Case report Special Issues

Combined face-to-face and telerehabilitation physiotherapy management in a patient with chronic pain related to piriformis syndrome: A case report

  • Received: 16 April 2024 Revised: 08 May 2024 Accepted: 22 May 2024 Published: 03 June 2024
  • Piriformis syndrome is characterised as being one of the possible causes of sciatic pain, as well as being a syndrome that tends to become chronic. Because of this, different types of treatments for both this syndrome and the associated pain it causes have been investigated over the years. Nowadays, the evidence increasingly favors treating chronic pain with a multimodal physiotherapy treatment based on a biobehavioral approach. This case report describes the physiotherapy intervention performed on a 44-year-old woman with chronic pain related to piriformis syndrome. The multimodal intervention lasted for 9 weeks with a total of 12 sessions and included manual therapy, therapeutic exercise, neural mobilization, and pain neuroscience education. Initially, the pain characteristics alongside somatosensory, motor-functional, and psychosocial factors were assessed. Due to the Covid-19 pandemic, only the pain characteristics and psychosocial factors could be reassessed post intervention. Improvements in both pain characteristics and psychosocial factors were achieved, resulting in a better general condition of the patient. This case report suggests that a multimodal physiotherapy intervention adapted to telerehabilitation was an effective option to improve the pain symptoms and psychosocial factors in the reported patient during the Covid-19 pandemic. Therefore, this may be a treatment option in patients with chronic pain that are in a situation where face-to-face physiotherapy is not feasible.

    Citation: Carlos Forner-Álvarez, Ferran Cuenca-Martínez, Alba Sebastián-Martín, Celia Vidal-Quevedo, Mónica Grande-Alonso. Combined face-to-face and telerehabilitation physiotherapy management in a patient with chronic pain related to piriformis syndrome: A case report[J]. AIMS Medical Science, 2024, 11(2): 113-123. doi: 10.3934/medsci.2024010

    Related Papers:

  • Piriformis syndrome is characterised as being one of the possible causes of sciatic pain, as well as being a syndrome that tends to become chronic. Because of this, different types of treatments for both this syndrome and the associated pain it causes have been investigated over the years. Nowadays, the evidence increasingly favors treating chronic pain with a multimodal physiotherapy treatment based on a biobehavioral approach. This case report describes the physiotherapy intervention performed on a 44-year-old woman with chronic pain related to piriformis syndrome. The multimodal intervention lasted for 9 weeks with a total of 12 sessions and included manual therapy, therapeutic exercise, neural mobilization, and pain neuroscience education. Initially, the pain characteristics alongside somatosensory, motor-functional, and psychosocial factors were assessed. Due to the Covid-19 pandemic, only the pain characteristics and psychosocial factors could be reassessed post intervention. Improvements in both pain characteristics and psychosocial factors were achieved, resulting in a better general condition of the patient. This case report suggests that a multimodal physiotherapy intervention adapted to telerehabilitation was an effective option to improve the pain symptoms and psychosocial factors in the reported patient during the Covid-19 pandemic. Therefore, this may be a treatment option in patients with chronic pain that are in a situation where face-to-face physiotherapy is not feasible.



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    Author contributions



    Ferran Cuenca-Martínez, Mónica Grande-Alonso: conceptualization, supervision; all authors: methodology, validation, data curation, writing—original draft preparation, writing—review and editing, visualization; Mónica Grande-Alonso: investigation, project administration. All authors have read and agreed to the published version of the manuscript.

    Conflict of interest



    The authors declare no conflict of interest.

