Piriformis Syndrome in Pre-monsoon, Monsoon, and Winter: An Observational Pilot Study

Abstract

Introduction: Piriformis syndrome (PS) is a rare focal soft tissue rheumatic disease. Due to heavy rural work, we questioned whether PS was more prevalent in the rainy monsoon than in other seasons. In this pilot research, we studied the pattern of PS, the frequency of PS over the seasons, and whether there were typical preceding events. Methods: In this time-series descriptive study, PS cases diagnosed in a community-based clinic between January 2018 and December 2019 were enrolled. PS was diagnosed by clinical features and a 50% immediate pain relief from ultrasonogram-guided lidocaine (2%) injection in the piriformis muscle (PM). PS mimics were excluded.

Results: A total of 38 PS cases (11 males) were enrolled consecutively. In 2018, during dry winter (November-February), pre-monsoon (March-May), and rainy monsoon (June-October), nine, seven, and one PS cases were diagnosed, respectively; in 2019, the numbers were three, eight, and seven, respectively. Thus, over two years, 12 PS patients were diagnosed in dry winter, 15 in pre-monsoon, and eight in rainy monsoon. There was no correlation with the type of preceding events. There were no differences in the pattern of PS between the seasons.

Conclusions: In this pilot study, over two years more new PS cases were observed in the pre-monsoon and dry winter than in the rainy season; this was not supporting our research question. There was no association with specific preceding events.

Keywords: gluteal pain; low back pain; piriformis syndorme; rheumatic disease; seasonal; seasons.

Figure 1. Study participants

PS, Piriformis Syndrome; F, Female; M, Male; CF, Clinical Feature; MRI, Magnetic Resonance  Imaging

Figure 2. Piriformis syndrome in seasons: (A) number of PS over months, (B) PS pattern over seasons

PS, Piriformis Syndrome; Jan, January; Mar, March; Jul, July; Sep, September; Nov, November