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Piriformis Test - Everything You Need To Know - Dr. Nabil Ebraheim
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- čas přidán 22. 10. 2017
- Educational video describing test used to diagnose piriformis syndrome.
Piriformis Syndrome is very popular and is not clearly understood. There is minimal information related to the subject of piriformis syndrome. Piriformis syndrome can be confused with sciatica and lower back pain. Sometimes it's hard to differentiate between Piriformis Syndrome and lumbar spine disc herniation which both can cause sciatica.
Straight leg raising test is the gold standard as a clinical test to diagnose disc herniation that is irritating the sciatic nerve. Elevation of a painful limb causes sciatica and radicular paion.. other clinical tests are described but not frequently used. If the test is positive consider spine problem. Herniated disc is typically the source of sciatic pain.
The Piriformis muscle arises from the anterolateral part of the sacrum and is inserted into the posterior aspect of the greater trochanter (deep into the buttock). Pain associated with, Piriformis Syndrome is usually deep in the buttock and posterior thigh. It may also include the posterior aspect of the leg due to irritation of the sciatic nerve (sometimes misdiagnosed as lumber pine disc pathology). The patient will complain of pain in the buttock, posterior thigh, and may have “pins and needles” down the leg.
There are two tests commonly used to diagnose, Piriformis Syndrome:
Lasegue’s maneuver: stretching the nerve. Reproduction of the pain by hip is flexed to 90 degrees and the knee extended. The test can also be done with the patient on the side.
Stretching the piriformis: when stretching the piriformis muscle, assess if passive stretching of the muscle is predisposed to or causes pressure on the sciatic nerve. By adducting and internally rotating the hip, this maneuver will stretch the piriformis and will compress the nerve. This maneuver will reproduce the patient’s symptoms. Also during this maneuver, when the examiner adds pressure to the posterior part of the buttock, the patient will complain of severe tenderness and pain.
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That was very useful, we saw a spine surgeon and had x3 steroid injection one at S1 and two at L5 to treat my wife's pain and it was piriformis syndrome at the end
thank you for your time and effort
الله يعطيك ألف عافية
very Weldon doctor and thank u so much.i suffer from lower back pain....but every doc give me pain killer.....u r a kind doc and know all about the history of the body....and explain it
An excellent presentation of this condition! I have been recovering from Piriformis Syndrome over the past 3 weeks with the help of a Physiotherapist who has a particular interest in the hip after getting hip replacement surgery 13 years ago that resulted from an accident.
In my case, my condition is the result of athletic overuse and not doing the warmups, stretching, and complementary strength-building exercises that would have protected me from the problem. At age 68, I am finally learning (the hard way) how important these exercises are to support an active lifestyle into old age.
Gene Balfour what are you doing to fix/treat it? I’ve been in pain for almost two months and nothing has helped.
Ayam mit u doktar
Help me mi srilanka
@@ahndz3 ma'am try yoga ...i cured it all by myself after bearing severe discomfort of three months
@@pamsingh9797 how long did you do yoga nefore you started seeing improvements until cured? Were you taking meds with it?
That's the best explanation I have come across. Thanks doctor.
Thank you this was very helpful. I strained this muscle when I was lifting my 60 lb. Pit Bull Terrier who was disabled. Had it diagnosed by physical therapist. This helped me understand what is happening that I can't see.
Pp
We need more good doctors like you. 🙏🏾
This was extremely helpful, thank you. I've been misdiagnosed for years. Long time pain sufferer.
Something should send this to my hospital! I have had two back surgeries over this. Not really happy these days.
