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Diagnosing deep gluteal syndrome is often is a clinical challenge because the symptoms can have considerable overlap with symptoms of pelvic, hip, and spine pathology. [ 2 ] [ 5 ] [ 6 ] [ 4 ] In particular lumbar pathology should be excluded early [ 4 ] as sciatica that originates in the spine is thought to be more common than sciatica that ...
Piriformis syndrome is a condition which is believed to result from nerve compression at the sciatic nerve by the piriformis muscle. [2] [5] It is a specific case of deep gluteal syndrome. [6] The largest and most bulky nerve in the human body is the sciatic nerve. Starting at its origin it is 2 cm wide and 0.5 cm thick.
The sciatic nerve can also be entrapped outside of the pelvic space and this is called deep gluteal syndrome. [19] Surgical research has identified new causes of entrapment such as fibrovascular scar bands, vascular abnormalities, heterotropic ossification, gluteal muscles, hamstring muscles, and the gemelli-obturator internus complex. [20]
Extensive scar tissue formation is a major cause of nerve entrapment, and for deep gluteal syndrome (entrapment of the sciatic nerve in the deep gluteal space), it's the most common cause. [11] While the concept of scar tissue causing traction injuries is widely accepted, [2] its role is more complex than strictly causing stretching injuries.
Endoscopic treatment for sciatic nerve entrapment has been investigated in deep gluteal syndrome. Patients were treated with sciatic nerve decompression by resection of fibrovascular scar bands, piriformis tendon release, obturator internus, or quadratus femoris, or by hamstring tendon scarring. [13]
Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by chronic, direct pressure on a peripheral nerve. [1] It is known colloquially as a trapped nerve , though this may also refer to nerve root compression (by a herniated disc , for example).
Piriformis syndrome occurs when the piriformis irritates the sciatic nerve, which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve. [8] This referred pain is known as sciatica. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle.
Many large and small muscles have relationships with the ligaments of the sacroiliac joint including the piriformis (see "piriformis syndrome", a condition often related with sacroiliac joint dysfunction), rectus femoris, gluteus maximus and minimus, erector spinae, latissimus dorsi, thoracolumbar fascia, and iliacus. [1]