Definition of Sciatica

Irritation and inflammation of the sciatic nerve, which runs from the lumbar spine (low back) down the buttock and into the leg. Sciatica is a type of peripheral neuropathy that is often a chronic condition. Injuries to the hip and pelvis may involve the sciatic nerve. However, often there is no identifiable cause for sciatica.

Symptoms

The main symptom of sciatica is a shooting or searing pain that extends through the buttock and into the leg. Sciatica usually involves only one side of the body though sometimes symptoms are bilateral (involve both sides), depending on the cause. Typically no particular incident sets off the pain; it just occurs and may be severe. Sciatica may also interfere with foot placement or walking.

Diagnosis and Treatment

The diagnostic path begins with a neurologic examination that focuses on the lower body. In sciatica the reflexes at the knee and heel (achilles tendon reflex) are often slow or absent. Diagnostic procedures such as electromyogram (EMG) and nerve conduction studies typically produce abnormal results as well.

Treatment targets the cause of the sciatica when known and symptoms otherwise. Medications such as nonsteroidal antiinflammatory drugs (nsaids) can relieve inflammation and pain, though people who have severe pain may need prescription analgesic medications for pain relief. Exercises and physical activity to strengthen muscles and improve flexibility are helpful when the inflammation subsides.

Most sciatica is a long-term, chronic condition that comes and goes. Specific movements or activities may trigger pain in some people, and in other people the pain appears without apparent provocation.

See also DIABETESHERNIATED NUCLEUS PULPOSUS; SPINAL NERVES; SPINAL STENOSIS.

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