Now are you okay
Mr you are amazing at explaining things in a simple yet advanced way very useful for a student of physical therapy
I'm glad to hear you are fallowing noble As I am happy to see more young people watching his videos He is an amazing teacher Abou 10 yrs ago I was having my pelvis worked on I told my therapist who had been working as a physical therapist for only 2 yrs He wanted to work on my neck as I was needing a little relief I agreed but said to do it very slowly and I would tell him when it hurt & was enough I'm not supposed to stretch my neck because I have stenosis & the tendents were so tight & were full of scaring tissue with lumps forming around & on them So he went ahead ignoring my words! When I got home I had a nap I woke up with an extremely swollen face 😔 After that I went 9 months of almost starving to death after losing 50 lbs I went to a clinic cause my family physician couldn't figure it out When I walked in that clinic the doctor there also didn't have an answer but the muscles in my neck were so swollen that it would pinch a nerve that my face would go nump when chewing & swallowing so I ask the doctor to give me prednisone because they weren't sending me for physio again A friend of mine that had passed away shortly before had mentioned that maybe I should take it but I refused It was before I had went to the therapist so I didn't need that medicine I left the clinic that morning & by night time I was able to eat ice cream 🍦 LoL it was a start 🥴 I'm still able to chew and swallow but with great difficulty Automobile accidents, trauma, stress & falling as I do so much these days My pelvis was crushed in a MVA Acc. 28 yss ago & a few carious issues that naturally occur with time & age I had been in physical therapy for 2 yrs after 3 mts in the hospital Sorry about the very long message but I have 4 grand kids and I don't want them to go through life with the quality of life that I had for so many years ❤️🙏 thank you
I felt pain in my buttock and thigh, sometimes to all my legs. I had low back pain which made me unable to sit more than 10 minutes. Low back pain and buttock bones pain. But when I walked and did all the physical exercises, every muscle felt so comfortable (not painful anymore). Just later I knew that it was my piriformis muscle that hurt me. The rotgen said I had lumbalis spondylosis and straight lumbalis. Yoga and walking 30 minutes a day helped me. Every time my low back and piriformis hurt again, I do yoga and walking and everything will be okay.
what yoga exercises did you do?
Rt
Hey bro how are you now ? I too had same symptoms
Wow thank you SO much Dr.! Finally I have the answers I have been looking for. For so long I had been told by my doctor that I had a herniated disc causing sciatica pain, and therefore my physical therapy focused on that and did not seem to help much. I switched physical therapy locations, and had a man actually focus on my buttock area and posterior thigh area (because I had been complaining of radiating left buttock pain and tenderness for so long) and he told me he definitely thought it had more to do with the muscles in my buttocks causing the sciatic pain as opposed to my back. Once I did a little research, I came across this video and it makes so much sense! Thank you!
Sir!! I came to know about my problem by this video but how can I get rid from this what I have to do daily along with consulting doctor ..
Aoa
Beautifully explained thanks dear doctor Nabil Ebrahim
Keep doing the Straight leg test that's shown in this video, slowly every day, until you can have leg down and the other at a 90 degrees. If you don't have a person to help you stretch, you can use a doorway to keep one leg up. I've had this pain for over 4 years now and seen several Dr. with no success. But doing the two simple stretches shown on this video has helped me out a lot. Now I can get 6 to 7 hours of sleep.
Hi Friend. Did you have pain when trying to stretch your leg in a seating position? Or pain only when standing from a seated position? I only have pain in butt cheek, no pain in leg nor radiates. Have you gotten 100% better?
@じん oh, no. Surgery is the least one to consider. You could end up with worse problems.
@じん Sorry to hear that.
@じん im sorry for this
@@AdamAlexanderK i had same problem as you. It was just buttock pain, almost like a spasm just right on my butt cheek with no leg pain or anything, but about 3 weeks ago, i think because my back compensated, i now have Herniated disc and its giving me leg problems. Have you had any luck?
Thank you doctor for your in-depth explanation of the causes of inflammation of the periformis.
I have suspected this for years but as you said it's hard to diagnose because it's so similar to other disorders. Sometimes I try to massage the area with a ball like a tennis ball & put it between me & a wall & you can control the amount of pressure. I used to do stretched everyday for months & there was a bit of relief but it never goes away
Thank you very much . I have this pain for almost for a month now. the first week I couldn't walk properly and so pain full ,then went to hospital for MRI the result is at my L4/L5 there was mild denegerative disc , I went for physiotherapy two times in Hospital and I do stretching everyday 2-3 times 30-45 mins each time . Thanks God, the third week I can walk and resumed to work. Now I think 90% my pain cured. I don't feel the low back pain now but still little pain at my upper thigh. Hope all the pain Gone with the stretching everyday and physiotherapy follow up.
Cost of MRI ..?
@@yuvraj-vn3vs probably $3,000
Same problem I have..I can't walk and my back is very painful
Thank you very much Dr. Nabil Ebraheim !
