Treatment of Piriformis Syndrome with Neuraltheraphy in Chronic Pelvic Pain
Pinar Yalcin Bahat (TR), Berna Aslan Cetin (TR), Huseyin Nazlıkul (TR), Tijen Acarkan (TR)
[yalcin bahat] Istanbul Kanuni Sultan Suleyman Training and Research Hospital, [Aslan Cetin] Istanbul Kanuni Sultan Suleyman Training and Research Hospital, [Nazlıkul] Istanbul Vital Fulya Plaza, [Acarkan] Istanbul Vital Fulya Plaza
Piriformis syndrome is difficult to diagnose and resistant to therapy. Previously, it was not even considered as a diagnosis, in others it was quickly ruled out. Piriformis syndrome may overlap with a variety of other problems have called a "deep buttock" syndrome. This includes pain in the buttock region, possibly pain in the hamstrings, occasionally pain in the back of the leg that is difficult to locate. The symptoms most often reported are pain when running or walking in the gluteal region. Pain may go down the back of the leg. Dyspareunia is sometimes noted.These patients have chronic pelvc pain. Having the patient lie down, flex the knee to 10 - 20 degrees and then have the patient attempt to externally rotate the leg against resistance. Pain may occur with piriformis tendonitis. Direct tenderness will be found in the region of the piriformis tendon over the buttock region. If there is a positive test to the straight leg lift (causing sciatica like pain), externally rotate the leg to see if this lessens the pain. This could indicate compression of the sciatic nerve by the piriformis. We make these patients neuralthetaphy for pain. An intracutaneous procaine injection is made between the back thoracal 11 and sacral 4. We make injectionen the origo and insercio of the priformis muscle and sacral canal. We have obtained significant results based on the use of visual analog scale (VAS). Prokain is a short-term local anesthetic which also exerts anti-inflammatory, analgesic, anti-bacterial, anti-tumoral , neuroprotective and anti-thrombotic effects. Here In order to increase tissue perfusion and innervation of the pelvic region of all to regulate with local and segmental treatment scarring in the pelvis in all possible inclusion in the treatment of tissues in the same area again and especially perfusion innervation for it is important.