Bulging Disc vs Piriformis Syndrome: How to Tell the Difference
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- Опубліковано 7 бер 2023
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(Amazon Affiliate links) To subscribe to 3-Tip Friday, Will's free weekly email where he shares his best health tips, new videos and fascinating research, go here: info.ht-physio.co.uk/3tf Welcome to the latest episode of HT Physio Quick Tips!
In this episode, Farnham's leading over-50's physiotherapist, Will Harlow, reveals how to tell whether a case of sciatica is caused by a bulging disc or piriformis syndrome.
Both a bulging disc and piriformis syndrome can cause sciatica leg pain as well as numbness in the leg. For the average person, telling them apart can be difficult. However, there are some subtle signs that help to differentiate between these two conditions.
To get a copy of Will's new book, Thriving Beyond Fifty, you can find it on Amazon below:
UK link: amzn.to/3mAISFv
US link: amzn.to/3J1ACGi
(Amazon Affiliate links)
You can find our dedicated sciatica website with more information and a relevant article that might interest you here: www.howtogetridofsciatica.com...
If you're suffering from back pain that stops you from doing the things you love, you can take our back pain guide - which will give you 9 expert tips to put a stop to back pain at home - by visiting here: ht-physio.co.uk/back-pain-gui...
If you're over-50 with a painful problem in the Farnham, Surrey area, you can learn more about how Will Harlow and HT Physio can help you overcome a painful problem here: ht-physio.co.uk/
*Any information in this video should not be used as a substitute for individual medical advice. Please seek advice from your local healthcare professional before taking action on the information in this video.* Full policy here: ht-physio.co.uk/injury-discla...
Please keep in mind folks, there’s piriformis syndrome from the muscle being too tight, and there is piriformis syndrome from the muscle being too stretched out. Mine is Too stretched out, and it entailed a completely different style of treatment.
I am so grateful because your explanation is so much understandable and really helpful . Please keep on doing these excellent videos and God bless you!
I went a yr with Piriformis pain. I read online to roll on a ball right in the middle of the butt, not a smooth tennis ball but a ball with pricks and the pirformis pain will go away. I put a towel on the ball and just roll on it on the floor. Like clockwork, it worked! I bought the ball at Walmart.
This is a perfekt presentation for differential diagnosis. I have 2 y-huge-pain in walking, standing and sometimes in bed night now 3 y after my total hip replacement. Morning without massive pain for appr. 😊😊200 steps. Doctors suggest exersises generating worst in my butt. Thank you for your practice with ball I am going to try. 😊
Very clear info..good work!
Perfect explanation!
Excellent presentation, thank you!
Thank you for this video. I’ve been bouncing back and forth on this very topic for six months!
Great explanation!
Absolutely excellent and you have made a complex topic so easy to understand. Not only that it made it easy to differentially diagnose my situation which I have attempting to do for a considerable time despite having a healthcare background in working with therapists and doctors managing children with neuromusculoskeletal disabilities as a career. Interesting how so much of that background is now helpful to me managing myself and working to continue being functional now into my 80s. I am so happy to find you as a resource and will be sharing this with ofter of my peers!
Have had a bulging disc for 30 years, exactly as you explained. Can’t do work in garden bending over, work at my desk standing or on a lean to stool was only way I could tolerate 8-10 hours. Also had bursitis in trochanter, both sides.
This was an excellent overview! I feel like I am the center of the Venn Diagram though. Pain peaks in a few certain positions such as pushing in the clutch and turning my body to look out the rear window. It is notably worse pain in my buttock and nerves when I cough, sneeze or blow my nose. I was diagnosed with piriformis after MRI and nerve tests (L5 and S1) but I do wonder if they are missing something? 5 Months with minimal activity beyond walking (but happy I can do a mile now) no way I will ski... time for a second opinion? Diagnostic cortisone shot to pirifomis and another to SI joint did not reduce any pain in the buttock area.
You solved the case! For a month, I have wondered what is causing this strange and intermittent pain. Now, I think it is referred pain coming from a month old injury I can hardly remember. I am very busy in the morning feeding and cleaning after 5 cats, 2 birds, and 8 fish. I rush around, because they (cats) complain if their food is delayed and try to steal from each other if I am not near. Balancing food and water refill for the birds through a narrow pathway, I tripped and almost fell against the bookcase edge, but caught myself, landing on my right shin but straightened and managed not to spill the food or the water. It hurt, but I was too busy to acknowledge it thoroughly, then returned to my pets. I didn't think about it for a while, until I noticed I had 3 bruised lower ribs. I have bruised ribs several times before while mountain biking, so I recognized the sporadic pain. I had back pain the next day, but it went away, then thigh pain, and it went away, then calf pain, then that went away. And they cycled like that. Then, I noticed shoulder pain but that disappeared and returned, also. The rib pain hung around for a while, but has completely disappeared. The others are intermittent but slight. (By the way, I am 72 years old if you wondered.) Also, I think this situation is probably common and that many people would appreciate a video about it. Thank you for all the time and effort you put into your videos. I will be watching more of them soon. Jane
so, is it sciatica or piriformis syndrome?
