Piriformis Syndrome in the Wheelchair-Confined Patient with Neuromuscular Disease

Abstract

Wheelchair-confined patients with neuromuscular diseases are vulnerable to the piriformis syndrome. This syndrome, a not uncommon cause of entrapment sciatic neuritis, has a typical presentation, is easily diagnosed by placing direct or indirect tension on the piriformis muscle, and can be managed with injection of local anesthetic and steroid into the muscle augmented by tone relaxation including passive stretch.

Secondary Muscle and Nerve Impairment in Primary Neuromuscular Disease

“…Such ankles should be protected by elastic or neoprcne supports, hracing (tone balancing supramallcolar orthoses), or surgery (posterior tibial release or transfer) to prevent falling and to maintain the ability to stand and ambulate. Piriformis syndrome (non-discogenic sciatica) in the wheelchair-conhned patient with neuromuscular disease has been reported (6). In this situation, the sciatic nerve is compressed by spasm of the piriformis muscle ( Figure 5).…”