The syndrome has colloquially been referred to as “wallet sciatica” since a wallet carried
in a rear hip pocket will compress the muscles of the buttocks and sciatic nerve when the
bearer sits down and produce the same symptoms. Activities performed in the sitting
position that involves strenuous use of the legs as in rowing/sculling and bicycling can
also compress the sciatic nerve. In 15% of the population, the sciatic nerve runs through
the piriformis muscle rather than beneath it. These people have a greater incidence of
piriformis syndrome than does the general population.
This syndrome may be difficult to diagnose and treat due to the lack of x-ray or MRI
findings. It is also known as pseudosciatica or non-discogenic sciatica since it causes
symptoms similar to spinal nerve root compression. Piriformis syndrome should be
considered as a possible diagnosis when sciatica occurs without a clear spinal cause. CT,
MRI, ultrasound, and electromyography are useful in excluding other conditions and
help in reaching at a diagnosis.
Cauda Equina syndrome
Cauda equina syndrome is a serious condition in which the bundle of nerve roots at the
end of the spinal cord (cauda equina) is squeezed. It may be associated with bowel and
bladder problems as well as tingling or a loss of sensation and feeling to the lower pelvic
(perineal) area and the legs; these symptoms require immediate medical attention and
probable surgery.