Pain in the leg: The sciatic nerve can pass through the pyriformis muscle, or go under it, and it may not be in spasm, just larger than normal. The pain is then felt in the leg because it is the nerve that is injured; the muscle can be normal but large or the nerve is misplaced from birth.
Answered 5/24/2019
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Piriformis syndrome : Not necessarily. Piriformis synd may cause sciatic nerve compression and true sciatica. This is due to either a thick tissue band pressing the sciatic nerve in the buttock or the nerve exiting abnormally through the muscle itself. Alternatively, a tendinitis picture may also occur with primarily buttock pain especially with activity. Treatment involves stretches, injections, nsaids, surgery.
Answered 9/15/2017
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Piriformis Pain: The sciatic nerve runs underneath the piriformis muscle and typically does not irritate the nerve. However if the muscle is irritated or the nerve runs through the belly of the muscle (5-10% of people) it can press on the sciatic nerve and cause the sciatica type pain in the buttock region but also radiate into the leg as well. Typically stretching and nsaids are mainstay for treatment.
Answered 2/24/2018
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