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Question: Two months after having a Laminectomy/Discectomy, I re-injured my lower back. An MRI with and without contrast was negative, but I am again experiencing pain down my left leg. Can the disc slip back and forth against the sciatic nerve and possibly not show up on an MRI? Is that causing my pain?

Answer by James Kim, DO, Pocono Medical Center:

To answer this question, I have to first clarify something. A disc cannot anatomically push against the sciatic nerve (the body’s largest nerve, which roughly runs from the lower buttocks to the lower leg). The term “sciatica,” which is often used to refer generally to pain in the sciatic nerve, is actually a misnomer. Lower back pain that radiates down the back of the leg is generally due to a “radiculopathy,” which actually pertains to a problem in the spinal nerve roots, not the sciatic nerve itself.

The sciatic nerve is formed after the nerve roots have left the spine, roughly at the level of the buttocks. Sciatic nerve injuries are rare. The medical community coin the phrase “sciatica,” since many radiculopathies radiate in the same distribution as the sciatic nerve, particularly the first sacral nerve root (S1), which is a major nerve contributor to the sciatic nerve.

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