My situation seems kind of double. Definitely started with buttocks pain and down the leg, so Piriformis syndrome. But it hasn't gone away and feels like I have now more sciatica with the bending over causes pain along the leg. Like the hamstring muscles. So it's like 50/50. I don't have any real back pain. Just if I press the spine area above the sacrum it's tender.
My biggest problem right now is sitting down and standing up my leg sort of don't want to extend without pretty substantial pain. Like the muscles are tight and constricting and then after standing and walking they loosen up. Many with Sciatica has pain walking. For me the pain goes away if I am standing and walking for a longer period. So it's a confusing situation.
I think the culprit is my chair that over time pressed on the Piriformis muscle and made it tender and that inflamed it and pressed on the nerve underneath. I don't know if I have a nerve split muscle. I think you can get the same pain if the area is compressed. It will press on the nerve lying underneath as well. Inflaming it.
I bought a new chair and hoping it being "fresh" and not used as much as my old one that likely has sagging cushioning and do on causing the problem. That my pain will go away.
Because it's extremely annoying and can't barely bend over and tie my shoes when it's bad. Shooting pain along the leg. I have to walk around for several minutes before it has reduced the pain some.
I have the same
Problem that you have,what’s the best way to get rid of it?
Same for me… try clamshell pt exersise and light walking ONLY for a couple days. No stretching . See how you feel in a couple days if you see improvement, continue it. . The pain was getting so bad for me. I was starting to feel a little suicidal. I’m on the upswing now! just from clamshell !
@@Jrusko1clamshell pt exersise
I need to show your video to my pain Doctor
Good all uck with that. My pain Dr. put me on a pain patch and told me to live with it. That's when I finally found an Orthopedic surgeon. He guessed at how long I had been hurting and how many Drs I had seen. 7 years and 6 Drs.
Definitely helpful thanks! Mine started with a burning foot and moved up my calf and ended up stuck in both my hips and butt. Driving sucks get symptoms down the legs to the foot. I can bend my spine all over do the slump test and all thats and nothing changes. Sitting on a special butt pillow definitely has helped
My piriformis muscles and all my deep gluteals are super tight and painful. My hip flexors too. Found especially my opturator internus is really tender and very hard to get to....The price I'm paying for sitting for work for 15 years I guess.
Been in pt for a month and it's very slowly getting better. Strengthing my glutes especially the medius to stop torturing my poor hip rotators. Also stretching and strengthing the hip flexors trying to find balance. It's no fun for sure
Sorry to hear that! Hope it improves for you very soon!
Do the clamshell
Thanks for infromations.Have a good day!
Great video again, thanks Will! Two questions please: Is it possible to have both bulged disc AND piriformis syndrom at the same time? Can Piriformis syndrom be found out through a MRI please? Thanks.
Thank you! Yes it is possible to have both at the same time. To my knowledge, PS cannot be identified on MRI unless very severe (where inflammation can be seen) but I am not an expert on MRI interpretation.
@@HT-Physio Ok cool, thanks. Anyway, this video is a good indicator on how to identify it, very helpful again!
Able to do a video on what to do if you have both as well as bursitis on both hips? 32 yr old farmer, life's fun.... @@HT-Physio
Hi Dr. Will, thank you for the insightful videos, My pain is not severe and I noticed that I don't have back pain with my sciatica symptoms, and twisting and turning my spine does not cause pain.. so what you said seems to make me think it's Piriformis Syndrome, but the only thing is I do have leg weakness.. I am not able to do the calf raise test on my bad leg.. what does this mean?
Hi, thank you for the comment! The video is a rough guide and there will be some outliers as everyone is different. PS does not usually give leg weakness in my experience. Impossible to tell over the internet so I would recommend a face to face assessment with someone who can give you a proper diagnosis.
How about if the pain just stays in the centre upper section of the glutes and back pain.
Excellent! Thank you!
Is a SLR postive with pirifomis syndrome?
my symptom is weird. i was having back muscle spasm coming back from hiking for a few days. gradually after my back recovered, i'm developing pain on my hips and my thigh. and finally my whole leg feeling sharp shooting pain. the straight leg test is positive (disc herniation i suppose) and i'm not having pain in my buttock. however i have no problem bending forward of twisting my spine (no pain at all). i went to PT for few sessions but nothing work. i went to traditional massage and surprisingly it is getting better. the masseur told me that it is my back muscle spasm/strain that causing my sciatica, not relating to disc herniation or piriformis syndrome. any opinion?
I've been having unexplained sciatica, most likely caused by 12+ daily sitting for months. I have every single thing that you mentioned which suggests it's piriformis syndrome. But I've done MRI of the pelvis and the conclusion was "unremarkable" so my doctor said just based on that, that I don't have a problem with piriformis and discharged me. I've also done MRI of the lower back and no serious issues have been found there. I don't know what to do.
