Sciatica

Sciatica
SynonymsSciatic neuritis, sciatic neuralgia, lumbar radiculopathy
Sciatic nerve2.jpg
Anterior view showing the sciatic nerve going down the right leg
Pronunciation
SpecialtyOrthopedics, neurology
SymptomsPain going down the leg from the lower back, weakness or numbness of the affected leg[1]
ComplicationsLoss of bowel or bladder control[2]
Usual onset40s–50s[2][3]
Duration90% of the time less than 6 weeks[2]
CausesSpinal disc herniation, spondylolisthesis, spinal stenosis, piriformis syndrome, pelvic tumor[3][4]
Diagnostic methodStraight-leg-raising test[3]
Differential diagnosisShingles[3]
TreatmentPain medications, surgery[2]
Frequency2–40% of people at some time[4]

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.[3][6][7]

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]

Definition

The term "sciatica" usually describes a symptom—pain along the sciatic nerve pathway—rather than a specific condition, illness, or disease. Some use it to mean any pain starting in the lower back and going down the leg. Others use the term as a diagnosis (i.e. an indication of cause and effect) for nerve dysfunction caused by compression of one or more lumbar or sacral nerve roots from a spinal disc herniation. Pain typically occurs in the distribution of a dermatome and goes below the knee to the foot. It may be associated with neurological dysfunction, such as weakness and numbness.[4] The pain is characteristically described as shooting or shock-like, quickly traveling along the course of the affected nerves.[10]

Other Languages
العربية: عرق النسا
català: Ciàtica
Cymraeg: Clunwst
Deutsch: Ischialgie
eesti: Ishias
Ελληνικά: Ισχιαλγία
español: Ciática
Esperanto: Iskiatalgio
français: Lombosciatique
Gaeilge: Sciaitíce
हिन्दी: सायटिका
italiano: Sciatalgia
македонски: Ишијас
Nederlands: Ischias
日本語: 坐骨神経痛
norsk: Isjias
ଓଡ଼ିଆ: ସିଆଟିକା
ਪੰਜਾਬੀ: ਰੀਹ ਦਾ ਦਰਦ
polski: Rwa kulszowa
português: Ciática
română: Sciatică
کوردی: ڕەگ پشتی
српски / srpski: Ишијас
suomi: Iskias
svenska: Ischias
తెలుగు: సయాటికా
Tiếng Việt: Đau thần kinh tọa