Is It Sciatica or Piriformis Syndrome?

Ever felt a deep ache in your glute that shoots down your leg? Many people assume it’s sciatica—but there’s another common culprit: piriformis syndrome.

Though the symptoms can feel similar, understanding which one you're dealing with helps guide the healing process.

What is Sciatica?

Sciatica is a term used to describe symptoms caused by compression or irritation of the sciatic nerve. It usually stems from a spinal issue—like a herniated disc, spinal stenosis, or degenerative disc disease. Sciatica is typically diagnosed through a combination of physical exams, your medical history, and imaging like MRIs or CT scans to determine whether a herniated disc or spinal issue is compressing the sciatic nerve.

The sciatic nerve, the largest nerve in the body, originates in the low back and travels down each leg. When it's compressed at the spinal level, pain often starts in the lower back and travels down the glute, hamstring, and even into the foot.

Common symptoms of sciatica:

• Pain radiating from the low back down one leg

• Tingling, numbness, or weakness in the leg

• Pain that worsens with coughing, sneezing, or sitting for long periods

What is Piriformis Syndrome?

Piriformis syndrome is different. It’s caused when the piriformis muscle, a small but mighty muscle deep in your glute, becomes tight, spasms, or inflamed—compressing the sciatic nerve that runs directly beneath (or in some cases, through!) it.

This compression mimics sciatica symptoms, but the source is muscular, not spinal.

Here’s why that matters:
The piriformis muscle plays a key role in rotating and stabilizing your hip. It sits deep in your buttock, underneath the gluteus maximus. The sciatic nerve runs directly under the piriformis in most people—so if that muscle is tight, shortened, or inflamed, it can pinch the nerve and send pain down the leg.

Common signs of piriformis syndrome:

• Pain that starts in the glute and may travel down the leg

• Symptoms that worsen with sitting, climbing stairs, or getting in/out of a car

• Tenderness in the gluteal region, especially when pressed

How Can You Tell the Difference?

Here are some general guidelines:

With sciatica, the pain usually starts in the lower back and radiates down the leg, often caused by a herniated disc or spinal compression. It tends to follow a more consistent, defined path along the sciatic nerve and can be accompanied by numbness, tingling, or weakness.

In piriformis syndrome, the discomfort often begins deep in the buttock and may radiate down the leg, but it's typically more localized at the glute. This happens when the piriformis muscle— a small muscle located deep in the glutes— becomes tight or inflamed and compresses the sciatic nerve. The pain may worsen when sitting for long periods, climbing stairs, or after intense activity involving the hips.

Both conditions can affect the same nerve, but the source of the irritation is different—and that’s what shapes the most effective treatment path.

Of course, these symptoms can overlap—and it’s always best to consult a professional. But knowing the difference can help you choose the most effective care.

How Massage Can Help

Regardless of the cause, your nervous system responds to compression with pain, inflammation, and often muscle guarding. That’s where targeted, therapeutic bodywork can make a huge difference.

In my practice, I use a combination of myofascial release, deep tissue, and neuromuscular therapy to ease glute and low back tension, improve circulation, and give the nerve space to breathe.

By softening the piriformis and surrounding fascia, we can reduce nerve compression and get you back to moving—and sitting—more comfortably.

✨ Want personalized support? Let’s work together to calm the nerve, release the tension, and help you feel at home in your body again.
[Book your session here.]