What is a positive finding for the Piriformis Stretch Test?

• A. Pain in the lower back only
• B. Pain that follows the sciatic distribution
• C. Pain with hip flexion only
• D. No pain when hips are moved

Answer: (B)

A positive finding for the Piriformis Stretch Test is indicated by pain that follows the sciatic distribution. This test is designed to assess the flexibility of the piriformis muscle and its effect on the sciatic nerve. When the piriformis muscle is tight or inflamed, it can irritate the neighboring sciatic nerve, leading to pain that radiates along the path of the nerve. This manifestation typically mirrors the classic symptoms associated with sciatica, which may include pain running down the back of the leg, and is significant in diagnosing conditions like piriformis syndrome.

The other options do not represent a positive finding in the context of this test. Pain localized in the lower back alone does not necessarily indicate an issue with the piriformis muscle affecting the sciatic nerve. Similarly, pain elicited solely during hip flexion won't reflect the involvement of the sciatic nerve and does not align with the expected outcomes of the test. Lastly, having no pain when the hips are moved suggests that the piriformis muscle is not contributing to any neural or musculoskeletal dysfunction in this specific scenario. Thus, identifying pain that follows the sciatic distribution is integral in confirming a positive Piriformis Stretch Test.