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Sciatica

Sciatica is pain resulting from irritation, impingement, or compression of the spinal nerve roots in the spine.

Causes:

Sciatica can be caused by a variety of factors, ranging from minor issues to more serious conditions such as:

  • Prolapsed intervertebral disc: the most common cause
  • Degenerative disc disease
  • Spinal stenosis
  • Spondylolisthesis
  • Osteoarthritis
  • Trauma
  • Tumours
  • Piriformis syndrome

Presentation:

It can vary based on the underlying cause and may include the following:

  • Lower back pain associated with hip and leg pain that extends to the feet
  • Isolated leg pain that radiates to the feet
  • Increased pain during movement or mobility limitations
  • Legs may buckle, feel cold, or experience a lack of sensation
  • Sharp, shooting, electric sensations or burning feelings
  • Pins and needles, numbness in the legs
  • Cauda Equina: loss of bladder or bowel control and perineal numbness

    • Assessment and Diagnosis:

    To effectively understand and treat sciatica, a thorough evaluation is essential for identifying the underlying cause. This includes the following components:

  • Comprehensive History and Assessments
  • Investigation: MRI, CT Scan, Nerve Conduction Study
  • Follow-up for the Personalised Multimodal Management Plan
  • Review of the Agreed Tailored Pathway Outcomes

    • Multimodal Treatment:

    Treatment varies depending on the underlying cause and may include:

  • Initiation of oral analgesics, including anti-neuropathic agents
  • Physiotherapy for core muscle strengthening exercises
  • Spinal injections to the nerve roots, including transforaminal epidural and caudal epidural
  • Radiofrequency pulsing of the spinal nerve roots
  • Surgical opinion, if necessary
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