That sharp, shooting pain that travels from your lower back or glutes down through your leg is one of the most disruptive things your body can throw at you.
It makes sitting unbearable.
It wakes you up throughout the night.
It shows up without warning and disappears just as unpredictably as it arrived.
Most people assume it’s sciatica. Which, in some cases, it is! However, one of the most common causes of sciatica-pattern pain isn’t the sciatic nerve at all. It’s a small muscle most people have never heard of: the piriformis.
Let me introduce you to the pain patterns.
Here’s how to tell the difference, and why it matters for how you treat it.
What Sciatica Actually Is
Sciatica is a symptom, not the actual diagnosis. It describes the pain that travels along the path of your sciatic nerve, the longest nerve in the body, running from the base of your spine, the lumbar spine, through the glutes and stretches down into each leg.
True sciatica is usually caused by compression at the nerve root itself. A herniated disc is the most common culprit, responsible for the majority of cases according to the National Institutes of Health. Spinal stenosis and other lumbar spine issues can also be the source.
The pain patterns tend to be one-sided. It often includes numbness or tingling alongside the shooting sensation. It tends to be worse with sitting and better with walking or lying down. Movement is therapy.
What Piriformis Syndrome Is
The piriformis is a small, deep muscle that sits underneath the gluteal muscles. Its job is to rotate the hip outwards, think external rotation. When it becomes too tight, inflamed, or goes into a muscle spasm, it can compress the sciatic nerve as it passes nearby or directly through the muscle, depending on individual anatomy.
The resulting pain feels almost identical to disc-related sciatica. Shooting and burning sensation down the leg. Aching in the glutes. Numbness that travels into the foot.
The difference is where the compression is happening. With true sciatica, the problem is in the spine. With piriformis syndrome, the problem is in the muscle itself, and that changes what treatment actually reaches it.
Why the Distinction Matters for Treatment
Treatments aimed at the lumbar spine won’t reliably resolve piriformis syndrome because the compression isn’t there. And treatments focused only on the glutes and piriformis won’t help if the actual issue is a herniated disc putting pressure on a nerve root.
This is why it matters to work with someone who understands the difference and can tailor the approach based on where the pattern actually originates rather than just where the pain presents.
How Ashiatsu Addresses Both Patterns
Ashiatsu is particularly well-suited for both sciatica and piriformis syndrome because of the depth and surface area it can reach.
For piriformis syndrome, the muscle sits deep under the gluteal layer. Hands-based massage can reach it, but not with the kind of sustained, broad pressure that actually changes chronically tight tissue. Ashiatsu delivers consistent, gravity-assisted pressure through the entire gluteal region without the fatigue that limits hands-based work. It can hold a point on the piriformis long enough for the muscle to actually release, rather than just temporarily compress.
For lumbar nerve pain, ashiatsu addresses the paraspinal muscles and broader low back tissue that contributes to compression at the nerve root level. Reducing muscular tension in the lumbar spine doesn’t fix a disc, but it can meaningfully reduce the mechanical load that aggravates it.
The two approaches can be used in the same session, which is part of why clients dealing with shooting leg pain tend to respond well to a full-length ashiatsu treatment rather than shorter, more targeted work.
What to Tell Your Therapist Before the Session
If shooting leg pain is what brings you in, be specific about where it starts and where it travels. Does it begin in the low back or in the glute? Does it go all the way to the foot, or does it stop at the knee? Is it worse when sitting, when standing, or in the morning? Is it one side or both?
That information helps identify whether the pattern looks more like a lumbar nerve issue or a piriformis issue, and it shapes where the session spends the most time.
One important note: if you’re experiencing any loss of bowel or bladder control alongside leg pain, significant leg weakness, or numbness in the inner thigh or groin region, those are signs to see a physician before booking your massage appointment. These symptoms can indicate something that needs medical evaluation first.
For the vast majority of people with shooting leg pain, though, the pattern is muscular in origin and responds well to consistent, targeted soft tissue work.
In the meantime, our post on sciatica stretches you can do at home is a great place to start between sessions!
Ready to address your shooting leg pain at the source? Book your appointment online or call/text 719-459-0780. Inspire Movements Massage Therapy is located at 1295 Kelly Johnson Blvd, Suite 250 in Briargate, Colorado Springs 80920. Open Monday, Tuesday, Friday, and Saturday 9am-7:30pm. By appointment only.