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The OVER-diagnosed ‘Piriformis Syndrome’ – problems with current techniques of palpation, assessment, and treatment

February 15, 2011

In this clip, Dr. Spina discusses the problems with current methods of palpation, assessment, and treatment techniques leading the the highly over-diagnosed condition labeled ‘Piriformis Syndrome.’  These problems, coupled with a lack of understanding of neuro-genic vs. referral symptoms has lead to a great deal of confusion in the literature which has manifested itself into clinical applications and treatment approaches.

Of note, when considering the access of deeper structures for the purposes of assessment and/or treatment, keep in mind the 3D nature of the patients….meaning that tissue DEPTH must be considered.  In the F.A.P.™ and F.R.™ systems, we utilized what we refer to as the ‘Layering Technique’ to ensure that we maintain proper contact with the tissue/fascial plane of interest.  Attempts at palpating deeper tissues (for example the piriformis as is discussed) without such consideration will lead to an incorrect tissue diagnosis….and thus less than optimal treatment approaches.

Along with this video clip, I invite you to read this article entitled “The Piriformis Syndrome is Overdiagnosed” published in Muscle & Nerve (2003) which highlights some of the concepts noted above:

Of note, the author states that there has been no clinical evaluation of any of the common tests utilized to diagnose this condition.


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