Sciatica

[Bigwaved]

Originally Posted by chachee52

As a Physical Therapist I can say that it is important to know what is causing the sciatica. "sciatica" is a description of the symptoms and doesn't say what is causing it. Also once you have a herniated disc, it's always there. there symptoms may decrease because the inflammation around the area will decrease and not irritate the nerve.
Just my 2 cents, but I feel it's important to understand where the problem is coming from and fix the problem.

Not to be contrary, but as far as the herniated disc goes, stating that it will always be there really is not completely true. One could argue that it never returns to its original state, but to say that the herniation is always there is incorrect, imo. The bulge does recede over time, if allowed. Once this occurs, the annulus fibrosis will scar over. Granted, it will not be as strong or as efficient as it was prior to the injury. You hit the nail on the head when you say the pain generator needs to be identified. Just a release of chemicals in the area of injury can cause nerve pain without any physical pressure placed on the nerve by the nucleus palposis. A lot of cases show this pattern backed up by imaging. Just like a lot of imaging backs up that a lot of people are symptom free even with quite large bulges.

BTW, sciatca is a junk term in my opinion. Do you agree? I can count on one hand how many true sciatic nerve impingements I have seen at the piriformis. Most people report a pain that is really referred from somewhere else.