The sciatic nerve is composed of branches of the nerve roots originating from the lower 2 lumbar vertebrae (L4 and L5) and the spine below the lumbar vertebra (sacrum). It passes through the buttocks and descends from behind the legs and knees down to the feet.
The term sciatica is often defined as the spread of pain along the sciatic nerve. Therefore, it is not a disease but a symptom of certain diseases. It is usually defined as a sharp, burning, deep pain that begins from the buttocks and goes down the back or side of the right or left leg. The pain usually goes below the knee, down to the foot. Pain may also be accompanied by numbness or a pinprick sensation. Sitting and standing up can be very painful. Coughing and sneezing can increase pain.
Herniated disc: It is one of the most common causes of sciatica pain. It occurs as a result of the cartilage herniated between the lumbar vertebrae directly pressing on the nerve roots that form the sciatic nerve. Other than pain, numbness (loss of sensation), weakness or tingling may occur.
Lumbar narrow canal: It is frequently seen in older ages. It is seen due to the compression of the nerve roots by the bone and connective tissue as a result of the narrowing of the spinal cord canal in the spine. The pain usually depends on the position. It increases in activities such as standing up and walking and decreases while sitting.
Spondylolisthesis: It is defined as the shifting of one vertebra on another vertebra. As a result of this shift, the nerve roots that form the sciatic nerve can become stuck and cause sciatica.
Trauma: Sciatic pain may be the result of pressure exerted by external forces such as traffic accidents, sports injuries on the nerve roots that form the sciatic nerve in the waist region or directly on the sciatic nerve. Sometimes fractures of the lumbar vertebrae may also crush the nerve.
Piriformis syndrome: The piriformis muscle is one of the hip muscles located deep in the buttocks. It may occur as a result of the compression of the sciatic nerve under the piriformis muscle. It may be difficult to diagnose because there is no radiological finding to make a definite diagnosis using X-ray and MRI.
Spinal tumors: They are benign or malignant abnormal growths. They are rarely seen. A spinal tumor that grows in the lower back may cause nerve compression and cause sciatica.
Spinal infection: An infection that grows around the spine can cause sciatica with an inflammatory reaction or the effect of compression.
First, the patient’s complaint is evaluated and the history of the disease is questioned. An attempt is made to recognize the form of the pain with questions such as how the pain started, how severe it is, whether there is a history of an accident or injury etc. The source and cause of the pain are investigated by physical examination. Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and X-rays are usually requested at the diagnosis stage.
After the diagnosis is confirmed, treatment planning is made according to the disease.
