Sciatica vs Piriformis Syndrome
Often, people are diagnosed with the umbrella term ‘sciatica’ and many people are not sure exactly what that means, nor what they can do to help themselves.
Sciatica and piriformis syndrome are two separate conditions often presenting with very similar symptoms. First, let’s look at sciatica.
Sciatica:
Sciatica is not a medical diagnosis in and of itself—it is a symptom of an underlying medical condition. Common lower back problems that can cause sciatica include a lumbar herniated disc, degenerative disc disease, spondylolisthesis, or spinal stenosis.
The pain labelled as ‘sciatica’ actually has a very specific source. The sciatic nerve’s origin point is just at the top of the gluteal muscle in the L3, L4 and L5 vertebrae. When inflammation occurs in this area, it can compress the sciatic nerve and send a radiating pain down the back of the leg, typically ending at the knee but potentially radiating into the calf. Sciatica can also be an issue for some women during pregnancy.
The specific symptoms—the leg pain, numbness, tingling, weakness, and possibly symptoms that radiate into the foot—largely depend on where the nerve is pinched. For example, a lumbar segment 5 (L5) nerve impingement can cause weakness in extension of the big toe and potentially in the ankle.
Some treatments that have been shown to reduce pain symptoms are: Chiropractic treatment, Massage Therapy, Acupuncture, alternating heat & ice treatment, and NSAID’s.
Piriformis Syndrome:
The piriformis is a deep stabilizer muscle of the hip which originates on the front surface of the sacrum and inserts at the top of the femur. The piriformis is one of the external rotators of the hip. The muscle runs diagonally, with the sciatic nerve running vertically directly beneath it (although in a small percentage of people, the nerve can actually run through the muscle)
The close proximity of the piriformis muscle to the sciatic nerve, which is the largest nerve in the human body, can be a contributing factor to ‘sciatic pain’ in some individuals. Piriformis syndrome is the result of an inflammation of the piriformis, which then causes pressure on the sciatic nerve. This pain can run from the buttock to the calf and sometimes into the bottom of the foot.
Repetitive motion is the most common cause of inflammation in the piriformis. Distance runners and soccer players are often most susceptible to this inflammation, but it is possible for anyone to be affected by it.
Treatment for a strain of this muscle includes stretching and exercises, deep tissue massage, and anti-inflammatory medication, which can reduce swelling of the piriformis, and reduce pressure on the sciatic nerve.
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