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Encyclopedia > Sciatica

Sciatica
Classification and external resources
Left gluteal region, showing surface markings for arteries and sciatic nerve.
ICD-10 M54.3-M54.4
ICD-9 724.3
eMedicine emerg/303 
MeSH D012585

Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five nerve roots that give rise to the sciatic nerve, or by compression or irritation of the sciatic nerve itself. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. Image File history File links Gray1244. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Look up Pain in Wiktionary, the free dictionary. ... The sciatic nerve (also known as the ischiatic nerve) is a large nerve that runs down the lower limb. ...


Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. This point is important, because treatment for sciatica or sciatic symptoms will often be different, depending upon the underlying cause of the symptoms.


The first cited use of the word "sciatica" was registered in 1450.[1]

Contents

Causes of sciatica

Sciatica is generally caused by the compression of lumbar nerves L4 or L5 or sacral nerves S1, S2 or S3, or far less commonly, by compression of the sciatic nerve itself. When sciatica is caused by compression of a dorsal nerve root (radix) it is considered a lumbar radiculopathy (or radiculitis when accompanied with an inflammatory response) from a spinal disc herniation (a herniated intervertebral disc in the spine), or from roughening, enlarging, and/or misaligning of the vertebrae (spondylolisthesis), or degenerated discs. Sciatica due to compression of a nerve root is one of the most common forms of radiculopathy. The formation of the spinal nerve from the dorsal and ventral roots Grays Fig. ... The five sacral nerves emerge from the sacrum. ... The sciatic nerve (also known as the ischiatic nerve) is a large nerve that runs down the lower limb. ... penis ... A spinal disc herniation, incorrectly called a slipped disc, is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. ... Intervertebral discs lie in between adjacent vertebrae in the spine. ... The vertebral column seen from the side The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. ... A diagram of a thoracic vertebra. ... Not to be confused with spondylosis or spondylolysis. ... Degeneration of the intervertebral disc, which is often called degenerative disc disease (DDD) of the spine, is a common disorder of the lower spine. ... Radiculopathy is not a specific condition, but rather a description of a problem in which one or more nerves are affected and do not work properly. ...


"Pseudo-sciatica", which causes symptoms similar to spinal nerve root compression, is caused by the compression of peripheral sections of the nerve, usually from soft tissue tension in the piriformis or related muscles (see piriformis syndrome and see below). The piriformis (from Latin piriformis = pear shaped) is a muscle in the gluteal region of the lower limb. ... For other uses of Muscle, see Muscle (disambiguation). ... Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle. ...


Spinal disc herniation

One cause of sciatica is a spinal disc herniation, pressing on one of the sciatic nerve roots. The spinal discs are composed of a tough spongiform ring of cartilage (annulus fibrosus) with a more malleable center (nucleus pulposis). The discs separate the vertebrae, thereby allowing room for the nerve roots to properly exit through the spaces between the L4, L5, and sacral vertebrae. The discs cushion the spine from compressive forces, but are weak to pressure applied during rotational movements. That is why a person who bends to one side, at a bad angle to pick something up, may more likely herniate a spinal disc than a person falling from a ladder and landing on his or her back. Herniation of a disc occurs when the liquid center of the disc bulges outwards, tearing the external ring of fibers, extrudes into the spinal canal, and compresses a nerve root against the lamina or pedicle of a vertebra, thus causing sciatica. This extruded liquid from the nucleus pulposus may cause inflammation and swelling of surrounding tissue which may cause further compression of the nerve root in the confined space in the spinal canal. A spinal disc herniation, incorrectly called a slipped disc, is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. ... A spinal disc herniation, incorrectly called a slipped disc, is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. ... Nucleus pulposus is the jelly-like substance in the middle of the spinal disc. ...


Spinal stenosis

Main article: Spinal stenosis

Other compressive spinal causes include spinal stenosis, a condition wherein the spinal canal (the spaces through which the spinal cord runs) narrows and compresses the spinal cord, cauda equina, and/or sciatic nerve roots. This narrowing can be caused by bone spurs, vertebral dislocation, inflammation, or herniated disc which decreases available space for the spinal cord, thus pinching nerves from the spinal cord that travel to the sciatic nerve and irritating them with friction. This article does not cite any references or sources. ... This article does not cite any references or sources. ... The cauda equina is a structure within the lower end of the spinal column, that consists of nerve roots and rootlets from above. ...


