Sciatica vs. Piriformis Syndrome — And What If Your Dizziness Is Actually BPPV?
Sciatica and piriformis syndrome both cause leg pain, numbness, and muscle tightness — but they require different treatments. This guide outlines the key differences between the two, and explains why some patients experience dizziness or imbalance from conditions like BPPV at the same time.
Why These Two Conditions Get Confused
Both sciatica and piriformis syndrome involve irritation of the sciatic nerve, leading to:
Leg pain
Burning sensations
Tingling
Weakness
But the source is different.
Sciatica: nerve compression in the spine
Piriformis syndrome: muscle irritation deep in the hip
The Overlooked Symptom: Dizziness
Some patients experience dizziness alongside nerve pain — especially when lying down, bending, or turning quickly. This can indicate BPPV, not just a musculoskeletal issue.
BPPV often presents when:
Rolling over
Looking up
Getting out of bed
Changing head positions
These motions can also aggravate sciatic pain, making the two issues blend together.
How PT Pinpoints the Real Cause
A Next Level therapist evaluates:
Neural tension
Hip muscle mobility
Lumbar spine mechanics
Vestibular function
Balance and gait
Treating only the pain without addressing dizziness can prolong recovery and increase fall risk.
Treatment Approaches
For sciatica:
Lumbar mobility
Nerve glides
Postural correction
For piriformis syndrome:
Soft tissue release
Hip strengthening
Targeted stretching
For BPPV:
Repositioning maneuvers like Epley or Semont
Most patients see improvement quickly when all factors are addressed together.
