Sciatic or sciatic pain is a very severe pain that radiates (distributes) from the lower back, lower back of the thigh and leg and can reach the foot. In many cases the pain does not have this complete distribution, but reaches the knee or only in the gluteus; at other times it manifests itself without pain, but with tingling (paresthesias), or both. The distribution of pain is very important as it helps to know the source and cause of pain.
Sciatic pain is usually accompanied by low back pain, although sometimes low back pain is prior to sciatic pain and improves when sciatica appears. In many cases there are episodes of lumbar pain (lumbago or lumbago) previously.
Causes of Sciatica
It is caused by irritation of the sciatic nerve, either by direct compression or by inflammation of the nerve trunk or its roots. The most frequent cause is an entrapment of a nerve root at its exit from the spinal canal, either by a degeneration of the vertebrae (vertebral spondylosis) or by degeneration of the intervertebral disc (herniated disc).
In most cases, pain disappears spontaneously in a period ranging from four to six weeks. If after this time there has not been better, a surgical intervention should be considered.
In case of loss of strength or sphincter alteration, the treatment must be faster. In the case of loss of sphincters, it should be urgent.
Diagnosis of sciatica
The main diagnostic method is magnetic resonance imaging. The most important is to know the type of pain, the distribution of the pain and the clinical examination obtained.
At the same time, performing simple lumbar spine radiographs is useful in case of suspected transitional abnormalities and to clarify the presence of vertebral instability.
Neurophysiological analysis is not essential, although it may be useful for previously operated patients, in case of diagnostic doubts or to establish root damage prior to surgery.