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

Sciatica

Causes:

Presentation:

Assessment and Diagnosis:

Multimodal Treatment:

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