Thanks for explaining about Pirifirmis Test.
Monsieur le professeur je vour remercie pour votre consseille et votre dévouement pour ce que vous faîtes merci PROFESSEUR
What about the disk at the back
Great video explaining clearly How to test for Piriformis syndrome. I have right leg pain and hip pain when lying down on my back, or on my sides. The only thing that has helped is an SI joint injection but for only a few days. I wish I could come see you to get diagnosed properly! Thank you very much for the video.
Olo
با سلام و تشکر از دکتر ابراهیم فیلم خیلی مفیدی بود بسیار عالی . ممنون
This video convey a very useful revision about piriformis syndrome
sir i m also patient of this problem.your lecture was very help full for me.please tell us some exercise for reduse pain and problem
thank you very much it was very helpful to me because of my lower back and leg pain thank you
اختصرت الطب د.نبيل thanks
Very well understandle video.
Please make a video for the treatment
Thank you for posting this video....I suffered from severe pain for almost a year, could not sit or walk. (Being a medical language specialist and having worked with orthopedic surgeons, I have knowledge and an inquiring mind). It is True, that these symptoms (as often described by patient's) can be easily misinterpreted and reference is soon made relating to a lower back issue, or a 'sciatica'. Although the sciatic nerve can become involved, it is the way the piriformis muscle reacts to pain that continues this very painful process. (Even with DDD, it does not necessarily mean that the discs are the cause of the problem. I know from my own experience that this was not the case. Each and every time I went to physio, I was asked, 'where does your back hurt?' - it does not!) I sit for many hours, with my work as an editor/writer. Now, I go for walks every day and keep a check on how long I am sitting per session. Warm Epsom salt baths can really sooth and relax.
Again, thank you for uploading this explanation related to piriformis syndrome and the tests to identify it.
Hey
Thank you, Doc. Unfortunately, too late for me. My doctor decided that my pain and foot drop wae due to a spinal disk herniation, so he sent me to surgery. Surgery did not help but almost killed me due to anesthesia overdose. Now I believe it was piriformis muscle problem, not spine problem, because every time I fo FAIR test, it comes back positive
My goodness I hope you got financial compensation
Sir please upload a video for the treatment procedures
very useful presentation thanks
Thank you, very well explained.
The diagnostic is perfect, I have the same problem, but there is no solution or remedy for the problem in the video!
Yep. Home treatment information would be nice
3 months ago, I slipped on ice and fell flat on my butt, almost into split. Had a deep ache from my right buttock down to the back of my knee and it hurt to walk up even the slightest incline. Pretty sure this is what I had. Leg stretches have helped some.
Qqoomooallo
You might have injured your hamstring muscle and tendons. Have you seen a doctor about this?
thanks for everything. your video help a lot for my video. thanks
I suffer from this syndrome and had to use a cane to be able to walk or stand. about a year ago I discovered magnesium flakes and ordered a bag from Amazon. poured myself a hot bath with about a cup of these flakes. a few minutes after I got in the tub I felt the whole leg and foot muscles around that nerve start to jump and relax. I came up out of that tub a new woman with no cane!
i started making magnesium oil and magnesium body butter and use it throughout the day to keep the muscles from cramping. magnesium IS the original muscle relaxer! if u present in the ER having a heart attack, u get a shot of magnesium to stop it.
I'm still suffering from piriformis but the magnesium helps to soothe. I went to an amish country store where I buy my groceries and they carry many tinctures and oils - folk medicine. I found something called deep tissue oil and the man said it stopped sciatica nerve and muscle pain in under a minute and he gave me a sample. I was a bit skeptical but
I went out to the car and put a little bit on my lower back and buttock and almost immediately it felt like the nerve was being frozen and it travelled down to my foot. THE PAIN WAS GONE!! I bought what he had in stock and i use it every for to six hours. it contains wintergreen oil, menthol, cayenne and other herbal including st. johns wort. I'm an herbalist and make folk medicines, lotions, etc and sell them at local farmers markets so I used my knowledge of making different types of oils and whipped up a batch. took it to the markets this stuff is a huge hit! it has worked for every single person with nerve and/or muscle pain who has tried it! purely amazing.
i found piriformis stretches here on CZcams which have helped to heal the condition. I am 1000% improved in one year!😊👍 one year ago when I was bent over walking with a cane and in a state of constant pain, numbness and pins and needles in my foot, I never thought this possible.
