Piriformis and Related Entrapment Syndromes: Myth & Fallacy

This article explores the myths surrounding piriformis syndrome. It looks at the syndrome's history ranging from early hypothesis to acceptance; then from disfavor to resurrection as a diagnosis for patients with leg pain devoid of objective neurologic deficits, without disc herniations. It includes a critical review of the clinical literature and treatment strategies. It calls for a renaming of the syndrome to “nonlocalizing sciatica” and restriction of surgical resection of the piriformis to cases where all other treatment has failed. This is part of a Point-Counterpoint discussion with Dr. Aaron Filler's presentation of “Diagnosis and Management.