A large amount of confusion and misunderstanding exists concerning the conditions sciatica and piriformis syndrome. There are some who insist that the two conditions are actually the same thing, but even though they can have symptoms that are very much alike, the underlying causes differ.
Sciatica refers to irritation of the sciatic (often mis-spelled as syatic or psyatic) nerve, that arises from nerve roots in the lumbar spine. The most common cause of sciatic nerve irritation, or "true" sciatica is compression of one or more of its component nerve roots due to disc herniation or spinal degeneration in the lower lumbar region. Sciatica usually begins in the buttock area and, depending on the severity of the underlying nerve comression and inflammation, may extend down the entire leg to the ankle and foot.
Piriformis syndrome, also known as "pseudo-sciatica" (meaning "false sciatica"), is actually referral pain and other symptoms (tingling, numbness, etc.) caused by tight knots of contraction in the piriformis muscle, which attaches to the upper femur bone and then runs across the back of the pelvis to the outside edge of the sacrum, the triangular pelvic bone at the base of the spine. The symptoms of piriformis syndrome are very similar and may be indistinguishable from true sciatica.
In some cases, piriformis syndrome may cause true sciatic nerve irritation, as the sciatic nerve may run underneath or even through the middle of the piriformis, so contraction of the piriformis may produce sufficient compression of the sciatic nerve to produce actual nerve symptoms. This is one of the main sources of confusion when it comes to distinguishing true sciatica from piriformis syndrome.
As mentioned earlier, the symptoms of true sciatica are very similar to piriformis syndrome. Both cause pain, tingling, burning, "electrical shock" sensations, and/or numbness down the leg, often all the way to the foot. In addition, both sciatica and piriformis syndrome tend to be at least partially related to biomechanical functional problems in the joints of the back and pelvis and they may even be present simultaneously in the same person, so it an be difficult to tell them apart.
But since the most effective treatment for the two conditions varies signficantly, it is important to determine the correct diagnosis if at all possible. In most cases there is an easy way to distinguish between sciatica and piriformis syndrome.
In most cases,sciatica can be differentiated from piriformis syndrome with a couple of simple test maneuvers. To begin, from a seated position, one straightens the knee on the side of sciatic pain, holding the leg out straight and parallel to the floor, and if this position causes an increas in symptoms, it is a good indicator of true sciatica.
The second is done in two parts. First, from the sitting position one bends the leg and pulls the knee on the painful side towards the same-side shoulder. In all but the most severe cases, there is usually no major increase in pain in this position. The second half of the test is to stretch the knee (on the painful side) towards the opposite shoulder. An increase in the sciatica-like symptoms is a strong indication of piriformis syndrome.
It is important to distinguish between sciatica and piriformis syndrome, because the treatment for the conditions varies, and getting the diagnosis right typically leads to more effective treatment.
By: Dr. George Best
Piriformis muscle Syndrome or Sciatic Nerve Pain Treatment.
There is considerable confusion regarding the conditions sciatica and piriformis syndrome. Some think that they are the same thing, but although they have very similar symptoms in many.

I’m going to share with you some of my favorite exercises to relieve sciatica related pain in the lower back, buttocks, legs and feet. This can be a very painful condition that seems to haunt people with pain no matter what they do. The great thing is there are easy ways to relieve the pain.
There other causes which include when you spinal canal ends up narrowing and puts pressure on the nerves. 15% of people suffer from piriformis syndrome. This is where a nerve runs through the middle a muscle, instead of underneath it. When the , the nerve is compressed and you will feel pain.
The term Sciatica is the word commonly used to refer to pain, tingling, numbness, or weakness in the leg caused by compression or an injury to the sciatic nerve, located in the back of the leg. People who suffer from severe Sciatica definitely know the meaning of the word "pain".
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So you have been diagnosed with sciatica and even though your doctor explained to you about the condition, you have come looking for a bit more information on sciatica.
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Lumbar Spinal Stenosis: This is the narrowing of the spinal canal causing sciatica type symptoms. Disk problems and arthritis of the spine can cause this narrowing.

Sciatica is known as a nightmarish back and leg pain syndrome which often resists even the most seemingly appropriate treatment modalities.
eakness in the lower extremities.
There is simply little evidence that most of these conditions cause any health concerns in the majority of diagnosed patients. Some unfortunate individuals certainly do suffer from physically induced pain due to structural of the spinal column. However, most sciatica patients are misdiagnosed when their pain is blamed on innocent, normal and completely expected facets of spinal aging. Remember… Spinal arthritis, stenosis and intervertebral disc conditions are all typical side effects of getting older.
This process is known as ischemia and is also sometimes called an oxygen deprivation pain syndrome. Every anatomical structure requires oxygen in order to exist and function properly. Nerve tissue is the most susceptible to even the tiniest levels of reduced oxygenation. It is no surprise that ischemia can have such dire and immediate effects on the sciatic nerve, since the nerve reacts violently the moment the oxygen supply is reduced. The autonomic system regulates oxygen supply throughout the body using the circulatory system. Small degrees of arterial constriction will reduce cellular oxygenation, while small degrees of arterial dilation will increase blood oxygen content. This is a stealthy and virtually invisible process which leaves no evidence of its occurrence, except for trace elements in the nuclei of affected cells.
Ischemia is indeed the most logical explanation for non-responsive and long lasting cases of sciatica. It is also the root cause of a number of poorly managed health concerns, including fibromyalgia, tendonitis, carpal tunnel syndrome, migraine and tension headaches and a tremendous assortment of gastrointestinal concerns. Ischemia is an even greater problem than it first appears to be, since it is most commonly driven by a psychosomatic symptom imperative. Given the Cartesian philosophy embraced by the modern medical establishment, it is no surprise that the overwhelming evidence supporting ischemic pain is systematically swept under the rug. After all, ischemia is easily treated and the cure is free for patients to enact using the basic principles of knowledge therapy. Remember too that the economic bottom line in the medical professions is the most basic directive as to effective treatment for any health condition. If a therapy goes against the idea of making money, it is typically arbitrarily ignored…

The second mistake sciatica sufferers often make is returning to normal activities too quickly once symptoms improve. The vast majority of true sciatica cases are due to bulging or herniation of one or more discs in the lumbar spine, and the inflammation that typically is associated with such disc problems. An amazing amount of symptomatic improvement is often achieved with just a small reduction in inflammation. Many sciatica victims mistakenly believe they are back to normal as soon as they feel better, but the reality is that the bulging/herniated disc is far from fully healed, and too much exertion too soon can easily trigger a recurrence of symptoms - sometimes even more severe than they were to begin with. Even professional physical therapists sometimes make the mistake of pushing a patient to do too much too soon, with the result being a return or increase in sciatica symptoms.
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Physiotherapy - this is something that I have not had any success with in dealing with my sciatica, however combined with the right exercises and assuming that your condition is suitable to be treated this way there is no reason not to give it a go. Many doctors see physiotherapy as the first step to easing the problem and once again the blood flow in and around the muscles and loosening of joints may be beneficial to you.
The word sciatica is used by most people suffering leg pain. Many low back pain sufferers can also suffer from sciatica. Even though the term is used frequently many other conditions can be mistaken for sciatica.
r chemical irritation from the inflammatory process.