There is an awesome post over at metafilter by a doctor who says, "Doctors and patients agree - doctors are lousy when it comes to recognizing, diagnosing and treating pain." He continues to tell about a new continuing education program that all doctors in California must take to help them with this. You can read the free online program and a very good discussion there as well. My comments to the post are reproduced below.
I have experienced a huge difference in pain management depending on the hospital.
My first back surgery in 2000 was a partial discectomy and, while I got a morphine shot upon initial recovery, the rest of the three days in the hospital was agony. I was watching the clock waiting for the darcovet to come in pill form.
I just had a spinal fusion with a different surgeon and hosptial and was given IV morphine the entire first day then switched to IV dilaudid for the next three days. I was much more comfortable that time around.
Both were with the same insurance company and after both I have been given ample amounts of darvocet (up to 2 every four hours). So, I don't know if the reason for the different treatments were due to the facility, the surgeon or the insurance company.
The doctors I have seen here in California do some pain assessment by moving bits of me around and watching me scream and jump. In a couple of cases, it didn't seem horribly scientific, but since we both agreed I was in pain, we were able to move on to pain management. I do feel like I have been lucky, as I used to run a sciatica forum and heard horror stories of folks with doctors who refused to recognize their conditions due to the fact that it "couldn't be measured." The other stories posted above seem to bear this out as well.
I am glad to see that my doctor will be getting more education on the subject.
I have found it helpful to do the stretching exercises my physical therapist recommends. Do some core strengthening exercises, such as the ones highlighted at The Mayo Clinic. By keeping your core strong, your back won't put itself in a position to cause that sciatica pain you are having.