Sciatica or Piriformis Syndrome: The Symptoms May Be Similar
The sciatic nerve is the largest nerve in the body that starts in the lower back and runs down both legs. Sciatica pain occurs as the result of a spine or disc condition that compresses part of the nerve, causing inflammation, extreme pain and even numbness from the low back down throughout the leg. The most common symptoms of sciatica pain include weakness, numbness and tingling in the low back that radiates down the side of one of your legs. The pain is rarely experienced in both legs and it’s described as a sharp, shooting type of pain, explains Edi Woods, massage therapist at Elements Indianapolis North.
While many people seek relief from sciatica pain symptoms as described above, many may actually be suffering more from a muscular issue, rather than a true sciatic nerve condition. In Woods’ experience, the muscular condition of piriformis syndrome is often more common in people, but may not always be accurately detected, as it can compress the sciatic nerve and imitate pain similar to sciatica.
“I see clients with sciatica-like symptoms frequently in my practice”, explains Woods. “But, from a muscular standard it’s usually more of a piriformis muscle issue than true sciatica. The piriformis muscle is one of our deep lateral hip rotators that extend into the glute area. It can get inflamed, contracted and can compress the sciatic nerve as well. When this happens, it mimics the sciatica condition, which people are more commonly aware of. So, a lot of people may come in saying they have sciatica, but in reality more times than not it’s piriformis syndrome.”
Causes Range from Health Conditions to Activity Induced
True sciatica pain can happen to anyone since any of us can develop a disc disorder like herniation or degeneration. The cause in these long-term conditions could be hereditary or the result of a lifestyle event like an accident or injury that creates prolonged compression on the sciatic nerve. Pregnant women also have a tendency to develop a temporary sciatica condition as the weight from carrying a baby either pinches or puts extra pressure on the sciatic nerve.
But, for the majority of the people that Woods treats who seek relief from what they call sciatica pain, the cause tends to be muscle overuse from runners, walkers, cyclists, etc. who push their bodies through a constant forward leg motion. When this happens, a trigger point develops in the piriformis muscles, which can compress on the sciatic nerve and cause similar sciatica-type symptoms.
“When I have clients who are coming to me with sciatica-type symptoms, I don’t treat the nerves, but rather the muscles that are compressing on the nerve,” explains Woods. “To work on someone with sciatica symptoms, I’m going to first focus on the piriformis muscles, which are located in the middle of each glute, and then move on to the gluteus muscles, hamstrings and sacrum. I prefer to use a mix of trigger point therapy and a stretching routine in all of these areas because everything is connected and pulling on each other.”
Alternative Treatments May Help with Addressing Pain
Since true sciatica is typically the result of a herniated or degenerative disc, the medical community recommends surgery as the number one way to remedy the condition, says Woods. However, there are other ways to address the pain before you get to the surgical table. Woods suggests a mix of heat, ice, pain medications, physical therapy, stretching and regular massage therapy as possible alternative solutions to help alleviate the pain associated with both sciatica and piriformis syndrome. And, contrary to what you might expect, Woods also advises her clients suffering from sciatica symptoms to stay active, continue exercising and stretching. If you stop all activity, the area is more prone to locking up muscularly, compressing on the nerve more and increasing your level of discomfort.
“A lot of people think that they have to have surgery right away if they feel sciatica-type symptoms,” explains Woods. “But, what they’re feeling could actually just be the result of tight piriformis muscles that can be treated by massage therapy sessions that focus on the glutes and lower back areas. Their symptoms can be relieved and they won’t have to have surgery.”
“It’s important for people to realize that sciatica symptoms are something that can be treated with massage in cases when the cause isn’t really a disc issue, but is rather tight piriformis muscles,” concludes Wood.
If you’re experiencing sciatica-like symptoms in your lower back and glute areas, seek the advice of a medical professional to determine whether your symptoms are true sciatica or piriformis syndrome. In both cases, massage therapy can help alleviate pain in both the long-term and short-term. Just realize that you have options when it comes to treatment and make sure to explore all possible diagnosis and treatment plans, advises Woods.