Sciatica – Is it Piriformis Syndrome or a Herniated Disc? – Ask Doctor Jo

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Sciatica symptoms can be caused by piriformis syndrome or a herniated disc. Here are some easy ways to help narrow it down, and some treatments for each. More sciatic nerve stretches & exercises:

It’s important to know which one is causing the sciatica so you can treat it appropriately.

Piriformis syndrome is when the sciatic nerve is compressed by the piriformis muscle. Since the sciatic nerve runs down behind the leg and under the piriformis, if it is tight and pushing on the nerve, it can cause pain, weakness, numbness and tingling. An easy way to test if your piriformis is tight, is to lie on your stomach with your feet bent up to the ceiling. Let them drop down to the side. If one doesn’t go as far and feels tight, it could be piriformis syndrome.

Some piriformis stretches including the figure 4 and the knee to opposite shoulder should help loosen up the muscle and reduce symptoms.

A herniated disc can compress the sciatic nerve at the spine. To test this, you can lie on your stomach and prop up on your elbows. This might cause pain in the low back, and in the beginning, it might reproduce symptoms, causing pain, weakness, numbness and tingling. Though you might feel pain at first, one of the treatments is to hold this position, and the symptoms should start to go away.

Besides prone props, you can do prone press ups, and a cat/dog stretch in quadruped to help relieve the symptoms.

Related Videos:

Piriformis Syndrome Stretches & Exercises:

Herniated Disc Exercises & Stretches:


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Sciatica – Piriformis Syndrome or Herniated Disc? :

DISCLAIMER: This content (the video, description, links, and comments) is not medical advice or a treatment plan and is intended for general education and demonstration purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. Don’t use this content to avoid going to your own healthcare professional or to replace the advice they give you. Consult with your healthcare professional before doing anything contained in this content. You agree to indemnify and hold harmless Ask Doctor Jo, LLC, its officers, employees, and contractors for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. Ask Doctor Jo, LLC makes no representations about the accuracy or suitability of this content. Use of this content is at your sole risk.


AskDoctorJo says:

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Learnthrivecompassion says:

Not sure what worked but I performed all the movements in sequence with the video and my debilitating pain is gone. Thank you

Nick Moore says:

Back in youth league, our coaches usually included the knee to opposite shoulder stretches during warmups. Good times, sending good vibes to Princess and her hooman.

Lara Mae Mendoza says:

It was 2am and i woke up feeling pain on my left side butt and found this video. It was a great relief. Thank you!

Glen Carter says:

What is the difference between the Piri-formas and the Psoas muscle as there seems little difference in the stretches???

Judy Combs says:

Hi Dr Jo, I have alot of Degenerative Disc issues. I've had L4-5 Fusion and my L3-4 and L5-S1 are both herniated, pancakes on both sides, I have Stenosis, Arthrosis and Nerve Damage. I have been fighting Periformis Syndrome for over 3yrs. Last year I developed Sciatica and I haven't been able to get either under control despite floor exercises I've been doing. Recently I have developed I.T. Band issues as well. I can't seem to get either my Hamstring or I.T. Band to relax, as soon as I get up and start moving, bending, squatting, and I literally cannot stand in one place for 15min without the I.T., Periformis, Gluten to lock up. My sit bone area hurts and under my buttocks stings like hundreds of bee stings. I'm sure my core is very weak hips etc. as I have been dealing without undermanaged Chronic Pain Syndrome for 22yrs. I've been trying to put together some type of stretching and exercises but up to now nothing I've tried seems to help. Is it possible that my situation requires surgery or can you suggest a set of exercises and stretching? Thanks, Judy

Jaike Locht says:

if the last exercise, the cat camel stretch, hurts really bad. Could it be the piriformis?

Kurt Smith says:

I have both herniated disc and piriformos too I’m gonna try this to see if it will help

Kenneth Studley says:

I have a question around maybe 7yrs ago I believe my sciatica got messed up I say it is that because I've never had pain like that it was so bad when I went to the ER they wanted me to lift my back up to put the defray board underneath my back and because of the pain I couldn't do it I was saying I can't lift anyway for years my right lower back has bothered me I've had to go to the ER I keep trying to point out were it hurts basically nothing got done so my lower back groin and on the side of my hip I can press on that side of my hip or that right side of buttocks and the pain will radiate down my right leg to my Achilles tendon but the pain can be so bad I've taken Tylenol bottles and press on this area on my right lower back that the bottle it self would just about flatten from pressing dwn so hard now I use a glass ashtray would you have any idea what this could be

Nature says:

Thanks for the video,
From the demonstration I could tell I have periformis. The problem with my right leg: pain, tingling, numbing starts not so much when I'm sitting but especially when driving. I tried the familiar stretching exercises but in vain. Your explanation and suggested remedy will be highly appreciated.

savagerobuxanddiamond playz says:

nope I definitely have a disc

Peter Winkler says:

Thank you! I've never had Piriformis Syndrome before, and your video helped me figure out the pain. I don't think I have a herniated disc, and I will continue using your stretches.

Lindsey Thomas says:

Would this test also apply to see if a bulging disc (not herniation) is causing the pain? Does it have to reproduce the pain in the moment doing them or if it creates pain a day or so after doing several sets of these can the pain be from the bulging disc?

Alessandra Scotti says:

Hi Dr Jo, just subscribed to your channel, as I found it amazing. I have a question: what if the pain is coming from the pubic area and shooting down the leg, as well as from the back? This pain doesn't enable me to sit. Is that Piriformis, or herniating disk? And which exercise would be more effective?

Karshan Gorsar says:

Thank u much so informative 🙏

Lenore Davi says:

Lucky me l had both😣…..

Xerxes says:

I think you just saved my life with the figure-4 move 😩

Shoaib Soomro says:

Its not easy excrise

Dave says:

I feel pain in both tests 😂

sydzkid says:

Thank you for this. I have experienced some relief after just one stretch session. I am pregnant and cannot take any anti inflammatories. Is there anything else I can do for pain management as I heal from this? I cannot bend at the waist without pain from mid-butt all the way into inner ankle.

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