Tests for Piriformis Syndrome – which ones are available?

In piriformis syndrome, the compression of the sciatic nerve under the piriformis muscle causes severe pain in the gluteal region, which can radiate to the lumbar region and the posterior thigh up to the knee. Due to these symptoms, a piriformis syndrome can often be confused with a herniated disc of the lumbar spine. For the treatment of this disease, conservative methods, such as physiotherapy specifically for Piriformis Syndrome, are particularly suitable. For the diagnosis of piriformis syndrome, several tests have been established that focus on the function of the piriformis muscle. Further information can be found under:

  • Piriformis Syndrome
  • Physiotherapy for Piriformis Syndrome

Piriformis muscle (Musculus piriformis)

The piriformis muscle (lat. pear-shaped muscle) belongs to the inner layer of the hip muscles and runs from the inside of the pelvis to the thigh bone. The muscle has the task to turn the thigh outwards while standing, stretches it and is responsible for the abduction. Piriformis muscle

  • Pear-shaped muscle – Musculus piriformis
  • Iliac scoop -Ala ossis ilii
  • Posterior sacral holes -Foramina sacralia posteriora
  • Sacrum – Os sacrum
  • Large rolling mound – Trochanter major
  • Small rolling mound – Trochanter minor
  • Femoral shaft -Corpus femoris
  • Ischium – Os ischii (ischium)
  • Fifth lumbar vertebra -Vertebra lumbalis V

FAIR test

The FAIR test is an important and relatively reliable test for the diagnosis or exclusion of piriformis syndrome. FAIR stands for flexion (flexion), adduction (bringing a limb to the center of the body) and internal rotation (turning inwards), i.e. the movements that make up the test. The FAIR test cannot determine with 100% certainty whether the symptoms are due to piriformis syndrome, but it does provide an important point of reference in the diagnosis of such a syndrome.

To perform the test, the patient lies on the healthy side, with the lower leg stretched out straight and the upper body lying as flat as possible on the examination couch. The leg on the sick side is bent at the knee and pulled towards the body, so that the flexion in the hip joint is 60°. The same leg is simultaneously guided to the body in the hip joint (adduction) and turned inwards (internal rotation).

The examiner now causes a stretching of the piriformis muscle by pressing the upper leg downwards towards the lying position. The FAIR test is positive if pain in the buttocks occurs during the examination. As mentioned above, the test can also be positive for other diseases of the buttocks or lumbar region, and a negative test result does not exclude piriformis syndrome with certainty.