Sciatica

Question 1

What is sciatica

Answer 1

Pain felt in lower back, buttock & posterior of lower leg

Question 2

What compression causes sciatica

Answer 2

any of the 5 nerve roots contributing to sciatic nerve
Most common L5/S1

Question 3

What is common pathophysiology of sciatica

Answer 3

Ageing causes less water in intervertebral discs causing them to weaken & prolapse
Protruding material can then impinge a nerve
Contributes to pain & altered sensations in a dermatome

Question 4

What is prolapse of intervertebral discs

Answer 4

Defect in annulus fibrosus allowing nucleus to herniate out
(e.g. strenuous activity of lumbar spine)

Question 5

Other causes of sciatica

Answer 5

Impingement via:
- Tumours
- Fractures
- Degenerative diseases
Or no impingement in peripheral neuropathies

Question 6

Symptoms of sciatica

Answer 6

Unilateral leg pain - worse than back pain (sometimes no back pain)
Pain radiate to foot
Numbness & paraesthesia in foot

Question 7

Clinical signs of sciatica

Answer 7

Nerve irritation signs
Motor, sensory or reflex changes in 1 nerve root

Question 8

What is the pain characteristic in sciatica

Answer 8

Sharp, shooting, elastic

Question 9

Investigations

Answer 9

Clinical diagnosis