Shooting Leg Pain? It Might Not Be What You Think
That shooting pain down your leg – is it sciatica? Piriformis syndrome? Something else entirely?
If you’ve been dealing with pain that radiates from your lower back or buttock down through your leg, you’ve probably heard both terms thrown around. Maybe your doctor mentioned sciatica. Your friend who had similar symptoms swears it was piriformis syndrome. Meanwhile, you’re just trying to figure out what’s actually wrong so you can fix it.
Here’s why the confusion exists: both conditions cause remarkably similar symptoms. Both create pain that travels down the back of your leg. Both can make sitting unbearable and walking uncomfortable. But they have different root causes – and that matters when it comes to treatment.
Understanding the difference isn’t just medical trivia. It’s the key to finding relief that actually works instead of treating the wrong problem for months.
Let’s break down what’s really happening in your body, how to tell these conditions apart, and most importantly – what actually helps.
What Is Sciatica?
Sciatica isn’t actually a condition – it’s a symptom. The term describes pain that follows the path of your sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg.
What causes it:
- Herniated or bulging disc – The most common cause. When the cushioning discs between your vertebrae bulge or rupture, they can press directly on the sciatic nerve roots
- Spinal stenosis – Narrowing of the spinal canal that puts pressure on nerves
- Bone spurs – Overgrowth of bone on the vertebrae
- Degenerative disc disease – Age-related wear and tear on spinal discs
- Spondylolisthesis – When one vertebra slips forward over another
The key point: True sciatica originates in your spine. Something is compressing the nerve at its root before it even leaves your back.
Classic sciatica symptoms:
- Sharp, shooting pain that radiates from lower back down the back of one leg
- Pain that worsens with prolonged sitting or standing
- Numbness or tingling in the leg or foot
- Weakness in the affected leg
- Pain typically affects one side only
- May include lower back pain, but leg pain is usually worse
- Coughing or sneezing may increase pain
What Is Piriformis Syndrome?
Piriformis syndrome occurs when a small muscle deep in your buttock – the piriformis muscle – irritates or compresses the sciatic nerve.
Your piriformis muscle runs from your lower spine to the top of your thigh bone, and its job is to rotate your hip outward. The problem? The sciatic nerve runs directly underneath this muscle (and in about 15% of people, it actually passes through the muscle).
When your piriformis muscle becomes tight, inflamed, or goes into spasm, it can squeeze the sciatic nerve like a vice, creating symptoms that mimic true sciatica.
What causes piriformis syndrome:
- Overuse or repetitive motion – Running, cycling, prolonged sitting
- Direct trauma – A fall on the buttock or hip injury
- Muscle imbalance – Weakness or tightness in surrounding muscles
- Prolonged sitting – Especially with a wallet in your back pocket
- Structural variations – Some people have anatomical variations that increase risk
The key point: Piriformis syndrome originates in your buttock. Your spine is fine – it’s a muscular problem creating nerve irritation.
Classic piriformis syndrome symptoms:
- Deep, aching pain in the buttock
- Pain that radiates down the back of the thigh (usually doesn’t go below the knee)
- Pain when sitting, especially on hard surfaces
- Discomfort when climbing stairs or walking uphill
- Reduced range of motion in the hip
- Pain when crossing your legs or during hip rotation
- Tenderness when pressing deep into the buttock
How to Tell the Difference
Here are the key differentiators that can help you (and your healthcare provider) distinguish between these conditions:
Location of Worst Pain
- Sciatica: Lower back and leg pain, with leg symptoms often worse than back pain
- Piriformis: Deep buttock pain is the primary complaint
How Far Down Your Leg It Goes
- Sciatica: Often travels all the way down to your foot, following a specific nerve pathway
- Piriformis: Usually stops at the knee or mid-thigh
What Makes It Worse
- Sciatica: Prolonged sitting, standing, bending forward, coughing/sneezing
- Piriformis: Sitting (especially on hard surfaces), climbing stairs, hip rotation movements
What Makes It Better
- Sciatica: Often relieved by lying down or walking slowly
- Piriformis: Relieved by standing, stretching the hip, or changing positions
Numbness and Tingling
- Sciatica: Common, can extend into specific areas of the foot
- Piriformis: Less common, usually limited to buttock and upper thigh
Muscle Weakness
- Sciatica: May cause noticeable leg weakness (foot drop, difficulty standing on toes)
- Piriformis: Weakness is rare, more often reduced hip mobility
Clinical Tests That Help Diagnose
For Piriformis Syndrome:
- FAIR test (Flexion, Adduction, Internal Rotation) – Pain when the hip is bent, brought inward, and rotated internally
- Piriformis stretch test – Pain when the affected leg is stretched across the body
- Direct palpation – Tenderness when pressing deeply into the buttock muscle
For Sciatica:
- Straight leg raise – Pain when lying down and lifting the straight leg
- MRI or CT scan – Can show disc herniation or spinal stenosis
- EMG (Electromyography) – Measures electrical activity in muscles to detect nerve damage
Important note: You need a healthcare professional to perform these tests correctly. Don’t try to self-diagnose based on symptoms alone.