To: Sherry K.
From: V. Calloway. I would like to know where I can order some deep tissue oil, because I suffer from piriformis. I'm constantly in pain every day. If I sit down for awhile, it hurt to stand up, and if I stand to long it hurts to sit down. CONSTANT PAIN IN SYRACUSE NY.
I have sciatic pain n when i benddown have pubs n needls. Can u send me the name of oil plz?
'Bonjour comment s'appelle se produit qui contient de l'huile tissulaire profonde l’huile de gingembre, du menthol, du poivre de cayenne et d’autres plantes, y compris du st. johns wort. Ou peut-on l'acheter ? Avez vous un lien sur le net? Merci
Hello' is called produces that contains deep tissue oil ginger oil, menthol, cayenne pepper and other plants, including st. johns wort. Where can we buy it? Do you have a link on the net? Thank you
To everyone who replied to Sherry K -
I've just ordered the wintergreen essential oil (I have the menthol already; also some comfrey oil) and will make up my own healing lotion. It's easy to do! You need a base, a massage oil, such as comfrey which has great healing properties to which you add the essential oils. Make sure they are not 'fragrance' oils. Add only a few drops of the wintergreen, menthol etc.. You can find out exactly how many essential oil drops to add by finding a credible aromatherapy web site for advice; or read aromatherapy books by SHIRLEY PRICE. Good luck fellow chronic pain sufferers! xox
@@kb2072 Hello Karim, please read my reply below :)
Sir same problem is with me ,tellsome exercise, treatment for quick relief 👍
Hey contact me ..same problem give your number
Ur videos are really helpful pls add treatmnt videos along with anatomy and physiology
Excellent detailed explanation and different tests especially for piriformis syndrome and difference between FAIR AND FABER TESTS 👍
I exercises and run a lot , i had this problem last year, it was too pain full and it made me so depressed, and also that prevent me from my favorite activities like running almost an year ,
since i have multiple other muscle related pains at first no doctor or physical therapist fount the issues , only after 4 months i lived in pain a doctor found that i have multiple vitamin/mineral/protein deficiencies that causes the problems , that weaken my muscles,
after that I took vitamins and other sports supplements as prescribed and i did spike ball massage and some stretching myself for my back and legs with the help of you tube tutorial, and this time I completely cured and I resume all my activities running , lifting etc. it took almost one year to me to see the light at the end of the tunnel,
what stretches do you recommend for the piriformis in particular?
What sort of vitamins/mineral/ proteins did you consume to help strengthen your muscle?
Ravi Nair doctor tested my blood and muscle strength and recommended according to test result
I almost cry when the pain attacks😢
D B what sort of vitamins did you consume?
I can't sit, I can't stand, I can't sleep and I can't walk. This video gave alot of clarification. I can see that I have a long road ahead of me.
Sir i have same problem please help me
@@rupachaudhary9509 I am so so sorry. I was In absolute agony. For two days I was in tears fighting the urge to call the ambulance. I stood up to go to the rest room and i thought someone stabbed me. Then I got lightheaded and almost passed out. The ambulance came but wouldn't take me due to the Coronavirus. 10 days of agony but I'm seeing some results from the stretching and medications. Feel better
I was in the same boat. So much pain couldnt sleep more than 1 hour. Now i can at least walk a bit and pain has gone down a lot. Recovering from this is tough. Hang in there.
@@filoco85 How did it get better? What methods/treatment did you use?
@@ballbreakerproductions8820 What meds did you take?
Excellent information
Thank you Dr. Ebraheim for your most worthwhile video. I am in the midst of trying to verify the problem and coming to the conclusion it may be the Piriformis (syndrome). One interesting note: When leaning only a little forward my walking leg pain is very uncomfortable but walking very upright, the sharpness of pain is reduced every time. What might that suggest? My thanks and appreciation to you for your time producing this valued video. Best wishes Christine
A
top
Right On It . . Explanation very well presented ! And your description correlates precisely with my current symptoms. TNX
Mandar en idioma Español, gracias,
I have lower back pain going down to the legs as described above which kind of medication I can take or where can I get sir for better treatment
الف شكر ياريت يترجم للعربي
How one should take care of daily activities in case of positive periformise syndrome..What to avoid, what to do when left leg is affecting
Thanks sir 👍🏼
The visuals presented in this video were very helpful! Thank you!
