MANUAL THERAPY AND PHARMACOTHERAPY IN THE REHABILITATION OF PATIENTS WITH PIRIFORMIS SYNDROME

Piriformis syndrome (PS) is the low back pain manifestation that is accompanied by reversible compression of the sciatic nerve by the hypertrophied piriformis muscle. Among other low back pain manifestations the PS accounts for 6–35%. However, the PS diagnosis as well as its treatment is still difficult. There are many methods for the rehabilitation of patients with PS including invasive and non-invasive treatment. The drug therapy, injections of botulinum toxin A, sciatic nerve neurolysis, and piriformis muscle tenotomy are widely used, but they do not always lead to recovery, thereby making it necessary to search for new methods of treatment. Manual therapy has long been used in the rehabilitation of patients with low back pain. However, most often it is prescribed only as an additional therapy to the main treatment and not fully implemented. The manual therapy effectiveness as a monotherapy has not adequately been studied.