Leg and back pain: Sciatica or Piriformis Syndrome?

The sciatic nerve is the biggest and longest nerve in our bodies, made of five nerves that come together in the lower spine and run down the back of the legs to the toes. It's as big around as an adult's thumb at its widest point.

Since it goes through so many active parts of our body, it can get compressed or damaged in different ways. This results in a variety of conditions. Two of the most common are sciatica and piriformis syndrome. Here are the basic differences:

Sciatica pain starts in the low back and radiates down the leg. It's caused by bulging discs in the low back that compress the sciatic nerve. Bending forward usually makes the pain and the condition worse. Treatments focus on getting the discs to go back into place by strengthening the core and reducing inflammation in the area.

Piriformis syndrome pain stays in the hip and buttock area and does not usually radiate further. It's caused by inflammation in the piriformis muscle deep inside and toward the back of the hip. The sciatic nerve runs close to, or in some people, right through this muscle. When it the muscle swells, the nerve gets compressed and causes pain. Treatments focus on reducing inflammation of the muscle and stretching it.

With both conditions (and like most orthopedic problems) surgery is usually not necessary. You and your orthopedic doctor can discuss all the options for you and find a treatment plan that works with your lifestyle and fitness goals.