The understanding of the aetiology of sciatic pain continues to develop. There is an increasing understanding of the role of cytokines and inflammatory mediators in the origin of this pain. Early clinical trials seem to suggest that there may eventually be a non-operative solution to the treatment of this condition. However, the gold standard for operative treatment for those patients who fail to resolve spontaneously remains microdiscectomy.
The condition itself is one that with relatively little knowledge in terms of understanding the dermatomal distribution of nerves and the clinical history of patterns of pain can be easily diagnosed from a history and examination. The imaging techniques now available to us should be used to confirm the clinical impression given by the patient on consultation. They should never be used as a substitute for obtaining a good history and a thorough examination.
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