Piriformis syndrome

Main article: Piriformis syndrome

In 15% of the population, the sciatic nerve runs through the piriformis muscle rather than beneath it. When the muscle shortens or spasms due to trauma, it can compress or strangle the sciatic nerve beneath the muscle. This cause of sciatic symptoms is piriformis syndrome. This may be the major cause of sciatica when the nerve root is normal.[2] Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle. ... The piriformis (from Latin piriformis = pear shaped) is a muscle in the gluteal region of the lower limb. ... Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle. ...


The risk of self-inflicted sciatica has increased in recent years with the fashion trend of lower-hanging trousers as well as lower-positioning of the pockets. For instance, sitting on a wallet for prolonged hours every day can cause self-inflicted sciatica. [3] Symptoms of numbness and/or pain behind the knee cap are associated with this form of sciatica.


Sacroiliac joint dysfunction

Another cause of sciatic symptoms is sacroiliac joint dysfunction[citation needed]. Unhealthy postural habits, such as excessive time sitting in chairs, and sleeping in the fetal position, along with insufficient stretching and exercise of the relevant myofascial areas, can lead to both the vertebral and soft tissue problems associated with sciatica. The sacroiliac joint is the joint between the sacrum, at the base of the spine, and the ilium of the pelvis, which are joined by ligaments. ...


Trigger points

Main article: Trigger points

Another source of sciatic symptoms is active trigger points of the lower back and the gluteus muscles.[citation needed] In this case, the referred pain is not consequent to compression of the sciatic nerve, though the pain distribution down the buttocks and leg is similar. Trigger points occur when muscles become ischemic (low blood flow) due to injury or chronic muscular contraction. The most commonly associated muscles with trigger points triggering sciatic symptoms are: the quadratus lumborum, the gluteus medius, the gluteus minimus, and the deep hip rotators[citation needed]. Trigger points are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. ... Trigger points are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. ... The Quadratus lumborum is irregularly quadrilateral in shape, and broader below than above. ... The gluteus maximus is the largest of the gluteus muscles which are located in the buttock. ... The gluteus maximus is the largest of the gluteus muscles which are located in the buttock. ...


Pregnancy

Sciatica may also be experienced in late pregnancy, primarily resulting from the uterus pressing on the sciatic nerve, and, secondarily, from the muscular tension and / or vertebral compression consequent to carrying the extra weight of the fetus, and the postural changes inherent to pregnancy.[citation needed] This article is about human pregnancy in biological females. ... This article is about female reproductive anatomy. ... The sciatic nerve (also known as the ischiatic nerve) is a large nerve that runs down the lower limb. ... For other uses, see Fetus (disambiguation). ...


Diagnosis and treatment

Because of the many conditions which can compress nerve roots and cause sciatica, treatment and symptoms often differ from patient to patient. Diagnostic tests can come in the form of a series of exams a physician will perform. Patients will be asked to adopt numerous positions and actions such as squatting, walking on toes, bending forward and backward, rotating the spine, sitting, lying on back, and raising one leg at a time. Increased pain will occur during some of these activities.


Treatment of the underlying cause of the compression is often the most effective course. When the cause is due to a prolapsed or lumbar disc herniation, research has shown that, with supportive treatment to help relieve pain, 90% of disc prolapse will recover with no specific intervention. Genetics appear to influence the risk of developing disc herniation. A spinal disc herniation, incorrectly called a slipped disc, is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. ...


