Spinal Cord Disease - Sciatica

Question 1

What is Sciatica?

Answer 1

Symptoms associated with irritation of the Sciatic Nerve.

Question 2

Sciatic Nerve Anatomy (3).

Answer 2

1. L4-S3.
2. Exit Posterior Pelvis : Greater Sciatic Foramen.
3. Bifurcates at Knee into Tibial Nerve and Common Peroneal Nerve.

Question 3

Sciatic Nerve Functions (2).

Answer 3

1. Sensory : Lateral Lower Leg and Foot.

2. Motor : Posterior Thigh, Lower Leg and Foot.

Question 4

Aetiology of Sciatica (3).

Answer 4

LUMBOSACRAL NERVE ROOT COMPRESSION :

1. Herniated Disc.
2. Spondylolisthesis.
3. Spinal Stenosis.

Question 5

Clinical Features of Sciatica.

Answer 5

1. Unilateral Pain from Buttock Radiating Down Thigh to Below Knee or Feet - Electric/Shooting.
2. Paraesthesia.
3. Numbness.
4. Motor Weakness.

Question 6

Importance of Bilateral Sciatica.

Answer 6

Red Flag : Cauda Equina Syndrome.

Question 7

Examination of Sciatica.

Answer 7

Sciatic Stretch Test - positive if pain in buttock/posterior thigh.

Question 8

Management of Sciatica (3).

Answer 8

1. Same as Acute Low Back Pain.
2. Neuropathic Relief - no Gabapentin or Pregabalin.
3. Specialist : Epidural Corticosteroid Injection, Local Anaesthetic Injection, Radiofrequency Denervation, Spinal Decompression.