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sciatica or piriformis syndrome


Piriformis Syndrome Muscle

What is the difference between Piriformis Syndrome and Sciatica?  I am addressing this topic today because I have seen it dealt with poorly by so many others.  Any time someone asks the question, “Is it Piriformis Syndrome or Sciatica?” I think they are mostly getting it wrong from the very beginning and have a poor understanding of how it all works.  This is not typically an either / or issue.  PIRIFORMIS SYNDROME is the result of irritation, tension, spasm, or Scar Tissue at the Piriformis Muscle for any number of different reasons — one of the most common being FASCIAL ADHESIONS and / or TENDINOSIS.  The Piriformis Muscle then affects the Sciatic Nerve.

People always seem to think of nerves as small and wiry.  I am here to tell you that the Sciatic Nerve is different.  It is a beast!  The Sciatic Nerve is both the biggest and longest nerve in your body —- as big around as your biggest finger (see picture below).  All of the nerves that exit from your low back grow together to make one nerve — the Sciatic Nerve.  Almost immediately after, the Sciatic Nerve comes through the little “hole” just below the Piriformis Muscle (see picture top left).  If there is a problem with the Piriformis Muscle, irritation to the Sciatic Nerve can occur at this point.  And just how common does Sciatic irritation by the Piriformis occur?   It is so common that UCLA’s Mount Sinai Medical School called Piriformis Syndrome the number one cause of Sciatica in a 2005 study (HERE).  Did you catch that?  Peer-reviewed research has called Piriformis Syndrome is the number one reason that people have sciatica.  Having over two decades in clinical practice tells me that they are probably correct.

People who author articles with headlines like, “Is it Sciatica or Piriformis Syndrome?” don’t get it.  Piriformis Syndrome, while not synonymous with Sciatica, is its number one cause.  This often times leads to the mistake I see almost everyone who has Piriformis Syndrome having gone through.  Their Sciatica, butt pain, and leg pain, is usually called “Disc-Related”.  In other words, someone saw something on an MRI of the lumbar spine (low back) that they have attempted to relate to the patient’s Sciatica.  While it’s true that DISC HERNIATIONS are also a major cause of sciatica, they are certainly not the only cause —- or as UCLA determined, the most common cause.

Fortunately, Dr. Schierling deals with large numbers of people suffering from Piriformis Syndrome.  He understands what you are going through.  It will help if you understand ASYMPTOMATIC DISC HERNIATIONS as well  For more information on the subject, HERE is a list of all his blog posts on Piriformis Syndrome.


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