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Carrollton, VA
A 32-year-old female asked:

If my sciatica was caused by piriformis syndrome wouldnt i feel themmuscle spasm pain in my buttocks?

3 doctor answers7 doctors weighed in
Dr. Andrew Dutka
Neurology 46 years experience
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.
Dr. Brian Kaufman
Internal Medicine 20 years experience
I agree with above. That said, many do have buttock pain with radiation down the leg.
Apr 3, 2013
Dr. Douglas Linville II
Orthopedic Spine Surgery 31 years experience
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.
Dr. Qamar Khan
Pain Management 18 years experience
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.

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Last updated May 24, 2019

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