User:Mr. Ibrahem/Sciatica
| Sciatica | |
|---|---|
| Other names | Sciatic neuritis, sciatic neuralgia, lumbar radiculopathy, radicular leg pain |
 | |
| Anterior view showing the sciatic nerve going down the right leg | |
| Pronunciation | |
| Specialty | Orthopedics, neurology |
| Symptoms | Pain going down the leg from the lower back, weakness or numbness of the affected leg[1] |
| Complications | Loss of bowel or bladder control[2] |
| Usual onset | 40s–50s[2][3] |
| Duration | 90% of the time less than 6 weeks[2] |
| Causes | Spinal disc herniation, spondylolisthesis, spinal stenosis, piriformis syndrome, pelvic tumor[3][4] |
| Diagnostic method | Straight-leg-raising test[3] |
| Differential diagnosis | Shingles, diseases of the hip[3] |
| Treatment | Pain medications, surgery[2] |
| Frequency | 2–40% of people at some time[4] |
Sciatica is pain going down the leg from the lower back.[1] This pain may go down the back, outside, or front of the leg.[3] Onset is often sudden following activities like heavy lifting, though gradual onset may also occur.[5] The pain is often described as shooting.[1] Typically, symptoms are only on one side of the body.[3] Certain causes, however, may result in pain on both sides.[3] Lower back pain is sometimes present.[3] Weakness or numbness may occur in various parts of the affected leg and foot.[3]
About 90% of sciatica is due to a spinal disc herniation pressing on one of the lumbar or sacral nerve roots.[4] Spondylolisthesis, spinal stenosis, piriformis syndrome, pelvic tumors, and pregnancy are other possible causes of sciatica.[3] The straight-leg-raising test is often helpful in diagnosis.[3] The test is positive if, when the leg is raised while a person is lying on their back, pain shoots below the knee.[3] In most cases medical imaging is not needed.[2] However, imaging may be obtained if bowel or bladder function is affected, there is significant loss of feeling or weakness, symptoms are long standing, or there is a concern for tumor or infection.[2] Conditions that may present similarly are diseases of the hip and infections such as early shingles (prior to rash formation).[3]
Initial treatment typically involves pain medications.[2] However, evidence for pain medication and muscle relaxants is lacking.[6] It is generally recommended that people continue with normal activity to the best of their abilities.[3] Often all that is required for sciatica resolution is time; in about 90% of people symptoms resolve in less than six weeks.[2] If the pain is severe and lasts for more than six weeks, surgery may be an option.[2] While surgery often speeds pain improvement, its long term benefits are unclear.[3] Surgery may be required if complications occur, such as loss of normal bowel or bladder function.[2] Many treatments, including corticosteroids, gabapentin, pregabalin, acupuncture, heat or ice, and spinal manipulation, have limited or poor evidence for their use.[3][7][8]
Depending on how it is defined, less than 1% to 40% of people have sciatica at some point in time.[4][9] Sciatica is most common between the ages of 40 and 59, and men are more frequently affected than women.[2][3] The condition has been known since ancient times.[3] The first known use of the word sciatica dates from 1451.[10]
References[edit]
- ^ a b c "Sciatica". Archived from the original on 7 March 2018. Retrieved 2 July 2015.
- ^ a b c d e f g h i j k Institute for Quality and Efficiency in Health Care (October 9, 2014). "Slipped disk: Overview". Archived from the original on 8 September 2017. Retrieved 2 July 2015.
- ^ a b c d e f g h i j k l m n o p q r Ropper, AH; Zafonte, RD (26 March 2015). "Sciatica". The New England Journal of Medicine. 372 (13): 1240–8. doi:10.1056/NEJMra1410151. PMID 25806916.
- ^ a b c d Valat, JP; Genevay, S; Marty, M; Rozenberg, S; Koes, B (April 2010). "Sciatica". Best Practice & Research. Clinical Rheumatology. 24 (2): 241–52. doi:10.1016/j.berh.2009.11.005. PMID 20227645.
- ^ T.J. Fowler; J.W. Scadding (28 November 2003). Clinical Neurology, 3Ed. CRC. p. 59. ISBN 978-0-340-80798-9. Archived from the original on 28 March 2020. Retrieved 5 November 2017.
- ^ Koes, B W; van Tulder, M W; Peul, W C (2007-06-23). "Diagnosis and treatment of sciatica". BMJ : British Medical Journal. 334 (7607): 1313–1317. doi:10.1136/bmj.39223.428495.BE. ISSN 0959-8138. PMC 1895638. PMID 17585160.
- ^ Markova, Tsvetio (2007). "Treatment of Acute Sciatica". Am Fam Physician. 75 (1): 99–100. PMID 17225710. Archived from the original on 2016-02-02.
- ^ Enke O, New HA, New CH, Mathieson S, McLachlan AJ, Latimer J, Maher CG, Lin CC (July 2018). "Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis". CMAJ. 190 (26): E786–E793. doi:10.1503/cmaj.171333. PMC 6028270. PMID 29970367.
- ^ Cook CE, Taylor J, Wright A, Milosavljevic S, Goode A, Whitford M (June 2014). "Risk factors for first time incidence sciatica: a systematic review". Physiother Res Int. 19 (2): 65–78. doi:10.1002/pri.1572. PMID 24327326.
- ^ Simpson, John (2009). Oxford English dictionary (2nd ed.). Oxford: Oxford University Press. ISBN 978-0199563838.