Is It Sciatica or Piriformis Syndrome?


Sciatica is a condition that is caused by compression or irritation of the sciatic nerve, while piriformis syndrome is a condition that is caused by irritation or inflammation of the piriformis muscle. The symptoms of both conditions can be similar, but there are some key differences between them.

The 411 on Sciatica

The sciatic nerve is located in the lower back and extends down the length of the legs. It is the longest and widest nerve in the body and is responsible for providing sensation to the skin of the leg and foot, as well as muscle movement.

Sciatica refers to irritation of the sciatic nerve that arises from nerve roots in the lumbar spine. The most common cause of sciatic nerve irritation is compression of one or more of its component nerve roots due to disc herniation or spinal degeneration in the lower lumbar region. Sciatica usually begins in the buttock area and, depending on the severity of the underlying nerve compression and inflammation, may extend down the entire leg to the ankle and foot.  

Spinal dysfunctions, such as herniations of discs or spinal stenosis, can cause sciatica. 

The hallmark of sciatica is pain, numbness, or tingling that extends along the sciatic nerve. Symptoms typically begin in the lower back and buttock area and then shoot down the leg into the foot. The leg pain can be quite severe and is usually eased by walking. Sciatica symptoms are often described as sharp, burning, stabbing, or shooting pain.

The 411 on Piriformis Syndrome

Piriformis syndrome is sometimes called false sciatica because instead of actual nerve irritation, it is caused by referral pain from surrounding structures.  The syndrome is caused by tight knots of contraction in the piriformis muscle, which attaches to the upper femur bone and then runs across the back of the pelvis to the outside edge of the sacrum, the triangular pelvic bone at the base of the spine.  Muscle spasms in the piriformis can press up against the sciatic nerve, irritating it. 

While piriformis syndrome doesn’t always present the same way as sciatica, common symptoms include pain in the buttocks that’s worse when sitting, especially with the legs crossed in a figure four position. 

Differentiating Between the Two Conditions

Gait, posture, and alignment, as well as leg length discrepancies, may contribute to sciatic pain or excessively stress the piriformis muscle.

 There are a variety of specific physical examination and assessment tests that can be used to identify Sciatica from Piriformis Syndrome. 

True sciatica is directly related to the sciatic nerve and is likely due to a more severe cause like a disc bulge, herniation, or spinal stenosis.  Piriformis syndrome is due to inflammation and muscle spasms of the piriformis and tissues around it.

Treatments for Sciatica and Piriformis Syndrome

The best way to alleviate most sciatica or piriformis syndrome pain, in addition to receiving regular chiropractic adjustments,  is to do any stretch that can externally rotate the hip to provide some relief. Icing, heat packs, rest, gentle exercising such as walking, and OTC pain relievers can help alleviate some of the discomfort as well.  Listen to your body and do what makes you feel better.

Foam Roller Stretches

Seated Glute Stretch

Figure 4 Stretch

Standing Piriformis Stretch

Scissor Hamstring Stretch

How Chiropractic Care Can Help Those Experiencing Either Sciatica or Piriformis Syndrome

Dr. Lydia can assess your overall spine and functional movements to determine whether you might be experiencing Sciatica or Piriformis Syndrome.  

A few of our techniques to treat these conditions include chiropractic adjustments to mitigate nerve irritation, therapeutic muscle work to address any tight, inflamed muscles, the Graston technique, gentle stretches, and suggested homecare activities. 

Schedule a visit for chiropractic care at Vaida, and let us help you minimize any pain or discomfort you might be experiencing from either of these conditions.

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