Many patients write to us saying that they have lower back sciatica. In reality, lower back pain and sciatica are 2 completely different issues and true sciatica only exists from the buttocks down and does not extend into the actual lower back area. It is common for lumbar back pain and sciatic nerve pain to exist together, but it is wise to keep the 2 separated ideologically, as well as diagnostically, as they may or may not be related to the same causative condition. Assuming they are one and the same symptomatic expression, caused by the same source process, is the first mistake committed by both many patients and care providers alike.
This treatise examines lumbar pain experienced in combination with lower body radiculopathy.
Sciatica is defined as pain, tingling, numbness or weakness in the buttocks, legs and/or feet. This is logical, since it traces the path of the sciatic nerve. This largest of all bodily nerves does not even exist in the lower back, so it is quite impossible to have sciatica low back pain as many patients report.
The nerve roots which eventually go on to form the sciatic nerve do exist in the lumbar and sacral spinal regions and these can sometimes be the source of both the lower back issues, as well as the sciatica pain. However, in other patients, symptoms in the legs and feet may be unrelated to the occurrence of low back pain.
For example, sciatica symptoms may occur due to cervical spinal stenosis in some patients, who also have coincidental low back pain due to some other unrelated spinal structural issue, soft-tissue pathology or regional process.
Lower back pain can result from spinal issues, such as herniated discs or osteoarthritis, as can pure sciatica. However, there are numerous other explanations for low back pain which may not cause sciatica symptoms in the legs or feet, including spondylolisthesis, facet joint syndrome, muscular strains and sprains, scoliosis, hyperlordosis and ischemia.
Sciatica can also be sourced in any of the above conditions, but may also come from unrelated issues, such as piriformis syndrome, sacroiliac joint pain, regional soft tissue or joint injury in the legs or feet or even general health conditions, such as diabetes. Unless the symptoms of both conditions match the theorized causative diagnosis exactly, never simply assume that both the low back and lower limb expressions are identically sourced, since this often leads to poor curative results when treatment is applied.
In my own experience, I was foolish enough to group all of my symptoms, no matter how diverse they may seem, all under the explanation of my original diagnosis of disc degeneration and 2 lumbar herniations. In all fairness to myself, I did this because my doctors always did the same and always had some answer as to why new symptoms were related.
Pain above the affected spinal levels? Oh, that is due to muscular interactions.
Pain in the neck? Oh, that is because of your posture changing.
Headaches? Oh, that is the spinal realigning inside the canal after a chiropractic adjustment.
It was all a bunch of fantastic lies. The truth should have been told. It might have gone something like this:
We have no idea why you are experiencing these seemingly illogical symptoms from lumbar spinal conditions. But, we will investigate the new expressions and find out. This was never the case, since these doctors already had a good thing going. I was paying their mortgages, car payments and kid’s college tuitions.
Why fix something that was not broken?
Well, our financial relationship might not have been broken, but judging by my pain, I was. The money meant more than my suffering.
It took me literally quitting care cold turkey after 18 years in order to learn the truth about so many aspects of back and neck pain. I discovered most of these bits of knowledge through independent research, rather than being told by my doctors and chiropractors, which was my human and legal right.
Here is my point: Never assume. Never. Doing so when it comes to symptoms is sure to backfire. Always investigate all possible explanations and never take the easy way out by simply grouping all your sufferings under one umbrella diagnosis, especially one which does not even make sense, like lower back sciatica.
If you really need everything so impossibly oversimplified, then I can spell it out for you right now. You have pain because you are human. The diagnosis is being human. Good luck finding a cure for that.