Sciatica

Question 1

Define Sciatica?

Answer 1

Pain, tingling and numbness that arises from nerve root compression or irritation in the lumbrosacral spine

Question 2

What is Sciatica most commonly caused?

Answer 2

Disc herniation

Question 3

What are the other causes of Sciatica?

Answer 3

Spinal stenosis 
Spondylolisthesis 
Spinal injury or infection
Tumour 
Cauda equina syndrome

Question 4

What are the risk factors for Sciatica?

Answer 4

Age - older people are more likely to get slipped discs

Job that requires regular heavy lifting

Question 5

What is the epidemiology of Sciatica?

Answer 5

Relatively COMMON

More common in MALES

Question 6

What are the presenting symptoms and signs of Sciatica?

Answer 6

Pain (usually affects the buttocks and the legs more than the back)
Numbness
Tingling sensation that radiates from the lower back down one of the legs
Weakness in the calf muscles or the muscles that move the foot or ankle

Question 7

What investigations do you do for Sciatica?

Answer 7

CLINICAL Diagnosis
Straight Leg Raise
CT/MRI

Question 8

Why do we do Straight Leg Raise for Sciatica?

Answer 8

If pain in the distribution of the sciatic nerve is reproduced on passive flexion of the straight leg at the hip between 30-70 degrees then it is considered a positive sign (Lasegue’s Sign)
This test is sensitive but not very specific

Question 9

Why do we do CT/MRI for Sciatica?

Answer 9

Helps visualise a lumbar disc herniation