    [1] Dionne CE, Dunn KM, Croft PR, et al. (2008) A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 33: 95-103. https://doi.org/10.1097/BRS.0b013e31815e7f94
    [2] Konstantinou K, Dunn KM (2008) Sciatica: review of epidemiological studies and prevalence estimates. Spine 33: 2464-2472. https://doi.org/10.1097/BRS.0b013e318183a4a2
    [3] Robinson DR (1947) Pyriformis syndrome in relation to sciatic pain. Am J Surg 73: 355-358. https://doi.org/10.1016/0002-9610(47)90345-0
    [4] Broadhurst NA, Simmons DN, Bond MJ (2004) Piriformis syndrome: correlation of muscle morphology with symptoms and signs. Arch Phys Med Rehab 85: 2036-2039. https://doi.org/10.1016/j.apmr.2004.02.017
    [5] Pecina HI, Boric I, Smoljanovic T, et al. (2008) Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome. Skeletal Radiol 37: 1019-1023. https://doi.org/10.1007/s00256-008-0538-0
    [6] Che WS (1994) Bipartite piriformis muscle: an unusual cause of sciatic nerve entrapment. Pain 58: 269-272. https://doi.org/10.1016/0304-3959(94)90208-9
    [7] Sayson SC, Ducey JP, Maybrey JB, et al. (1994) Sciatic entrapment neuropathy associated with an anomalous piriformis muscle. Pain 59: 149-152. https://doi.org/10.1016/0304-3959(94)90060-4
    [8] Pace JB, Nagle D (1976) Piriform syndrome. WJM 124: 435.
    [9] Beatty RA (1994) The piriformis muscle syndrome: a simple diagnostic maneuver. Neurosurgery 34: 512-514. https://doi.org/10.1227/00006123-199403000-00018
    [10] Fishman LM, Dombi GW, Michaelsen C, et al. (2002) Piriformis syndrome: diagnosis, treatment, and outcome—a 10-year study. Arch Phys Med Rehab 83: 295-301. https://doi.org/10.1053/apmr.2002.30622
    [11] Hilal FM, Bashawyah A, Allam AE, et al. (2022) Efficacy of botulinum toxin, local anesthetics, and corticosteroids in patients with piriformis syndrome: a systematic review and meta-analysis. Pain Physician 25: 325.
    [12] Siraj SA, Dadgal R (2022) Physiotherapy for piriformis syndrome using sciatic nerve mobilization and piriformis release. Cureus 14.
    [13] Wyant GM (1979) Chronic pain syndromes and their treatment iii. the piriformis syndrome. Canad Anaesth Soc J 26: 305-308. https://doi.org/10.1007/BF03006291
    [14] Cohen SP, Vase L, Hooten WM (2021) Chronic pain: an update on burden, best practices, and new advances. Lancet 397: 2082-2097. https://doi.org/10.1016/S0140-6736(21)00393-7
    [15] Booth J, Moseley GL, Schiltenwolf M, et al. (2017) Exercise for chronic musculoskeletal pain: a biopsychosocial approach. Musculoskeletal Care 15: 413-421. https://doi.org/10.1002/msc.1191
    [16] Bonatesta L, Ruiz-Cárdenas JD, Fernández-Azorín L, et al. (2022) Pain science education plus exercise therapy in chronic nonspecific spinal pain: a systematic review and meta-analyses of randomized clinical trials. J Pain 23: 535-546. https://doi.org/10.1016/j.jpain.2021.09.006
    [17] Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8: 1153-1157. https://doi.org/10.1111/j.1553-2712.2001.tb01132.x
    [18] Nolan MF (1985) Quantitative measure of cutaneous sensation: two-point discrimination values for the face and trunk. Phys Ther 65: 181-185. https://doi.org/10.1093/ptj/65.2.181
    [19] Kinser AM, Sands WA, Stone MH (2009) Reliability and validity of a pressure algometer. J Strength Cond Res 23: 312-314. https://doi.org/10.1519/JSC.0b013e31818f051c
    [20] Chattanooga GroupStabilizaer TM pressure bio-feedback operating instructions (2002).
    [21] Quintana JM, Padierna A, Esteban C, et al. (2003) Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Acta Psychiat Scand 107: 216-221. https://doi.org/10.1034/j.1600-0447.2003.00062.x
    [22] Stratford PW, Binkley J, Solomon P, et al. (1996) Defining the minimum level of detectable change for the Roland-Morris questionnaire. Phys Ther 76: 359-365. https://doi.org/10.1093/ptj/76.4.359
    [23] Martín-Aragón M, Pastor MA, Rodríguez-Marín J, et al. (1999) Percepción de autoeficacia en dolor crónico. Adaptación y validación de la chronic pain selfefficacy scale, (Spanish) [Perception of self-efficacy in chronic pain. Adaptation and validation of the chronic pain selfefficacy scale]. J Health Psychol 11: 51-75. https://doi.org/10.21134/pssa.v11i1.799
    [24] Gómez-Pérez L, López-Martínez AE, Ruiz-Párraga GT (2011) Psychometric properties of the spanish version of the Tampa Scale for Kinesiophobia (TSK). J Pain 12: 425-435. https://doi.org/10.1016/j.jpain.2010.08.004
    [25] García Campayo J, Rodero B, Alda M, et al. (2008) Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia. Med Clin 131: 487-493. https://doi.org/10.1157/13127277
    [26] George SZ, Valencia C, Beneciuk JM (2010) A psychometric investigation of fear-avoidance model measures in patients with chronic low back pain. J Orthop Sport Phys 40: 197-205. https://doi.org/10.2519/jospt.2010.3298
    [27] Marcos-Martín F, González-Ferrero L, Martín-Alcocer N, et al. (2018) Multimodal physiotherapy treatment based on a biobehavioral approach for patients with chronic cervico-craniofacial pain: a prospective case series. Physiother Theor Pr 34: 671-681. https://doi.org/10.1080/09593985.2017.1423522
    [28] López-de-Uralde-Villanueva I, Beltran-Alacreu H, Fernández-Carnero J, et al. (2020) Pain management using a multimodal physiotherapy program including a biobehavioral approach for chronic nonspecific neck pain: a randomized controlled trial. Physiother Theor Pr 36: 45-62. https://doi.org/10.1080/09593985.2018.1480678
    [29] Filip R, Gheorghita Puscaselu R, Anchidin-Norocel L, et al. (2022) Global challenges to public health care systems during the COVID-19 pandemic: a review of pandemic measures and problems. J Pers Med 12: 1295. https://doi.org/10.3390/jpm12081295
    [30] Boletín Oficial del Estado, Royal Decree 463/2020 of 14 March declaring the state of alarm for the management of the health crisis caused by COVID-19. Available from: https://www.boe.es/eli/es/rd/2020/03/14/463
    [31] García-Salgado A, Grande-Alonso M (2021) Biobehavioural physiotherapy through telerehabilitation during the SARS-CoV-2 pandemic in a patient with post-polio syndrome and low back pain: a case report. Phys Ther 24: 295-303. https://doi.org/10.1298/ptr.e10100
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