Effect of Mannitol plus Vitamins B in the management of patients with piriformis syndrome

Abstract

BACKGROUND:

Piriformis syndrome (PS) is an entrapment of the sciatic nerve by the piriformis muscle, or myofascial pain from the piriformis muscle.

OBJECTIVE:

The aim of this study was to investigate the effectiveness of Mannitol plus Vitamins B regime in the management of PS.

METHODS:

Twenty two patients were included in this study and received 250 ml of mannitol 20% intravenous infusion for 5 days $+$ Vitamins B (vitamin B ${}_1$ 10 mg $+$ vitamin B ${}_2$ 10 mg $+$ vitamin B ${}_{12}$ 50 $\mu$ g PO) for 6 weeks. Clinical outcomes were assessed systematically by clinical tests (tenderness, FAIR test, Beatty’s, Freiberg’s and Pace’s maneuver), Numeric Rating Scale (NRS), Likert Analogue Scale (LAS), and MR examination.

RESULTS:

The clinical evaluations showed a significant reduction ( $p<$ 0.05) of tenderness, FAIR test, Beatty’s maneuver, Freiberg’s maneuver and Pace’s maneuver when compared with baseline evaluation during the 3rd and 6th month follow-ups. A statistically significant improvement of pain was measured by NRS at resting ( $p<$ 0.001), at night ( $p<$ 0.001) and during activities ( $p<$ 0.001) and LAS with prolonged sitting ( $p<$ 0.001), standing ( $p<$ 0.001) and lying ( $p<$ 0.001). Concomitantly, swelling of SN revealed a significant reduction ( $p=$ 0.003) from 86.4% to 18.2%.

CONCLUSIONS:

Mannitol plus Vitamins B is effective in the management of piriformis syndrome and it could be an alternative regime in treating PS.