Spine: Radiculopathy

Question 1

Define sciatica

Answer 1

Pain, tingling and numbness that arise from nerve root compression or irritation in the lumbosacral spine.

Question 2

Explain the aetiology/risk factors of sciatica

Answer 2

Most commonly caused by a disc herniation

Other causes:
Spinal stenosis
Spondylolisthesis
Spinal injury or infection
Tumour
Cauda equina syndrome

Risk Factors
Age - older people are more like to get slipped discs
Job that requires regular heavy lifting

Question 3

Summarise the epidemiology of sciatica

Answer 3

Relatively COMMON

More common in MALE

Question 4

Recognise the presenting symptoms and signs of sciatica

Answer 4

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 5

Identify appropriate investigations for sciatica

Answer 5

CLINICAL diagnosis

Straight Leg Raise - 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

CT/MRI - helps visualise a lumbar disc herniation