Do I Have Piriformis Syndrome Or Sciatica?

Are you confused on whether you’re suffering from piriformis syndrome or sciatica? I’m going to give you the details about how to distinguish between the two, and know which one you have going on, so that you can know what to do next, how to treat the problem that you’ve got. You’ve likely got some hip pain, some pain in the butt, literally pain in the butt cheek area, and this pain in the butt cheek area is causing your symptoms. But it can be confusing to know whether it’s sciatica or whether it’s piriformis syndrome.

But real quick, my name is Dr. David Middaugh. I’m a specialist physical therapist over at El Paso Manual Physical Therapy. I treat sciatica problems all the time. And I often see piriformis syndrome too. So I know how to tell the difference between the two and how to treat them both independently, or together as you’ll find out, so that the problem goes away and people get back to being active and healthy and mobile, while avoiding injections and medications. And of course, avoiding surgeries if that’s something that might be a potential solution for this problem.

So first off, let’s define the two just to get some clear-cut borders on what is sciatica and what is piriformis syndrome. Let’s start with piriformis syndrome. Piriformis syndrome refers to the piriformis muscle which is a muscle deep in the butt cheek area. If you pull up a picture on Google of the piriformis muscle, you’ll find that right around it, above and below it, there are a bunch of other muscles.

The reason why there isn’t a gluteus medius syndrome, or a optrainer it up trader external syndrome is because the piriformis just gets a bad rap, the piriformis gets blamed for a lot of pain in the butt area because of its position, it is directly over the sciatica nerve. So when people have pain in that area, then they start to blame the pressure of the piriformis muscle pushing on to the sciatic nerve.

That’s why these two are kind of related, it’s hard to tell them apart. But let me give you two quick signs that you can check on yourself to see if it’s more piriformis syndrome that you’ve got. Number one, pain deep in the butt area, you can kind of poke into the butt cheek in on the side that bothers you and find kind of a knot, a hard spot in there that is tender. It’s very likely that the piriformis muscle can become stiff and spasm. And sometimes it literally just needs to be rubbed out kind of gently to make sure that it calms down and it gets alleviated.

The second sign is hip stiffness, the function of the piriformis muscle is to rotate the hip outwards, it also stabilizes the ball into the socket of the hip joint. So if you have stiffness, when you first go to get up, or if you’re trying to just move your leg around say in bed or sitting in a chair and driving, and you feel like your hip on the side that it hurts, just doesn’t move as good as your other hip. And that’s a sign that you might have a piriformis syndrome problem as well.

Now, some people might have hip arthritis, and they may also experience hip stiffness as well. The difference between the two there is the piriformis muscle stiffness tends to free up a lot quicker than in arthritis stiffness. So if you begin to move around, walk around, stretch your hip out a little bit and then it frees up it feels better. It’s very likely that you’ve got piriformis syndrome.

If you’re going to go look into hip arthritis, then you want to get an X-ray and see if see how the hip joint looks and have a doctor interpret it for you so that you can know that it’s more of a hip arthritis problem.

Now let’s talk about sciatica. Sciatica refers to the sciatica nerve, it’s irritation, or pain in the sciatica nerve. The sciatic nerve comes out of the hip on the backside of the butt area, and it travels down the back of the thigh, down into the back of the knee, into the lower leg like calf area and then it branches in a bunch of different directions. It actually ends up going into the bottom of the foot all the way the tips of the toes on the bottom side of the foot.

This nerve when it gets irritated, when you have sciatica, it can also cause pain in the butt area, but it will typically radiate down into the back of the thigh and you’ll get more than just pain, you’ll also get potentially numbness and tingling problems, burning sensations, aching sensations. And in more severe cases of sciatica people will feel cramping in their hamstring area, in the calf are, even in the foot and like in the arc of the foot, and even heel pain, it could set off plantar fasciitis type symptoms too. So you also seem to be having plantar fasciitis, like heel pain type of symptoms, then it is very much more likely that it’s sciatica.

The second sign that you’ve got a sciatica problem is if you begin to get the symptoms whenever you’re standing or walking too long. Too long is relative to the individual. It depends on you. If for some people, it happens right away, as soon as they stand up and walk around a bit, they’re getting their symptoms within a minute that people can tolerate 30 minutes to 60 minutes or more. And then they begin to get the leg pain, the back of the thigh pain, the buttock pain, it may go down all the way into their calf and foot and maybe get that cramping as well.

There you go, you’ve got a clear differentiation of what piriformis syndrome is, and what Sciatica is, and a few signs to tell the two apart. But here’s the thing, here’s what’s important for you to take away from this, because there’s not a whole lot of treatment you can do from the information that I’m giving you. And the reality is both happen at the same time. Most of the time. Probably about 70 80% of cases that I’ve seen, if I just give a rough estimate, have some symptoms of sciatica and symptoms of piriformis syndrome happening together simultaneously. And the reason for that is because the root problems of sciatica and of piriformis syndrome are the same. S

I’m going to cover with you next, the three same root problems of these two syndromes, the piriformis syndrome and the Sciatica problem.

The first most common root problem is a muscle imbalance, meaning the muscles on one side of the body, usually on the front of the body are a lot stronger than the muscles in the back side of the body. And when that happens, it causes the hip joints, the lower back joints, even the knee joints, to be out of balance.

