Global prevalence of piriformis syndrome: a systematic review and Meta-analysis

Abstract

Background. Piriformis syndrome is a neuromuscular disorder that causes pain in the posterior thigh and buttocks as a result of the piriformis muscle compressing or irritating the sciatic nerve. Clinically similar symptoms to sciatica, such as buttock pain, leg discomfort, and pain exacerbated by sitting or hip motions, can be caused by compression of the nerve within the deep gluteal region The Global epidemiology of piriformis syndrome, especially in Africa, is poorly understood due to the lack of comprehensive studies that assess risk factors or estimate prevalence.

Objectives: To determine the pooled prevalence of piriformis syndrome.

Materials and methods: PubMed, Google Scholar, and Scopus were searched. The data were extracted using Microsoft Excel and analyzed by using STATA version 17. Publication bias was checked by funnel plot and more objectively through Egger's regression test, considered to indicate the presence publication bias. Heterogeneity of studies was checked using the I² test. Pooled analysis was conducted. Leave out one sensitivity analysis was employed to see the effect of single study on the overall estimation.

Results: The overall prevalence of piriformis syndrome was at 46.79% (95% CI: 34.7 to 58.8). Based on Leave out analysis, the result showed that the excluded studies did not show significant difference in the prevalence of piriformis syndrome.

Conclusion: The prevalence of piriformis syndrome is high. The pooled estimate prevalence provides an important preliminary benchmark; however, the limited geographic distribution of studies and the generally low availability of high-quality evidence suggest that the true prevalence may differ substantially from region to regions. Due to the absence of rigorous diagnostic criteria in 96% of studies, pooled prevalence estimates should be interpreted with extreme caution. Standardized, imaging- and injection-based diagnostic criteria are urgently needed.