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Piriformis Syndrome vs. Sciatica

Instructor: Courtney Dohse
In this lesson, we will learn the basic definitions and causes of sciatica and piriformis syndrome, as well as the similarities and differences between the two conditions.

Case Study

Jennifer is a healthy 28-year-old who plays professional soccer. She presents to her physician's office with complaints of a burning pain in her buttocks that shoots down her left leg. The doctor asks Jennifer to fill out a questionnaire about her health history. In her questionnaire, Jennifer reports that she has never knowingly suffered an injury to her back, hip, or leg. She reports working out 7 mornings a week for 2 hours to build strength for soccer. Jennifer also has a 3-hour practice in the evenings 6 days a week.

What could be the cause of Jennifer's symptoms? To figure this out, let's examine the definitions of sciatica and piriformis syndrome.

What is Sciatica?

The sciatic nerve is the largest and longest nerve in the human body, extending from the lower back, through the buttocks, and down each leg. Sciatica refers to pain experienced along the pathway of the sciatic nerve. Typically, sciatic pain is described as a burning or tingling feeling affecting the lower back, buttocks, and leg, usually only on one side of the body.

The most common cause of sciatica is compression of the nerve pathway, usually caused by a herniated spinal disc or bone spur putting pressure on the nerve. This often causes damage to the nerve, inflammation, and irritation, which in turn causes pain. Because of the compression of the nerve by a segment of bone, nerve signals are often interrupted and the person may experience a sensation of numbness in their leg.

What is Piriformis Syndrome?

Piriformis Syndrome is pain along the pathway of the sciatic nerve, caused by compression from the nearby piriformis muscle. This is a large muscle located in the buttocks, close to the hip joint. The main function of this muscle is to allow people to lift and rotate their thighs. When this muscle spasms, or becomes inflamed, it may put pressure on the sciatic nerve, causing symptoms that mimic sciatica. Piriformis syndrome most commonly affects athletes and occurs due to overuse of the muscle. However, it can affect other people as well, not just due to overuse but perhaps due to trauma to the muscle.

piriformis muscle

Sciatica and Piriformis Syndrome: Compare and Contrast

Similarities

Sciatica and piriformis syndrome share the same set of symptoms, and therefore, it is sometimes hard to distinguish one diagnosis from the other. Both sciatica and piriformis syndrome cause a person pain throughout the lower back, buttocks, and leg because both of these syndromes affect the sciatic nerve. Both of these syndromes may cause numbness in the affected leg because both of them block the nerve pathway and interrupt nerve signals.

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