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How to Tell if Your Sciatica is Actually Piriformis Syndrome

Dr. Tollestrup deciphers whether it's piriformis or sciatica.

Is your sciatica acting up, or do you have piriformis syndrome? You may be surprised at just how much these conditions get confused with one another. If you have chronic pain that radiates through your buttocks and lower back, it could mean that you’re living with piriformis syndrome. It’s not uncommon for these two conditions to be mistaken for each other. However, learning if you have piriformis syndrome can help you get on the right path for recovery. Let’s take a closer look at understanding the difference between these conditions and what you can do about it. 

Sciatica vs. Piriformis Syndrome

First, it’s important to know that sciatic and piriformis syndrome has many of the same symptoms. That’s why it’s so easy to mistake them for each other. However, the primary symptoms of piriformis syndrome include:

  • Pain in the buttocks that is worse when sitting
  • Pain in the opposite sacroiliac joint 
  • Pain when sitting or standing for 20 minutes 
  • Iain when sitting or squatting down 
  • Pain that is felt from the sacrum down the back of the thigh that usually stops just above the knee 
  • Pain that lessens with movement 
  • Numbness of the foot

The main thing to remember is that the underlying causes of these conditions are different. Sciatic is a series of symptoms that are caused by another issue, such as a herniated disc. Piriformis syndrome occurs when your sciatic nerve is irritated or compressed by your piriformis muscle, deep in your pelvis.

Piriformis Syndrome Self Test

While your doctor can fully evaluate you to determine if you have piriformis syndrome, you can also conduct a preliminary self-test at home. Here are some tips for doing that. First, you should determine if the pain is worse when you are sitting down. Pay attention to if you have pain or numbness in the buttocks and/or back of your legs. If you don’t have this pain or discomfort, then it is unlikely that you have piriformis syndrome. 

If you answered yes to these questions, then it’s time to move forward with the rest of your self-test. Try pressing on the muscle in each buttock. Press slightly in the middle of the cheek. If you experience pain on one or both sides, then you may have piriformis syndrome. 

You can also try what is referred to as the “straight leg test.” You should ask a family member or friend to help you with this test. Lie flat on your back on a hard surface. WIth someone helping you, raise your legs one at a time. As you do this, let the person helping you know when you feel pain. If you notice pain at the 30 and 90-degree angles, then it is likely that your sciatica is irritated, which could be a sign of piriformis syndrome. 

Piriformis Syndrome Exercises You Should Do

To help relieve some of the pain associated with piriformis syndrome, your doctor may suggest a series of exercises. Here are some of the common exercise you should do:

  • Hip rotator stretches
  • Lower abdominal strengthening
  • Piriformis stretches 

Piriformis Syndrome Exercises to Avoid

There are certain exercises you should avoid if you have piriformis syndrome. If you’re an office worker that sits regularly, you should likely avoid doing exercises in a sitting position as this could make your condition worse. Specific exercises that you should avoid are those that overwork the aggravated area, such as the exercise known as “the clam.” 

Common Questions about Piriformis Syndrome

There are many popular questions that people have when it comes to piriformis syndrome. Here are some of the ones that we commonly get. 

Can you have piriformis syndrome and sciatica at the same time?

It’s important to understand that these are two different conditions that are largely identified by the type of pain that you have. So if you experience pain in your hips and buttocks only, then it is likely piriformis syndrome. If you have pain in your legs, more so than your lower back, then it is likely sciatica. 

Is walking good for piriformis syndrome?

It’s important to listen to your body. Walking can often make piriformis syndrome symptoms worse. Once you start stretching and treating the area, you may be able to build up to short walks. 

How to sleep with piriformis syndrome?

Proper sleep helps the body heal, but that can be a challenging thing to do when you are in pain. Sleeping can be difficult for people with piriformis syndrome. It is noted that sleeping on your side with a pillow between your knees can reduce pressure and offer some comfort. 

How can you tell the difference between a herniated disc and piriformis syndrome?

One of the ways that you can tell the difference between a herniated disc and piriformis syndrome is the location of the pain. Piriformis syndrome causes pain in the buttocks, while a herniated disc can occur in all areas of the spine, so the pain from this can be in the lower back as well as other areas such as the shoulder or the arm. 

Learning more about piriformis syndrome can help you better identify if you may have the condition. If you have ongoing pain in your lower back and buttocks, then make sure that your doctor is aware. It’s important to correct this issue as soon as possible so you can have better mobility and no pain. 

Contact Dr. Tim Tollestrup

Are you concerned that you’re living with piriformis syndrome? If so, allow Dr. Tim Tolelstrup to help. He can help you understand your condition and learn about treatment options that could work for you. Contact our office today to schedule an appointment. We look forward to helping you get back to feeling your best.