Symptoms
Sciatica-like pain
Buttock and leg pain that mimics nerve root compression — frequently muscular in origin, especially from piriformis and gluteus medius.
Overview
True radicular pain follows a specific dermatome and is often accompanied by neurological signs. Many patients labeled 'sciatic' have a myofascial referral pattern instead — most commonly from piriformis or gluteus medius — with no nerve root involvement on careful examination.
Clinical notes
Compare slump and straight-leg-raise findings with reproducible muscle palpation. Pain stopping above the knee, with negative neurological exam, makes myofascial origin much more likely.
Red flags — when to refer
Progressive weakness, bilateral symptoms, saddle anesthesia, bowel/bladder changes — urgent referral.
Muscles often involved
References
- • Travell & Simons, Vol. 2