the

True Sciatica VS Piriformis Syndrome

do you know the difference between

sciatica and piriformis syndrome well

they both cause the same symptoms but

there are actually two different

conditions that need to be treated

differently in today's video dr. David

Oliver who's a chiropractor is gonna

tell you about that difference true

sciatica and piriformis syndrome are

often confused there are two separate

conditions but they share very similar

characteristics and symptoms the word

sciatica is actually the issue here

sciatica is really just symptoms

sciatica is essentially irritation to

the sciatic nerve which causes pain to

go down your leg so your sciatic nerve

comes out of your lumbar spine here your

low back and it goes down through your

butt and goes down your the back of your

leg true sciatica comes from usually

some sort of impingement along the

Lombard nerve roots most common cause of

that is a herniation of a disc so if you

have a herniation of a disc just as in

right here you can see an impingement

upon the nerve root which can affect

that sciatic nerve which will cause

sciatic symptoms piriformis syndrome on

the other hand is due to sciatic type

symptoms as well this is where this gets

confusing but you have a piriformis

muscle which attaches this is your

sacrum it's the base of your spine goes

from your sacrum to your hip and

attaches right there it's a thin muscle

it's not a huge muscle but it's a muscle

that goes right there and your sciatic

nerve actually runs underneath that if

your piriformis muscle is dysfunctional

or too tight or in spasm it can compress

against that sciatic nerve and give you

symptoms down the leg so the real

difference here is where the problem is

either it's in the low back or it's in

the butt in the piriformis muscle itself

so with any type of sciatica type

symptoms so any pain going down the

sciatic nerve you can get everything

from shooting burning pain numbness and

tingling or even spasms that occur in

the leg so you're looking for a variety

of symptoms that travel down the back of

the leg essentially from the hamstring

into the calf that's generally the

course of sciatica type symptoms you can

get them into the foot as well when

we're looking for a generally pain

radicular pain or sciatica type pain

that travels down the back of

so if you have true sciatica again or

piriformis syndrome you can get very

similar symptoms as it's very confusing

but you need to differentiate this and

there's a couple different ways you can

look at this

most people with true sciatica or lumbar

disc herniation that's causing sciatica

will have more pain when they sit

because when you sit you compress the

disc which causes more herniation or

more progression of the problem

impinging the nerve gives more symptoms

whereas with when you stand you

generally feel at least a little bit

better this is not a definitive rule but

its general case for most people with

this

whereas with piriformis syndrome when

you sit you might not have as much

symptoms you might your symptoms might

be increased actually when you stand and

when you stand you actually tense that

muscle a little more and it could put

more compressive against the side of

nerve that's one way to differentiate it

the other way is to go through a few

tests just to see the simplest one for

the piriformis should just touch it so

literally take your hand or finger and

just kind of poke it around in your butt

and again you're looking for the hip and

the sacrum so to find your hip you go

right on the side II here there's a bone

and kind of knobby bone if you turn your

leg in and out it's called your greater

trochanter if you go from there and

slide inward with your thumb and just

kind of poke around if it feels really

tender one side versus another you may

have fear former syndrome that's

contributing through symptoms the other

way to test for the piriformis besides

just palpate and around and touching it

is if you lay on your back lay in your

bed or lay on the floor and you're gonna

essentially grab that knee as you bring

it towards you and you're gonna bring it

across your body if you feel a lot of

tenderness or a lot of pain in your butt

compared to the other side that's more

of a sign that it's that's the symptom

of your piriformis if you're looking for

a self-test for your low back or more of

a true sciatica or or symptom coming

from the lumbar spine this slump test is

really important that's where you kind

of sit in the chair and you really kind

of slouch into bad posture and really

hunched your head towards your legs and

see if that increases your symptoms if

it does that's more of an indication

that's coming from your lower back it is

confusing but they are two separate

conditions and it's important we treat

them separately so piriformis syndrome

if it's just purest form of syndrome we

can get away with doing a lot more

because we can go into more stretches

that involve a little bit of flexion so

you might see the standard figure four

stretch where you cross one leg over and

you pulled it like towards you you can

do just simple ball work or soft tissue

work on the piriformis muscle and just

try to release it generally we get more

response for that whereas if it's a true

sciatica symptom or true lumbar

radiculopathy coming from your low back

we want to look at trying to decompress

that so we don't really want to go into

a flexion type stress because you can

make it worse a couple of those

exercises in sciatica could be that

cat-cow the gentle mobilization of the

spine or that prone press up again we

have other videos you can reference back

to this you have to go through these

exercises extremely slow to make sure

that the right ones for you but again

it's really important to differentiate

is it coming from your back or is it

coming from your butt and you treat each

one accordingly all right we hope you

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