These two are terms that most people confuse to be the same thing. Many times people may have interchanged these terms simply due to the relationship of the anatomical location of the; hip, piriformis and sciatic nerve. The conditions are sometimes related and both affect the sciatic nerve however, they are different .It is important to understand the difference between these two. This distinction lies in what is putting pressure on the sciatic nerve and the location in which the pain is originating.
So let’s define the two , Sciatica is a set of symptoms caused when the sciatic nerve is getting pressure either from conditions such as a herniated disc or bulging disc in the spine, bone spurs, tumor , trauma, arthritic changes or spinal stenosis. It is characterized by low back pain with pain shooting down the leg associated with numbness or tingling on the foot/toes.
Piriformis syndrome is a medical condition in which the piriformis muscle located in the buttock region, spasms. It causes buttock pain and/or irritates the sciatic nerve and cause pain, numbness and tingling along the back of the upper leg .Other causes can be inflammation (swelling) in the piriformis or the tissues around it and scarring in the muscle.
In order to differentiate the two, the following tests are conducted.
1.Lasègue’s sign
This is also known as Straight Leg Raise(SLR). The test is done when patient is lying down on a bed while facing up with both legs flat on the bed. The patient is asked to lift the affected leg up. If one was to experience pain down the leg to the foot Between 30° -70° or are unable to lift the affected leg as much as the other, this is a positive sciatica test result. If no pain occurs, the test is considered negative and any pain you’re experiencing may be due to other spinal conditions.
2. Slump Test
The slump test puts pressure on the spinal cord and peripheral nerves on your lumbar spine.
- Sit upright in a chair without back support.
- Clasp your hands behind your back.
- Slump forward and bring your neck down, touching your chin to your chest.
- Extend one leg forward and flex your foot towards your shin.
- Repeat with the other leg.
If the leg that experiences pain won’t go as high as the unaffected leg or if lifting your leg aggravates your symptoms, you may have sciatica.
3. FAIR test
FAIR is an acronym that stands for flexion, adduction, and internal rotation.
During the test, you’ll lie on your side with your injured leg on top. The tester will stabilize your hip with one hand and bring your knee toward your chest while moving it toward the midline of your body. At the same time, they’ll rotate your lower leg away from the midline of your body to put your piriformis muscle under tension.
When to seek medical attention
It is important to visit your health provider when one is experiencing either of the two for further diagnosis and discussions on the best treatment options which may include:
- Physical therapy
- Stretching and exercise
- Surgery
- Nonsteroidal anti-inflammatory drugs (NSAIDs).
Risk factor
Cauda equina syndrome
In rare cases, a herniated disc can press on nerves that cause you to lose control of your bowel or bladder. This condition is known as cauda equina syndrome.
It can also cause numbness or tingling in your groin area, decreased sexual sensation, and paralysis if left untreated.
This disorder often develops slowly. It’s important to go to your doctor or an emergency room immediately if the symptoms appear.
The symptoms of this disorder can include:
- inability to control your bladder or bowels, which can result in incontinence or retention of waste
- pain in one or both of your legs
- numbness in one or both of your legs
- weakness in one or both of your legs, making it hard to get up after sitting
- stumbling when you try to get up
Written By:
Danson Kingori,
Physical Therapist,
Chiropractic & Physiotherapy Health Centre
