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There is considerable confusion regarding the conditions sciatica and piriformis syndrome. Some think that they are the same thing, but although they have very similar symptoms in many cases and can be present simultaneously, the underlying causes of sciatica and piriformis syndrome can be quite different.Sciatica refers to irritation of the sciatic (often mis-spelled as syatic or psyatic) nerve, that arises from nerve roots in the lumbar spine. The most common cause of sciatic nerve irritation, or “true” sciatica is compression of one or more of its component nerve roots due to disc herniation or spinal degeneration in the lower lumbar region. Depending on the severity of the compression and/or inflammation of the sciatic nerve components, sciatica may extend into the buttock area, into the thigh, or sometimes all the way down the leg to the foot.
Piriformis syndrome, also known as “pseudo-sciatica” (meaning “false sciatica”), is actually referral pain and other symptoms (tingling, numbness, etc.) caused by tightness and knots of contraction in the piriformis muscle, which runs from the upper femur bone to the edge of the sacrum, the triangular pelvic bone that is below the lumbar spine. The symptoms of piriformis syndrome are very similar and may be indistinguishable from true sciatica.
In some cases, piriformis syndrome may cause true sciatic nerve irritation, as the sciatic nerve may run underneath or even through the middle of the piriformis, so contraction of the piriformis may produce sufficient compression of the sciatic nerve to produce actual nerve symptoms. This is one of the main sources of confusion when it comes to distinguishing true sciatica from piriformis syndrome.
As mentioned earlier, the symptoms of true sciatica are very similar to piriformis syndrome. Both cause pain, tingling, burning, “electrical shock” sensations, and/or numbness down the leg, often all the way to the foot. Add to this that the underlying causes of both sciatica and piriformis syndrome can be related to biomechanical problems in the spine and pelvic joints, and the fact that the two conditions can be present at the same time, even doctors may have a difficult time distinguishing between the two.
But since the most effective treatment for the two conditions varies signficantly, it is important to determine the correct diagnosis if at all possible. Fortunately, there is a simple way to tell the difference between sciatica and piriformis syndrome in most cases.
Two simple maneuvers will distinguish sciatica from piriformis syndrome in the majority of cases (when the problem is one versus the other and not both conditions at the same time). First, in a seated position, if one straightens the leg on the painful side (so that the leg is parallel to the floor), and the sciatica symptoms increase, this is usually a sign of true sciatic nerve irritation.
The second maneuver is done in two parts. First, from the sitting position one bends the leg and pulls the knee on the painful side towards the same-side shoulder. There usually is no major increase in pain except in severe cases of true sciatica in this position. The second part of the maneuver is to pull the knee toward the opposite side shoulder. An increase in the sciatica-like symptoms is a strong indication of piriformis syndrome.
Once it has been determined if symptoms are due to true sciatica or piriformis syndrome, or some combination of the two, the most effective treatment can be employed.
For more information, visit my sciatica exercises website or the resources on my natural remedies blog.
Tags: Sciatica And Herniated Disc, exercises, health, natural remedies, piriformis syndrome, sciatica
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