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  • Writer's pictureRashelle Bytendorp

Sciatica: Is it Piriformis Syndrome or Your Low Back?


When seeking answers for low back, hip, and leg pain, you may have heard the term

Sciatica. This condition occurs when the sciatic nerve (the largest nerve in the body) is

irritated or inflamed, causing pain, tingling, and/or numbness felt along part or all of the

nerve path; most often starting in the low back or the buttock and traveling down the outer

leg, even all the way down to the foot in some cases.


This irritation of the Sciatic nerve is actually quite common and is often attributed to one

of two causes, Piriformis Syndrome or a spinal abnormality in the low back; with a pretty

even a 50/50 split between the two.


Piriformis syndrome is when your piriformis muscle, a small muscle located deep in the

buttock that starts at the lower spine and connects to the upper surface of the thighbone,

irritates your sciatic nerve. The sciatic nerve runs directly under this muscle, and in some

people, it runs right through the muscle itself.


The upper portion of the nerve, as it comes out of the spinal cord, is also prone to irritation

from the spine. This could be due to stenosis (narrowing of the spinal canal) or a disc issue

such as a herniated or bulging disc. Any of these spinal conditions could result in pressure

on the Sciatic nerve creating pain and irritation felt in the hip and leg.


When it comes to treating Sciatica, the key is for your healthcare provider to understand

the cause of it first, because treatment plans will differ tremendously. While imaging tests

may help, most often you’ll start with simple mobilizations, stretches, and exercises to see

what exactly helps your pain or makes it worse. This can confirm which problem is the root

cause of the issue. Then a treatment plan will be developed which may include things such

as hot or cold therapies, massage therapy, low back and hip stretches, low back and hip

exercises, spinal mobilizations, posture and movement re-education, pain medications, and

even injections or other more invasive forms of treatment.


While differentiating and diagnosing sciatica and piriformis syndrome may be difficult,

paying close attention to what you feel and being honest with your healthcare providers

can make all the difference in the world.

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