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Sciatica has long been considered to be solely due to mechanical deformation (compression) of a spinal nerve root by herniating disc tissue. However, recent experimental findings have demonstrated that, even in the absence of mechanical insult, nucleus pulposus-related substances may not only induce significant structural and functional injury to the adjacent nerve root, but also sensitise the nerve root, producing pain in the event of subsequent root compression. Although neither the specific mechanisms nor the active nucleus pulposus-related substances causing pain have yet been identified, the recent findings suggest that the future may well bring new pharmacological treatment alternatives for sciatica and disc herniation.

Recent experimental studies performed at the Dept of Orthopaedics at Gothenburg University have systematically assessed the basic pathophysiological mechanisms behind sciatica due to disc herniation. It has hereby been seen that the epidural presence of nucleus pulposus may induce structural and functional injury of the adjacent nerve roots similar in magnitude to those induced by mechanical deformation. By increasing the knowledge of the substances and mechanisms leading to this nucleus pulposus-induced nerve injury it may be assumed that sciatica to a certain extent may be treated by specific pharmacologic agents in the future, in combination with existing treatment modalities.