As chronic pain educators, we are rather tired of hearing all the myths, misunderstandings and downright sciatica lies that are propagated in various ways within the healthcare sector. We always seek to provide a truthful account of sciatica in order to help patients to recover. We work hard to separate fact from fiction so that patients can make better informed diagnostic and treatment choices.
Many patients are provided with inaccurate information about why they have pain. Many doctors actually misunderstand why their patients have pain, explaining the very poor treatment statistics for virtually all causes of sciatic nerve symptoms. We know that some care providers even use these lies to convince patients that they require treatment, when they most often do not…
This critical article examines the many lies involved in sciatica care, some of which are directly propagated by care providers. After reading this essay, you will have a better chance of separating truth from falsehood when it comes to the actual facts of sciatica.
Many patients, and even many doctors, feel that sciatica is always caused by a spinal problem. This becomes a complicated issue to discuss, since by definition, ALL sciatica is caused by a spinal source. However, most sciatic nerve pain is NOT true sciatica, but instead is actually pseudo-sciatica. Doctors use this loophole to get away with proverbial murder when it comes to the diagnosis and treatment of these virulent chronic pain syndromes.
Most sciatica is actually pseudo-sciatica, not true spinal sciatica, and does not originate in the spine. While true sciatica can be caused by herniated discs, spinal and foraminal stenosis in the lumbar spine, the majority of cases are not spinally-motivated and should be called pseudo-sciatica.
Pseudo-sciatica mimics true spinal sciatica in every way, except that it is not sourced in the lumbar spine. It can be caused by a wide range of other mechanisms, as detailed in our comprehensive pseudo-sciatica section.
Only a minority of chronic sciatica syndromes can be called true sciatica and are therefore sourced in the lumbar spine. Therefore, the idea of treating the spine should never be assumed, but instead should be a last resort, since most cases do not require any form of therapy for the vertebral column in order to resolve.
As noted above, incorrect diagnosis of sciatica leads to the idea that the lumbar spine must be treated in order to relieve the pain. Since lumbar spinal abnormalities are virtually universal in adults, including arthritis, stenosis, disc abnormalities and other structural changes, these scapegoats accept blame of the pain and are treated unnecessarily in most patients, explaining the horrific curative statistics of thee same treatments for persistent sciatica symptomology.
The truth is that few sciatic sufferers require spinal interventions at all. Most instead simply need more enlightened diagnostic evaluation by a caregiver who has a clue. More importantly, the patient needs to see a doctor who is not brainwashed into ranking profit above the health of their patients. This is becoming increasingly difficult in the modern age of medical business, where treatment is the path to riches, regardless of objective need, efficacy, safety or sanity.
We mention often about how money has short-circuited logic in the healthcare system. It is an inside joke how poorly treatments work for virtually all back, neck and sciatica pain conditions. These treatments are designed to work, and believe it or not, actually do work when the diagnosis is correct. However, being that diagnosis is a subjective science and since diagnostic standards and practices protect the care provider against legal claims in all but the most criminal cases, doctors can basically do as they like and treat what they like, how they like. The result is a financial windfall for caregivers and a healthcare catastrophe for patients.
If you think we are exaggerating, do your own research from credible sources. You will see that conservative care is meant specifically to increase profit until the patient accepts a surgical recommendation. Sciatica surgeries demonstrate terrible results for resolving pain due to most lumbar diagnoses, especially herniated discs. After surgery, the patient is right back into rehabilitative care, then pain management, since the operation will probably fail. Do you feel someone is lying to you about the true nature of sciatica now???