6 Tests for Piriformis Syndrome: Fair Sign, Faber Sign, Pace Sign, Beatty Test, Stetch Test, Seated Test

Piriformis syndrome is a painful condition that is often misdiagnosed, leading to a delay in proper treatment. It occurs when the tight piriformis, located in the buttock region, compresses the sciatic nerve, resulting in pain, numbness, and tightness.

While the diagnosis of piriformis syndrome may seem challenging, there are several tests that can be utilized to accurately diagnose this condition.

In this article, we will explore 6 special tests for piriformis syndrome, their procedure, and how to perform them. Accurate diagnosis is crucial for obtaining proper treatment and alleviating the associated pain and discomfort.

Piriformis syndrome often goes undiagnosed or misdiagnosed due to the similarity in symptoms with other conditions. It's essential to conduct precise testing to ensure an accurate diagnosis to facilitate the right treatment. 

We will take a closer look at 6 special tests that can be used to diagnose piriformis syndrome. These tests are Beatty Test, Fair Sign, Faber Sign, Piriformis Stretch Test / Lasegue's Maneuver, Pace sign, and Seated Piriformis Stretch Test. Some of these methods can be used as self-test.

Each test is designed to evaluate different aspects, such as strength, range of motion, and pain areas. Once damage to the piriformis is identified, you can restore it with massage and stretching using a Piriformis Stretcher.

How to test for piriformis syndrome

Piriformis syndrome is often diagnosed based on a combination of symptoms, such as sciatica, pain, numbness, and tingling in the buttock, hip, and leg areas.

However, these symptoms are not exclusive to piriformis syndrome, and several other factors can trigger similar symptoms. Therefore, special tests such as Beatty Test can be undertaken to determine the exact source of the pain. 

- Beatty Test

Here's a simple pose you can use to self test for piriformis syndrome.

The Beatty Test focuses on finding the exact location of the pain. During this test, the patient lies on their unaffected side with their affected leg lifted off the ground. The specialist then applies light pressure to the piriformis muscle, testing for any discomfort, numbness, or tingling sensation. If the patient feels the pain, numbness, or tingling sensation, this could indicate piriformis syndrome.

- Faber Sign

Another test that is commonly used by practitioners to diagnose piriformis syndrome is the Fair Sign. This test entails moving the affected leg while the patient is lying down. If the pain increases when the specialist raises the affected leg, it could be due to tightness piriformis. 

The Faber Sign focuses on the range of motion of the hips. During this test, the patient lies down while the practitioner flexes, abducts, and externally rotates the affected leg. If the pain is triggered during the movement, it could suggest piriformis syndrome.

- Piriformis Stretch Test / Lasegue's Maneuver

Piriformis Stretch Test  is a test where the practitioner raises the affected leg while the patient is lying down. This test is commonly used to diagnose sciatica, which is often present in piriformis syndrome patients. If pain is triggered when the practitioner raises the affected leg, it could indicate sciatica and hence piriformis syndrome.

If pain is found within 60 degrees, it is positive, and after exceeding 60 degrees, the pain will be relieved. Because the damaged piriformis muscle is stretched and in a tense state, the pathological relationship with the sciatic nerve is strengthened, so the pain is obvious; after the elevation exceeds 60 degrees, the damaged piriformis muscle is no longer stretched, so the pain is relieved instead.

- Pace Sign

Sitting on the treatment table, the patient's legs hang naturally down. The doctor holds the patient's knees together with both hands, while the patient resists by pushing their legs outward.

This test is designed to test the strength of the gluteal muscles.

- Seated Piriformis Stretch Test

The patient sits on the treatment table and extends the leg that is in pain. The doctor holds onto the patient's foot and rotates the leg, in order to check if the patient experiences any pain in the sciatic nerve while it is being rotated.

- FAIR Test Piriformis

The patient lies on their back with the affected leg bent at the hip and knee. The examiner then internally rotates the hip while applying pressure to the knee to assess for pain and tenderness.

The 6 tests for piriformis tightness, including the Beatty Test (Self Test), Fair Sign, Faber Sign, Piriformis Stretch Test, Pace sign, and Seated Test, are essential tools for diagnosing this medical condition. These tests can identify the root cause of the problem and help develop a targeted treatment plan. 

However, these six tests can help clinicians determine the exact source of the pain, making a more accurate diagnosis, and deliver targeted treatment.

It is important to note that these tests have their limitations, and pre-existing lower back pain or hip joint pathology may affect the interpretation of the results. A thorough clinical assessment is necessary to minimize errors and increase diagnostic accuracy for piriformis syndrome.

Keep reading: The Remarkable Thing That Actually Freed You Of Piriformis Syndrome