There’s excessive pressure on one side of the joints, because of the muscles being stronger on that side, and it’s forcing the tissues on the other side of the muscles and nerves, ligaments, all that stuff back there to move inappropriately. When this happens too much, over time, tissues get irritated, certain muscles might spasm like the piriformis, the sciatica nerve might get irritated. So you’ve got to look at that muscle imbalance.

The second most common root cause is pelvis bones are either stuck or moving too much. The pelvis bones, the ones that make up your hips, one may be shifted one way or another. And it could be putting some tension on the piriformis muscle because the piriformis muscle is connected to the back of the to the front side of the tailbone, and then it goes out crosses the hip joint attaches to the femur, the thigh bone, but it’s in the pelvis area.

If the pelvis bone has shifted, it’s going to put some different stress and strain on that piriformis muscle and can cause it to spasm. By the same positional changes that pelvis bone moves, it can compress the opening for the sciatic nerve when it comes out of the pelvis bone to go down the leg and they can also cause it Sciatica symptom. The pelvic rotation could be causing both symptoms of the piriformis syndrome pain. The discomfort from the muscles spasming as well as the nerve itself getting compressed and irritated.

The third most common root cause of these two problems is lower back issues. To put it simply, low lumbar problems. We are talking about disc problems, like disc herniations, arthritis in the lower back. Stenosis is another very common one that which is closing of the nerve openings, they’re getting more narrow, and that can be causing nerve compression that causes the piriformis muscle to spasm, or that irritates the sciatic nerve as it goes down the leg as well.

Those roots symptoms need to be addressed in order to fix both the piriformis syndrome and the sacral problem. If we just treat the symptoms of the piriformis syndrome, or the symptoms of the sciatica problem but not the root causes, it’s going to keep coming back.

That’s why people don’t ever get rid of this. In some cases, it becomes chronic, and they don’t really understand how to maintain muscle strength or the joint stability or the joint mobility as well as the motion in the joints, so that this problem isn’t recurring every month or every few months. So these root problems need to be addressed.

Now I know you’re watching this on our website right now. And if you want more helpful tips on sciatica videos, you first finish watching this video, so you get all the information from here. But if you’re looking for what to do next on your own at home, go over to the top right corner of our website here and find the little magnifying glass icon. If you click on that a little search bar will come up, type in their sciatica and then hit enter.

All our webpages regarding sciatica will come up so that you can find exercises to do for sciatica, so you know what not to do and what to do for sciatica, what stretches are harmful for sciatica, you’ll also find home remedies for Sciatica and there too. So you can look through all those videos and get all the free help you can.

And also, we’ve got a free ebook that you can get instantly downloaded to your email. If you find the orange book cover some around here might be to my, to your right here or down lower below here, look around, you can also go to the homepage of our website, and you’ll find if you just scroll down a tiny bit, and it looks like an orange cover, it has a bunch of sciatica tips, you can get that instantly sent to you if you just leave us your details. And then check your email, check your spam folder if you don’t see it within a minute. And you’ll get those tips ready to read.

My number one recommendation though, is that you get specialist expert help for your sciatica and or piriformis syndrome problem. Get with a manual therapist, that’s my biased opinions. Go see a manual physical therapist who knows how to handle sciatica problems and pelvis problems at the root level. They know how to free up those lower back joints. They know how to mess with the pelvis joints to make sure that it’s the way it’s supposed to be. And they’ll be able to guide you very well on how to correct the muscle imbalances, so that this problem isn’t coming back, so that you can avoid ever seen a surgeon, avoid injections and medications and remain active and healthy and mobile in your body.

That by far is the quickest route to getting healthy again. So that you’re able to stand as long as you want, walk as long as you want, sit as long as you want. Oh my gosh I can’t tell you how many piriformis and sciatica patients come in and say they took a long drive, they took a little road trip and it was just killing them. They were miserable. They had a pullover at a gas station and buy some pain medication because it just was so uncomfortable to sit in the car for that long their sciatica was going off. And they’re having to try to figure out how to do some exercises in the car. And it’s just it’s just a miserable situation.

I don’t want you to end up like that, get this problem fixed as fast as possible. If you can get to a manual therapist in your area, if you want to consider coming out to us, you can do that as well.

Hey, if you thought this was helpful information for you, and you’re thinking about working with us, you want to talk to us specifically about solving your piriformis and sciatica problem, there are two ways to get in touch with us. The first way is to go to the top of our website here and find the cost and availability button there, you’ll get taken to a page where you can leave us for details about your issue, fill it out as best he can.

One of my staff will call you back as soon as they can, once you submit that information to talk to you more about this issue, want to just hear all about your problems so that we can make sure that it’s the right type of problem that we can help you out with. So we don’t waste your time we can send to the right person in case it’s not for us to treat. If it is something, we can potentially help you out with, then we’ll tell you the next steps, you’re never obligated to do treatment with us. We just want to help you out as much as we can. And leave the decision up to you on whether or not you want to come to see us.

You can also call us directly at 915-503-1314 and just begin the conversation that way too. I really hope that we can help you out if you’re suffering from a piriformis or a sciatica problem. Just get specialist attention. It helps so much to see the right person for the problem so that you can go as fast as possible to getting back to what you want to do without dealing with this issue. I hope we can be a part of your success story real soon. Have a wonderful day.