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Sciatica vs. Piriformis Syndrome - By Nicola Grice, RMT

Not too long ago I noticed that Jody had educated his Facebook followers on Sciatica vs. Piriformis Syndrome and I thought "oooooh what a great idea". So here I am, paying it forward. I can't count the number of times as both a student and, more recently, an RMT that a client has come in stating they have sciatica, or rather what they think is sciatica


If you were to tell someone you have sciatica, chances are they know you are suffering from an intense shooting leg and buttock pain. Yet tell someone you have piriformis syndrome and they likely won't know what you’re saying. Piri what?

Now here comes the science of Sciatica.....

The term “Sciatica” is actually incredibly over used. Some people at the first sign of buttock pain automatically claim it is sciatica. This term is perhaps more of a description than a clinical diagnosis but is now so commonly used as the latter. True “Sciatica” is an irritation of the sciatic nerve, the large nerve that runs from the back through the buttock muscles, continues down into the back of the leg and splits when it gets to the back of your knee cap (patella). The nerve can be irritated by joints in the low back, a disc herniation, or a muscle entrapment by a muscle other than that which I'm about to talk about.

Still with me?

When the sciatic nerve becomes entrapped in the piriformis muscle, the resulting pain is called Piriformis Syndrome aka "Pseudo Sciatica". Piriformis syndrome, in addition to causing buttock pain that may also radiate down the leg, may also present with pain that is relieved by walking with the foot on the affected side pointing outward. This position externally rotates the hip, lessening the stretch on the piriformis and relieving the pain slightly. Piriformis syndrome is also known as “wallet sciatica” or “fat wallet syndrome,” as the condition can be caused or aggravated by sitting with a large wallet in the affected side’s rear pocket

There are several ways an RMT can assess where the sciatic pain is coming from. Often that means ruling out conditions such as disc herniations or lumbar muscle strain and performing tests that stress and stretch the piriformis muscle.

It is important to distinguish between sciatica and piriformis syndrome. The treatment for these conditions varies and getting the diagnosis right typically leads to more effective treatment. If these symptoms seem familiar to you, come and see a Tonume Integrated Health massage therapist for an assessment. By releasing the muscle tissue in the area, you may find relief in just a few treatments. We are a clinic dedicated to the health of the community through massage therapy, naturopathic medicine and chiropractic care. We are located on the Drive in Vancouver, BC.

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