Sciatica: What is it? 

By Christina Lasich, MD

“Sciatica” is an old world term that refers to leg pain felt down the back of the thigh into the calf and foot. What about thigh pain? What about buttock pain? Unfortunately, “sciatica” has been wrongly applied to all types and locations of leg pain. In 1948, the use of the word “sciatica” was declared “unhelpful” by a leading orthopedic specialist because it is limited to a certain location and really does not address the origin of the pain. Over the years, many older medical terms like sciatica have become archaic as the newer research technologies give doctors clearer definitions and a better understanding of the human body. Leg pain that comes from the low back is most accurately categorized as referred pain or neurogenic pain. These terms apply to all locations and address the origin of the pain. With these newer terms, the antiquated word, “sciatica”, has no place in the modern world.

Sally has been waking up with right leg pain lately. This started when she strained her back while moving to her new apartment. Sometimes, she will feel a little tingling sensation in her little toe. Her mother told her not to worry because the pain is just sciatica. Sally doesn’t care what it is called because she just wants it to go away. The nights are utterly miserable when it feels like a hot poker is stabbing her leg.

Sally may not care what the leg pain is called. But, categorizing leg pain as either referred or neurogenic pain is a very important step towards finding a cure. If the leg pain is referred from the spine, then the pain would actually be coming from the spine structures like the ligaments, joints, or discs. Referred pain is a pain felt at a site distant to the origin of the pain. For example, in the event of a heart attack, sometimes the person will experience left arm pain. Nothing is wrong with the arm. But, the brain is just confused about where the pain is actually coming from; so, the arm hurts. The same thing can happen in the low back. A painful lumbar facet joint can refer pain into the groin, buttocks, or thigh. Referred lumbar pain should not be called sciatica because this type of pain can be in all areas of the leg. By calling the pain “referred pain”, healthcare practitioners will know the general cause of the pain which is very useful information for determining treatment (See Referred Pain: Can it be treated?).

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