Is It Sciatica or Just a Tight Muscle? 3 Ways to Tell the Difference

You feel a sharp pain deep in your buttocks. Maybe it travels down the back of your leg. Immediately, the word pops into your head: Sciatica.

It is one of the most Googled medical terms in existence, and for good reason—it can be incredibly painful. However, at our physiotherapy clinics in Rockland, Orleans and Beechwood, we find that a significant number of patients coming in with “Sciatica” don’t actually have a spinal nerve problem.

They have what we call “Pseudo-Sciatica”—tight muscles mimicking nerve pain.

Knowing the difference is crucial because the treatment for a pinched nerve in your back is very different from the treatment for a tight muscle in your hip.

First: What is “True” Sciatica?

True Sciatica (medically known as lumbar radiculopathy) is caused when the sciatic nerve is compressed or irritated at its root—right where it exits the spine.

This is usually caused by a herniated disc or narrowing of the spinal canal (stenosis).

The Imposter: Piriformis Syndrome

The sciatic nerve runs from your lower back, through your hips, and down your legs. On its way, it passes directly underneath (and sometimes through) a small muscle deep in your glutes called the Piriformis.

If your glute muscles are tight, spasming, or overworked, they can squeeze the sciatic nerve. This sends pain signals that feel exactly like sciatica, but your spine is perfectly healthy.

3 Ways to Tell the Difference

While only a physiotherapist can give you a definitive diagnosis, these three signs can help you distinguish between a back problem (Sciatica) and a muscle problem (Tightness).

1. The “Knee Line” Test
This is the easiest indicator.

True Sciatica: Because the nerve root is compressed at the spine, the pain signal is strong and travels the full length of the nerve. True sciatica often shoots below the knee, into the calf, and even into the foot or toes.

Tight Muscle: Muscular trigger points (knots) in the glutes can refer pain down the leg, but it rarely goes past the knee. If your pain is concentrated in the buttock and stops at the hamstrings, it is more likely a muscle issue.

2. The Type of Pain
True Sciatica: Often feels “electric.” Patients describe it as sharp, shooting, burning, or like water running down their leg. You might also feel distinct numbness or “pins and needles” in the foot.

Tight Muscle: Usually feels like a deep, gnawing ache or a “toothache” in the buttock. It may throb, but it rarely has that “electric shock” quality.

3. The “Slump” vs. The “Stretch”
What makes it worse?

True Sciatica: is often aggravated by spinal positions. Slumping in a chair, coughing, sneezing, or bending forward to tie your shoes often sends a zap of pain down the leg because these actions pull on the nerve root.

Tight Muscle: is often aggravated by direct compression or stretching. Sitting on a hard surface (compressing the glute), walking up stairs, or crossing your legs will trigger the deep ache.

Common Questions About Sciatica

We looked at what people in Ottawa are asking online about this condition. Here are the answers:

“Does sciatica come on suddenly or gradually?” It can be both. True sciatica from a disc herniation can happen suddenly (e.g., after lifting a heavy box). However, pain from tight muscles (Piriformis syndrome) usually comes on gradually after a period of increased activity or long bouts of sitting.

“Is walking good for sciatica?” Generally, yes. “Motion is lotion.” For most back-related sciatica, short walks are better than bed rest. However, if walking significantly increases your leg pain or causes numbness/foot drop, stop and consult a professional.

“How long does sciatica last?” Acute sciatica usually resolves significantly within 4 to 6 weeks. However, if it is caused by muscle tightness, it can linger for months if the muscle isn’t physically released through stretching, dry needling, or massage.

The Bottom Line

Whether it is a disc issue in your back or a tight muscle in your hip, you do not have to live with the pain.

If you are unsure what is causing your leg pain, let us check. We can perform a simple “Straight Leg Raise” and other orthopedic tests to pinpoint the exact source of your pain.

Book your assessment at Bellefleur Physiotherapy today and let’s get you moving pain-free.

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Jason Bellefleur

Jason Bellefleur is a multi-award-winning physiotherapist. Most recently, he was recognized as a 2016 Ottawa Forty Under 40 recipient and received numerous awards from the Orléans Chamber of Commerce (the 2011 Young Business Person of the Year, the 2012 Healthcare Professional of the Year and the 2014 Business Person of the Year awards). Jason is proud to be an Orléans resident and to raise his family in a bilingual community. He enthusiastically promotes local business within the Orléans area and frequently supports and participates in local events. Jason was recognized for his community involvement by receiving the Orleans 150 Community Builder award in 2017 by Ottawa-Orléans MPP Marie-France Lalonde. Jason firmly believes in high-quality one-on-one physiotherapy interventions. His treatment approach emphasizes hands-on intervention, continued client education, and active involvement by the individual to help them reach their full potential. By opening a clinic that offers 'Higher Standards of Care,' Jason wants his patients to feel confident that they receive the highest level of patient care available. As a result, he is also preventing injury and helping to improve their health and well-being.