Article Index

 Sciatica Solutions: Diagnosis, Treatment, and Cure of Spinal and Piriformis Problems, by Loren Fishman, MD and Carol Ardman, 2006, ISBN: 0393330419.

Dr. Loren Fishman, a specialist in rehabilitation medicine, researcher and professor at Columbia College of Physicians and Surgeons, and his wife, Carol Ardman, a freelance writer and editor, wrote this book because of the misunderstanding that surrounds sciatica and associated problems. This is a genuine problem noticed by Dr. Fishman himself, who has over thirty years of clinical experience. Therefore, they wanted to provide a book which clarifies this type of pain, explains how to better recognize it, reviews the kind of tests or care one might consider getting for it, and explains the wide range of treatment options, both conventional and alternative.

This is not a book about general back pain, which is often muscular in nature, but one that focuses on sciatica—a pain, neurological in origin, that typically runs along the sciatic nerve and causes distinct set of symptoms and pain patterns in the buttocks and the legs (i.e., numbness, “electric shocks”, and other peculiar sensations).

The book is divided into two parts. In the first part, Dr. Fishman goes over the multiple causes of sciatic-type pain and describes how it feels, but also differentiates it from other conditions which are often mistaken for it.

One chapter reviews basic components and functions of the nervous system (i.e., the interaction of the brain, spinal cord, the nerve fibers and nerve roots). Of particular interest are the illustrations of the spine, nerve root patterns and diagnostic diagrams.

Another chapter is dedicated to the diagnostic and nerve function tests used to diagnose sciatica-related problems or to evaluate nerve damage.

The last chapter in the first part offers an extensive review of the conditions associated with sciatica. Here too, the in-depth explanation of the Piriformis Syndrome—a condition affecting the buttocks when the sciatic nerve becomes entrapped and compressed, was found to be especially informative and unique to this book.

The second part of the book deals with treatment options and many things that patients can do on their own. It is understood that patients will have first sought appropriate medical care and evaluation from their primary care providers or specialists.

Recommendations include such things as strengthening abdominal, torso and core muscles, becoming educated about different exercise/movement techniques, and paying attention to daily routines, posture, and even one’s clothing, handbags and footwear.

Medical treatments, such as physical therapy, medical devices, and various mechanical techniques are reviewed.

An overview is provided on frequently used medications, injections and other invasive treatments, as well as various surgical procedures (including brief descriptions and reasons for these surgeries).

The book concludes with many types of nonmedical alternative techniques and the importance of nutrition and lifestyle changes. Dr. Fishman is a strong proponent of alternative treatments, like yoga, and promoting patient education.

This book is easy to read and comprehend, even though it contains some technical information. The authors have done a good job in how they have explained or illustrated this information. Their writing style is friendly and speaks to the readers.

This book would be especially beneficial for individuals who are just starting out with sciatica, because it provides them with the knowledge they need to make informed decisions. Individuals who might already be receiving medical care for this problem will find parts of this book helpful because it provides a better understanding about the mechanisms driving the pain and offers additional ways to manage it.