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Treatment for Carpal Tunnel Works for Piriformis Syndrome

Young athletes are facing some old problems. Piriformis syndrome in older adults has been around for years. Now some young sports enthusiasts are experiencing the same problem.

The piriformis muscle rotates the hip out. It can also help move the hip outward. The sciatic nerve passes through an opening in the pelvic bone and runs along the underside of the piriformis muscle. (In some people, the sciatic nerve goes through or over the top of the muscle.) When the piriformis muscle contracts, it may squeeze the sciatic nerve. The result can be mild to severe buttock pain, called piriformis syndrome. Sports injuries can cause piriformis syndrome in young athletes.

Doctors in Japan have found a way to release this muscle using arthroscopy. An arthroscope is a slender tool with a tiny TV camera on the end. The doctor passes the arthroscope through the skin and muscle to view the sciatic nerve. The lining around the nerve is released by cutting it lengthwise. The piriformis muscle is cut at the tendon. A cavity is formed around the nerve to keep the area open. This operation takes pressure off the nerve.

The procedure is considered minimally invasive, meaning there's only a tiny puncture hole needed to insert the arthroscope. The doctor doesn't have to make a big incision to get to the nerve. This operation is done with local anesthesia. The athlete often gets pain relief right away and usually returns to sports quickly after the surgery.

This is the first report of arthroscopic release of the piriformis muscle under local anesthesia. The operation is patterned after the same one used for carpal tunnel syndrome. The patient can report results of the surgery right away.

References: Akira Dezawa, MD, PhD. Arthroscopic Release of the Piriformis Muscle Under Local Anesthesia for Piriformis Syndrome. In Arthroscopy. May/June 2003. Vol. 19. No. 5. Pp. 554-557.

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