Sciatica is a medical condition characterized by pain going down the leg from the lower back.[1] This pain may go down the back, outside, or front of the leg.[3] Onset is often sudden following activities like heavy lifting, though gradual onset may also occur.[5] The pain is often described as shooting.[1] Typically, symptoms are only on one side of the body.[3] Certain causes, however, may result in pain on both sides.[3] Lower back pain is sometimes present.[3] Weakness or numbness may occur in various parts of the affected leg and foot.[3]
About 90% of sciatica is due to a spinal disc herniation pressing on one of the lumbar or sacral nerve roots.[4] Spondylolisthesis, spinal stenosis, piriformis syndrome, pelvic tumors, and pregnancy are other possible causes of sciatica.[3] The straight-leg-raising test is often helpful in diagnosis.[3] The test is positive if, when the leg is raised while a person is lying on their back, pain shoots below the knee.[3] In most cases medical imaging is not needed.[2] However, imaging may be obtained if bowel or bladder function is affected, there is significant loss of feeling or weakness, symptoms are long standing, or there is a concern for tumor or infection.[2] Conditions that may present similarly are diseases of the hip and early herpes zoster (prior to rash formation).[3]
Initial treatment typically involves pain medications.[2] It is generally recommended that people continue with normal activity to the best of their abilities.[3] Often all that is required for sciatica resolution is time; in about 90% of people symptoms resolve in less than six weeks.[2] If the pain is severe and lasts for more than six weeks, surgery may be an option.[2] While surgery often speeds pain improvement, its long term benefits are unclear.[3] Surgery may be required if complications occur, such as loss of normal bowel or bladder function.[2] Many treatments, including steroids, gabapentin, pregabalin, acupuncture, heat or ice, and spinal manipulation, have limited or poor evidence for their use.
Depending on how it is defined, less than 1% to 40% of people have sciatica at some point in time.[8][4] It is most common during people's 40s and 50s, and men are more frequently affected than women.[2][3] The condition has been known since ancient times.[3] The first known use of the word sciatica dates from 1451.[9]
Wikipedia contributors. "Sciatica." Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 29 Dec. 2018. Web. 15 Jan. 2019.
