Evidence Checklist: Piriformis Syndrome

Orthopedic or neurological evaluation with piriformis-specific testingCritical

An examination including FAIR test, Pace sign, Freiberg sign, and Beatty test to document piriformis involvement and differentiate from lumbar radiculopathy.

Nexus opinion linking piriformis syndrome to serviceCritical

A medical opinion stating it is "at least as likely as not" that your piriformis syndrome is connected to military service, including prolonged sitting, physical training, or direct trauma during service.

EMG/NCS differentiating from lumbar radiculopathy

Electrodiagnostic testing to help distinguish piriformis syndrome from lumbar radiculopathy by ruling out spinal nerve root involvement.

Treatment records (physical therapy, injections, medications)

Records documenting treatment including physical therapy, piriformis injections, muscle relaxants, and any surgical intervention.

Documentation of occupational aggravation (prolonged sitting, duties)

Records documenting how military duties requiring prolonged sitting (vehicle operations, desk duties) or repetitive activities caused or aggravated the condition.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Completed DBQ Hip and Thigh ConditionsCritical

Standardized form capturing hip range of motion, pain, muscle involvement, and functional limitations.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.