Sciatica vs Piriformis Syndrome in Faridabad: How to Tell the Difference

Why Differentiating Matters

Buttock pain radiating down the leg -- commonly called "sciatica" by patients -- has two very different causes that require different physiotherapy approaches. True sciatic radiculopathy from lumbar disc herniation or spinal stenosis requires different treatment from piriformis syndrome (sciatic nerve irritation by the piriformis muscle). Treating one as the other delays recovery significantly.

True Sciatic Radiculopathy

Caused by: lumbar disc herniation (L4/5, L5/S1 most common), lumbar spinal stenosis, or spondylolisthesis. Key features: lower back pain usually present (though not always), pain follows a specific dermatomal pattern (sciatic nerve dermatomal distribution), pain provoked by lumbar spine movements (particularly flexion), straight-leg raise (SLR) test positive at under 60 degrees, may have neurological signs (weakness, reflex changes).

Piriformis Syndrome

Caused by: piriformis muscle spasm or trigger points irritating the sciatic nerve. Key features: deep buttock pain is the predominant complaint (rather than lower back), pain worsens with sitting (direct pressure on piriformis), pain worsens with hip internal rotation (stretches the piriformis), local tenderness in the deep buttock over the piriformis muscle, Pace test (hip flexion, abduction, external rotation against resistance) provokes pain, SLR often less positive than in true radiculopathy.

Treatment Comparison

Sciatica: neural mobilisation, lumbar traction, McKenzie exercises, core stabilisation. Piriformis syndrome: piriformis stretching, dry needling, hip strengthening, neural mobilisation of the sciatic nerve.

Accurate Diagnosis in Faridabad

At Realign Rehab Clinic, NIT-5, Faridabad, we accurately differentiate these conditions for targeted, effective treatment. Book your assessment today.