Thank jou doc you are lifesaver, this video were very helpful !!
Thank you so much doc👍
This broken chair that I always sit on is the cause of my butt pain which can't sit for a long time causes pain.. in the end I destroyed the chair so that the others wouldn't get piriformis
Yes thamk you right on the pain I'm having.
Hospital go good come no play iam onlhelping iam big no boss ok somtime helping onlyok
Jointed good passing
Greatest explanation
Thanks your information is well detailed and explained.which is useful to everyone in the field.⭐⭐⭐⭐⭐
نرجو الترجمه
Sir same problems me please help me
Good explain about sciatica pain & piriformis syndrome...
Very good information . thank yu sir 🙏
Great video sir
This is the right place i am suffering pain it started from back then is side hip now this side and traveled to back of my knee its very painful but dr said its sciatica pain .no its not thanks dr 🤲
Its piriformid pain pls dr help me with your advice 🙏
U should go to dr.ha realise triger point with dry neddling.and be happy🤠.
Very helpful
I have had same pain. Thank you for explaining
Very good..very well explained..thank you doctor..ive subscribed..
Thank you Dr. Ebrahim. I learned piriformis syndrome is the most commonly misdiagnosed pathology, followed by trochanteric bursitis.
Thank you
What will the treatment of this problem??? Pls help me with it.
Thank you for your explanation Sir
I had a auto accident 2019 with multiple injuries. Fractured spine 3 places ( lower part), shattered hips, shattered knees both sides, shattered ankles and all ribs on left side fractured. Everyday it’s painful to walk or setting for long. Heavy lifting is out of the question. Using icee hot patches but mild relief. Deep burning pain in hip area on left side. Any suggestions would be appreciated.
Use heat pads...best
May god bless you brother
Allah rehamat nazil farmai ap par
Very nice and useful
Thanks
V nice video and explanation.
Kindly if you can tell who to consult incase of this issue? orthopedics or neurosurgeon or physiotherapist ?
Also suggest is it curable, how can it go away and what treatment medication is required?
Thank you
Physiotherapist will help you relieve the pain by applying myofascial release
Piriformis stretch daily
Hip strengthening exercises targeting extensors , abductors and external rotators
And avoid sitting for a long periods
Thank you Doc.
Muito boa a explanação, bastante didáticos todos os videos.
Very well done, thank you doctor! Could you be so kind as to explain how to eliviate pain caused from decidedly acute piriformis syndrome?
GREAT INFORMATION! THANKS!
see my comment if u are still suffering from piriformis.
Priformis streching
From what I understand, if physical therapy (stretching and strengthening) doesn't help, they will sometimes give you a shot of either Botox or steroids into your piriformis muscle. It's best if they use and ultrasound to guide the injection so they don't accidentally injure the nerve.
@@darcymcgaffic7812 hello
I’ve done the tests in the video and don’t feel any additional pain. I have a stiffness in my right buttock and lower right back, with mild calf strain. The whole thing just feels like I slept with my leg hanging off the bed. But it’s been 3 days now with no relief. COVID has me sitting in my computer chair for 10+ hours a day. I pray this is not long term for me and just a strain from lack of stretching.
You need to stand more. Go to Bob and Brad here on CZcams and type in piriformis syndrome. They have several videos on this. I’m 98% back to pain free. They are both physical therapists and add humor to their information
@@brotoubrotou3164 Hey dude, I actually haven't had any real pain since I made this comment. I know of Bob and Brad, they're great. One stretch I do a few times a week is the one where you lay on your back, one foot planted against the wall, and bend the other foot over the knee of the foot against the wall. Then pull the thigh of the planted foot to your chest. You can immediately feel the stretch in your lower back and buttocks. It's great.
Very helpfull thank you !!
Very clear....as usual..thank you sooo much
Great graphics and information
Excellent. Very helpful. Thanks. God bless.
