Piriformis syndrome and lumbosacral radiculopathy: An overlooked coexistence

This study aims to investigate the presence of piriformis syndrome (PS) in patients with clinically diagnosed lumbosacral radiculopathy (LR).

In this prospective, cross-sectional study, 39 patients (14 males, 25 females; mean age: 48.2±12.2 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.

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<0.05).

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.