Unraveling the Complexities: Sciatic Neuropathy and Complex Regional Pain Syndrome Complicated by Infection Post-Total Hip Replacement

Abstract Total hip replacement (THR) is a common procedure for managing hip fractures and arthritis, but it can be complicated by a variety of post-surgical issues. This case report describes a 77-year-old male with symptoms of complex regional pain syndrome and sciatic neuropathy complicated by an infectious process following THR. Piriformis syndrome has always remained as a diagnostic dilemma because of its varied presentation. Piriformis syndrome is myofascial syndrome which causes pain not only because of trigger points within the muscle but also due to peripheral neuritis of the sciatic nerve. The delayed onset of sciatic palsy following the typical postoperative recovery period is rare with few case reports. This case was further complicated by magnetic resonance imaging findings which were indicative of lumbar canal stenosis. Therefore, it underscores the need for a thorough diagnostic workup and a multidisciplinary treatment strategy to optimize patient outcomes in case of chronic pain.