Thank you, Sir! I really appreciate your videos!
thank you very much for video
جزاک اللہ خیر، دکتور
Saya juga sakit yg sama seperti ini terasa sangat sakit di pinggul sampai kaki ke bawah kami mohon bimbingan cara pengobatannya dan penyembuhannya karena sudah lama sekali saya merasakan sakit ini terimakasih
Thank you sir.
Thank you so much Dr. Ebraheim it’s very helpful video and explanation .
Thanks for sharing Sir....bless you!
I probably have disc hernation... for some reason. However it only started happening after I overstretched my hamstring muscles. I'm going to get an appointment for some back photo's on monday if possible. My physical therapist was shocked at how easily my leg/calf/sole of foot burning and shooting pain was triggered with the SLR-test, but is baffled that back position doesn't seem to trigger it in any way. Also my glutes and piriformis are weak, yet my legs are always in outward rotation, I'm extremely mobile there and stretching them does nothing. However, flexing or extending my lower back also does nothing 90% of the time. That straight leg or some random movements though... excruciating pain.
Very helpful.
Thank you for this very clear education!
Hi
I have been dealing with this for past 4 years .. God this is the worst than Sciatica pain
Thank you Sir, lots of gratitude to you Sir
Thank you so much for your superb videos. I have an enquiry please. I've been walking with a limp on my left leg for a year without any pain whatsoever. I did all medical and lab tests, lumbar spine MRI and CT scan but everything was OK. However, I don't limp when I walk on my tiptoes. Any idea what the problem might be. Thank you for any info.
Well, there you have it. Leg raise, no pain, not lumbar disc. Twist, pain, piriformis. Bingo. Thank you!
How if I raise leg and pain (so lumbar disc right?) but when twisted it's also pain. So, lumbar disc or piriformis? I'm confused
@@TravelingWithKiwi Maybe you have both? See a professional.
@@pattiel1108 Don't say that :(
This was very helpful. Thank you.
That was very helpful thanks so much
That shit was super helpful actually. Thanks Dr.
I cant lay flat on my belly, its excruciating.. the muscle in my right glute has been locked up like the worst charley horse imaginable for over a week.. cant sleep, or stand up straight.. sharp stabbing burning pain that wont quit..and gets exponentially worse of a night... I would be beyond grateful for any advice.... thank you :'(
Hi dear loving doc how to cure this lower back pain.
Thank you! Very informative information!
نرجو الترجمة الى العربية شكرا
I have had this issue for years. I am now unable to run, I can only jog very slowly now. It is so sad as I used to play football twice a week. Now I can't even run and have put on a lot of weight because of this. Even when I get up from a chair I can feel a deep, dull ache. I can walk ok but if I want to break into a jog it hurts. While jogging (slowly) and if I want to run a little faster the pain comes back and I have to slow right down or stop.
Bro how is your pain now ? This same thing has happened to me
@@qsks8366 how are you now bro
@@BhashaLab-fv5pt still in really bad pain , but I figured out that I don’t have piriformis syndrome , I have a herniated disc.
Run can't even walk
Chronic inflammation of the sacroiliac joint is typical of anklyosing spondylitis, (AS,) a kind of chronic arthritis. I think I have piriformis syndrome caused by chronic inflammation of my right sacroiliac joint due to AS. The symptom I am referring to is a chronic burning pain between my second and third toe on my right foot. The inflammation causes contraction of the muscle attached just next to the right sacroiliac joint, causing compression of the right sciatic nerve.
Tq sir
Ty! 22 years as an ICU nurse,, Been Having debilitating groin/ hip pain and difficulty w/abduction, stairs, worse in AM,radiates to lower back, and aches deep within tissue- making sleep impossible. Difficult to get in& out if my SUV,etc....
I'm chewing motrin like candy( yes, I know..☠🙀).. I KNOW TOO MUCH, and am worried about too many things- co pay for MRI is $ 550, and d/t ill spouse- well- covid @work, him unemployed, etc..
Lifes been a nightmare .perhaps it is just muscular.. such as piriformis / ileopsoas/Ankylosing Spondylitis, ....avascular necrosis etc.. ty
Im so sorry for this, maybe I can help? Maybe you have a problem with the hip joint
Hows your walking?
Maybe you have OA of the hip?
Hello doctor. Today I am watching your video on CZcams . And I told you same problems on my body so what I can do. Tell me sir thank you so much for your video