Imaging methods such as MR neurography may help diagnosis and treatment of sciatica. MR neurography has been shown to diagnose 95% of severe sciatica patients, while as few as 15% of sciatica sufferers in the general population are diagnosed with disc-related problems.[4] MR neurography is a modified MRI technique using MRI software to provide better pictures of the spinal nerves and the effect of compression on these nerves. MR neurography may help diagnose piriformis syndrome which is another cause of sciatica that does not involve disc herniation.[citation needed]


Most cases of sciatica can be treated by one or more of the following:

Specific surgical techniques include: Acupuncture chart from Hua Shou (fl. ... Anti-inflammatory refers to the property of a substance or treatment that reduces inflammation. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... This article is about the chemical family of steroids. ... Chiropractic (from Greek chiros and praktikos meaning done by hand) is a health care profession whose purpose is to diagnose and treat mechanical disorders of the spine and musculoskeletal system with the intention of affecting the nervous system and improving health. ... A catalog page offering Cannabis sativa extract. ... This article is about a type of complementary medicine practiced worldwide. ... An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). ... Acetaminophen (USAN) or paracetamol (INN), is a popular analgesic and antipyretic drug that is used for the relief of fever, headaches, and other minor aches and pains. ... Physical therapy (or physiotherapy[1]) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. ... “Surgeon” redirects here. ... Structural Integration is a type of Alternative medicine which aims to align the human body in the gravitational field. ... For other uses such as Yoga postures, see Yoga (disambiguation) Statue of Shiva performing Yogic meditation Yoga (Sanskrit: योग Yoga, IPA: ) is a group of ancient spiritual practices originating in India. ...


Intradiscal Electrothermoplasty (IDET)

A needle is inserted into the affected disc, guided by x-ray. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc. The heat also partially melts the annulus, which triggers the body to generate new reinforcing proteins in the fibers of the annulus.[citation needed]


Radiofrequency Discal Nucleoplasty (Coblation Nucleoplasty)

A needle is inserted into the affected disc, although instead of a heating wire, a special RF probe (radio frequency) is used. This probe generates a highly focused plasma field with enough energy to break up the molecular bonds of the gel in the nucleus, essentially vaporizing some of the nucleus. The result is that 10-20% of the nucleus is removed which decompresses the disc and reduces the pressure both on the disc and the surrounding nerve roots. This technique may be more beneficial for sciatica type of pain than the IDET, since nucleoplasty can actually reduce the disc bulge, which is pressing on a nerve root. The high-energy plasma field is actually generated at relatively low temperatures, so danger to surrounding tissues is minimized.[7]


See also

Back pain (also known dorsalgia) is pain felt in the back that may originate from the muscles, nerves, bones, joints or other structures in the spine. ... A spinal disc herniation, incorrectly called a slipped disc, is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. ... Laminectomy is a surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. ... Hemilaminectomy is a surgical procedure in which only part of a vertebral lamina is removed in the spine. ...

References

  1. ^ Oxford English Dictionary, 2nd Ed. "a1450a Mankind (Brandl)."
  2. ^ Lewis AM, Layzer R, Engstrom JW, Barbaro NM, Chin CT (2006). "Magnetic resonance neurography in extraspinal sciatica". Arch. Neurol. 63 (10): 1469-72. doi:10.1001/archneur.63.10.1469. PMID 17030664. 
  3. ^ BBC News: Is your wallet a pain in the back?
  4. ^ Filler, Aaron; Haynes, J., Sheldon, E., Prager, J., Villablanca, J.P., Farahani, K., McBride, D., Tsuruda, J.S., Morisoli, B., Batzdorf, U. & Johnson, J.P. (February 2005). Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. 99-115.
  5. ^ Daniel Kerr, Deirdre Walsh, David Baxter (November/December 2003), “Acupuncture in the Management of Chronic Low Back Pain: A Blinded Randomized Controlled Trial”, The Clinical Journal of Pain: 364-370, <http://www.clinicalpain.com/pt/re/clnjpain/abstract.00002508-200311000-00004.htm;jsessionid=LVgRjl3gM12CwGJ34vC424L16fTKQcySVw2W2425p84q6ngTndxl!271767458!181195628!8091!-1> 
  6. ^ Chiropractic manipulation in low back pain and sciatica: statistical data on the diagnosis, treatment and response of 576 consecutive cases.”, Journal of Manipulative Physiological Therapy 7(1): 1-11, 1984 Mar, <http://www.ncbi.nlm.nih.gov/pubmed/6232332> 
  7. ^ SpineUniverse: New Sciatica Treatments

