Many people become afflicted with sciatica. Patients who have sciatica report some sort of radiating pain in the leg and difficulty in moving the affected area. Some patients undergo primary care treatment, while some may be referred to secondary care leading to surgical procedures. Lumbosacral radicular syndrome, ischias, nerve root pain, and nerve root entrapment are terms synonymous to sciatica.
A herniated disc with compression of the nerve root can be attributed to almost 90% of sciatica cases. Less often causes are lumbar stenosis and tumors. Diagnosing and managing sciatica greatly varies within and between countries. This is due to (a) lack of clear clinical guidelines, (b) differences in healthcare and insurance systems, as well as (c) scarcity of diagnostic and therapeutic proofs.
There is also a lack of evidential data when it comes to the exact number of sciatica incidence and prevalence. An estimated 5%-10% of patients that come in with low back pain are diagnosed with sciatica, while the occurrence of lifetime low back pain rangers from 49% to 70%. Every year, an estimated 2.2% from the general population develops sciatica. Risk factors include a person’s age, height, mental stress, smoking, and exposure to vibrating vehicles. Physical fitness and sexual activity is yet to be linked to sciatica pain.
Sciatica is characterized by pain that is radiating in the leg. It is diagnosed using physical examination through neurological testing and by reviewing the patient’s history. Patients will be asked to point where the pain is distributed. Sensory symptoms may also be discussed with the patient. The patient will be instructed to do a Lasègue’s sign or a straight leg raise during a physical examination. In severe sciatica cases, patients may also have low back pain that is less severe than the leg pain. Unfortunately, there are very few studies done to prove the value and effectiveness of history and physical examination tests for sciatica. The only test that can be specifically linked to this affliction is the Lasègue’s sign, with 88% pooled specificity. On the whole, sciatica is justified when a person reports typical radiating pain in the leg with positive results in nerve root tension or neurological deficit tests.
If you feel you may have sciatica, or you are suffering from back pain or leg pain, contact our office today for a free evaluation.