The sciatic nerve is composed of branches of the nerve roots originating from the lower 2 lumbar vertebrae (L4 and L5) and the spine (sacrum) below the lumbar vertebra. Passing through 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 some 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 pricking. Sitting and standing up can be very painful. Coughing and sneezing can increase pain.
Causes of sciatica pain
Herniated disc: It is one of the most common causes of sciatica pain. It occurs as a result of the herniated cartilage between the lumbar vertebrae, which directly presses the nerve roots that form the sciatic nerve. Other than pain, numbness (loss of sensation), weakness, tingling may occur.
Narrow canal in the waist: It is frequently seen in older ages. It is seen due to the compression of nerve roots by bone and connective tissue as a result of narrowing of the spinal 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 slip of one vertebra on the other vertebra. As a result of this slip, the nerve roots that form the sciatic nerve can become stuck and cause sciatic pain.
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 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 deep in the buttocks. It may be the result of compression of the sciatic nerve under the piriformis muscle. It may be difficult to diagnose because there is no radiological finding such as X-ray and MRI.
Spinal tumors: They are benign or malignant abnormal growths. They are rare. A spinal tumor that grows on the waist may cause nerve compression and cause sciatic pain.
Spinal infection: An infection that grows around the spine can cause sciatica pain with an inflammatory reaction or compression.
First, the patient’s complaint is evaluated and the history of the disease is questioned. The form of the pain is tried to be recognized with questions such as how the pain started, how severe it is, whether there is a history of an accident or injury. 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.