Syndrome myofascial du muscle piriforme et sciatalgie persistante chez le lombalgique en rééducation

La Lettre de médecine physique et de réadaptation 01/2009; 25(3):158-161. DOI: 10.1007/s11659-009-0127-1


ContexteLe syndrome myofascial du muscle piriforme est fréquent, en milieu de rééducation, chez le lombalgique chronique. Le diagnostic
de sciatique persistante est souvent évoqué dans ce contexte.

ObjectifsÀ partir d’un cas clinique, mieux définir la symptomatologie clinique et le traitement de la pathologie fonctionnelle du muscle

RésultatsLes infiltrations de corticoïdes sous contrôle tomodensitométrique et une rééducation spécifique permettent une diminution
de la contracture et de la douleur musculaires, autorisant la reprise du programme de réentraînement à l’effort du lombalgique.

DiscussionLa reconnaissance précoce, par le spécialiste de médecine physique, du syndrome myofascial du muscle piriforme peut permettre
d’éviter des investigations lombaires inutiles et une perte de temps péjorative pour le programme de rééducation du lombalgique.

BackgroundMyofascial syndrome affecting the piriformis is quite common in rehabilitation patients with low back pain and may present
as persistent sciatica.

GoalsBased upon a clinical case, define the symptomatology and treatment of myofascial piriformis muscle syndrome.

ResultsComputerized tomography-controlled corticoid injections and specific rehabilitation relieve muscle contracture and pain, allowing
the back pain program to be resumed.

DiscussionThe physiotherapist’s knowledge of myofascial syndrome affecting the piriformis may help early diagnosis and treatment, thus
avoiding unnecessary lumbar investigations.

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