Why is the prognosis for sciatica always so poor? Sciatica is one of the most difficult pain syndromes to cure, often lasting for life. Few patients find lasting relief and even fewer enjoy a permanent end to their suffering from any particular form of treatment. If you ask most care providers about the realistic prognosis for sciatica, they will roll their eyes, sigh and begin to find a gentle way of delivering the bad news. This is if they are honest…
Some care providers will mislead patients, raising their hopes that sciatica can easily be cured with whatever therapy is on offer. These are the true villains, since statistics clearly show that sciatica is resistant to most types of care. However, the reason for this fact is not due to the ferocity or stubbornness of symptoms, in so much as it is a direct reflection of the epidemic problem of misdiagnosis of the underlying causative process. This is logical, since if the true origin of pain is not correctly ascertained, then any treatment will be powerless to cure sciatica, since they will be targeting a scapegoat condition instead.
This article explores the prognosis for sciatic nerve pain and explains why the verdict is grim for most patients.
We have studied sciatica is great detail for the past 15 years of our dorsalgia education and advocacy work. We can say for sure that it is the most defiant pain syndrome, regardless of which type of therapy is used to battle it. Our statistics present a bleak picture when it comes to finding sciatica relief, with less than 10% of patients finding true and lasting cures for their symptoms.
The medical establishment gets around unveiling such frightening statistics by recording the success or failure of specific treatments over very short durations. Patients report feeling better for a few weeks and are deemed to be "successfully treated", allowing doctors and therapists to make unrealistic claims about efficacy. In reality, most of these patients suffer relapses and often escalated symptoms following reports of their "cures".
We would love to be optimistic about the chances of any given patient achieving a cure, but have found little reason for demonstrating such a positive attitude. Sciatica remains one of the most fearsome pain conditions in severity, lifestyle consequences, duration and ability to resist cures. This is the real truth and we must tell it like it is.
Studying the actual curative statistics for sciatica treatments, one would think that all of these therapies fail due to the intensity of sciatica. The condition must simply be too strong to cure using the types of therapies utilized. This is not at all true. In fact, some patients do enjoy excellent results from therapy, even when they have very severe symptoms. The real reason for this fact is simple.
Treatment works when it is indicated and targeting the correct source of pain. In some patients, the diagnosis is spot-on, allowing doctors to resolve the underlying mechanism by which pain is produced, thereby enacting real cures. While these cases are rare, they do occur and represent excellent doctoring in the face of many impediments to accurate diagnosis and successful treatment. In the remainder of cases, the explanation for why treatment fails time and time again is almost always the exact same: misdiagnosis.
We support this position with evidence that once treatment fails, subsequent therapies targeting the same causative process tend to fail in virtually all cases. This is a truth that we have seen regardless of the particulars of the patient’s case profile, the clinical presentation of the sciatica or the type of treatments utilized.
The main reason why treatment tends to fail patients is certainly linked to misdiagnosis of the actual reason why pain exists. If this part of the equation can be corrected, then patients can drastically change their future sciatica prognosis for the better. To this end, we provide the following crucial advice:
Do lots of independent research and learn all you can about the various forms of sciatica and pseudo-sciatica. Knowledge is your best weapon against misdiagnosis and unsuccessful treatment. This website is a great resource, as are some of the other properties of The Cure Back Pain Network.
Invest time and effort in the diagnostic process. Consult with more than one doctor and make sure that they perform a thorough diagnostic evaluation, including physical exam, imaging study and general health screening.
Watch out for signs that your sciatica might be blamed on a coincidental scapegoat condition, as this is a very common occurrence. Most arthritis, herniated discs and degenerative disc disease implicated in creating sciatica are misdiagnosed.
Be aware that many sciatica pain conditions are actually mindbody syndromes and can be traced to a psychogenic causation. This possibility is rarely suggested by traditional care providers, so integrating mindbody medicine into the diagnostic mix is an excellent idea.