• The Korean Journal of Pain
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• v.24 no.2
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• pp.93-99
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• 2011

Background: Rocker bottom shoes (RBS) are popular among patients with different foot, leg, or back problems in Korea. Patients with knee osteoarthritis concurrent weakness in the quadriceps femoris muscle, who wear these shoes, are often assumed to develop piriformis syndrome (PS). This study was performed to improve the understanding about the effect of wearing such shoes on duration of the syndrome in knee osteoarthritis. Methods: We randomly assigned 150 patients with PS, who had used RBS daily for at least 6 months, to 2 groups, the S (stopped wearing) and K (kept wearing) groups. Both the groups were subdivided into the O and N groups, comprising patients with and without knee osteoarthritis, respectively. The effects of the treatment, including piriformis muscle injections and a home exercise program, were compared between the 2 groups by using a flexion-adduction-internal rotation (FAIR) test, a numeric rating scale (NRS), and the revised Oswestry disability index (ODI) during the 12-week follow-up. Results: The positive FAIR test ratios, mean NRS scores, and revised ODIs were higher in the KO group than the SN group from 4-12 weeks after treatment. Conclusions: RBS may extend duration of the PS in osteoarthritis patients.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.87-92
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• 2011

Backgroud: The objective was to evaluate the distance from the skin and the diameter of the piriformis muscle and their relationship to the body mass index (BMI). Methods: The study was a prospective study involving 60 patients. Patients were prepared on a radiological table in the prone position. Several images were obtained of each. In this view, the distance between the subcutaneous tissue and the piriformis muscle, and the diameter of the piriformis, were measured at three points (medially to laterally). Results: The distance to the piriformis from the skin was $6.6{\pm}0.9\;cm$, $6.3{\pm}0.8\;cm$, and $5.2{\pm}0.9\;cm$ in terms of the lateral, center, and medial measurement, respectively. The center of the piriformis had a greater diameter with $1.7{\pm}0.4\;cm$ (0.9-2.5) cm. The distance to the piriformis increased with BMI. Conclusions: This study shows that the lateral of the piriformis muscle has a relatively greater distance from the skin. The center of the piriformis showed a greater diameter than other two portions. We found that the distance of the piriformis from subcutaneous tissues was correlated with BMI, but the diameter of the piriformis was not affected by BMI. These measurements can be used as a reference for determining the piriformis injection site in patients with piriformis syndrome.

• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.217-226
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• 2024

Objective : The efficacy of sciatic nerve decompression via transgluteal approach for entrapment of the sciatic nerve at the greater sciatic notch, called piriformis syndrome, and factors affecting the surgical outcome were analyzed. Methods : The outcome of pain reduction was analyzed in 81 patients with sciatic nerve entrapment who underwent decompression through a transgluteal approach. The patients were followed up for at least 6 months. The degree of pain reduction was analyzed using a numerical rating scale-11 (NRS-11) score and percent pain relief before and after last follow-up following surgery. Success was defined by at least 50% reduction in pain measured via NRS-11. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. In addition, demographic characteristics, anatomical variations, and variations in surgical technique involving sacrotuberous ligamentectomy were analyzed as factors that affect the surgical outcome. Results : At a follow-up of 17.5±12.5 months, sciatic nerve decompression was successful in 50 of 81 patients (61.7%), and the pain relief rate was 43.9±34.17. Subjective improvement based on a 10-point Likert scale was 4.90±3.43. Among the factors that affect the surgical outcome, only additional division of the sacrotuberous ligament during piriformis muscle resection played a significant role. The success rate was higher in the scarotuberous ligementectomy group (79.4%) than in the non-resection group (42.6%), resulting in statistically significant difference based on average NRS-11 score, percent pain relief, and subjective improvement (p<0.05, independent t-test). Conclusion : Sciatic nerve decompression is effective in pain relief in chronic sciatica due to sciatic nerve entrapment at the greater sciatic notch. Its effect was further enhanced by circumferential dissection of the sciatic nerve based on the compartment formed by the piriformis muscle and the sacrotuberous ligament in the greater sciatic notch.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.6 no.1
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• pp.5-13
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• 2000

This evaluation was made through 11 persons who discogenic disease and it emergency disease. There was all complains low back. with sustained buttock pain with radiating to the leg due to piriformis syndrome during the period of march 2000 to November 1999 in seoul wooridul hospital. The purpose of this study was to determine the effect of manual therapy through 11 persons. The results were as follow : 1. Right buttock pain group(n = 11). there was significant difference before manual treatment(P<.05). 2. Pain decreased before Tx then after Tx by VAS.

