Sciatica and Piriformis Syndrome Pain Relief

Have you ever been told you have sciatica?

Or have you done an internet deep dive and decided that, based on your symptoms, you are most likely dealing with sciatica pain?

What if I told you that it may not actually be sciatica?

How to know if you have sciatica or piriformis syndrome vs. back pain:

Sciatica and piriformis syndrome are generally differentiated from lower back pain based on location and behavior of symptoms.

Low back pain	Sciatica/piriformis syndrome
Pain may be aggravated by bending forward, backwards, or rotating Pain is localized to the back Numbness & tingling are typically not present	Pain is usually worse with forward bending, sitting, lying on your side, or rotating the spine towards the symptomatic side Numbness, tingling, or paresthesia present Pain begins in the back but radiates down the leg (typically through the buttocks, back of the thigh, sometimes into the side or back of the leg and the foot)

If sciatica and piriformis syndrome have similar symptoms, what is the difference?

Roughly, fewer than 10% of all lower back and leg pain cases are related to true sciatica.

Sciatica refers specifically to an L5/S1 disc herniation with nerve impingement - the nerve compression affects one of the nerve roots that make up the sciatic nerve thus leading to radiating symptoms down the leg. And this kind of nerve impingement can only be confirmed on an MRI scan.

If you’re searching for at-home sciatica treatment or trying to manage pain without clear imaging, keep in mind: what you’re experiencing may not be “true” sciatica.

So Why Does it Matter if you have Sciatica or Piriformis Syndrome?

You might ask: if the symptoms are similar, why does it matter if your symptoms are due to sciatica or piriformis syndrome?

Determining the root cause can help you and/or your care team

• Determine your prognosis and length of time to rehab

• Direct treatment towards the underlying structure causing your pain

• Choose and implement correct stretching & strengthening exercises

What causes piriformis syndrome?

The symptoms you’re feeling may actually be caused by irritation of the lumbar facet joints, leading to pain referral into the glute, SI joint, or upper thigh.

If pain radiates into the leg, it could be due to sciatic nerve entrapment in one of the muscles the nerve passes through. The most common place for this entrapment is the piriformis muscle. Because the sciatic nerve pierces through the piriformis, overuse, fibrosis, and tightness can lead to piriformis syndrome—which often presents almost identically to sciatica.

The Top 3 Exercises for Piriformis Syndrome Relief

If your pain is caused by piriformis syndrome rather than true sciatica, these strategies may help:

1. Strengthen your hips: Focus on the hip abductors and external rotators, especially the glute medius and minimus. Weakness here can lead to overuse of the piriformis.

2. Perform myofascial release: Use a foam roller or lacrosse ball to target the piriformis muscle.

3. Stretch your piriformis: Lie on your back, internally rotate your hip, and adduct it across your body for a deep stretch.

   

   
   

These piriformis stretches and exercises are often included in online physical therapy programs for sciatica relief, since they can reduce pressure on the nerve and restore mobility.

Other Common Conditions That Mimic Sciatica

Piriformis syndrome is a frequent culprit, but other conditions can cause similar symptoms, including:

• Hamstring tendinopathy or chronic hamstring strain

• Low back muscle strain

• Lumbar facet arthropathy with facet referral

This is why getting the right diagnosis is so important before starting any rehab or exercise plan.

Next Steps for Sciatica Pain Relief

If you’re struggling with sciatica symptoms or ongoing lower back and leg pain, it’s not always easy to know the true cause on your own. A tailored approach is the fastest way to find lasting relief.

At Elevate Performance & PT, we specialize in virtual physical therapy for back pain, sciatica relief, and orthopedic rehab.

If you’d like help determining the root cause of your symptoms, schedule a free consultation call today to discuss your pain and the next steps for getting back to the activities you love.