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Our Doctor comments on recent article: “Newest Options for Treating Sciatica


Dr. Sakai’s thoughts:

I would like to take this opportunity to clarify exactly what sciatica is.  Sciatica describes a pattern of pain radiating from the back into the leg, usually below the knee.  However, sciatica does not indicate the cause of the symptoms and is therefore not a diagnosis.  A common misconception is that sciatica implies a problem of the sciatic nerve.  The pain pattern of sciatica can be caused by a problem of the sciatic nerve itself, but more commonly, it is due to a problem affecting one of the 5 spinal nerves (L4, L5, S1, S2, and S3) which exit the spine and come together to form the sciatic nerve.  Problems of the sciatic nerve itself are actually rare.  One possible cause of direct sciatic nerve compression is piriformis syndrome.  About 10-15% of the population has a sciatic nerve that travels through the piriformis muscle in the buttock region, so that in some (but not all) of those individuals, a shortened piriformis or spasms of the muscle may irritate the sciatic nerve.  In any case, because of the confusion generated by the term, sciatica, I prefer not to use the term at all.  However, the fact is that it is a commonly used term, so it is helpful to remember that it simply describes a pattern of pain, but is not a diagnosis.

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