The Tricky Part: You Can Have Both
Here’s what complicates things: you can have both conditions simultaneously.
A herniated disc causing true sciatica can alter your gait and posture, leading to piriformis muscle tightness. Or chronic piriformis syndrome can cause you to move differently, eventually contributing to disc problems.
This is why accurate diagnosis matters – and why treatment that addresses only one aspect might provide partial relief but not complete resolution.
Treatment Approaches: What Actually Works
For True Sciatica:
- Medical evaluation first – Rule out serious spinal issues that need intervention
- Physical therapy – Specific exercises to reduce nerve compression
- Pain management – May include medication prescribed by your doctor
- Epidural injections – In some cases, to reduce inflammation around nerve roots
- Surgery – Reserved for severe cases or when conservative treatment fails
How massage helps: While massage can’t fix a herniated disc, it can address the muscle guarding and compensation patterns that develop around spinal issues, potentially reducing overall pain and improving mobility.
For Piriformis Syndrome:
- Therapeutic massage – Direct treatment of the piriformis muscle and surrounding tissues
- Stretching and strengthening – Specific exercises to restore balance
- Postural correction – Addressing the habits that caused the problem
- Activity modification – Reducing aggravating movements while healing
- Acupuncture – Can help release muscle tension and reduce inflammation
How massage helps: This is where therapeutic bodywork truly shines. Skilled massage therapists can access and release the piriformis muscle, break up adhesions, improve hip mechanics, and address the muscular imbalances causing the problem.
When to Seek Professional Help
See a doctor immediately if you experience:
- Loss of bowel or bladder control
- Progressive leg weakness
- Numbness in the groin or inner thighs (saddle anesthesia)
- Severe pain that doesn’t improve with rest
- Symptoms in both legs simultaneously
These could indicate cauda equina syndrome, a medical emergency requiring immediate intervention.
See a healthcare provider if:
- Pain lasts longer than a few weeks
- Symptoms are getting progressively worse
- You’re having trouble with daily activities
- Home care isn’t providing relief
- You’re unsure what’s causing your symptoms
How All Deep Massage & Wellness Can Help
At All Deep Massage & Wellness in Sherwood Park, we regularly work with clients experiencing both sciatica and piriformis syndrome.
Our approach:
- Thorough assessment – We evaluate your movement patterns, pain triggers, and medical history
- Collaborative care – We work alongside your other healthcare providers for comprehensive treatment
- Targeted treatment – For piriformis syndrome, we use deep tissue techniques, trigger point therapy, and myofascial release to address the root cause
- Supportive care – For sciatica, we address the muscular compensation patterns and provide relief while you pursue appropriate medical treatment
- Education – We teach you stretches and self-care techniques to maintain improvements
Our therapists are trained to recognize when symptoms require medical referral versus when therapeutic massage is the primary solution you need.
Ready for Relief?
Whether you’re dealing with piriformis syndrome, managing sciatica symptoms, or still trying to figure out what’s causing your pain, our experienced team at All Deep Massage & Wellness is here to help.
Schedule a consultation today:
📞 (780) 416-0659
🌐 www.alldeepmassage.com
📍 Located in Sherwood Park, Alberta
Let’s figure out what’s really going on – and get you back to moving without pain.
