Sciatica

Question 1

What is sciatica?

Answer 1

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

Question 2

What is the most common cause of sciatica?

Answer 2

Disc prolapse of the L5/S1 disc

Question 3

What are some other causes of sciatica?

Answer 3

Root compression by degenerative disease
Root compression by sinister cause
Root compression outside the spine
No root compression

Question 4

What are some causes of root compression by degenerative disease, leading to sciatica?

Answer 4

Bone spurs
Canala stenosis
Spondylolisthesis
Facet arthropathy

Question 5

What are some causes of root compression by sinister cause, leading to sciatica?

Answer 5

Tumour
Fractures
TB

Question 6

What are some causes of root compression outside the spine, leading to sciatica?

Answer 6

Piriformis syndrome
Endometriosis
Pelvic disease
Peroneal compression

Question 7

Describe the pathophysiology of disc prolapse

Answer 7

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

Question 8

What are some symptoms of sciatica?

Answer 8

Unilateral leg pain + back pain
Sharp, shooting, electric pain, radiating to the foot
Numbness and parasthesia may occur in the same distribution

Question 9

What are some signs of sciatica?

Answer 9

Nerve irritation signs
Motor, sensory, or reflex changes in one nerve root

Question 10

How is sciatica managed?

Answer 10

• NSAIDs and analgesia
• Consider surgery if unremitting/recurrent symptoms

Question 11

What is the prognosis of sciatica?

Answer 11

Reasonable - 50% recover from acute attack in 6 weeks, 90% within 3 months