Sciatica vs. Piriformis Syndrome

Read Time: ~4 minutes
Time to perform exercises: ~10 minutes

Hey there!

One of the most common complaints I hear from patients and clients is deep glute or buttock pain, sometimes with tingling or numbness down the leg.

If you’ve ever looked it up, you’ve probably seen sciatica and piriformis syndrome mentioned as possible causes.

They can feel similar, but they’re not the same. Understanding the difference is the first step in figuring out what’s really going on.

What They Actually Are

Sciatica

• Irritation or compression of the sciatic nerve at one of it’s nerve roots in the low back

• Most commonly caused by a herniated disc, but can also be caused by spinal stenosis

Piriformis Syndrome (and Deep Gluteal Irritation)

• Irritation of the sciatic nerve further down, as it passes under or through the piriformis or other deep gluteal muscles

• True piriformis syndrome is rare, but piriformis pain (or gluteal muscle pain) can cause very similar symptoms even if they don’t irritate the sciatic nerve

Side By Side Comparison

Could This Be You?

If you have buttock pain with or without leg symptoms and it:

• Started after bending, lifting, or twisting — think sciatica.

• Flares when sitting, crossing your legs, or rotating your hip — think piriformis/deep gluteal irritation.

⚠️ These differences can be subtle. If you’re worried your symptoms might be disc-related, see a licensed provider first before starting self-treatment.

What You Can Try at Home

If you think you might have sciatica, make sure to get checked by a provider before trying to treat it yourself, and keep an eye out for next week’s newsletter. I’ll be covering the exact exercises I use with my patients for disc herniations and true sciatica.

If your symptoms point toward piriformis syndrome or deep gluteal irritation (and not sciatica), here’s a routine I’ve used with many of my patients with great success.

Do it once a day for 1–2 weeks and see how your body responds.

1. Piriformis Release: Foam Roller (4 spots until pain decreases, per side)

What it does: Helps reduce sensitivity in the deep gluteal region and relieve tension around the sciatic nerve.

How to do it:

• Sit with a foam roller under one butt cheek.

• Cross that leg over the opposite knee in a figure-4 shape.

• Slowly roll or shift side to side, looking for tight or tender areas.

• When you find a spot, pin and hold until pain decreases.

• Repeat 3 more times.

• Switch sides and repeat.

2. Pigeon Stretch (4 sets of 30 second per side)

What it does: Targets the piriformis and surrounding rotators to improve hip mobility and reduce guarding.

How to do it:

• From a push-up position, bring one knee toward your hand and lay your shin across your body.

• Extend the back leg behind you.

• Lower your hips and breathe into the stretch.

• Hold 30 seconds.

• Relax and repeat 3 more times.

• Repeat on the other leg.

⚠️ Avoid this one if it bothers your knee or low back. Support with a block or cushion if needed.

3. Supported Hip Airplanes (3 sets of 10 per side)

What it does: Builds hip stability, improves proprioception, and helps reduce glute overuse or compensations.

How to do it:

• Stand on one leg with a slight bend in your knee and your back leg balanced on a chair.

• Hinge forward and rotate one way as far as possible (think about your belt buckle moving as far as you can)

• Now rotate the other direction.

• Repeat 9 more times.

• Repeat on the other leg.

Be Patient, But Don’t Ignore It

If your pain is piriformis or deep glute-related, these exercises can help relieve tension and restore mobility if done consistently.

If it’s sciatica from a spinal issue, you’ll need a different plan, and that’s exactly what we’ll cover in next week’s newsletter. I’ll walk you through the specific exercises I use for disc herniations and true sciatica.

Want Help With This?

Right now, my 1-on-1 coaching is full, but I’m still happy to help get you some answers!

I’m offering free 30-minute assessments for two types of people:

1. Those who just want to pick my brain about their specific problem (like sciatica or piriformis syndrome) and walk away with ideas for what to work on, even if they have no intention of doing my 1-on-1 coaching.

2. Those who want to get on my coaching waitlist and be first in line when a spot opens up.

Either way, we’ll talk through your situation, I’ll give you my honest thoughts on the best next steps, and you’ll leave with a plan you can start using right away.

If that sounds helpful, grab a time here:

What’s Coming Next?

Next week’s newsletter will walk you through the exact exercises I use for sciatica and disc herniations.

After that, I’d love to hear what would help you most. Pick one from the list below or reply with your own idea:

You’re Not Alone

Whether you’ve had this for a few days or a few years, you’re not stuck.
Your body can change. Movement helps. And small steps add up.

Let me know how it goes, and I’ll be back next week with another issue to help you keep moving better, longer.

See you next week!

Dr. Matt Moreno, D.C., C.C.S.P.®
The Move More Minute

Disclaimer: The information provided in this newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, chiropractor, or other qualified healthcare provider with any questions you may have regarding a medical condition or before starting any new exercise program.

The exercises and suggestions provided are general recommendations and may not be suitable for everyone. If you experience pain, discomfort, or any concerning symptoms while performing these exercises (such as numbness, dizziness, or increased pain), stop immediately and consult a qualified healthcare professional.

Do not disregard professional medical advice or delay seeking it because of something you have read in this newsletter. The author, Move More Minute, and its affiliates assume no responsibility for injuries or issues that may arise from following the recommendations provided. By engaging with this content, you agree to do so at your own risk.

For personalized care or specific advice, please schedule an appointment with a qualified professional.