In this episode we go inside Dr. Tollestrup’s operating room to watch him perform a piriformis muscle removal surgery, a procedure he invented and has done successfully with hundreds of patients from around the world. Dr. Tollestrup explains how Piriformis Syndrome can look very different from patient to patient which can cause confusion and missed diagnosis.
These patients with piriformis syndrome can actually present in a lot of different ways. But generally speaking, people with piriformis syndrome will have sciatica of one degree or another. So that includes things like buttock pain. In quite a number of these patients, they can have pretty significant pain radiating up into the low back area. Then most patients will have some degree of pain that radiates down into the leg. And oftentimes, that can be sort of spotty; meaning they may have buttock pain and something somewhere in the back of the thigh, may skip the knee, then show up again in the calf area, usually the outer part of the calf.
I would say most people don’t have symptoms as far down into the foot, but quite a few do though. And then you can get really strange presentations, too, where people may only have pain in the back of the knee or something unusual like that. So patients who have piriformis syndrome can really present quite differently from one another, and I think that might be one reason why people who don’t see a lot of it can be confused because if they get two patients with piriformis syndrome, they can look quite different from one another.