Piriformis Syndrome vs Sciatica

There can be a lot of guesswork as to figuring out the root of the problem when you have pain in your buttocks. You may hear and read about piriformis syndrome or sciatica when researching the problem. So what exactly is piriformis syndrome vs. sciatica? How are the symptoms and treatments different for each one? Continue reading for more details on properly diagnosing both issues and understanding some of the basic causes behind them. 

Before we get into that, if you have either condition and live in the San Diego area, our chiropractors can help! Click here to schedule an appointment.

Piriformis Syndrome vs. Sciatica 

Because both piriformis syndrome and sciatica affect the sciatica nerve, it can be difficult to know the difference between the two. However, they are different conditions with different causes and treatments. 

Piriformis syndrome only deals with the piriformis muscle pressing on an area of the sciatic nerve. When dealing with this issue, you’ll typically feel more centralized pain in a specific area of your buttocks.

Sciatica is caused by spinal stenosis or a herniated disc and is felt often in the lower back with radiation down the back of the leg.

What is Piriformis Syndrome? 

Piriformis syndrome is a condition in which the piriformis muscle in the buttocks irritates the sciatic nerve, causing spasms and causing pain. This pressure on the piriformis muscle presses on the sciatic nerve, causing numbness in your buttocks, hip or upper leg. You don’t experience back pain with piriformis syndrome due to the local compression of the nerve below the level of the nerve root. 

The piriformis muscle is a narrow, flat muscle that runs from your lower spine through your buttock and over to the top of your thigh. This muscle assists in the movement of almost every part of your lower body. 

Your sciatic nerve is found underneath the piriformis and is the longest nerve in your body. It starts from your spinal cord, goes through your buttocks, and travels down the back of each leg to your feet. 

Symptoms of Piriformis Syndrome 

Patients dealing with piriformis syndrome may describe the following symptoms felt mainly in their buttocks and legs:

  • Tingling or numbness in the buttocks and down the leg which may get worse after sitting for long periods of time, walking, running, or climbing stairs 
  • Sharp pain 
  • Shooting or burning sensation 
  • Dull aching pain 

Causes of Piriformis Syndrome 

Typical causes of piriformis syndrome stem from sporting activities such as running and lifting weights as well as performing exercises incorrectly. Unbalanced and improper lifting techniques can definitely play a part. Another common cause may be sitting for long periods of time, putting too much pressure on the nerve. 

Ways to Prevent Piriformis Syndrome 

Consider some of the following methods and strategies when hoping to prevent piriformis syndrome from starting or recurring:

1. Focus on Good Posture 

Make sure you have good posture, especially when you’re standing, sitting, or driving for extended periods of time. If you have to sit for several hours, take breaks by stretching or walking around. This will help prevent piriformis syndrome and other back ailments from starting or flaring up.

2. Regularly Exercise and Stretch 

Talk to your healthcare provider about a regular exercise and stretching routine that works for your body. Remember to warm up before physical activity and stretch immediately after.

3. Lift and Bend Properly 

When lifting heavy items, keep your back straight and let your legs do most of the work. Hold objects you’re carrying close to your body and don’t twist when carrying a heavy load. 

Treatment Options for Piriformis Syndrome 

There are a variety of ways to treat piriformis syndrome. We don’t recommend surgery unless it’s your last resort and all other treatments have been unsuccessful. Piriformis syndrome treatments may include the following: 

  • Medications that relax your muscles
  • Physical therapy focusing on stretching and strengthening your piriformis 
  • Steroid injections 
  • Botox injections 
  • Resting 
  • Exercising and stretching routine at home 
  • Massage therapy 

What is Sciatica? 

Sciatica is defined as a condition to describe nerve pain in the leg that is caused by compression or irritation of the sciatic nerve. With sciatica, the compression of the nerve typically comes from the nerve root which is where it leaves the spine above the piriformis muscle. 

Symptoms of Sciatica 

People dealing with sciatica will likely describe the following symptoms: 

  • Back pain in the lumbar region 
  • Back pain extending down the back of your thigh and in worse cases, all the way to your foot 
  • Numbness, tingling, or the pins and needles feeling in your lower limbs 
  • A tightness or pulling feeling down the back of your leg 
  • Short bursts of sharp pain in your leg 
  • Can become worse when coughing or sneezing 

If you start experiencing more severe symptoms such as loss of bladder or bowel control, loss of movement in your feet, or numbness in your genitals, seek emergency care immediately. While these issues are rare, they may be irreversible if significant compression to your nerve has caused damage.

Causes of Sciatica 

Causes of sciatica are often quite different from piriformis syndrome. Common ways to develop sciatica may include poor posture, improper weight lifting technique, or excessive amounts of sitting. However, sciatica most often occurs when a herniated disc or bone spur puts pressure on part of your nerve. This can cause pain and numbness along with inflammation. Additionally, diabetes or in rare cases, a tumor may damage the nerve. 

Sciatica Prevention

Even though it may not always be possible to prevent sciatica from occurring, there are some steps you can take to protect yourself:

1. Pay Attention to Posture 

Sitting for long periods of time can certainly be a factor in back pain. Maintaining good posture can prevent several painful back conditions. Be sure to choose a seat with good lower back support to keep your normal back curve and try to keep knees and hips at the same level.

2. Exercise Regularly 

Keeping up with a regular exercise routine can help strengthen your core muscles to ensure proper spine alignment and good posture. Don’t start an exercise plan without first checking in with your healthcare provider.

3. Know How to Use Your Body Correctly 

If you have a job that requires you to stand for long periods of time, it’s smart to rest one foot on a box or stool throughout your day. Always remember to use your legs, not your back, when doing heavy lifting. Pay attention to not lift and twist at the same time, and be sure to carry heavy items close to your body. 

Sciatica Treatment Options 

The following is a list of treatments that are often prescribed for sciatica:

  • Gentle chiropractic care
  • Non-surgical spinal decompression
  • Cold laser therapy
  • Medications such as anti-inflammatories 
  • Steroid Injections around the root of the nerve that’s causing the pain 
  • Appropriate physical activity and exercise 
  • Physical therapy 
  • Alternating heat and ice therapy 
  • Surgery as a last resort 

How to Test for Piriformis Syndrome vs. Sciatica 

A simple way you can test yourself for piriformis syndrome vs. sciatica is to try pressing on the muscle in each buttock. Start in the middle of your cheek. Discovering pain on one or both sides could indicate piriformis syndrome. 

Next, try moving your hips and legs to identify where your pain is coming from. If your pain is stemming only from your lower back and buttocks, it’s likely piriformis syndrome. If your pain is generally located in your lower extremities, you’re likely suffering from sciatica. 

Piriformis Syndrome vs. Sciatica: Knowing the Difference Conclusion

While piriformis syndrome and sciatica certainly have some similarities, they are different conditions. It’s important to know which one you’re dealing with so it can be treated properly and you can find relief. While most episodes go away as quickly as a few days or weeks with rest and proper treatment, consulting with an experienced chiropractor may assist in quick recovery and prevent your condition from returning. No matter what kind of back or neck pain you’re dealing with, our expert team at Intouch Chiropractic can help your find health solutions. Click here to schedule an appointment with our chiropractors if you’re in San Diego.