Leg Pain

Abstract

Together with lumbar pain, leg pain accounts for about two thirds of all pain of vertebral origin (PVO). Ignoring pain arising in the hip, knee, ankle, and foot, a substantial proportion of leg pain is found in the distribution of the greater sciatic nerve. Astonishingly, it is still widely believed that disc protrusion is responsible for the majority of cases of lumbar and leg pain. One source put the figure at 95% (23). Yet it has been shown that appreciable disc protrusions are to be found in no less than 37% of patients who do not currently have and never have had back or leg pain (53). And, in no way reflecting upon the skill of the surgeon, it is not an uncommon finding for no clinical benefit to follow surgical “cure” of a demonstrable protrusion (54). The inference that has to be drawn from these facts is clear: such a belief is unsound.