The term sciatica is frequently confused with the term “pinched sciatic nerve”. Sciatic nerve is the longest and the largest nerve in the body that runs from the pelvis into the leg. Sciatica is the typical pain, usually accompanied by numbness and weakness in the leg, that runs along the same course as the sciatic nerve, but is not strictly speaking always due to a pinched sciatic nerve. In fact, there are many causes of sciatica, but direct impingement of the sciatic nerve is uncommon.
The more common cause is slipped spinal disc. Other causes can include spinal canal narrowing, scoliosis, spondylolisthesis, tumor, infection and piriformis syndrome (in this case, pinching of the sciatic nerve by the gluteal piriformis muscle).
History and physical examination alone usually are adequate to isolate the pain source. Further testing can include electromyography, nerve conduction study and MRI.
Treatments should progress from the more conservative (rest, medication, PT), to the interventional (epidural steroid injection, selective nerve root block), to the more invasive (surgery) based on each patient’s situation.
IDD Therapy and Chiropractics are also helpful treatment alternatives.