A sciatica scapegoat is an abnormal spinal condition which takes the blame for otherwise idiopathic sciatic nerve pain, but is not the real source. In essence, a spinal irregularity exists, but is completely coincidental to the symptoms expressed.
Spinal scapegoats are the crutch holding up the back pain industry. Without them, doctors and chiropractors would actually have to figure out why we have unresolved chronic pain, instead of simply blaming the pain on some mostly innocent and benign anatomical irregularities.
This article will focus on scapegoat conditions which are implicated in causing pain, despite the lack of evidence of any pathological process. There are many possible scapegoat conditions which may be unfairly blamed for causing back, neck and sciatica pain. However, it is crucial to know that the vast majority of these conditions can exist in both symptomatic and asymptomatic forms. This is why proper evaluation with several objective doctors is always advised.
A scapegoat is a condition which is blamed for pain when it is not the actual cause. In back pain patients, scapegoats account for more diagnoses than can be counted. I typically use the terms abnormalities or irregularities to describe spinal scapegoats, but even these terms are not accurate. In fact, most spinal scapegoats are extremely common and this is one of the very reasons they are so often used to explain chronic symptoms.
Doctors do not want to tell any patient that they do not know what is actually wrong. If there seems to be a plausible answer for a painful complaint, then count on the doctor to use that condition as a scapegoat, even if the symptoms do not exactly match the diagnosis. It should be noted that in a great many patients, the expression does not correspond exactly or at all.
Add to this fact that many doctors were educated when abnormalities in the spine were viewed in a completely different light. It is only recently that research has clearly shown the true nature of most innocent scapegoat conditions, although many are still vilified by physicians with antiquated training and care providers who are simply trying to capitalize on a patient’s fear and misinformation.
Degenerative processes are the most common of all spinal scapegoats. Doctors simultaneously report that these conditions are universal and a normal part of the aging process, then turn around and blame pain on these same normal and universal conditions.
If spinal degeneration was indeed an inherently painful process, then we would see a universal downward spiral effect as we get older, since the process is indeed progressive until we die. However, this is simply not the case.
In fact, most severe chronic sciatica occurs in patients between the ages of 26 and 55. These are not the ages of enduring the worst spinal degeneration, but they are the years of being burdened by the most psychoemotional responsibility.
A back injury is a scary event, but is also shrouded in myth more than fact. Injuries heal, that’s what they do. The body’s primary imperative is to heal wounds and repair itself. That is what the body does. This is basic medical fact.
It is normal for an injury to cause pain. It is normal that a severe injury might cause extreme pain. However, it is also normal that an injury will heal. Experiencing years of chronic sciatica due to some minor back injury is illogical and nonsensical. Far more likely, the injury left some evidence in the spine (an abnormality, if you will) and this abnormality is being used as a scapegoat.
The actual injury has long since healed, but the mind may have sought to perpetuate the pain based on various factors detailed in the psychosomatic sciatica section.
The patient may also be a victim of the conditioning process and now feels they are permanently damaged due to their exposure to less ethical doctors and lawyers. This is extremely common in the field of back and neck injury litigation. Sure, the plaintiff might win some money, but is it really worth it to be in pain for life?
There is no discounting the minority of patients who have endured truly horrific trauma and can not fully heal. These are the exceptions to the rule, but in these sad circumstances, my heart goes out to anyone who suffers from chronic pain based on purely anatomical criteria which can not be adequately addressed by medical science.
Every day I speak to dozens of patients. Literally, thousands or even tens of thousands a year. They mostly like my sites and appreciate the information as honest and a very mirror, if you will, of their own experiences with sciatic nerve pain. However, when reading a page like this one, they mostly say: "Oh, that’s not me, I actually have a (insert your diagnosis here). I am really hurt. The MRI says so."
These poor patients are doomed to continue suffering, since they do not seem to understand the scope of this very article. So, let's make it super clear: Any spinal abnormality can act as a scapegoat in asymptomatic form.
All these conditions can act as scapegoats, while existing innocently and coincidentally to any pain:
Kyphosis or lordosis
For every example of a condition you can show me that actually causes painful symptoms, I can show you 100 in which no pain exists with the same diagnosis.
If these diagnoses are the actual cause of your pain, treatment should have made you all better by now. If your diagnosed condition has caused you ongoing pain and resisted all attempts at treatment, how can you still have confidence that the sciatica scapegoat is indeed the actual cause?
Here are some tips:
Always be sure to get multiple professional opinions from different types of doctors and complementary therapists.
Always do lots of independent research to look for holes in the diagnostic theory.
Always demand that the pathological process associated with any diagnosis be explained to you in detail and make the doctor put it in writing.
In summary, let’s clarify this article. Any spinal abnormality can be problematic in rare cases. Most are innocent. Most are sciatica scapegoats.