Differentiating Piriformis Syndrome from Other Sciatic Nerve Conditions

There are differences between piriformis syndrome vs. sciatica, even though the symptoms are similar. The reason they are similar is due to the fact the piriformis muscle may irritate or compress the sciatic nerve. This may cause pain similar to sciatica pain that is due to other medical conditions, like disc herniation or spinal stenosis. It usually takes a physician’s assessment to determine the specific diagnosis.

What is the Sciatic Nerve?

The sciatic nerve is a large nerve that branches out at the lower back. It runs through each hip and buttock and down the thigh and leg to the foot. Pain frequently radiates down the nerve when the sciatic nerve is compressed, inflamed, irritated, or injured. The pain originates in the lower spine (lumbar spine) where the nerve begins.

What is Sciatica?

Sciatica is a set of symptoms that occur when the sciatic nerve is irritated, compressed, or inflamed. It is usually caused by the compression or impingement of nerve roots due to spinal degeneration. The degeneration could be due to conditions that include but are not limited to:
Herniated spinal disc, Bulging disc, Bone spur, Spinal stenosis (narrowing of the spine canal),Tumor, Spondylolisthesis, Injury to the spine and Infections.

However t he pain experienced depends on the specific nerve root impacted. It can be intermittent or constant but often feels like a sharp pain shooting down the leg from the lower back. Other symptoms include weakness in the leg and foot, numbness, or tingling in the leg’s back.

What is Piriformis Syndrome?

Piriformis syndrome is a condition in which the piriformis muscle compresses the sciatic nerve. The piriformis muscle is in each buttock and attaches the sacrum to the top of the thigh bone. However piriformis muscle and the sciatic nerve are in close alignment.

Due to the contractions or spasms of the piriformis muscle, sciatic nerve pain can begin. When the muscle contracts, spasms, or experiences other issues, it can compress or irritate the sciatic nerve.

piriformis syndrome

What is the Difference between Sciatica and Piriformis Syndrome?

The main differences between sciatica versus piriformis syndrome are:

Where the pain is typically felt ; buttock and hip for piriformis syndrome, while leg pain may radiate down to the toes for sciatica

What causes the pain; the piriformis muscle is causing the pain by impacting the sciatic nerve in piriformis syndrome. However the pain of sciatica is one symptom of a particular medical condition creating a set of symptoms

What causes more pain; pain increases while sitting for a prolonged period in piriformis syndrome, while raising the leg (the one impacted). However while lying down may cause pain with sciatica

Sciatica & Pirifomis syndrome management

Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a program of exercises & stretches. Also traction to help reduce sciatic nerve compression.

Reference

Journal of Medical Society. Prevalence of piriformis syndrome among the cases lowback/buttock pain with sciatica:

Written By 

Winnie Yusa
Physiotherapist

Could You Be Suffering From Piriformis Syndrome and Not Sciatica?

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