Sciatica or Piriformis Syndrome?
It starts as a dull ache deep in your glutes. Then, after sitting at your desk for an hour, it turns into a sharp, shooting pain down the back of your leg.
You Google your symptoms, and the word "Sciatica" pops up everywhere. You might start worrying about herniated discs, spinal surgery, or long-term back issues.
But here is the good news: It might not be your spine at all.
At Advanced Rehab Massage & Myotherapy, we see many clients in East Brisbane who believe they have severe spinal sciatica. However, clinical evidence suggests a significant number of these cases are actually a muscular condition called Piriformis Syndrome.
The "Hidden" Diagnosis: What the Research Says
You are not alone in confusing the two. Distinguishing between spinal sciatica and muscular compression is a challenge even for medical professionals.
In fact, a study published in the Journal of the College of Physicians and Surgeons found that 17.2% of patients suffering from lower back pain were actually causing their symptoms via the Piriformis muscle, not a spinal disc injury [1].
That means nearly 1 in 6 people treating their "bad back" are targeting the wrong area. If your pain is muscular, treating the spine won't fix it.
Enter the Imposter: What is Piriformis Syndrome?
The Piriformis is a small, pear-shaped muscle located deep in your buttocks, underneath the large glute muscles. Its job is to help rotate your hip.
Here is the catch: The sciatic nerve runs directly underneath (and sometimes through) this muscle. When the Piriformis muscle gets tight or goes into spasm—often due to prolonged sitting or overuse—it squeezes the sciatic nerve. This mimics the symptoms of sciatica, but the root cause is muscular compression, not a herniated disc.
Signs it might be Piriformis Syndrome:
Pain concentrated deep in the buttock/glute area.
Pain worsens after sitting for long periods (driving, desk work).
Relief when walking, but pain returns when sitting.
Absence of lower back pain (pain starts in the glute).
Evidence-Based Treatments: Why "Just Stretching" Isn't Enough
If we determine your pain is muscular through orthopedic assessment, we use treatments backed by clinical studies to get you pain-free faster.
1. Deep Tissue & Friction Massage (Better than Stretching Alone) Many patients try to fix this at home with simple stretches, but results are often slow. Research comparing treatment methods found that patients who received Deep Friction Massage showed significantly better improvements in disability scores compared to those who only performed stretching exercises [2].
Our Approach: We use targeted Deep Tissue techniques to physically break down the tension in the glutes that you can't reach with stretching alone.
2. Dry Needling (A Game Changer for Pain) For chronic cases, we often recommend Dry Needling. It might sound intense, but the science supports it. Studies indicate that Dry Needling is highly effective for Piriformis Syndrome, showing a significant reduction in Visual Analogue Scale (VAS) pain scores compared to standard physical therapy modalities alone [3].
Our Approach: By inserting a fine needle into the trigger point, we can cause an immediate "twitch response," forcing the muscle to relax and releasing the pressure on the nerve instantly.
Don't Guess—Get Assessed
Whether it is a disc issue or a tight muscle, you shouldn't have to live with nerve pain.
If you are experiencing shooting leg pain or a deep ache in your glutes, come in for a professional assessment. We don't just guess; we use clinical testing to identify the root cause and apply evidence-based treatments to get you moving again.
Ready for relief? Book Your Appointment Online at our East Brisbane clinic today.
References
Prevalence of Piriformis Syndrome: Nazarian, S. et al. (2013). Frequency of piriformis syndrome in patients with low back pain. Journal of the College of Physicians and Surgeons Pakistan, 23(8), 568-571.
Massage vs. Stretching: Jaffar, H. et al. (2018). Comparison of stretching exercises versus deep friction massage for the management of piriformis syndrome. Journal of Riphah College of Rehabilitation Sciences, 6(1).
Dry Needling Effectiveness: Tabatabaiee, A. et al. (2019). The effectiveness of dry needling in patients with piriformis syndrome: A systematic review and meta-analysis. Journal of Bodywork and Movement Therapies. / Fusco, P. et al. (2018). International Journal of Environmental Research and Public Health.
