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Sciatica

Pain felt down the back and outer side of the thigh. The usual cause is a herniated disk, which is pressing on a nerve root.

PubMed Health Glossary
(Source: NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases)

About Sciatica

Many people have low back pain that keeps on coming back. Often, an exact cause cannot be determined and the pain goes away on its own after a few days or a couple of weeks. But if you have low back pain that extends further down through your leg and into your foot, it may be a sign of a slipped disk, or "herniated disk". This kind of pain, which extends into the extremities, is called sciatica. A slipped disk does not always cause symptoms, however.

Sciatica can be very unpleasant. But the good news is that if a slipped disk is in fact causing the pain, symptoms usually subside in less than six weeks on their own in 90 out of 100 people with this problem. If the pain lasts longer than six weeks, it is less and less likely that it will go away on its own or that non-surgical treatment will be any help. Surgery may then be an option depending on the circumstances... Read more about Sciatica

What works? Research summarized

Evidence reviews

Botulinum toxin injections as a treatment for low‐back pain and sciatica

Back pain is a common symptom affecting roughly 50% of the population every year. For the majority of people, back pain goes away gradually ‐ usually within several weeks.

Physical examination for the diagnosis of lumbar radiculopathy due to disc herniation in patients with low‐back pain and sciatica: a systematic review.

Of all patients with back pain, less than 2% will undergo surgery for a herniated disc in the lumbar spine. In back pain patients who also have leg pain (sciatica), doctors and therapists use a physical examination to estimate the probability that the pain is caused by a disc herniation, and to assist the selection of patients for imaging and surgery. We conducted a systematic review to summarize available information on the diagnostic value of different aspects of physical examination. We included 19 different studies in which a wide variety of tests were investigated, such as the straight leg raising test, absence of tendon reflexes, or muscle weakness. The results show that most individual tests carried out during physical examination are not very accurate in discriminating between patients who have, or do not have a herniated disc with sciatica. However, most of the studies were conducted in highly selected patients who had already been referred for surgery, and only one study was carried out in a primary care population. Furthermore, better diagnostic performance of physical examination may be expected when combinations of tests are used, including information from both the patient history and physical examination. However, more research is needed to investigate the performance of such test combinations.

Advice to rest in bed versus advice to stay active for acute low‐back pain and sciatica

Low‐back pain (LBP) is one of the most common conditions managed in primary care and a significant cause of absence from work and early retirement. Individuals, their families and society at large all carry part of the burden.

See all (74)

Summaries for consumers

Botulinum toxin injections as a treatment for low‐back pain and sciatica

Back pain is a common symptom affecting roughly 50% of the population every year. For the majority of people, back pain goes away gradually ‐ usually within several weeks.

Physical examination for the diagnosis of lumbar radiculopathy due to disc herniation in patients with low‐back pain and sciatica: a systematic review.

Of all patients with back pain, less than 2% will undergo surgery for a herniated disc in the lumbar spine. In back pain patients who also have leg pain (sciatica), doctors and therapists use a physical examination to estimate the probability that the pain is caused by a disc herniation, and to assist the selection of patients for imaging and surgery. We conducted a systematic review to summarize available information on the diagnostic value of different aspects of physical examination. We included 19 different studies in which a wide variety of tests were investigated, such as the straight leg raising test, absence of tendon reflexes, or muscle weakness. The results show that most individual tests carried out during physical examination are not very accurate in discriminating between patients who have, or do not have a herniated disc with sciatica. However, most of the studies were conducted in highly selected patients who had already been referred for surgery, and only one study was carried out in a primary care population. Furthermore, better diagnostic performance of physical examination may be expected when combinations of tests are used, including information from both the patient history and physical examination. However, more research is needed to investigate the performance of such test combinations.

Advice to rest in bed versus advice to stay active for acute low‐back pain and sciatica

Low‐back pain (LBP) is one of the most common conditions managed in primary care and a significant cause of absence from work and early retirement. Individuals, their families and society at large all carry part of the burden.

See all (17)

Terms to know

Hernia
The bulging of an internal organ through a weak area or tear in the muscle or other tissue that holds it in place.
Herniated Disc (Slipped Disk)
A potentially painful problem in which the hard outer coating of the disk is damaged, allowing the disk's jelly-like center to leak and cause irritation to adjacent nerves.
Intervertebral Disc (Spinal Disk)
A circular piece of cushioning tissue situated between each vertebrae of the spine. Each disk has a strong outer cover and a soft jelly-like filling.
Lumbar Spine
The lower portion of the spine. The lumbar spine comprises five vertebrae.
Nerves
A bundle of fibers that receives and sends messages between the body and the brain. The messages are sent by chemical and electrical changes in the cells that make up the nerves.
Sciatic Nerve
A nerve which originates in the spinal cord. The sciatic nerve is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve.

More about Sciatica

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Also called: Lumbar radiculopathy, Sciatic neuralgia, Sciatic neuritis

Other terms to know: See all 6
Hernia, Herniated Disc (Slipped Disk), Intervertebral Disc (Spinal Disk)

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