What is Piriformis Syndrome and Sciatica, and Are They the Same?
Piriformis Syndrome and sciatica share similar symptoms, but different causes. Massage can significantly help the symptoms associated with piriformis syndrome and sciatic pain; however, the root cause needs to be identified first. Let’s explore each condition below.
What is Sciatica?
Sciatica (often referred to as lumbar radiculopathy) is a condition that involves pain caused by compression of the sciatic nerve roots. This compression can be due to a disc herniation at the lumbar spine, narrowing of the spinal canal (stenosis), bone spurs or compression of the sciatic nerve by other structures.
According to the Harvard Medical School, as many as 40% of the population will suffer sciatica during their lifetime, and the pain associated with sciatica can be debilitating. The likelihood of occurrence tends to increase with age. Other risk factors include a history of back pain, a sedentary lifestyle, excessive weight gain, and cigarette smoking.
The pain, numbness and/or tingling sensations caused by this condition can travel from the low back down to the hips/glutes and down the leg as far down as the foot. The pain or discomfort of sciatica is usually experienced on one side of the body.
Diagnostic tests such as muscle/nerve tests and imaging will help identify if the sciatic nerve root compression is due to a disc herniation or degenerative disc disease. If these are ruled out, the pain experienced may be attributed to Piriformis Syndrome.
What is Piriformis Syndrome?
Piriformis syndrome is caused when the sciatic nerve is compressed by the piriformis muscle.
This compression can be due to a spasming of the muscle itself, or pressure put on this area caused by prolonged sitting.
If not treated, piriformis syndrome can lead to sciatica.
Symptoms of Piriformis Syndrome
Some of the symptoms associated with piriformis syndrome can mirror sciatica.
- Lower back pain
- Pain in the hip that can radiate to the rear of the leg
- Posterior hip pain
- Numbness or tingling sensations in the leg that can travel to the foot
Symptoms that are specific to piriformis syndrome include:
- Pain, numbness or tingling sensations in the buttock with prolonged sitting
- Pain when ascending stairs
Medical Massage Therapy
Massage therapy can significantly reduce the pain associated with piriformis syndrome by relaxing the muscles to help reduce the pressure on the nerve. The muscles and nerves involved in this condition are found in the deeper layers, so it is important to seek a licensed massage therapist who has received advanced training in the science of medical-massage.
A thorough understanding of anatomy, how the body moves, as well as an understanding of fascia, is necessary to effectively address the areas surrounding the sciatic nerve.
Active Release Techniques (ART)®
An Active Release Techniques® practitioner is trained to not only treat the piriformis muscle but to assess and address other necessary soft tissue structures that may be trapping the nerve throughout its course. In addition to the Piriformis muscle, it is important to look at the deep hip rotators (superior gemellus, inferior gemellus, internal obturator, and the quadratus femoris), as well as other areas along the sciatic pathway when treating this condition.
Active Release Techniques® is a “patented, state of the art soft tissue system/movement-based massage technique that treats problems with muscles, tendons, ligaments, fascia nerves.”
A full-body Active Release Techniques® Practitioner has completed a rigorous course of study and is qualified to assess and treat a multitude of conditions.
The classroom component for this certification requires the therapist to complete nearly 60 hours of hands-on work, followed by an exam for the three regions of the body (upper extremity, lower extremity, and spine). In addition to the hands-on practical component, several months of preparatory work is necessary to successfully achieve certification.
Piriformis Syndrome and sciatica have similar signs and symptoms, but the causes differ. Piriformis Syndrome involves the sciatic nerve at the hip and is often due to pressure placed on the nerve by the Piriformis muscle and other muscles of the posterior hip. Sciatica originates at the lower back and can be due to herniation at the lumbar spine, narrowing of the spinal canal (stenosis), bone spurs, or compression of the sciatic nerve by other structures.
Massage Therapy techniques such as medical massage and Active Release Techniques® can help reduce the pain and discomfort associated with Piriformis Syndrome. It is important to seek a massage therapist with extensive training in medical massage to treat this condition effectively.
Richard A. Lehman, LMT, CSCS
Compliment Your Body LLC has been providing in-home and corporate/event chair massage for New York City since 2004. You are safe in our hands!
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