American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary treatment for piriformis syndrome?

1. Invasive surgical procedures

2. Rest and immobilization

3. Analgesic agents and physical therapy

4. Cold compresses and splints

The correct answer is: Analgesic agents and physical therapy

Piriformis syndrome is a neuromuscular condition that occurs when the piriformis muscle, located in the buttock region, compresses the sciatic nerve, leading to pain, tingling, or numbness in the buttocks and down the leg. The most effective approach to managing this syndrome typically combines analgesic agents with physical therapy. Analgesic agents, including nonsteroidal anti-inflammatory drugs (NSAIDs), help alleviate pain and reduce inflammation. Physical therapy is key in addressing the underlying muscular issues; it focuses on stretching and strengthening the piriformis muscle, improving flexibility, and correcting any biomechanical imbalances. This dual approach is often effective in reducing symptoms and restoring function. In contrast, invasive surgical procedures are generally not the first-line treatment due to the potential risks and complications involved, making them more appropriate in refractory cases. Rest and immobilization may provide temporary relief, but they do not address the root cause of the symptoms. Similarly, while cold compresses can help reduce inflammation, they do not provide comprehensive treatment for piriformis syndrome, especially when combined with splinting, which is not standard practice for this condition. The combination of analgesics and physical therapy serves as the foundation of treatment,