Is it Sciatica, or Piriformis Syndrome?

December 28, 2011

What is sciatica?

To answer the question, we need to know the sciatica nerve first. The sciatica nerve is the longest nerve in the body. It runs from the lower part of the spinal cord to the buttock and all the way down to the back of each leg. Sciatica, also known as sciatic nerve pain, refers to pain that radiates along the path of the sciatica nerve and its branches. This means that sciatic nerve pain typically radiates from the lower back to the buttock and all the way down to the back of the leg.

Sciatic nerve pain can vary widely, from dull ache to burning sensation or sharp pain. It generally gets worse after sitting for an extended time. Coughing or sneezing may also make the pain worse. Sciatic nerve pain can affect both sides of the lower body (lower extremities), but in most cases it affects only one side the body.

In addition to radiating pain, other symptoms of sciatica include tingling in the leg or toes, and numbness or muscle weakness in the leg or foot. In severe cases, sciatica can cause a loss of bladder or bowel control.

The direct cause of sciatica, or sciatic nerve pain, is the irritation of the sciatic nerve. And a number of conditions can cause such irritation, including disc herniation, spinal stenosis, degenerative disc disease, and spondylolisthesis.

What is piriformis syndrome?

To answer this question, we first need to know the piriformis muscle. The piriformis muscle is a small, band-like muscle located deep in the buttock. It attaches to the base of the spine at one end and the joint of the thigh bone (femur) at the other end. The piriformis muscle plays important roles in our lower body movement. It stabilizes the hip joint, and it enables us to walk, shift our weight from one foot to another, and maintain balance. The sciatic nerve runs alongside or through the piriformis muscle. Piriformis syndrome refers to the symptoms that occur when the sciatic nerve is compressed by the piriformis muscle.

Similar to symptoms of sciatica or sciatic nerve pain, symptoms of piriformis syndrome also include pain that radiates along the sciatic nerve, as well as tingling or numbness in the buttocks. Tightness and spasm of the piriformis muscle are the main causes of piriformis syndrome.

So, is it sciatica, or piriformis syndrome?

Because symptoms of piriformis syndrome and sciatica are so similar, it’s often very challenging to tell them apart. In some cases when the sciatic nerve runs through the piriformis muscle, compression from the piriformis muscle could irritate the sciatic nerve. If this happens, sciatica and piriformis syndrome coexist. And this makes it more difficult to tell the radiating pain is caused by sciatica or piriformis syndrome. Besides reviewing a patient’s medical history and conducting a careful physical examination, doctors often need the assistance of imaging tests such as MRI to ensure accurate diagnosis.

Sciatica and piriformis syndrome require different treatments. So to make sure you receive the right treatment, talk to your doctor and have imaging tests done if you or your loved ones suffer from the symptoms of sciatica or piriformis syndrome.