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True sciatica refers to radiculopathy where the sciatic nerve roots (L4-S3) are compressed or irritated in the spine, typically due to issues like a herniated disc, spinal stenosis, bone spurs, or spondylolisthesis. This causes pain radiating from the lower back down the leg. In contrast, a tight piriformis muscle can compress the sciatic nerve peripherally in the buttock (piriformis syndrome), mimicking sciatica symptoms, but the symptoms rarely traverse down the leg, and instead cause pain mor
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