SciaticaPronounced: sigh-AT-i-kuh
by
Elizabeth Smoots, MD DefinitionThe sciatic nerve begins from the lower spine on either side. It travels deep in the pelvis to the lower buttocks. From there, it passes along the back of each upper leg and divides at the knee into branches that go to the feet. Sciatica is an irritation of the sciatic nerve.
Causes TOPSciatica is caused by irritation or pressure on the sciatic nerve. This can be the result of:
Risk Factors TOPSciatica is more common in men. Other factors that may increase your chance of sciatica include: Lifestyle and personal health factors, such as:
Occupational factors, such as:
Health conditions, such as:
Symptoms TOPSciatica causes symptoms that can range from mild to severe. Symptoms may include:
More serious symptoms associated with sciatica that may require immediate medical attention include:
Diagnosis TOPYou will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will pay particular attention to your back, hips, and legs. The physical exam will include tests for strength, flexibility, sensation, and reflexes. Imaging tests are used to evaluate the affected area: Your doctor may also need to test your nerves. This can be done with a nerve conduction study. Treatment TOPThe goal of treatment is to reduce sciatic nerve irritation. Treatment options include: ActivityBed rest is not generally recommended. It may be suggested for no more than 1-2 days in those with severe pain. Activities may be restricted for a period of time and then resumed as soon as possible. Recovery time may be shortened by staying active and exercising. MedicationMedications used to treat sciatica include:
Physical Therapy TOPPhysical therapy may include:
Alternative Therapies TOPThese therapies have not been proven by scientific studies to have an effect on sciatica. However, some people may find some pain relief from: Surgery TOPSurgery may be done to relieve pressure on the sciatic nerve. This is performed in emergency situations or if other treatments fail. Common surgical procedures are microdiscectomy and lumbar laminectomy. Prevention TOPSciatica tends to happen more than one time. To help reduce your chance of sciatica:
RESOURCES:North American Spine Society http://www.spine.org Ortho Info—American Academy
of Orthopaedic Surgeons http://www.orthoinfo.org CANADIAN RESOURCES:Canadian Orthopaedic Association http://www.coa-aco.org Canadian Orthopaedic Foundation http://www.canorth.org References:Allen C, Glasziou P, et al. Bed rest: A potentially harmful treatment
needing more careful evaluation.
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1999; 354:1229-1233. Sciatica. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: ...(Click grey area to select URL) Updated December 2013. Accessed November 15, 2017. Sciatica. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115166/Sciatica. Updated May 8, 2017. Accessed November 13, 2017. Waddell G, Feder G, Lewis M. Systematic reviews of bed rest and advice to
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http://www.dynamed.com: Peul WC, van Houwelingen HC, et al. Surgery versus prolonged conservative treatment for sciatica.
N Engl J Med.
2007;356:2245-2256. Last reviewed November 2017 by EBSCO Medical Review Board
Teresa Briedwell, PT, DPT, OCS, CSCS Last Updated: 12/20/2014 |
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