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People have heard about a sciatic nerve and sciatic pain. Often they come with leg pain or back pain and say: "I've got sciatica".

What is sciatica exactly?

Sciatica is a medical term to describe pain irradiating down to the rear side of one's leg. The sciatic pain is felt at least as far down as the knee or, more typical, down to the ankle and foot.

Back pain, hip pain or front thigh pain is therefore nothing to do with sciatica. Sciatica is sometimes, but not always, caused by irritation of, or a pressure on the sciatic nerve. Moreover, even in those infrequent cases of true sciatica "squeezing" or direct mechanical compression on the sciatic nerve is seldom present. As it is understood at present, true sciatica is caused by chemical irritation, swelling of surrounding tissues and/or reflectory activity (in other words, abnormal and excessive firing within and between nerves and spinal cord).

The most common cause of true sciatica is disc herniation. Discs are layers of cartilage, that separate vertebrae from each other and provide shock absorption during spinal movements. It consists of a jelly substance in the centre surrounded by a rough cartilaginous ring. With aging and/or heavy physical work, lifting the outer ring may give a "crack" and the central jelly partially leaks out. When it leaks toward a nerve it starts irritating the nerve sheath and may cause back pain, sciatica and often - neurological symptoms. In most of the cases disc herniations recover quite satisfactory and these days are considered by many as a part of a normal aging process.

Do nerves get "pinched" in the spine?

In actual fact nerve compression is not common in the spine and when a nerve gets compressed it gives you LOSS OF FUNCTION (i.e. weakness, diminished sensation along the nerve etc.), sometimes paraesthesia (numbness/pins&needles), but not pain usually.

So when you feel as if something is pinching in your back, it is not because the nerve is under pressure. It is more likely to be a tight muscle, locked joint or a trigger point. The same is true for a "nerve pain". Although all our sensations, including pain, go along nerves, usually pain originates in other structures. Nerves act as conductors rather than primary sources of painful sensations.

So if suddenly you start to suffer from sciatic pain do not panic thinking "my sciatic nerve is under pressure and may be damaged". There is a small chance of having a disc problem and even smaller chance of having anything serious. More likely your sciatic pain is a part of a simple mechanical back pain and will disappear with a proper treatment. In cases of disc herniation sciatic pain also disappears but over much longer period of time.

It is difficult to make a self-judgment as to what type of pain or type of injury is present. The best thing to do is to go and see a specialist who knows about spinal disorders like an osteopath, for example.