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Sciatica or Piriformis Syndrome - Which is It?
A large amount of confusion and misunderstanding exists concerning the conditions sciatica and piriformis syndrome. There are some who insist that the two conditions are actually the same thing, but even though they can have symptoms that are very much alike, the underlying causes differ.
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.
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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. In addition, both sciatica and piriformis syndrome tend to be at least partially related to biomechanical functional problems in the joints of the back and pelvis and they may even be present simultaneously in the same person, so it an be difficult to tell them apart.
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. Every cloud has a silver lining; so consider that this article on sacrum sciatica to be the silver lining to the clouds of articles on sacrum sciatica. It is this article that will add more spice to the meaning of sacrum sciatica.
But since the most effective treatment for the two conditions varies signficantly, it is important to determine the correct diagnosis if at all possible. In most cases there is an easy way to distinguish between sciatica and piriformis syndrome.
It is important to distinguish between sciatica and piriformis syndrome, because the treatment for the conditions varies, and getting the diagnosis right typically leads to more effective treatment. Did you ever believe that there was so much to learn about sacrum sciatica? Neither did we! Once we got to write this article, it seemed to be endless.
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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. In all but the most severe cases, there is usually no major increase in pain 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.
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. Sciatica usually begins in the buttock area and, depending on the severity of the underlying nerve comression and inflammation, may extend down the entire leg to the ankle and foot.
About the Author:
Dr. George Best is in private practice in San Antonio, Texas. For more information, check out Dr. Best's free e-book and online video course to assist in understanding and treating sciatica and piriformis syndrome, including in-depth instruction on sciatica exercises at http://www.SciaticaSelfCare.com .
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