Prevalence of Piriformis Muscle Syndrome Among Individuals with Low Back Pain

Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling. Starts at the lower spine and connects the upper surface of each femur (thighbone). Functions to assist in rotating the hip and turning the leg and foot outward Runs diagonally. Objective: To �nd out the prevalence of piriformis muscle syndrome among individuals with low back pain. Methods: Participation of population from Gujranwala city from various emergency clinics was remembered for this study in view of inclusion and exclusion criteria. The data was collected through non-probability convenient sampling technique. A�rmed instances of low back torment patients were added and get some information about their agony as indicated by VAS (visual simple scale) and outer muscle tests (FAIR test, pace sign, Piriformis stretch (test) were performed on patients. Results: The results have been obtained from 219 participants. The overall Prevalence of piriformis muscle syndrome among individuals with low back pain was 18.3%.The Mean±SD of exact BMI were 27.43±6.859. Out of 219 patients, male and female Pace sign were respectively (85.8% negative and 14.2% positive). (81.7%) Negative and (18.3%) Positive Prevalence of piriformis muscle syndrome in the general population in Age groups chi-square value is (47.753b) and P- Value (<0.001*). Conclusions: In this research, the positive prevalence rate is 18.3%. It demonstrates that several individuals with low back pain have piriformis muscle syndrome.


I N T R O D U C T I O N
Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling. Starts at the lower spine and connects the upper surface of each femur (thighbone). Functions to assist in rotating the hip and turning the leg and foot outward Runs diagonally. Objective: To nd out the prevalence of piriformis muscle syndrome among individuals with low back pain. Methods: Participation of population from Gujranwala city from various emergency clinics was remembered for this study in view of inclusion and exclusion criteria. The data was collected through non-probability convenient sampling technique. A rmed instances of low back torment patients were added and get some information about their agony as indicated by VAS (visual simple scale) and outer muscle tests (FAIR test, pace sign, Piriformis stretch (test) were performed on patients. Results: The results have been obtained from 219 participants. The overall Prevalence of piriformis muscle syndrome among individuals with low back pain was 18.3%.The Mean±SD of exact BMI were 27.43±6.859. Out of 219 patients, male and female Pace sign were respectively (85.8% negative and 14.2% positive). (81.7%) Negative and (18.3%) Positive Prevalence of piriformis muscle syndrome in the general population in Age groups chi-square value is (47.753b) and P-Value (<0.001*). Conclusions: In this research, the positive prevalence rate is 18.3%. It demonstrates that several individuals with low back pain have piriformis muscle syndrome. among those who are at risk for secondary piriformis syndrome [5]. There are two principal components contributing to PS clinical features, somatic and neuropathic [6]. Since clinical presentations of PS frequently confuse with lumbago sciatica [7]. The sciatic nerve can be compressed between the piriformis muscle and the roof of the sciatic notch due to myositis ossi cans of the piriformis muscle [8]. Low back discomfort is a rather prevalent condition among dancers, accounting for up to 25% of all dance injuries [9]. Conveying wallet in pocket containing bills, cards and coins are the propensity for men. At the point when they sit having wallet in back pocket, they have expanded possibility of getting the nerves harmed that altercation that piece of lower back and lead to outrageous agony. The other name of this condition is "fat wallet disorder or wallet neuropathy". It includes both sciatic nerve and piriformis muscle as it is neuromuscular condition [1]. In Literature, the prevalence of PS among patients with low back pain ranges from 5 to 36 % (7). Similarly, another study reported that PS occur most frequently in the fourth and fth decades of life.PS is more common in women than man because of the biomechanics associated with the wider quadriceps femoris muscle angle (Q angle) of hip bone [10]. The rate of piriformis disorder among people with low back torment has been displayed to go from 5% to 36% [3]. According to Hopayian's research review, PS often has the following four symptoms: pain that worsens when you sit, soreness in the buttocks, and outward tenderness above the bigger sciatic notch. Systems that increment piriformis muscle strain incorporate the FAIR test (Flexion Adduction Internal Rotation), the Beatty test, the Piriformis sign, the Pace sign, and Freiberg's sign [11]. Differential diagnosis includes herniated lumbar disc, intervertebral discitis, intraspinal lesions, lumbar canal stenosis, pelvic masses, diabetic neuropathy, primary sacral dysfunction, sacroiliitis, and trochanteric bursitis [12]. Recurrent piriformis syndrome may result from entrapment of the sciatic nerve due to extensive brous tissue formation in surgically treated piriformis syndrome cases [13]. The diagnosis of piriformis syndrome is primarily clinical because no signi cant investigations have been recorded. Bone scans and electrodiagnostic tests do not appear to be generally effective, despite sporadic claims to the contrary [14]. Stationary individuals regularly whine of low back distress brought about by muscle irregularity, which, in the event that not tended to, can prompt a constant torment condition in the lower back [1]. The recurrence of PS is indistinct because of its confounding show and logical under diagnosis. Zero direct three toward six percent of lower back and upper/back thigh irritation is viewed as brought about by PS. There are around 2.4 million new occurrences of PS each year, with a forty million yearly rate of back/sciatic torment [15]. To additionally portray the sickness and help in conclusion, this forthcoming review led a clinical assessment of members who had side effects reliable with PMS. It additionally utilized imaging and electrophysiological strategies. Based on these outcomes, it was trusted that a clinical evaluation score might be made and later used to analyze PMS. It was likewise visualized that a treatment procedure might be created to improve patient results [16].

