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Piriformis Syndrome Harvard Case Solution & Analysis