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

J Back Musculoskelet Rehabil. 2019;32(2):329-337. doi: 10.3233/BMR-170983.

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 B1 10 mg + vitamin B2 10 mg + vitamin B12 50 μg 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.

Keywords: Mannitol; Vitamins B; management; piriformis syndrome.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Diuretics, Osmotic / therapeutic use*
  • Female
  • Hip
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mannitol / therapeutic use*
  • Middle Aged
  • Muscle, Skeletal
  • Pain Measurement
  • Piriformis Muscle Syndrome / diagnostic imaging
  • Piriformis Muscle Syndrome / drug therapy*
  • Sciatic Nerve
  • Vitamin B Complex / therapeutic use*
  • Vitamins

Substances

  • Diuretics, Osmotic
  • Vitamins
  • Vitamin B Complex
  • Mannitol