Sciatica from herniated discs is one of the main diagnostic theories used to explain the majority of lower body radiculopathy issues. Sciatica, by definition, is nerve pain and related symptoms sourced in the spine, but experienced in the buttocks, legs and/or feet. Being that disc desiccation and herniations are virtually universal in the lumbar spinal region, it is no surprise that almost every person with sciatica symptoms will also have disc issues which may be blamed for their occurrence. However, research statistics clearly reveal little, if any, correlation between intervertebral disc issues and any variety of back pain, including sciatica.
Herniated discs can result from injury or normal spinal degeneration. Herniations are most common in the lower cervical and lower lumbar intervertebral levels. Herniated discs at L4/L5 and L5/S1 are the most prevalent targets of blame for sourcing sciatica pain. While it is certainly possible that a bulging or ruptured disc can enact sciatica pain, tingling, weakness or numbness in the back, buttocks, legs or feet, most herniations are coincidental to any pain experienced. This has been proven time and time again in more clinical studies than can be cited. However, this does not stop even the most innocent minor herniations from being theorized as the cause of pain in many sciatica sufferers.
A herniated disc unto itself is not painful. Traumatic injury to the back pain can surely cause pain and a fresh disc injury may hurt for a while. However, unless the disc influences some other spinal structure, the pain is not likely to last for more than a few weeks. The possible mechanisms which can create chronic pain in herniated disc patients are as follows:
* Spinal stenosis can reduce or cut off nerve supply of the actual spinal cord, possibly enacting dire symptoms. Although diagnosed often in combination with herniations, actual symptomatic spinal stenosis is more often the result of arthritic osteophyte buildup within the spinal canal.
* Foraminal stenosis is the proverbial pinched nerve. In these cases, the disc bulges into the space through which the spinal nerve roots leave the spinal column. In many cases, the disc is said to "impinge", "encroach upon" or "compress" the affected nerve root. The result may be painful short term, but will enact complete objective numbness and weakness in a specific set of muscular tissues in the long term. Once again, this rarely occurs and most pinched nerve diagnoses do not even account for the lack of correlation between symptoms experienced and symptoms expected.
* Chemical radiculitis is thought to exist in some patients with particularly sensitive neurological tissues. This diagnosis comes into play when a ruptured disc or disc with an annular tear spills the nucleus proteins unto nearby nerve tissues. This protein may be irritating to some people, but not others. Chemical radiculitis is a highly controversial theory of pain which may apply in some cases, but not in all. Even when the diagnosis is accurate, it would not likely explain sciatica pain, but may provide an answer to localized back pain.
* Discogenic pain may be diagnosed when the small nerves in the endplates are affected mechanically or when they are exposed to irritating protein inside the disc. In some cases, these endplate nerves may grow into the disc, enacting pain. However, being that these nerves are so small and not known for their sensory properties, this theory is once again highly controversial and would never explain sciatica, since these nerves are localized only.
Sciatica is a radiculopathy process, and like most nerve pain issues, is rarely traced back to definitive structural compression concerns. In my experience, the majority of patients with any type of lower body radiculopathy are not suffering from a spinal causation, but are instead being victimized by a regional oxygen deprivation syndrome which is affecting the entire sciatic nerve. This explains both the treatment-resistant nature of the pain, as well as the typical symptoms which are far too widespread to be explained from the working medical diagnosis. I routinely advise many patients to consider this explanation for their pain if they have tried everything for their diagnosed condition and have not found lasting relief...
Sensei Adam Rostocki suffered with chronic back and leg pain for many years. Sensei is the author of popular book, "Cure Back Pain Forever" (ISBN 1-59971-997-5). His Sciatica website details many nerve pain conditions, including sciatica from herniated discs.
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