Sciatica

Etiology

  • Nerve root irritation, most commonly from herniated disc, osteophyte, other manifestation of arthritic changes
  • Less common: cancer, infection, other

Symptoms

  • Waxes/wanes, typically radiates down one leg below knee
  • Vast majority affect L5 or S1 roots
  • Typically pain w/o weakness or deficits unless severe compression

Physical Exam Findings

  • More common to have pain without frank sensory or motor deficits
  • If disc related root irritation: straight leg raise sensitive, crossed leg raise specific
  • L5 pain/numbness top of foot; weakness in extension of toe, foot inversion
  • S1: pain/numbness lateral foot; weakness in plantar flexion; diminished achilles reflex