• The Korean Journal of Pain
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• v.33 no.4
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• pp.305-317
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• 2020

Not all sciatica-like manifestations are of lumbar spine origin. Some of them are caused at points along the extra-spinal course of the sciatic nerve, making diagnosis difficult for the treating physician and delaying adequate treatment. While evaluating a patient with sciatica, straightforward diagnostic conclusions are impossible without first excluding sciatica mimics. Examples of benign extra-spinal sciatica are: piriformis syndrome, walletosis, quadratus lumborum myofascial pain syndrome, cluneal nerve disorder, and osteitis condensans ilii. In some cases, extra-spinal sciatica may have a catastrophic course when the sciatic nerve is involved in cyclical sciatica, or the piriformis muscle in piriformis pyomyositis. In addition to cases of sciatica with clear spinal or extra-spinal origin, some cases can be a product of both origins; the same could be true for pseudo-sciatica or sciatica mimics, we simply don't know how prevalent extra-spinal sciatica is among total sciatica cases. As treatment regimens differ for spinal, extra-spinal sciatica, and sciatica-mimics, their precise diagnosis will help physicians to make a targeted treatment plan. As published works regarding extra-spinal sciatica and sciatica mimics include only a few case reports and case series, and systematic reviews addressing them are hardly feasible at this stage, a scoping review in the field can be an eye-opener for the scientific community to do larger-scale prospective research.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.25-40
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• 2021

Objectives This study was conducted to analyze the effect of using acupotomy for piriformis muscle syndrome. Methods The databases used for the search were PubMed, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS), KMbase, and National Digital Science Library (NDSL). The literature was searched using a total of 9 domestic and foreign databases. randomized controlled trial using only acupotomy as an intervention was selected. The selected studies are analyzed the risk of bias through Cochrane risk of bias, and meta-analysis was performed using Revman. Results As a result of meta-analysis of 11 selected studies, acupotomy was more effective than nerve block and acupuncture. In terms of visual analog scale and immediate analgesic effect, acupotomy did not have statistically significant results compared to other treatment methods. meta-analysis of electro-acupuncture and acupotomy showed no significant results. Conclusions When acupotomy is applied as a treatment for piriformis muscle syndrome, it is more effective than nerve block and acupuncture. but most of the studies have been judged as 'unclear' in the risk of bias assessment. Due to characteristics of treatment group and control group's intervention, It is judged that the blinding of the participant was not properly implemented. Therefore, it is considered that high-quality studies are necessary to supplement the problems in the future.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.43-50
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• 2001

Objectives : Scalenus anticus syndrome and Piriformis syndrome is representative of myogenic Nerve entrapment syndrome, and their clinical symptoms are similar to HIVD(herniated Intervertebral disc) of cervical or lumbar spine. But, distinguished by muscle test, these syndrome apply to Meridian-muscle therapy. Methods : Meridian-muscle therapy consists of Ashi(阿是)-point therapy, taping therapy, myofascial release technique, manipulation, their based on the traditional meridian-muscle theory. This theory is similar to myofascial pain syndrome in western medicine. The study population consisted of 9 patients who were already diagnosed as Nerve entrapment syndrome with radiological examination & physical examination and muscle test. The evaluation of clinical outcome was done by Visual Analogue Scale (VAS) and Pain Assesment Questionnaire(PAQ). Results and Conclusions : After treatment, All patient's VAS is decreased as $2.11{\pm}1.59$ and the evaluation of clinical effect was excellent(6 cases) or good(3 cases) according to PAQ. Conclusively, Meridian muscle therapy is efficacious against Nerve entrapment syndrome.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.1 no.1
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• pp.15-15
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• 1995

• The Korean Journal of Pain
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• v.2 no.1
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• pp.72-77
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• 1989

Sciatic neuralgia has been considered as the symptom of herniated lumbar disk. but disk disease is not the only causes of sciatic neuralgia. Sciatic neuralgia uncombined with disk disease in thought to be a sign of myofascial syndrome of the piriform is muscle. Local anesthetic injection into piriform is muscle is recommended for the therapeutic treatment of sciatica without lumbago.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.2
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• pp.57-64
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• 2016

This is a case report about left leg radiating pain treated with complex traditional Korean medical intervention, while the case did not responded to prolotherapy and extracorporeal shock wave treatment for lumbar herniated intervertebral disc (HIVD). The patient was diagnosed with a piriformis problem after a physical examination and was treated with lumbar and piriformis muscle treatment. After 9 sessions of treatment for 33 days, Numeric Rating Scale (NRS) for pain has been decreased from 8 to 3. Further studies with more cases and longer observation period should be conducted to provide evidence for optimum acupuncture procedure considering its effectiveness, safety and patients' compliance altogether.