Piriformis Syndrome vs. Sciatica: What’s The Difference?

In the United States, up to 6% to 8% of people with sciatica (lower back/leg pain in the distribution of the sciatic nerve) are diagnosed with piriformis syndrome each year. If you have ever experienced sciatica pain, tingling, and/or numbness, you have probably heard the terms piriformis syndrome and sciatica. Although the terms are sometimes used interchangeably, piriformis syndrome and sciatica are not the same and differ in their causes, symptoms, and treatment. Below, Comprehensive Spine Care will explain the differences between the two conditions and potential treatments.

What Are The Different Causes Of Piriformis Syndrome and Sciatica?

Both sciatica and piriformis syndrome can cause symptoms in the lower back, hips, and/or legs, but have different underlying causes:

  • Piriformis syndrome is a condition in which the sciatic nerve is irritated or compressed by the piriformis muscle deep in the pelvis. Symptoms of piriformis syndrome affect your buttocks and travel along your sciatic nerve to your thighs and legs. Piriformis syndrome may result from anatomical changes in the piriformis muscle and/or sciatic nerve, trauma to the hip or buttocks, or prolonged sitting. 

  • Sciatica can be caused by a number of problems affecting the nerve roots in the lower spine, such as herniated discs, spinal stenosis, or spondylolisthesis. Sciatica is a group of symptoms caused when a medical condition such as a herniated disc or spinal stenosis irritates or compresses one or more spinal nerve roots in the lower spine (rather than the sciatic nerve itself). These nerve roots later fuse to form the sciatic nerve. 

How Are Piriformis Syndrome and Sciatica Symptoms Different?

Several symptoms of sciatica and piriformis syndrome overlap, and you may be confused about the real cause of your back and leg pain.

  • In piriformis syndrome, hip and buttock pain is usually more common than low back pain. With sciatica, the leg pain is usually worse than the lower back pain, and the pain may radiate to the toes and feel heavy. In piriformis syndrome, the pain usually worsens with prolonged sitting and/or hip movement.

  • For sciatica, lifting the affected leg (while keeping the other leg straight) while lying down can cause pain. Neurologic symptoms such as tingling and numbness usually occur in the area where the pain is felt. While these are fairly common patterns, the actual appearance can vary widely, making self-diagnosis very difficult.

Treatment Options For Piriformis Syndrome And Sciatica Vary

It is important that the underlying cause of your back, hip, and/or leg pain is properly diagnosed by a healthcare professional in order to develop an effective treatment plan. Successful treatment depends on addressing the underlying cause of irritation or compression of the sciatic nerve or spinal nerve root.

Therefore, treating piriformis syndrome is often very different from treating sciatica caused by a problem in the lumbar spine, such as a herniated or degenerated disc. When you have a herniated disc, stretches for piriformis syndrome may make your symptoms worse. To accurately diagnose your lower back problem, consult your doctor to find out whether your pain originates from the lower spine or the piriformis muscle. A doctor can perform relevant medical tests to diagnose your pain and develop an effective treatment plan.

At Comprehensive Spine Care, we have two decades of experience offering patients spinal pain relief with a wide range of treatments to families in New Jersey, with Surgeon Rafael Levin, a Board Certified Orthopedic Surgeon, specializing in spine surgery. If you want to know if you are a candidate for spine care procedures or have questions about your condition, please call 201-634-1811 to book a consultation today.

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