Sciatica Flashcards
What is sciatica?
This is a condition characterised by pain in the lower back, buttocks and posterior leg, resulting from compression of any of the 5 nerve roots that contribute to the sciatic nerve
What are the most commonly affected sciatic nerve roots in sciatica?
L5
S1
What is the most common cause of sciatica?
Intervertebral disc prolapse
What are some degenerative causes of sciatica?
Bone spurs
Canal stenosis
Spondylolisthesis
Facet arthropathy
What are some sinister causes of root compression in sciatica?
Spinal TB (Pott’s disease)
Tumours
Fractures
What are some causes of sciatica occurring outside of the spine?
- Piriformis syndrome
- Endometriosis
- Pelvis disease
- Peroneal compression
What are some causes of non-compressive sciatica?
Arachnioditis
Peripheral neuropathy
How will sciatica usually present?
Sciatica usually presents with unilateral leg pain that is worse than the back pain
This pain will often be sharp, shooting and radiating to the foot
There may also be some numbness and parasthesia in the same distribution
What investigations are used in sciatica?
This is a clinical diagnosis made using symptoms and testing
Some tests available include testing for nerve irritation and motor or sensory reflex changes in the nerve roots
What is the prognosis of sciatica?
Prognosis is reasonable, with 50% recovering from an acute attack within 6 weeks and 90% within 3 months
What conservative treatments can be used during recovery?
NSAIDs
Other analgesia
When may surgery be considered in sciatica?
Recurrent or unremitting symptoms
