Sciatica vs Piriformis syndrome
Both conditions relate to the Sciatic nerve.
The Sciatic nerve is around the width of our little finger and is also the longest nerve in the body.
It has five roots and can have multiple causes that create nerve compression.
What is Sciatica pain?
Sciatica is when the sciatic nerve is compressed from a slipped disc or from the vertebrae itself, creating pain down from the lower back down the leg to the foot, and is usually felt in one leg only and can be felt as a sharp, shooting pain, an electric, burning sensation, or a throbbing pain like a toothache in the buttock (gluteal) area and goes into the leg. You might not be able to sit, walk or sleep comfortably.
Sometimes surgery may be required to free off what ever is causing the tension around the sciatic nerve.
What is Piriformis pain?
Piriformis syndrome is when the piriformis muscle spasms causing glute pain. This can be due to overactive or under active Glute muscles. This condition can also then compress onto the sciatic nerve sending pain from the glute down to the leg. So although the symptoms of pain are similar between sciatica, it's more down to the piriformis muscle itself.
The sciatic nerve runs very close to the piriformis muscle and sometimes in 20% of people can run directly through the muscle. Therefore, the piriformis muscle can easily have an impact on the sciatic nerve.
Through exercise and physical treatment this condition can be eased off.
In jobs which require us to sit for long periods e.g. desk work, HGV driver, this will compress the piriformis and glutes and overtime will weaken the muscle as they're in a relaxed state for prolonged time periods.
There are a few cases when massage/manipulations can't help:
- The case of a bone spur (osteoarthritis), when the bone grows into the nerve. Sometimes a minor surgery of shaving the bone can massively improve the situation.
- If the disk has massively degenerated and the Sciatic nerve gets compressed.
- Spinal stenosis – is the narrowing of the spinal canal, this narrowing reduces the space for the nerve and as a result, it can create Sciatica pain.
Cases when we can help:
- A common one is a herniated or slipped disk. The disk will compress the nerve especially when you move in a certain position that is squeezing the disk. In this case, in our treatments, we pay attention to the lumbar area: Quadratus lumborum, Erector spinae, and Psoas muscles. Working on them we can relax the area so the disk can settle back into its place.
If the degeneration has gone too far then surgical intervention is needed.
-The sacroiliac joint can be another factor that can irritate the Sciatic nerve. The joint where the spine and the pelvis connect can get inflamed which can affect the Sciatic nerve.
- Piriformis syndrome
These stretches can be very helpful for Piriformis pain