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Sciatica vs. Piriformis

Hello everyone,

I don't know if I have sciatica or piriformis, but I am pretty sure it is piriformis. I am pretty sure of this, because my chiropractor agreed that it is probably piriformis. My question to you is this:

Suppose there are two people. One person has piriformis and the other person has sciatica. Suppose the one with piriformis is named Piriformis and the one with sciatica is named Sciatica. Now these two people each is trying to treat their back problem. They are both doing stretches and icing/heating their backs. If one watched what they do to cure them of their sciatica or piriformis, would one be able to tell if they have sciatica or piriformis?

If one can tell, I may consider getting a thorough examination to find out for certain what I am currently dealing with. Otherwise, I am going to keep treating this problem as if I have piriformis.

Thank you for reading this post, and I am sorry if this question has been posted earlier.
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Comments

  • LizLiz Posts: 7,883

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • If its sciatica you don't want a chiropractor doing adjustments or manipulations on you. That could end very, very badly!

    Both present in a very similar way. Physical therapy exercises are different but have a lot of similarities. The things that can help piriformis like deep massage can also help sciatica because the muscles often tighten up. Both can get a pain flare after such treatments. Sciatica needs an MRI to diagnose. Can need surgery if nerve impingement is bad enough. Piriformis can need (simpler) cutting treatments if bad enough.

    I hope that answered what you want to know. Let me know if you want me to tell you more in my experience & knowledge. Both need specialist (not chiropractor) diagnosis. If you're in the position to do so I'd have an MRI to be sure if you're in doubt. It's always better to be safe than sorry when nerve compression could be to blame. Both are very, very painful. It's best to treat either properly with specialist advise. Either will get better faster & treated properly once you know which you have.
    Osteoarthritis & DDD.
  • Sorry. To answer your question. Yes! I could tell who was Mr Sciatica & who was Mrs Piriformis if you told me how they were being treated if they were both getting the best care for their conditions.
    Osteoarthritis & DDD.
  • I was under the impression that certain things could cause sciatica as opposed to sciatica being the issue. Like piriformis could cause sciatica pain, as well as a herniated disc. My doc had diagnosed me with piriformis by examination. When the pain did not go away I had an MRI which showed a herniated disc and was causing pinched nerves. Sorry I don't have an answer for your question.
  • Yeh. Sciatica is one of 'those' words. Most of us, myself included, think of it as 'that' feeling, the PAIN! I took the post to mean Sciatica being something in the spine impinging the nerve & piriformis to be that muscle problem. They're two very different things with the same result...PAIN!

    To continue the metaphor you are Mr Sciatica. Your doctor thought you were Mr Piriformis but the MRI showed otherwise. (unless you have both?)

    My husband has had piriformis syndrome on & off for years. I know that if I tried to do his physical therapy routines it would cripple me! Therapists treat a herniation by gently strengthening our core & stretches that get motion etc. For piriformis they REALLY work & stretch that muscle. If its beyond just therapy there are so many things we can do to help either condition but in my experience they're very different.
    Osteoarthritis & DDD.
  • What I am about to say is the main reason I believe I have Piriformis. Even when the pain becomes great, I feel no numbness in my legs. None. Plus, after a strenuous walk, there is a very slight chance the pain goes away. Secondly, the majority of the pain seems to be in my Gluteus Maximus. The thing that sucks is that I have also have Plantar Fasciitis. I believe this two conditions are related, because if I do strenuous leg exercise to get rid of one, I am just exacerbating the other.

    If the pain originates in my butt, what is the most likely culprit? Does this sound like I am Mr. Sciatica? Or Mr. Piriformis?
  • MarWinMarWin OhioPosts: 353
    Exactly. If you do exercise, especially weight bearing, you're only exacerbating the condition. Got a muscle that's imbalanced, just weight lift and have that muscle become stronger while still imbalanced. OUCH!! In my history and experience I don't differentiate the treatments (piriformis vs sciatica). Sciatica is a funny beast and shows many forms. You can have it and not even know it. It can affect only your low back, or butt, or leg, or toes, or ???, or it can affect all of the above. It can tingle. It can be numb. It can be electricity-like. It's one crazy beast!! I had to stop strenuous exercise, including running and weight lifting.

    Get the sciatica under control or eliminated, and slowly get back into the exercise routine. If you gotta exercise, I'd suggest no impact training and stick to the machines that isolate the muscle you're trying to work out. Just don't over-do-it with the machines because that could lead to repetitive exercise injuries due to the isolation factor and non-use of secondary/supporting muscles. Unlike free weights where you're forced to use those secondary muscles.  


  • SavageSavage United StatesPosts: 5,941
    Hello Meditating.....
    Curious what your doctor has to say to your question?
    What does he say about your strenuous leg exercises?

    Just a reminder, there are no medical professionals on the forums.
    Please discuss with your doctor what is best for your over all situation and your over all well being.
    What may be effective for one person may be harmful to another.


    Sue
    Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

  • UtubeliteUUtubelite CaliforniaPosts: 1


    What I am about to say is the main reason I believe I have Piriformis. Even when the pain becomes great, I feel no numbness in my legs. None. Plus, after a strenuous walk, there is a very slight chance the pain goes away. Secondly, the majority of the pain seems to be in my Gluteus Maximus. The thing that sucks is that I have also have Plantar Fasciitis. I believe this two conditions are related, because if I do strenuous leg exercise to get rid of one, I am just exacerbating the other.

    If the pain originates in my butt, what is the most likely culprit? Does this sound like I am Mr. Sciatica? Or Mr. Piriformis?

    I am in the same boat as you. My pain is mostly in the left butt, localised ion the center. It is same point which pains when I bend forward but once I bend 2 or 3 times the pain starts getting low and then almost disappears. It comes mainly when I bend or when I walk. The pain sometimes feel slightly extending up near to left glute and I can press that area and feel the pain when it pains. Some times I feel very low level aches inner thigh near the knee. But I also have planter fasciitis which started 4 months back after about 10 miles walk in leather shoes in SFO down town.

    2 months back when I was doing an exercise for planter fasciitis which required standing on toe on one leg and then bending down 90 deg while on one toe I got out of balance kind of twisted and then after that took a shower and had to go to bed with severe back pain. There was no pain in the butt or leg but back pain and morning stiffness continued for 5 weeks. Then one day after 5 weeks it started, the stiffness and back pain disappeared and I started getting the butt pain. 3 days before that I did the exercise given by the PT which made me feel pain in butt while doing it but the PT told me to continue. Since then the butt pain has not gone. I  did change that PT who induced the butt pain.

    I did my MRI 2 weeks back and it shows L5-S1 disc protrusion with nerve impingement at lateral recess. All my sciatica tests like straight leg raise, leg raise while sitting and all strength tests, walking on toe and heels are all normal.
    The PT says though MRI shoes nerve impingement it does not necessarily mean that it is causing nerve pain and there could be some nerve play but also some ligament damage.

    I am struggling to find if it is piriformis, nerve or something else. I wish there was an easy way to find out. The spine specialist has told me to perform PT and report back after 4 weeks. 

    Another thing which changed a week back is pain while sitting. I used to get lots of pain on sitting and getting up would cause pain from butt down till the knee on inner thigh. Since last one week, sitting has become pain free and I can sit for many hours at a stretch and there is no pain when I get up. Still the butt pain as I said before comes on walking for sometime and bending forward or side bending /movement but it does not happen all the time. 
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