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Sciatica or Sassy Butt? Understanding Muscle Spasms in the Gluteus

Did you know… muscle spasms in the gluteus are often misdiagnosed as sciatica

You might have been told that you have Sciatica by a doctor, Chat GPT, a frantic Google search at one in the morning, or by a friend who knows what everyone else’s problems are but their own. In short, YES, you have a sciatic nerve. Everyone does. Is it causing you problems?

Statistically, the answer is no; it is probably not.

Muscle spasms —also known as trigger points— in the gluteus, particularly in the gluteus medius and gluteus minimus muscles, are a common source of pain easily misdiagnosed as sciatica or radicular pain. This confusion arises because of the similarity in the symptoms they produce. Understanding the differences between these conditions is imperative for accurate diagnosis and effective treatment.

Sciatica vs. Muscle Spasm Symptoms

Let’s look at some overlapping symptoms that can help you distinguish between sciatica and muscle spasms in the glutes. Knowing what to look for can equip you to give a more accurate representation of your symptoms to your doctor and avoid potentially unnecessary and costly treatments.

Sciatica/Radicular Symptoms

Sharp, shooting pain that travels from the lower back through the buttock and down the leg. Pain wraps from the back/side of leg to the front of the leg.

Muscle Spasm/ Trigger Point Symptoms

Sharp, shooting pain that travels from the lower back through the buttock and down the leg. Pain is limited to the back and side of the leg.

Muscle Spasms in the Gluteus

X = muscle spasms
Red Dots = reported pain

Regardless of which pathology, you are likely to experience some or all of the following:

  • Tingling or burning sensations.
  • Numbness or muscle weakness in the affected leg or foot.
  • Pain that worsens with movement.
  • Pain in the buttock and/or lower back.
  • A sensation of tightness or cramping in the gluteal muscles.
  • Difficulty in sitting for prolonged periods.

Is it Radicular or Just Plain Ridiculous?

With these overlapping symptoms, no wonder the sciatic nerve is so commonly blamed. A nerve that is being pressed or entrapped by another structure of the body causes radicular symptoms most commonly a bulging disc. However, bulging discs can only be identified by an MRI.

Anyone who claims you have a bulging disc without first viewing an MRI of your spine is ignorant at best or disingenuously lying at worst. It is such a common practice to tell patients they have a bulging disc without sufficient evidence to back up the claim that this form of malpractice is given little thought.

The Piriformis Trigger Point Referral Pattern

To make diagnosis even harder, there is a muscle called the piriformis that the sciatic nerve innervates the muscle in some people.

When the piriformis muscle is tight or spasming, not only will the trigger point patterns be present, but the sciatic nerve may be irritated, giving you temporary radicular symptoms.

Muscle Spasms in the Gluteus

Treatment Approaches

Treatment for each condition varies significantly.

Sciatica or radicular symptoms often require addressing the underlying cause of nerve compression, which may include:

  • Decompression
  • Anti-inflammatory medications
  • Surgery (in severe cases)

Muscle Spasms in the Gluteus are typically managed with:

  • Rest
  • Stretching
  • Massage therapy
  • Myofascial release
  • Heat therapy
  • Muscle relaxants

Typically, less invasive treatments should be done before others. This includes a specific form of massage therapy called myofascial release, which can be a useful tool for helping physicians make an accurate diagnosis. It is safe to stretch and massage the gluteus muscles at home.

If you’re unsure how to stretch safely, consult a professional. Read The Art of Stretching, to gain a deeper understanding of how to properly stretch your muscles without making matters worse.

Understanding the differences between muscle spasms in the gluteus and sciatica is crucial for accurate diagnosis and treatment. While the symptoms can be similar, careful assessment and attention to the pain patterns can help differentiate between the two conditions, ensuring appropriate and effective care.

If you experience persistent buttock, low back, or leg pain, it is important to seek medical advice for a proper diagnosis and treatment plan. Contact our specialists at Northwest Health Specialties to address this type of pain today.

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Northwest Health Specialties

Based in Vancouver, Washington we specialize in Naturopathic Medicine, Acupuncture, Nutrition, Massage Therapy, and more.

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