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An observational Cross-sectional study was conducted. Non-probability convenient sampling was used to select the sample. The study included 219 con rmed patients with low back pain. Participation of population from Gujranwala city from different hospitals were included in this study based on inclusion and exclusion criteria. Con rmed cases of low back pain patients were added and ask about their pain according to VAS (visual analogue scale) and musculoskeletal tests (FAIR test, pace sign, Piriformis stretch test) were perform on patients. Self-made questionnaire was used to collect data. In questionnaire d e m o g r a p h i c d a t a q u e s t i o n s w e r e a s k a n d musculoskeletal test questions were asked after perform the special tests. The following were among the inclusion criteria: Age 20+ with chronic low back pain. The following were among the exclusion criteria: Lumber injury during road tra c accident. Lumber spinal surgery. Lumber disc pain. All data were analyzed using SPSS (statistical package of social science) by using version 26. Numerical data were described in mean ± standard deviation. Frequencies and percentages were used to display quantitative data. For the signi cance, Chi square test was applied for quantitative data. Pearson's correlation was applied for measuring statistical relationship or association between the variable of interest. All results were calculated at 95% con dence level. P-value < 0.05 was considered as a signi cant value.

R E S U L T S
The results have been obtained from 219 participants. Overall prevalence of piriformis muscle syndrome among individuals with low back pain was 18.3%. All results were calculated at 95% con dence level. For quantitative data Chi square was used. The signi cant P-value was considered as ≤ 0.05. The signi cant P-value was set at <0.05. Table 1

D I S C U S S I O N
Above table 3 shows BMI of 9 patients (14.1%) were underweight, 94 patients (42.9%) were normal, 51 patients (23.3%) were overweight, 33 patients (15.1%) were existing class one obese, 18 patients (8.2%) were existing class two obesity and 14 patients (6.4%) were existing in class three obesity. According to visual analogue scale 113 patients (51.6) were exist in less pain, 32 patients (14.6%) were existing in moderate pain, 64 patients (29.2%) were existing in more pain and 10 patients (4.6%) were exist in worst pain. Chi square test was applied for quantitative data. 60) years old patients were 9.1%, age group (>60) years old patients were 5.5%. However according to marital status 208 patients (95.0%) were married, 9 patients (4.1%) were single and 2 patients (0.9%) were divorced. According to patients' occupation 4 students (1.8%), 32 o ce workers (14.6%), 73 patients (33.3%) labors, 2 patients (0.9%) farmers, 87 patients (39.7%) house wives and 21 patients exist in others category (9.6%).     Current study concluded that general population with low b a c k p a i n m i g h t ex p e r i e n c e t h e p r eva l e n c e o r pervasiveness of piriformis muscle syndrome. The aim of study to nd out the prevalence of piriformis syndrome among individuals with low back pain. For those record was taken from 219 males and females' patients in Gujranwala city from different hospitals. patients were added and ask about their pain according to VAS (visual analogue scale) and musculoskeletal tests (FAIR test, pace sign, Piriformis stretch test) were perform on patients. Self-made questionnaire was used to collect data. In questionnaire d e m o g r a p h i c d a t a q u e s t i o n s w e r e a s k a n d musculoskeletal test questions were asked after perform the special tests. A cross sectional exploration was directed in male understudies of college of Lahore. The objective of study to nd out piriformis disorder among college understudies. Information was gathered 113 arbitrarily chosen male understudy. Results showed ve percent predominance of piriformis muscle condition in college understudies. There was a relationship with long sitting and feeble muscles among understudies and

PJHS VOL. 3 Issue. 4 September 2022
Copyright (  In our study we also use visual analogue scale to nd out pain intensity. According visual analogue scale 113 patients (51.6) were existed in less pain, 32 patients (14.6%) were existed in moderate pain, 64 patients (29.2%) were existing in more pain and 10 patients (4.6%) were existed in worst pain. The difference between both researches because of sample size and setting Another crosssectional research conducted in Faisalabad. The sample size was 190 among bankers. Piriformis stretch test was proceeded as corroborative proof preceding principle out Current study shows that with low backache some patients had existence of piriformis muscle syndrome and patients with low back pain have a risk to get piriformis syndrome. There was relation between piriformis syndrome and BMI of the patients but the association were not signi cant according to our observation. In this research, we employed three tests to evaluate individuals for piriformis syndrome. Our observations indicated that the FAIR test was the most prevalent diagnostic exam. In addition, the Pace sign exam, which came after the FAIR test, was useful in making a diagnosis. Freiberg maneuver was the test that had the fewest favorable results.

R E F E R E N C E S
The authors declare no con ict of interest. [2] DOI: https://doi.org/10.54393/pjhs.v3i04.98