Article Reviewed & Updated
Medical Reviewer: Kari Haberman
Have you heard of or been concerned about piriformis syndrome? Or are you unsure if sciatica is the same thing as piriformis syndrome?
Many people have heard of Piriformis Syndrome but aren't sure what it is. It is a common cause of lower back pain in adults. Sciatica can also produce similar symptoms, but the two are very different conditions.
This article hopes to give you insight into both so that you can be aware (but not self-diagnose) and get appropriate treatment for your condition!
What's Piriformis Syndrome?
Piriformis syndrome is a condition that results when the piriformis muscle becomes tight and compresses the sciatic nerve. The result is pain, tingling, numbness, and weakness in the buttocks and leg. The sciatic nerve is also involved, which is why it's often mistaken for sciatica.
In order to better understand what this piriformis syndrome is, one should know what and where the piriformis muscle is.
The piriformis is a small muscle found deep in the buttocks. It connects the top of the femur (thigh bone) to the base of the spine. The sciatic nerve passes right through this muscle.
On the other hand, the sciatic nerve is a large nerve that runs from the lower back down the back of each leg. It controls the muscles of the thigh, knee and ankle, and provides sensation to the back of the leg and foot.
It can be challenging to tell the difference between piriformis syndrome and sciatica, but a self-test can help.
This blog post aims to explain how to do the self-test and what the differences between piriformis syndrome and sciatica are.
However, keep in mind that only a doctor can diagnose you for certain, so if you think you may be suffering from either condition, please see your health care provider.
Symptoms of Piriformis Syndrome
The main symptom of piriformis syndrome is a pain in the buttock that may radiate down the back of the thigh.
You may also experience symptoms like numbness, tingling, or weakness in the affected leg. The symptoms often worsen with prolonged sitting, sneezing or coughing.
There are a few other things that can cause buttock pain. You should see your doctor so he or she can assess your symptoms and exclude other conditions such as a herniated disk, osteoarthritis of the hip joint, sacroiliac joint dysfunction, and ischial bursitis.
Piriformis syndrome in pregnancy
The prevalence of piriformis syndrome among pregnant women is controversial. Some studies have shown that its prevalence increases during pregnancy.
The reason for this increase may be hormones (relaxin) that loosen the ligaments in the pelvis that allows the muscles to become too relaxed and thus can increase tension on the sciatic nerve.
However, there are also several studies that show no increased risk of developing piriformis syndrome during pregnancy. It has been suggested that pregnancy-related pain syndromes such as back pain, leg cramps, and pelvic girdle pain may actually be early signs of piriformis syndrome.
Sciatica vs Piriformis Syndrome
Piriformis syndrome with sciatica is a big problem.
Sciatica diagnosis
A sciatica diagnosis is given when the sciatic nerve is compressed or irritated. This compression can be due to a herniated disc, bone spur, narrowing of the spinal canal (spinal stenosis), or a problem with one of the joints in your spine.
When the sciatic nerve is compressed, it can cause pain, tingling, numbness, and weakness in your leg. You may also have discomfort or difficulty walking or standing.
Most cases of sciatica are linked with a herniated disk, which presses on the nerve where it exits the spine.
Compression and irritation of the sciatic nerve can be due to other problems as well, such as pregnancy, obesity, diabetes, and stress. When this occurs, you will feel pain in your lower back along with tingling, numbness or weakness in your leg that worsens when you stand up or sit down.
Doctors use findings from a physical exam along with your medical history to diagnose sciatica. In some cases, imaging tests such as an magnetic resonance imaging (MRI) may be necessary to confirm the diagnosis and check for less common causes of pain.
In most cases, sciatica resolves on its own within a few weeks or months. However, if you feel severe pain that lasts for more than six weeks or recurs frequently, it may indicate a more serious problem.
Doctors can also relieve sciatica with conservative treatment that includes rest, heat or cold therapy, and certain exercises. They might also make a referral to physical therapy.
Sciatica symptoms can vary, depending on which nerve root is irritated or compressed. Pain that radiates into the leg may occur along with tingling, numbness or weakness in the affected leg.
If you have sciatica, you may also feel pain when you cough or sneeze because it can put pressure on the irritated nerve. If your sciatica is a result of a herniated disk, you may also have lower back pain and muscle spasms in your buttocks and upper leg.
