Sciatica is not a disease. It is a collection of symptoms. It is usually caused by a pinched nerve in the back, but it can also start in the piriformis muscle or the sacroiliac joint (which are both in the buttocks area, for simplification!).
The sciatic nerve is the largest nerve in the body, about the size of a little finger. The nerve roots of the lower spine all intertwine and pass through the central canal where they eventually branch into the sciatic nerve which runs across the buttock and down the side-back of each leg.
Any disc problem in the lower back CAN pinch a neural root. Not all herniated discs cause pain. But it is fairly common for something resulting from the disc herniation to cause pain in the lower back and/or sciatic pain running down the leg. I don't believe there is any way to tell if you have a herniated disc unless you have a MRI.
It matters less whether you see a neurosurgeon or an orthopedic surgeon -- the important thing is to find one who is a fellowship trained spinal specialist. You want a doctor who has additional education and training in issues of the spine and back -- not a generalist who also does joint replacements, sets broken bones, etc. I personally have found orthopedic spinal specialists to be more communicative than neurosurgeons, and, in my case, their diagnoses involved less surgery than the diagnosis of the neurosurgeons I consulted with...but this is just my personal preference. I'm sure others on the board would have a different experience.
hope this helps --
xx M:wave:M
