Patients often confuse true sciatica and piriformis syndrome, two separate conditions, but share very similar characteristics and symptoms. The presentation of Newtown piriformis syndrome is due to sciatic-type symptoms, which get confusing. You have a piriformis muscle, which attaches. Your sacrum is the base of your spine. The piriformis muscle goes from your sacrum to your hip, and your sciatic nerve runs underneath it. If your piriformis muscle is dysfunctional or too tight or in spasm, it can compress against that sciatic nerve and give you symptoms down the leg.

What is Sciatica?

Sciatica is irritation to the sciatic nerve, which causes pain to go down your leg. Your sciatic nerve comes out of your lumbar spine, back and goes down through your butt and the back of your leg. True sciatica comes from some impingement along with the lumbar nerve roots. The most common cause of that is a herniation of a disc.

What are the symptoms of sciatica and piriformis syndrome?

Therefore, the real difference is the location of the problem in the low back, butt, or piriformis muscle. So with any sciatica-type symptoms, any pain going down the sciatic nerve, you can get complications like shooting, burning, pain, numbness, tingling, or even spasms in the leg.

To differentiate between the two conditions, look for various symptoms that travel down the back of the leg, essentially from the hamstring into the calf, which is generally the course of sciatica-type symptoms. You can get discomfort in the foot but look for pain, radicular pain, or sciatica-type pain that travels down the back of the leg.

Typically, if you have true sciatica or piriformis syndrome, you can get similar symptoms which are very confusing. Fortunately, there are ways to help you differentiate the two. Most people with true sciatica or disc herniation causing sciatica will have more pain when they sit. When you sit, you compress the disc, which causes more herniation or more progression of the problem. Impinging, the nerve gives more symptoms, whereas when you stand, you generally feel at least a little bit better. You might not have as many symptoms with piriformis syndrome when you sit. Your symptoms might increase when you stand. Standing causes tension in that muscle and can put more compression against the sciatic nerve.

The other test involves taking your hand or finger and poking, looking for the hip and the sacrum. If it feels tender on one side versus another, you may have piriformis syndrome. The other way to test for the piriformis besides just palpating around and touching it is if you lay on your back, lay on your bed, or lay on the floor. Grab your knee and bring it across to your body. If you feel a lot of tenderness or pain in your butt compared to the other side, you have piriformis syndrome. If you are not satisfied with the self-test, contact Performance Pain and Sports Medicine for a more accurate diagnosis of piriformis syndrome.