Intraoperative microscopy studies of sciatica patients demonstrate that disc herniation, and the adherence of spinal nerve roots to bulging or herniated discs, causes sciatica discomfort and pain when the dura matter of the frail nerve roots become attached to the hernia and compressed matter. Though the connection between sciatica pain and disc herniation is clear, spinal care practitioners should not rely solely upon imaging results in making a definitive diagnosis of sciatica but should recognize the microscopic and physiologic alterations that may occur with nerve root stretching. Roughly 10 percent of patients with sciatica will not have positive disc compression or excessive traction results in MRI tests, as mechanical stresses and post-surgical epidural fibrosis can stretch nerve roots and contribute to restricted blood flow and other ischemic changes that can cause symptoms of radiculopathy and sciatic pain—with, or without nerve compression.
Expressions of Sciatica Pain
Though the precise mechanisms of sciatica discomfort are not completely understood, it appears that the condition can lead to many different types of pain—mechanical, inflammatory, neuropathic, and ischemic— within a single patient. Injury to the nucleus pulposus, for example, may create inflammation around the dorsal root or ganglion. Normally benign movements can create a hyper-sensitive pain response in patients with disc herniation or nerve root compression or stretching. The spinal cord may develop an exaggerated sensitization, leading to chronic or acute allodynia and neuropathies.
The Professional LxH Disc Model is our most popular three-dimensional spine design model for educating patients about the many possible mechanisms at work in sciatica pain. Using in vivo kinematics, the highly detailed LxH brings to life the dynamics of herniated or prolapsed discs, nerve root compression, in-growth and stretching. A downloadable disc disruption graphic is also included with the model to help demonstrate the multi-faceted nature of spinal discomfort. The LxH model is an invaluable educational tool that helps sciatica patients understand the nature of their spinal injury, promotes better postural attention, and explicates in a tangible way the mystery of spinal nerve pain and numbness. Alleviating the mystery of a patient’s sciatica pain helps to reduce their anxiety and stress, which contributes to the healing process.