Refractory sciatica is the most common form of pain syndrome in the lower back and legs. Sciatica has a well-earned reputation as a chronic and stubborn symptomatic expression and is known to be extremely difficult to cure. In fact, patients who experience symptoms that last longer than 6 months are more likely to endure a lifetime of suffering than truly make a 100% recovery.

Sciatica is not a condition or diagnosis in itself. It is a term reserved for a set of symptoms that generally include pain, tingling, weakness and/or numbness in the lower back, buttocks, legs and/or feet. Sciatica can be caused by a variety of mechanical, vascular, neurological, and psychosomatic sources, although the vast majority of affected patients are diagnosed with spinal causation of one kind or another.

Common spinal sources of diagnosed sciatica may include conditions such as: degenerative disc disease, herniated discs, osteoarthritic bone spurs, foraminal stenosis, spinal stenosis, spondylolisthesis, scoliosis, chemical radiculitis from ruptured disc, and extreme lumbar hyperlordosis. The most commonly diagnosed non-spinal structural sources of sciatica include piriformis syndrome and sacroiliac joint dysfunction. While it is true that virtually all of these conditions can cause sciatic nerve pain in the lower body, it is also a fact that these symptoms are rarely long-lasting and will almost always respond well to appropriate treatment modalities.

If sciatica caused by a structural source is generally not a chronic concern and usually resolves with the right therapy, why do most patients never recover from their pain? This is an old question that has plagued sciatica patients and care providers for generations. The answer to this question is becoming clearer as new research points to the epidemic incidence of ischemia as the logical cause of most sciatica and general radicular pain syndromes. Ischemia is also known as oxygen deprivation back pain and can be due to a variety of anatomic causes, often associated with poor cardiac or vascular function. However, the vast majority of ischemic pain syndromes are the direct result of a psychogenically or psychosomatically perpetuated pain imperative enacted by the subconscious mind as a defense mechanism against repressed, suppressed, and completely unconscious expressions of anger, fear, insecurity. , low self-esteem, guilt, regret and other negative and highly sensitive emotional issues.

Physicians do not receive comprehensive training in mind/body medicine and are taught in the well-established Cartesian tradition of designing the human body as one large, complex machine. This approach to care is ill-conceived, ineffective, and directly responsible for the chronic pain epidemic that is burdening our healthcare system to the point of failure. Physicians must realize that the mind and body work together to create all conditions of disease and health. Doctors must address the emotional side of chronic pain. Above all else, doctors need to stop blaming ongoing pain on coincidental, completely normal spinal scapegoats like disc abnormalities and spinal arthritis. The medical approach to treating back pain is a complete failure and it is time caregivers accepted the idea that they are dead wrong on almost everything that is accepted about common back pain and sciatica. Once this occurs, then real progress towards effective treatment can begin…

Fortunately, in the meantime, there are a growing number of doctors who have accepted the truth about chronic pain and have treated it very successfully using a completely psycho-emotional approach. The treatment statistics are incredible using knowledge therapy, as opposed to the plethora of mostly punitive and wasteful medical modalities such as spinal surgery, ongoing chiropractic manipulations, risky pharmaceutical treatment, and invasive injection therapy. It’s amazing how well psychological therapies work to permanently resolve physical pain, while physical treatments do little more than provide temporary placebo effects and fatten caregivers’ wallets…