Workers Comp piriformis syndrome symptoms are pain radiating down the back of the leg and may be confused for a herniated disc in the lumbar spine. Changes in sensation and weakness in the leg or foot are rare. Some people say they feel a sensation of vague tingling down the leg. Sitting may be difficult and people tend to sit with the sore side buttock tilted up.
Diagnosis begins with a history and physical exam. The doctor will ask questions about the symptoms and how the pain is affects daily activities. The doctor also wants to know what positions or activities make the symptoms worse. If the pain started with an injury at work, it is very important that employee give an accurate and complete description of the work accident. Also give a complete history to the physical therapist. Often the PT will identify an injured piriformis and let the referring orthopedic surgeon know.
Next the doctor examines checks posture, how one walks, and where the pain is located. The doctor checks to see which back movements cause pain or other symptoms. Skin sensation, muscle strength, and reflexes are also tested because it is difficult to distinguish piriformis syndrome pain from other spine conditions’ pain.
If there is any question of an infection or some type of arthritis affecting multiple joints, laboratory tests may be ordered. A bone scan is useful to rule out arthritis or infection of the sacroiliac joint.
X-rays are commonly ordered of both the low back and pelvis. X-rays can indicate how much wear and tear has developed in the sacroiliac joint. X- rays of the lumbar spine and hips are also helpful to rule out problems in these areas that may seem like piriformis problems.
A magnetic resonance imaging (MRI) scan can be used to look at the lumbar spine and pelvis in much more detail and rule out other conditions in the area. The MRI scan uses magnetic waves rather than X-rays and shows a very detailed picture of the soft tissues of the body.
The most accurate way to tell if the piriformis muscle is the cause of pain is with a diagnostic injection into the muscle. The muscle is deep inside the buttock, so the injection requires X-ray guidance with a fluoroscope, a CT scanner, or an open MRI machine. Once the needle is placed in the muscle, an anesthetic can be injected into the muscle to paralyze the piriformis muscle. If the pain goes away after the injection, the doctor can be reasonably sure that the pain is from piriformis syndrome.
McCormick Law Office attorneys obtain successful results for injured workers in Wisconsin with permanent work restrictions due to piriformis syndrome.