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Both involve compression of the sciatic nerve, but the location and mechanism differ. With a herniated disc, a disc in the lumbar spine bulges or ruptures and presses on a nerve root as it exits the spinal column. Piriformis syndrome involves the piriformis muscle — a deep muscle in the hip — becoming tight or inflamed and compressing the sciatic nerve as it passes through or beneath it. The symptoms can feel similar, but piriformis syndrome tends to produce more pain deep in the buttock and often worsens with prolonged sitting. Acupuncture can be useful for both, though the approach may differ slightly depending on the source of compression.