Sciatica Flashcards
What is sciatica?
Characteristic pain felt in the lower back, buttocks and the posterior and lower leg that results from compression of any of the 5 nerve roots that contribute to the sciatic nerves
What is the most common cause of sciatica?
Disc prolapse of the L5/S1 disc
What are some other causes of sciatica?
Root compression by degenerative disease
Root compression by sinister cause
Root compression outside the spine
No root compression
What are some causes of root compression by degenerative disease, leading to sciatica?
Bone spurs
Canala stenosis
Spondylolisthesis
Facet arthropathy
What are some causes of root compression by sinister cause, leading to sciatica?
Tumour
Fractures
TB
What are some causes of root compression outside the spine, leading to sciatica?
Piriformis syndrome
Endometriosis
Pelvic disease
Peroneal compression
Describe the pathophysiology of disc prolapse
Ageing causes dehydration and weakening of the disc
A defect in the annulus fibrosus may occur allowing the nucelus to herniate out, impinging on the spinal cord
What are some symptoms of sciatica?
Unilateral leg pain + back pain
Sharp, shooting, electric pain, radiating to the foot
Numbness and parasthesia may occur in the same distribution
What are some signs of sciatica?
Nerve irritation signs
Motor, sensory, or reflex changes in one nerve root
How is sciatica managed?
- NSAIDs and analgesia
- Consider surgery if unremitting/recurrent symptoms
What is the prognosis of sciatica?
Reasonable - 50% recover from acute attack in 6 weeks, 90% within 3 months