The Short Answer
True Sciatica is caused by a disc herniation in your spine pressing on the nerve root. Piriformis Syndrome is caused by a tight muscle in your buttock trapping the nerve further down. If your back doesn't hurt but your leg does, or if sitting makes it worse, it's likely Piriformis Syndrome. The good news? Both are caused or worsened by adhesions, and both can be treated without surgery.
You have a sharp, shooting pain running down the back of your leg. Your doctor says "Sciatica." Your MRI shows a "mild bulge." You get an injection, but the pain comes back.
Why? Because you might not have a back problem at all. You might have a butt problem.
The sciatic nerve is the longest nerve in your body. It starts in your lower back, runs through your hips and buttocks, and goes all the way down to your feet. Because it travels such a long distance, it can get trapped in multiple places.
The "Fake" Sciatica: Piriformis Syndrome
Deep in your glutes lies a small, pear-shaped muscle called the Piriformis. The sciatic nerve runs directly underneath it (and in some people, right through it).
When this muscle gets overworked, injured, or stuck in a seated position for too long, it develops adhesions (scar tissue). These adhesions glue the muscle to the nerve.
When the muscle contracts, it strangles the nerve. This sends pain shooting down your leg that feels exactly like a disc herniation. But if you look at the spine, it's fine.
The 3-Second Test
How do you know which one you have? Try this simple test (The Seated Piriformis Stretch):
- Sit in a chair.
- Cross your painful leg over your other knee (figure-4 position).
- Lean forward slightly.
If you feel a deep stretch or reproduction of pain in your buttock, you likely have Piriformis Syndrome. The problem is in the soft tissue, not the bone.
See It In Action: Releasing the Sciatic Nerve
Watch Dr. Chris Stepien demonstrate how releasing adhesions in the deep gluteal muscles frees the sciatic nerve and stops the pain.
Expert Care in Idaho
Nickolas Fransen is one of the few advanced ARM practitioners in the country personally trained by Dr. Chris Stepien. You don't need to fly to New Jersey to get this world-class treatment—it's available right here in Meridian.
The Fix: Adhesion Release Method (ARM)
Whether the nerve is trapped at the spine (disc) or the hip (piriformis), the solution involves creating space.
At Snake River Acupuncture, we use Adhesion Release Method (ARM) to physically peel the adhered muscles off the sciatic nerve.
- If it's Piriformis Syndrome, we release the gluteal muscles. The relief is often instant.
- If it's True Sciatica (disc), we release the muscles around the spine (multifidus, erectors) to take pressure off the disc, allowing it to heal.
Stop guessing. Let us find exactly where your nerve is trapped and release it.
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Leg Pain Won't Go Away?
Call (208) 481-4800 to schedule your assessment with Nickolas Fransen. We'll determine the true cause of your sciatica and fix it.