Piriformis syndrome: a real pain in the buttock?

OBJECTIVE: Herein, we provide an unbiased review of piriformis syndrome (PS), a highly controversial syndrome for which no consensus exists regarding diagnostic criteria or pathophysiology. METHODS: A review of the literature in the English language. RESULTS: A nonpartisan review of the medical literature pertaining to PS revealed that the existence of this entity remains controversial. There is no definitive proof of its existence despite reported series with large numbers of patients. CONCLUSION: PS remains a controversial diagnosis for sciatic pain. The debate regarding the clinical significance of PS remains active. Nonetheless, there may be a subset of patients in whom the piriformis muscle is a source of pain. The syndrome should be considered in the differential diagnosis of patients with unilateral lower extremity pain.