I’m with you same story here. No doctor has been able to help me today is 1 yeAr since I got this. Have you found relief ? Please let m know
@@diegopadilla5042 Hey, sorry to hear it. I'm far from recovered but my symptoms are somewhat lesser, although that depends on the day (each day is different).
I am doing around 9-10 different strength exercises for gluteal and hamstring region, one day I do half to those, the next day other half and so on. I avoid any type of stretching. If I have to sit for a bit, I use orthopedic pillow with memory foam.
I don't know how much any of that helps, but I don't have anything else to work with and I've tried with doctors so here's how it is.
I have both disc bulge l5 and piriformis , on my left side what exercises or stretching do you recommend??
See my response above
Clamshell
My mri says..L5/S1 mild broad based disk bulge with central protrusion and mild inferior migration no neural compression seen and L4/L5,L5/S1 ligament flavum hypertrophy..pain comes for 1 week in the left or right buttock only not in legs..but very severe pain in buttock.is it piriformis syndrome??
MRI results should always be looked at in correlation with a physical exam so best to seek some individual advice!
Can piraformis syndrome cause decreased sensation/numbness?
How about sciatica due to stenosis?
I can’t walk in the morning getting out of bed. As I loosen up the pain improves. Right glute to hip muscle area. Does piriformis muscle act that way?
Did you get an explanation of your symptoms?
I rarely leave comments. But happen to have 4 bulging discs (L2,3,4,5) (which cause mild arthritic-style pain) AND sciatica from piriformis syndrome (all as a result of a bad hip replacement surgery). I have been living with the pain for over 7 years & keep being told to just take ibuprofen. I’m in that 10% where my sciatic nerve was inside the gluteal muscle which means the muscle has strangulated my sciatic nerve as my hip “healed”. I would like to point out that the pain is MUCH worse from the piriformis (starts just to top R of butt cheek, radiates diagonally down my butt cheek, into hip, thigh, groin, leg, foot). You can visibly see the knots. His comments that sciatica from bulging discs is much worse is UNTRUE for some of us. Im awake multiple times per night due to leg, hip & butt pain & numbness to change positions or stand up & walk around to alleviate. Don’t even get me started on the changes in my daily life. And I do still work full time. Do a lot of research, don’t believe everything you hear on YT & find a different dr if you’re not being helped. I’m on a quest to get relief & mostly to finally sleep through just one night. Good luck to all of you who have chronic pain. It bites! Pray you’ll be pain free soon!!
I have been dealing with severe pain for 7 years also. For 5 years I have asked 6 different Drs to have a qualified radiologist to look at the many tests I have had. Last week I finally found an Orthopedic surgeon and will have surgery soon. I am 100% sure of my problem. The horrible pain has kept me in bed for 18 hrs. per day. Never give up.
my mri showed a bulging disc but I tick all the boxes for piriformis and my physiotherapist insists that my pain is because of piriformis inflammation caused by great trochanter injury (yeah lunges).
I can do all movements without issue but I have a lingering mild discomfort in my leg that is driving me crazy because sitting for too long can be painful. My butt hurts :P It is really confusing though as I can never actually be certain whether the disc is causing this or the piriformis at the end of the day, it's all speculation...
Believe I have both, and best thing I recently discovered in clamshell pt exersise… changed my life
What if the pain switches between the left and right hip?
How to make SURE?
Morn' Doc...
🙏Namaste from India
G8rt explanation...really makes senses...thanks a ton.
Past 1 month I have pain on my left buttocks....most of the time in the middle area orelse just above the middle buttocks below hip line (may be medius area) & at times down the calf area...specially morning hours.
Trying to rule out the root cause but in vain...not really able to concentrate on any strengthening & stretching routines due to confusion...it's become a Herculean task.
Done Xray L5 S1 reduced space...as per Orthopedic...given few anti inflammatory doses for a week and have asked to take maximum rest...
Past 1 week seeing a PT...using Tens/IFT
Would appreciate ur best guidance in this situation...Pls assist !!!
I feel like my bulged disc is never going to heal ):
Could one have both going on?
That is the question that's never answered.
What tests can determine if you are one of the 10% that have Piriformis syndrome? I had an MRI of my back, would it have shown up? Can a person have both issues? Piriformis and sciatica? Which would radiate to horribly strain or cause pain in your groin?
Piriformis syndrome will cause sciatic nerve pain. Look for some diagnostic stretch test videos. That helped me determine what’s going on
I think question is if this is ps then is this due to nerve going inside p muscle or around it
Question please, I suspect I have herniated disk, can that cause swelling on bottom left side above the butt? Thanks
I have tender spots in my lower spine, just a tingle when i move something or when i try to lift something heavy mild numbenss in leg comes and goes mostly starts when im sitting. I can bend over without pain
It's not fair to have this crap