Sciatica can be a difficult condition to pin down, and confusing the issue there is also a condition that is commonly called “pseudo-sciatica.” The condition is called piriformis Syndrome. It has different causes from sciatica, but it mimics the symptoms so it won’t be a surprise if you and your doctor believe that it’s sciatica.
Sciatica is caused by the compression of the sciatic nerve by a slipped or herniated disc. This nerve runs from the lower back, through the buttocks and all the way down to the feet and toes. This means that you will experience pain throughout your lower body from this condition.
Piriformis syndrome is uncommon, but causes the same kind of compression. The piriformis is a flat muscle just above the buttocks. This muscle spasms and pinches the sciatic nerve, causing the same sort of pain as sciatica. However, it only seems to be sciatica. Sciatica is generally caused by compression caused by the discs in the back, so when the piriformis muscle is the culprit, it may cause some confusion.
Despite the name, there is nothing imaginary about “pseudo” sciatica. The sciatic nerve is being pinched and compressed in the same manner, just from a different cause. The pain is just as real and the “pseudo” in the name just refers to the fact that the syndrome falsely appears like sciatica.
Despite how similar the syndrome is to sciatica, there are two simple physical manoeuvres that can be used to distinguish between the two. This, of course, depends on a patient only having one or another of the conditions. If you have both conditions at the same time, these will not work. The first position is done this way: from a seated position, straighten the leg in which you are having pain, so that your leg is parallel with the floor. If the symptoms increase, there is a good chance that what you have is true sciatica.
The second position is achieved in two steps. Again, take a sitting position. Then, in the leg in which you have pain, bring the knee up to the shoulder on the same side. While this may sound painful, it generally isn’t except in the most severe cases. Once you have done this, move your knee over toward the opposite shoulder. If there is an increase in pain, there is a good chance that you are suffering with piriformis syndrome.
As the name implies, the symptoms are very similar to regular sciatica. The major symptom is pain and burning down the length of the nerve, from the buttocks to the feet. It usually affects only one side of the body, and can be more intense when you are sitting, or after sitting for a long time.
The main difference between regular sciatica and piriformis syndrome is that it often causes more intense pain in the hip, to the point where it can actually cause the patient to limp or have other difficulty walking. Conversely, people with pseudo-sciatica generally don’t have pain in the thigh. Unfortunately, these differences can appear very slight and may not be enough to give doctors a clue what is causing the pain.
Pseudo sciatica can be caused by poor posture or exercise related injury. This is very unlike the causes of regular sciatica, which are often being overweight or not being active enough. Regular sciatica is also often a side-effect of pregnancy.
Pseudo sciatica can also be caused by sitting too long at a computer with your head protruding to look at the screen. It can also be caused by muscular overuse, as in when a parent repeatedly lifts a child into a car seat in the rear of a car. Men can also develop this syndrome by sitting to long on a hard seat with a wallet in the back pocket.
The options for treatment of the syndrome will generally be very similar to the options available for regular sciatica. These include painkillers, anti-inflammatory medicines and physiotherapy. There are exercises you can do to help relieve pain and lessen the nerve compression that you piriformis muscle is causing.
Leg and Knee Stretch
One of the simplest and easiest ways to relieve pain is through a very basic leg stretch. Lie down on the floor with your legs straight. Then bring one knee up to your chest and hug it to you. Then slowly move it toward your opposite shoulder, so that your leg is stretched across your body diagonally. You should be feeling a stretch in your hip and buttock. Hold the stretch for a few seconds, then release it and repeat the stretch on the other side. Lie on the floor with your legs straight. Bend one knee into your chest, hugging it with your arms. Slowly bring the knee up towards your opposite shoulder, stretching it across your body. You should feel a decent stretch through your hip and buttock area. Hold the stretch for several breaths, then release and repeat on the opposite side.
A yoga pose called Parivrtta Trikonasana, also known as the revolved triangle pose, is able to stretch the piriformis muscle. This is a little more intense than a leg stretch and it will be important to consult with your doctor before you attempt it. However, once you have gotten the go-ahead, you’re ready to work on your yoga.
To perform this pose, come into a push-up position with your arms straight. Lift your buttocks towards the ceiling, coming into an inverted “V” shape pose. Step your right foot up between your hands. Keeping your left hand on the ground, revolve your chest towards the ceiling, bringing your arm straight up over your head so that it is pointing toward the ceiling. Don’t support your body with your left arm, rather support it with the muscles in your back. This position is meant to stretch your back and buttocks, so it’s important that you are using those muscles. Hold the pose for 30 seconds, then return to downward-facing dog pose and repeat on the opposite leg.
As with any condition, it is important to know what the root cause of your pain is. Treatment for regular sciatica is not going to be useless, but obviously it will be more effective if you and your doctor understand what you have before you begin with treatment measures.
“Pain Management Health Center: Piriformis Syndrome.” WebMD. http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments.
“Back Pain Health Center: Pain Management and Sciatica.” WebMD. http://www.webmd.com/back-pain/guide/sciatica-symptoms.
“What is ‘Pseudo’ Sciatica?” spinalhealthcare. http://www.spinal-healthcare.com/article.php?article_id=69.
“Revolved Triangle Pose.” by Natasha Rizopoulos. Yoga Journal. http://www.yogajournal.com/basics/2314.