Piriformis Diagnosis
The condition known as "piriformis syndrome" has been implicated in sciatica-type pain that radiates into the buttock and leg. The piriformis crosses over the sciatic nerve, which is why when it is tight or inflamed, it compresses and irritates it, causing pain in the buttocks and lower back.
Sometimes this pain projects down the back of one leg only.
People who sit a lot can develop a tight or contracted piriformis muscle, so if you have had previous back surgery or spent long hours driving or sitting at your desk, you could be vulnerable.
If so, don't self-treat -- see your doctor for help with stretching exercises to ease the compression and relieve related sciatic symptoms. If needed, ask for a referral to physical therapy.
Most cases of piriformis syndrome affect women between 30 and 60 years old. The condition can be difficult to diagnose because the symptoms are similar to those of other disorders, such as sciatica and spinal stenosis.
Both piriformis syndrome and sciatica can be treated with a combination of rest, ice, compression and elevation (RICE therapy), medications and/or physical therapy. If conservative measures don't relieve your symptoms, you may need surgery.
🔎 Read Related Aricle : Discover the 7 Best Ice Packs for Injuries
Symptoms of Piriformis Syndrome with Sciatica
When you have symptoms of piriformis syndrome, your symptoms may include pain in the buttocks that worsens with sitting and improves with standing; a weak hamstring muscle; and leg weakness.
The pain from sciatica usually begins in the lower back and radiates down one leg (sciatica nerve is the longest nerve in the body). Often it will go below the knee and even past the ankle, but rarely does it affect both legs equally (this indicates another possibility).
The pain is usually described as sharp or shooting, tingling or numbing, or electric shocks running down the legs.
The sciatic nerve that runs through your hips is much more likely to be irritated than the nerve that runs through your spine.
The likelihood of having this syndrome will usually increase dramatically if you have certain medical conditions such as diabetes, obesity, celiac disease, or kidney failure. This condition is also more likely if you are pregnant or give birth.
Can You Have Sciatica and Piriformis Syndrome at the Same Time?
Both sciatica and piriformis syndrome are distinct conditions, but they can both cause pain in the buttocks area and occur at the same time.
Best Self Test for Piriformis Syndrome
Piriformis syndrome is not easily detected by a diagnostic test, especially by doing a self-test. Keep in mind that a self-test is just one way to assess if you may have piriformis.
But like we always say, a physician's diagnosis is always the best approach, so before you take a self-test for piriformis syndrome, consult with your doctor if you have any of the symptoms mentioned above.
From physio-pedia.com, we learned that the Piriformis test could be performed in various methods:
1. Side-Lying Position Piriformis Test:
The FAIR test (Flexion Adduction and Internal Rotation) is another name for this test.
To do this test:
a. Lie flat in bed and turn to one side with the affected or painful side up to perform the examination.
b. Bend the top leg to a 90-degree angle, and the bottom leg (the one touching the bed) should be straight.
c. Hook your foot (top leg) on the bottom knee to keep it in place.
d. Let your knee stretch out and towards the floor.
e. Feel the stretch in the leg (at the piriformis muscle).
f. Take your hand (unaffected side) and place it on top of the bended knee.
g. Push the knee down slightly to help increase the stretch, but do it gently and cautiously and hold it for 30 seconds to 1 minute.
h. Then, extend your top leg slowly.
A positive test occurs when you feel pain in the buttocks area. Due to the position of the test, you may also have pain in the anterior thigh.
It is important to remember where you are feeling the pain in order for you to let your doctor know when you get to the clinic and have a consult.
2. Standing Position Piriformis Test:
a. Stand in an upright position, legs together and hands at sides or hips if needed to maintain balance.
b. Slowly lean forward so that your weight shifts slightly over one leg.
c. Lean forward slightly with mild tension in the muscles near the buttocks until you feel pressure over the piriformis muscle.
If there is pain, stop leaning forward too much and take note of where you felt the pain.
3. Piriformis Test in Seating Position:
The piriformis test can also be done in a seated position on a chair with the back upright and both feet resting on the ground.
The test is accomplished by crossing the legs and placing the ankle of the affected leg on the unaffected knee.
One hand is placed at the ankle to stabilize the legs, while the other hand is placed on the side of the knee.
