Sciatica vs. Piriformis Syndrome: How to Tell the Difference

Balanced Chiropractic Blog · Sciatica

Sciatica vs. Piriformis Syndrome: How to Tell the Difference

Same leg pain. Very different causes.

“Sciatica” gets used as a catch-all for leg pain, but not all leg pain is true sciatica. Piriformis syndrome can feel similar — and the right plan depends on where the irritation actually starts. Here’s how we help patients in Logansport make sense of it.

  • Clear patterns to watch for (disc vs. hip muscle vs. joint)
  • Common triggers: sitting, bending, walking, or training
  • When to stop guessing and get examined

First: What “Sciatica” Really Means

True sciatica typically involves irritation of the sciatic nerve pathway. Most often, that irritation originates in the low back (for example, disc-related issues or joint restriction), but it can also be influenced by the pelvis/hip region.

Common sciatica-type symptoms

  • Pain that travels from the low back/hip into the buttock and down the leg
  • Burning, tingling, numbness, or “electric” sensations
  • Symptoms that worsen with sitting, bending, or lifting
  • Occasional weakness, heaviness, or instability in the leg/foot

What Is Piriformis Syndrome?

The piriformis is a small deep hip muscle. When it becomes tight, irritated, or overworked, it can compress or irritate tissues near the sciatic nerve, creating sciatica-like pain.

More likely piriformis-related

  • Buttock pain is the main complaint
  • Symptoms flare with prolonged sitting or certain hip positions
  • Pain is reproduced with hip movement or deep glute pressure

More likely spine/disc-related

  • Symptoms travel below the knee more consistently
  • Worse with bending, coughing/straining, or lifting
  • Neurological changes (numbness/weakness/reflex changes)

What we do differently

We examine the low back, pelvis/hip, and leg mechanics to identify the source. Then we match care to your pattern — not a one-size-fits-all protocol.

See our sciatica approach →

FAQ

How can I tell if my pain is true sciatica?

If symptoms travel down the leg with nerve-type sensations (burning, tingling, numbness, weakness), especially below the knee, sciatica becomes more likely — but an exam is the best way to know.

Can piriformis syndrome cause numbness and tingling?

It can, but the triggers and exam findings often look different than disc-related sciatica.

When should I get checked?

If pain is worsening, affecting sleep, or you notice weakness, get evaluated. Seek urgent medical care for bowel/bladder changes, saddle numbness, or rapidly progressing weakness.

Ready for clear answers?

We’ll identify what’s actually driving your leg pain and map out a plan that makes sense.

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