Piriformis Syndrome vs. Sciatica: What’s Really Causing Your Hip Pain?

Hip pain can be frustrating, limiting, and—let’s be honest—confusing. One day it’s a dull ache, the next a sharp, shooting pain down the leg. If you’ve ever been told you have sciatica or piriformis syndrome, you might be wondering: what’s the difference? And more importantly, how do you find relief?

Let’s break it down in simple terms so you can better understand what’s really going on—and how therapeutic massage and bodywork can help.

Sciatica: A Symptom, Not a Diagnosis

“Sciatica” refers to pain that travels along the sciatic nerve, which runs from your low back through your hips and down each leg. It’s not a condition itself—it's a symptom of nerve irritation, compression, or inflammation.

Causes of sciatica include:

• A herniated or bulging disc pressing on a nerve root

• Spinal stenosis (narrowing of the spinal canal)

• Degenerative disc disease

• Pregnancy

• And yes—sometimes tight muscles like the piriformis

Piriformis Syndrome: The Muscle Mimic

The piriformis is a small but mighty muscle located deep in the buttocks, beneath the glutes. It helps with hip rotation and stability. In some people, the sciatic nerve runs directly under or even through the piriformis muscle. When this muscle becomes tight, inflamed, or spasms, it can compress the sciatic nerve, causing pain that feels exactly like sciatica.

This is known as piriformis syndrome, and it’s often misdiagnosed because the symptoms overlap so much.

Piriformis Syndrome vs. Sciatica: Key Differences

Here are some key ways to tell the difference between these two sources of hip and leg pain:

• Cause

  • Sciatica: Often related to a spinal issue such as a herniated disc, spinal stenosis, or degenerative disc disease.

  • Piriformis Syndrome: Caused by tightness or inflammation in the piriformis muscle compressing the sciatic nerve.

• Pain Location

  • Sciatica: Pain may radiate from the lower back down through the buttocks and into the leg.

  • Piriformis Syndrome: Pain is typically centered in the buttocks and may radiate slightly down the leg, but often not below the knee.

• Triggers

  • Sciatica: Pain may worsen with sitting, bending forward, or coughing.

  • Piriformis Syndrome: Pain is often triggered by prolonged sitting, climbing stairs, or walking uphill.

• Low Back Involvement

  • Sciatica: Low back pain is commonly present.

  • Piriformis Syndrome: Low back pain is usually absent.

• Response to Massage

  • Sciatica: Massage may help depending on the underlying spinal issue, but must be approached cautiously.

  • Piriformis Syndrome: Often responds very well to targeted soft tissue work and release techniques.

How Massage Therapy Can Help

If you’re dealing with hip or leg pain, hands-on work can be an effective part of your healing plan—especially when it targets the muscles that surround and support the sciatic nerve.

At our clinic, we use:

• Deep tissue and neuromuscular therapy to release tension in the piriformis and surrounding gluteal muscles

• Trigger point therapy to reduce referral pain

• Red light therapy, which may help reduce inflammation and support muscle recovery

We also work closely with clients to identify postural habits and stress patterns that may be contributing to their discomfort.

Movement, Stretching & Strength: A Whole-Body Approach

While massage can significantly relieve pain and muscle tension, long-term relief from piriformis syndrome and sciatica often requires improving mobility, posture, and strength—especially in the hips, glutes, and core.

That’s why we partner with Fitness Partners, the boutique gym right next door! Their team offers:

• Pilates sessions focused on core control and pelvic alignment

• Fitness classes that promote flexibility, strength, and functional movement

• Personal training for customized strength and mobility programs

If you're looking to pair therapeutic bodywork with supportive movement training, check out their website!

When to Seek Help

If you're unsure what's causing your pain—or you’ve been stretching, foam rolling, and googling for weeks with no real relief—it’s time to get some professional support.

Always consult with a doctor or licensed medical provider to determine an accurate diagnosis. While we don’t diagnose conditions, we’re here to support your recovery through therapeutic massage and bodywork that targets the muscles and soft tissue contributing to your discomfort.

Let’s work together, in coordination with your healthcare team, to get you moving comfortably again. Ready to book an appointment? Click below!