Sciatica

Excerpt

Sciatica represents a debilitating condition characterized by pain or paresthesias within the sciatic nerve distribution or an associated lumbosacral nerve root. A prevalent misconception often mislabeles any low back pain or radicular leg pain as sciatica. Sciatica entails pain directly resulting from sciatic nerve or root pathology. Comprising nerve roots from L4 to S3, the sciatic nerve, with a diameter of up to 2 cm, stands as the body's largest nerve. Pain associated with sciatica is exacerbated by lumbar spine flexion, twisting, bending, or coughing.

The sciatic nerve plays a pivotal role, providing direct motor function to the hamstrings and lower extremity adductors and indirect motor function to the calf muscles, anterior lower leg muscles, and select intrinsic foot muscles. Furthermore, its terminal branches indirectly contribute to sensation in the posterior and lateral lower leg and the plantar aspect of the foot. Importantly, sciatica predominantly arises from an inflammatory condition, leading to sciatic nerve irritation. Conversely, direct nerve compression results in more pronounced motor dysfunction, necessitating a thorough and prompt diagnostic evaluation if present.