These two terms are often associated with back or buttock pain and may sometimes be used interchangeably. But are they really the same thing?
Anatomy of posterior hip
To understand both conditions, we can first look at the structures in the back of the hip joint. One of the major nerves that can be found near the buttock is the sciatic nerve: a large nerve that is formed from the spinal nerves at the end of the spinal cord. It exits the pelvis beneath the piriformis muscle and continues down the back of the thigh bone. It provides sensation to most of the leg and activates the muscles of the leg and foot. This nerve is the namesake for which sciatica is named after.
Is sciatica the same as piriformis syndrome?
The short answer is no. Sciatica is a general term to describe pain travelling down the back of the leg from the buttocks. One possible cause of sciatica is nerve entrapment along the nerve of the lower back and sacrum by disc bulges or narrowing of the spinal canal (resulting in pain along the areas of the body which the nerve supplies). Sciatica by nerve entrapment can be accompanied by neurological signs like numbness, weakness, or inability to control functions of the bowel or bladder.
Piriformis syndrome, which is the term used to describe compression of the sciatic nerve as it leaves the pelvis by an irritated piriformis, is also another cause of sciatica. In this case, it is not accompanied by neurological signs.
In summary, sciatica is a broad name describing pain travelling down the leg from the buttocks, whereas piriformis syndrome is a condition that can cause sciatica. Usually, physiotherapy, regular stretching and self-release of the piriformis can effectively treat sciatica caused piriformis syndrome.
However, if your sciatica has neurological signs your physiotherapist may refer you on for further assessment and treatment.