As you bend forward or pull your knee towards your chest, you will feel a stretch in the gluteal region (buttocks). This is considered a positive test.
Frequently Asked Questions
Here are some of the most common questions that our experts are asked about piriformis syndrome:
Q: What causes Piriformis Syndrome?
A: The cause of piriformis syndrome is often difficult to determine. Some activities or injuries may increase your risk for developing this condition, such as running, cycling, and swimming.
If you have a job that requires you to sit for prolonged periods of time, you may also be at an increased risk.
Q: What are the risk factors for Piriformis Syndrome?
A: There are a few risk factors that can increase your chances of developing piriformis syndrome. They include:
- Having a sedentary lifestyle
- Sitting for long periods of time
- Obesity
- Having tight hamstrings and hip flexors
- Running or biking long distances
- Doing activities that put stress on the piriformis muscle, such as squats and lunges
- Having a history of sciatica or another type of back problem
If you have any of these risk factors, be sure to talk to your doctor or physical therapist about ways to lower your risk of developing piriformis syndrome.
Q: Are there any tests I can take to diagnose Piriformis Syndrome?
A: There is not a definitive test to diagnose piriformis syndrome. However, your doctor may order imaging studies such as an MRI or ultrasound to help rule out other diagnosis or conditions that may be causing your symptoms.
Q: What kind of doctor treats piriformis syndrome?
A: If you are experiencing symptoms of piriformis syndrome, your doctor will likely be a physiatrist or an orthopedic surgeon.
A physiatrist is a someone who specializes in physical medicine and rehabilitation, while an orthopedic surgeon specializes in the surgical treatment of the bones and joints.
In some cases, a neurologist may also be consulted to rule out any other possible causes of your symptoms.
Q: Is piriformis syndrome painful?
A: Yes. The pain is typically described as sharp or shooting, tingling or numbing, or electric shocks running down the legs.
Q: How is piriformis syndrome diagnosed?
A: Your doctor will diagnose you with piriformis syndrome by asking about your medical history and performing a physical examination of your lower extremities.
You may also receive an electromyogram (EMG) to confirm the diagnosis. During the test, small needles are inserted into specific muscles to examine their electrical activity while they contract and relax.
Q: Will piriformis syndrome go away?
A: Most cases of piriformis syndrome will improve with time and conservative treatment, such as pain relief medications and physical therapy. However, in some cases, signs and symptoms may persist, and surgery may be recommended.
Q: How to prevent piriformis syndrome?
A: There is no surefire way to prevent piriformis syndrome, but there are some things and care plan you can do to lower your risk of developing the condition. Some tips include:
- practicing healthy posture
- maintaining a healthy weight
- regularly stretching your hamstrings, glutes, and hip flexors
- avoiding prolonged sitting or standing
- using a support belt if you have to stand for long periods of time
Q: How to treat piriformis syndrome
A: The treatment for piriformis syndrome and sciatica can be very different. For piriformis syndrome, conservative measures such as ice therapy (RICE therapy), medications and physical therapy. If conservative measures don't relieve your symptoms, you may need surgery.
The treatment for piriformis syndrome typically includes pain relief medications, physical therapy, and corticosteroid injections. If these treatments do not relieve your symptoms, you may require surgery.
If you think you suffer from piriformis syndrome, see your doctor or physical therapist so he or she can diagnose the condition and recommend the best treatment for you.
Talk to your doctor!
So there you have it: everything you need to know about piriformis syndrome. Next time you're experiencing lower extremity pain, be sure to ask your doctor if you could be suffering from this condition.
Piriformis Syndrome vs Sciatica
Piriformis syndrome occurs when the piriformis muscle in your buttocks hurts. Sciatica, on the other hand, is an inflammation of nerves that can cause pain and numbness down one or both legs.
In conclusion, piriformis syndrome and sciatica are two different conditions with the same symptoms. The only way to make sure is by visiting a doctor or physical therapist who can diagnose you with either one of them. You may have both! If so, don't worry, your doctor can help!
Is this your first time hearing about piriformis syndrome?
If so, we hope you found this article helpful. We also recommend that you consult a doctor to see if it's sciatica or not because the two are different conditions and require different treatments. Stay tuned for our next blog post to learn more about conditions like piriformis syndrome and sciatica!