Is It Really SCIATICA?


by Senior Intern Alec Domjan

You’re bending down to pick a box up and all of a sudden you feel a sharp pain down your leg. Ouch! A quick web search may have you think that leg pain is coming from your sciatic nerve, a nerve that runs from your buttock to the back of the thigh. When affected, the nerve can refer pain down the back of the leg. However, does that mean the cause of the pain is from your sciatic nerve or could it be from somewhere else?


More often than not the pain generator is coming from the lumbar spine, specifically the discs of the lumbar spine. Lumbar disc dysfunction (bulge or herniation) can irritate the surrounding nerve roots which cause nerve pain down the back of the leg. This pain will refer down the same path as the sciatic nerve leading many to believe the issue is coming from somewhere in the leg.

Still, the question begging to be asked is how do we determine if the pain is coming from the sciatic nerve or the lumbar disc? One of the most effective diagnostic tools is also one of the most common therapies utilized here at Indy Spine and Rehab! Mechanical Diagnostic Therapy, also known as the Mckenzie Method, is a system of assessment that uses movement to determine if symptoms get better or worse. In other words, if you have sharp, shooting pain down the back of your leg and flexing forward makes it worse but standing back up and extending the low back makes it feel better then it’s not sciatica!

Research shows that a majority of those with radicular symptoms from the low back demonstrate a decrease in symptoms with repeated movements. This is powerful because costly imaging like an MRI may not be needed if the person responds to movements. In addition, if a certain movement reduces symptoms the patient knows exactly what to do to manage their pain! If you or someone you know has nerve-like pain down the buttock, hip, or legs send them this blog and encourage them to schedule an appointment with us! We love getting people back to their regular lifestyle and living pain-free!

Research: Murhphy DR, et al. A nonsurgical approach to the management of patients with lumbar radiculopathy secondary to herniated disk: a prospective observational cohort study with follow-up. J Manip Physiol Thera. 32.723-733. 2009.

Research: Hefford C. McKenzie classification of mechanical spinal pain: profile of syndromes and directions of preference. Manual Therapy. 13.75-81. 2007.

Brian Watters