- Kiley Holmes, PT
What is sciatica? And, do I have piriformis syndrome?
Updated: Aug 30, 2019
This is actually a question I get quite a bit. Often people are confused about whether or not they have sciatica or piriformis syndrome. As you ask Dr Google what is happening with you the symptoms for sciatica and piriformis syndrome seem almost identical. That's because they kind of are.
Sciatica actually refers to the nerve that comes out of your low back and travels down to your toes, innervating almost everything in between - that is why claims of sciatica are so common. It's easy to blame a nerve that seems to be everywhere.
At this point it may just be easier to explain what a nerve does. A nerve is like a connection cable that allows your toes to communicate with your brain. It travels a little bit like a hose, and if there is a kink in the hose, you're not going to get any information. That doesn't necessarily mean that it is damaged, but if you leave the kink in there long enough there could be a problem. You just need to find where the kink is and fix it.
The question that you need to ask yourself: Is the pain in the back of your butt? And is it traveling down your leg. An important thing to note is that the front of your thigh is separate from the sciatic nerve, so if your pain is there it has nothing to do with the sciatic nerve and maybe coming from somewhere else in your back.
Now, the piriformis is a little muscle nestled right below your glutes. Admittedly it is a weird muscle. It is responsible for rotating your hip - however which way it rotates is completely dependent on where your knee is. This makes it a very confusing muscle to pin down, unless of course you know what you're doing, in which case it's quite easy because that's the only muscle that can be responsible for your exact complaints.
Here's where it gets frustrating: in about a third of the population the sciatic nerve actually pierces through the piriformis on its way down the leg. In this group of people, when the piriformis gets tight it kinks the sciatic nerve causing sciatica.
So to recap, somebody can have piriformis syndrome and not have sciatica, people can have sciatica and not have piriformis syndrome, and an unlucky third of the population will get stuck with both.
So what do you do?
Read my next blog to find out.