BMJ  2007;335:112 (21 July), doi:10.1136/bmj.39275.951343.BE

Letters

Sciatica

An archaic term

In their clinical review Koes et al use the entirely non-evidence-based term "sciatica."¹ From the Greek, it literally means hip pain. In English, the Oxford English Dictionary gives precedent to a quote from Shakespeare's Timon of Athens (act IV, scene I), where sciatica is a curse placed on the senators. None of this is a good basis for current usage, which is supposed to describe nerve root or radicular pain, as the authors note but do not discuss.

The problem is that patients with back pain may also have referred pain, a phenomenon first pointed out by Kellgren over 60 years ago.² Clinicians are not good at making this distinction, but they should at least try. This issue takes on greater importance when studying the evidence base where often this distinction is not made. Persistent use of the archaic word sciatica in the clinical setting is not in the best interests of people with a miserable and disabling condition. It remains an effective curse, but English terms such as nerve root pain or radicular pain better describe the clinical problem.

Nuffield Orthopaedic Centre, Oxford OX3 7LD

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Competing interests: None declared.

References

1. Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ 2007;334:1313-7. (23 June.)[Free Full Text]
2. Kellgren J. Sciatica. Lancet 1941;i:561-4.

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Relevant Article

Diagnosis and treatment of sciatica

B W Koes, M W van Tulder, and W C Peul
BMJ 2007 334: 1313-1317. [Extract] [Full Text] [PDF]