Just how difficulties in the back cause sciatic pain – this being a typical example of what is called ‘referred pain’ (medical name: synalgia), that is a pain that occurs in a part of the body other than where it might have been expected – will be explained in full in the next chapter. In the meantime, let us briefly note that referred pain is quite a common phenomenon: for example, we all know that some heart disorders can cause pain in the left arm and fingers. Equally, an abscess below the diaphragm may lead to referred pain in the shoulders. The confusion created by referred pain stems from the fact that the sensory nerves from different parts of the body share common pathways when they reach the spinal cord. To treat any referred pain successfully, its origin must be located first, because that’s where the treatment will have to be effective to bring about permanent relief.
It follows from this that the treatment of sciatica must ultimately be addressed to its source, and this is invariably in the spine, and not where the pain may manifest itself. Having said that, some local treatments applied to the site of the pain – such as heat or gentle massage – can be extremely useful in reducing its severity, but these approaches will only reduce the pain temporarily, not cure it or improve its root cause. Nevertheless, palliatives – the name given to treatments that relieve or soothe the symptoms of a disease or disorder without effecting a cure – can be of great help. Pain-killing medicines, such as aspirin or paracetamol, are essentially palliatives, their effect limited either to making the pain disappear or at least lessening it, so that it becomes more bearable. Such simple remedies can, however, have an extremely important role to play in the management of sciatica, especially when the symptoms are fairly mild and/or occur but rarely and the main purpose of treatment is to stop them from interfering with the tasks of daily life.