Understanding Piriformis Syndrome and How It Causes Sciatica-Like Symptoms

If someone feels pain, numbness, and weakness that radiates along the sciatic nerve ― which goes from the lower back and down both legs ― they may think it’s sciatica. However, this isn’t always the case. Piriformis syndrome can also be the culprit. The symptoms can mirror each other, and the only way to tell the difference is with a thorough examination from a health professional.

In this blog, Kenneth Varley, MD, at Southern Pain Specialists discusses what makes piriformis syndrome different from sciatica and how it can be treated.

The lowdown on piriformis syndrome

You have a piriformis muscle on each side of your body in the buttocks region. The piriformis muscle functions in helping lateral rotation of the hip joint, abducting the thigh when the hip is flexed. So it’s involved in pretty much every movement you make in your lower body, such as walking, rotating your hips, shifting your weight, and keeping your balance. 

Your sciatic nerve runs just below these muscles, all the way down the back of your legs and to your feet. If either of your piriformis muscles are injured, they can spasm and compress the sciatic nerve. This condition ― called piriformis syndrome ― can lead to pain, numbness, and weakness along the sciatic nerve. 

With sciatica, the condition is due to irritation of the sciatic nerve’s roots in the lower spine. With piriformis syndrome, on the other hand, the irritation to the sciatic nerve is due to the muscle spasms of the piriformis muscles.

Symptoms of piriformis syndrome 

Pain normally associated with sciatica is common with piriformis syndrome, including burning, tingling, or dull, aching pain. It will usually occur on one side of the body and make that side feel weak. 

With piriformis syndrome, pain often occurs in the buttocks as well, which will usually feel achy, tender, and can go numb. Pain is often more severe when sitting. Although, in severe cases, standing can be uncomfortable as well.

The cause of piriformis syndrome 

Overuse of the piriformis muscles can potentially lead to piriformis syndrome. Activities that might lead to piriformis syndrome include: 

1. Climbing stairs 
2. Sitting for too long 
3. Exercising too often or too intensely 
4. Repetitive activities, such as running or walking 
5. Certain sports activities
6. Lifting and moving large or heavy items

Furthermore, sudden injuries to the legs or buttocks can cause spasms in the piriformis muscles.

Treatment for piriformis syndrome

If you’re suffering from sciatica-like symptoms as a result of piriformis syndrome, there are a number of treatment options available at Southern Pain Specialists, including:

1. Pain management with over-the-counter or prescription medications
2. Physical therapy 
3. Radiofrequency ablation treatment 
4. Muscle relaxants 
5. Spinal cord or nerve root electrical stimulation

There are also home remedies you can utilize, such as alternating ice and heat, performing approved exercises, and stretching. Though these treatments cannot cure piriformis syndrome, they can minimize your discomfort and make it easier for you to live your life.