Sciatica

Question 1

What is sciatica?

Answer 1

Lumbar radiculopathy: inflammation/compression of the lumbrosacral nerve roots (L4-S1) which form the sciatic nerve

Question 2

What causes sciatica?

Answer 2

• Slipped disc is the most common: L5/S1 usually caused by age-related degenerative changes
• Spinal stenosis
• Cancer
• Infection

Question 3

What are risk factors for sciatica?

Answer 3

• Smoking
• Obesity
• Occupational factors e.g. driving, operating machinery/strenuous physical activity
• Older age

Question 4

How does sciatica present?

Answer 4

• Unilateral leg pain radiating below the knee to the foot/toes
• Lower back pain
• Numbness/tingling
• Weakness or reflex changes
• Straight leg raise: Positive

Question 5

How is sciatica managed?

Answer 5

• Rule out red flags
• Referral to spinal urgery/urgent MRI if suspicion of tumour//infective cause
• STarT back risk assessment tool
• Analgesia: Paracetamol, NSAIDs
• Physiotherapy/group exercises can be used