You Don't Have Sciatica.
It's a symptom, not a sentence.
Sciatica is such a common condition. Like really common. So many people experience it at some point in their lives.
So, naturally, there is a wealth of information available to educate people about the condition and provide helpful advice and treatments.
Sounds great, right...?
WRONG!
Unfortunately, these commonly praised "sciatica treatments" are often useless at best. Trying to understand and treat "sciatica" often just leads to more confusion.
Let me explain.
One of the big issues in understanding and effectively treating back pain is that it is such a non-homogeneous diagnosis.
While we tend to broadly refer to it as "back pain" and say things like "I've got a bad back", what that means can vary greatly.
There is a variety of conditions and injuries that can cause back pain. They can occur in different locations in the spine, cause pain through different mechanisms and overall have different effects on your life and function. In some cases, back pain may not be caused by an issue in the back or spine at all!
As a result, the best way to treat your back pain may be completely different to the best way to treat someone else's. This often makes it horribly confusing for someone who has developed back pain and is trying to figure out what the hell is going on and what they should do about it.
Sciatica suffers from these same problems.
Sciatica is not a diagnosis; it's a symptom.
We need stop diagnosing people with sciatica. Sciatica is not a diagnosis; it's a symptom. We need to diagnose the cause of this symptom, not the symptom itself.
This is like your Doctor diagnosing you with a fever.
Imagine going to see your Doctor because you are feeling unwell, and they diagnose you with a fever. You would be thinking, "NO SH*T SHERLOCK... What's causing it!? What should I do about it!?"
Is it an infection? Do I need antibiotics, or is it viral? Should I medicate the fever, or let it run its course?
And so on...
Beginning to see how insane this is? It's no wonder people with sciatica struggle to get relief.
We need to identify the cause of the sciatica.
I continue to be shocked and disheartened as I repeatedly encounter concerned people that are told they have sciatica and are terrified about what this may mean. There is so much baggage associated with the term now that it has become such a confusing mess, particularly for people who may have just developed this pain for the first time.
I regularly read and hear things like:
"Will this go away? I cannot imagine living the rest of my life like this."
The equation in their heads seems to go something like: sciatica = permanent, incurable nerve damage and pain.
Sciatica does not mean any of these things. The only thing it refers to is radiating pain felt in the sciatic nerve.
While this pain is commonly caused by a lower back injury (such as a disc bulge), it isn't always. And the overwhelming majority of sciatica causes are very treatable without major intervention or lifelong pain and disability.
There is a big difference between telling someone:
You have sciatica... caused by severe spine cord compression that could lead to permanent loss of function if we don't operate immediately, and,
you have sciatica... caused by mild disc bulge, take it easy and it will probably resolve itself in 8 weeks or so.
This is just a ridiculous situation to be putting clients and patients in, and I believe it initially stems from diagnosing people with something that isn't a diagnosis.