Sciatica

Question 1

Describe the characteristic pain felt in sciatica

Answer 1

Shooting pain radiating down the leg and buttock

Question 2

Name three likely sites in which the sciatic nerve or its roots might be trapped

Answer 2

a) Intervertebral foramen of the spinal cord (root values L2-L4)
b) Greater sciatic foramen
c) As the nerve passes through substance muscles of the buttock, particularly piriformis

Question 3

What further tests (non-imaging) might you carry out in order to ascertain involvement of the sciatic nerve?

Answer 3

Straight-leg raise test, sciatic stretch test

Question 4

What imaging is likely to be carried out in a patient with suspected sciatica?

Answer 4

MRI

Question 5

How should a patient with suspected sciatica be managed?

Answer 5

Urgent referral to hospital for ortho/spinal team review

Question 6

How would a GP assess anal tone?

Answer 6

DRE and ask patient to squeeze!