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links

Muscle weakness (or lack of strength) is a direct term for the inability to exert force with ones muscles to the degree that would be expected given the individuals general physical fitness. ... Rheumatism or Rheumatic disorder is a non-specific term for medical problems affecting the heart, bones, joints, kidney, skin and lung. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... Neuralgia is a painful disorder of the nerves. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... Panniculitis is a group of diseases whose hallmark is inflammation of subcutaneous fatty and muscle tissue. ... Fibromyalgia (FM) is stated to be a disorder classified by the presence of chronic widespread pain and tactile allodynia. ... Bone disease refers to the medical conditions which affect the bone. ... Osteoporosis is a disease of bone - leading to an increased risk of fracture. ... Osteomalacia is a softening of the bones, resulting from defective bone mineralisation. ... Pseudarthrosis is the movement of a bone at the location of a fracture resulting from inadequate healing of the fracture. ... This article is about stress fractures in bones. ... Monostotic fibrous dysplasia (or monostotic osteitis fibrosa) is a form of fibrous dysplasia where only one bone is involved. ... Skeletal fluorosis is a bone disease exclusively caused by excessive consumption of fluoride. ... An aneurysmal bone cyst is an expansile osteolytic lesion with a thin wall, containing blood-filled cystic cavities. ... Hyperostosis is an excessive growth of bone. ... Osteomyelitis is an infection of bone, usually caused by pyogenic bacteria or mycobacteria. ... Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. ... Bold text X-ray of Pagets disease Pagets disease, otherwise known as osteitis deformans, is a chronic disorder that typically results in enlarged and deformed bones. ... Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. ... Dissolution or degeneration of bone tissue through disease. ... In medicine, Chondropathy refers to a disease of the cartilage. ... Osteochondrosis is a orthopedic disease. ... Legg-Calvé-Perthes syndrome is a degenerative disease of the hip joint, where a loss of bone mass leads to some degree of collapse of the hip joint, that is, to deformity of the ball of the femur and the surface of the hip socket. ... Osgood-Schlatter disease (also known as tibial tubercle traumatic apophysitis) is an inflammation of the growth plate at the tibial tuberosity. ... Köhler disease (also spelled Kohler) is a rare bone disorder of the foot found in children between six and nine years of age. ... Severs disease, or calcaneal apophysitis, is the most frequent cause of heel pain in children between the ages of 8 and 13 and is due to an inflammation of growing plates, the calcaneus in the back of the foot due to the rapid growth of bone when compared to... Osteochondritis Dessicans is when a loose piece of bone and cartilage seperates from the end of the bone because of a loss of blood supply and insuffecient amounts of calcium. ... Tietzes syndrome, also known as costochondritis, is a benign inflammation of one or more of the costal cartilages. ... // Q00-Q99 - Congenital malformations, deformations and chromosomal abnormalities (Q00-Q07) Congenital malformations of the nervous system (Q00) Anencephaly and similar malformations (Q01) Encephalocele (Q02) Microcephaly (Q03) Congenital hydrocephalus (Q04) Other congenital malformations of brain (Q05) Spina bifida (Q06) Other congenital malformations of spinal cord (Q07) Other congenital malformations of nervous...

  Results from FactBites:
 
Sciatica: What You Need to Know About Sciatica | Spine-Health (713 words)
The clinical diagnosis of sciatica is referred to as a "radiculopathy", which means simply that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve.
Sciatica nerve pain is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these factors.
Sciatica surgery, such as microdiscectomy or lumbar laminectomy and discectomy, to remove the portion of the disc that is irritating the nerve root.
sciatica - definition of sciatica in Encyclopedia (208 words)
Sciatica is a pain in the leg due to irritation of the sciatic nerve.
Sciatica may also be experienced in late pregnancy as the result of the uterus pressing on the sciatic nerve.
Acupuncture can also treat sciatica, as can auriculotherapy, but these methods of treatment are not without criticism and their respective efficacy has not been proven as of yet.
  More results at FactBites »

 

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