sciatica

Summary

Summary: A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of SCIATIC NEUROPATHY; RADICULOPATHY (involving the SPINAL NERVE ROOTS; L4, L5, S1, or S2, often associated with INTERVERTEBRAL DISK DISPLACEMENT); or lesions of the CAUDA EQUINA.

Top Publications

  1. Cho H, Lee S, Kim J. Thoracic disk herniation manifesting as sciatica-like pain--two case reports. Neurol Med Chir (Tokyo). 2011;51:67-71 pubmed
    Two patients presented with sciatica-like pain caused by thoracic disk herniation...
  2. Genevay S, Finckh A, Zufferey P, Viatte S, Balague F, Gabay C. Adalimumab in acute sciatica reduces the long-term need for surgery: a 3-year follow-up of a randomised double-blind placebo-controlled trial. Ann Rheum Dis. 2012;71:560-2 pubmed publisher
    Two subcutaneous injections of adalimumab in severe acute sciatica significantly reduced the number of back operations in a short-term randomised controlled clinical trial.
  3. Arts M, Brand R, Koes B, Peul W. Effect modifiers of outcome of surgery in patients with herniated disc related sciatica? A subgroup analysis of a randomised clinical trial. J Neurol Neurosurg Psychiatry. 2010;81:1265-74 pubmed publisher
    ..microdiscectomy has been introduced to speed up the rate of recovery in patients with lumbar disc related sciatica, although similar results have been shown...
  4. van den Akker M, Arts M, Van Den Hout W, Brand R, Koes B, Peul W. Tubular diskectomy vs conventional microdiskectomy for the treatment of lumbar disk-related sciatica: cost utility analysis alongside a double-blind randomized controlled trial. Neurosurgery. 2011;69:829-35; discussion 835-6 pubmed publisher
    Conventional microdiskectomy is the most frequently performed surgery for patients with sciatica caused by lumbar disk herniation...
  5. Jacobs W, van Tulder M, Arts M, Rubinstein S, van Middelkoop M, Ostelo R, et al. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. Eur Spine J. 2011;20:513-22 pubmed publisher
    The effectiveness of surgery in patients with sciatica due to lumbar disc herniations is not without dispute...
  6. Yoshimoto M, Kawaguchi S, Takebayashi T, Isogai S, Kurata Y, Nonaka S, et al. Diagnostic features of sciatica without lumbar nerve root compression. J Spinal Disord Tech. 2009;22:328-33 pubmed publisher
    Retrospective case series review of patients showing sciatica without radiographic evidence of nerve root compression.
  7. Leino Arjas P, Kauppila L, Kaila Kangas L, Shiri R, Heistaro S, Heliovaara M. Serum lipids in relation to sciatica among Finns. Atherosclerosis. 2008;197:43-9 pubmed
    ..supplying the lumbar region has been suggested as a mechanism leading to intervertebral disc degeneration and sciatica. The study described here examined whether serum lipid levels or pharmacologically treated hyperlipidemia were ..
  8. Herrmann W, Geertsen M. Efficacy and safety of lornoxicam compared with placebo and diclofenac in acute sciatica/lumbo-sciatica: an analysis from a randomised, double-blind, multicentre, parallel-group study. Int J Clin Pract. 2009;63:1613-21 pubmed publisher
    The efficacy and safety of oral lornoxicam (LNX) as early treatment of acute sciatica/lumbo-sciatica was compared with placebo and diclofenac in a 5-day double-blind, randomised study.
  9. Roncoroni C, Baillet A, Durand M, Gaudin P, Juvin R. Efficacy and tolerance of systemic steroids in sciatica: a systematic review and meta-analysis. Rheumatology (Oxford). 2011;50:1603-11 pubmed publisher
    The efficacy of pharmacological interventions in sciatica is limited and the use of systemic steroids is still controversial. We aimed at evaluating the efficacy and tolerance of systemic steroids in sciatica.

Scientific Experts

More Information

Publications62

  1. Holve R, Barkan H. Oral steroids in initial treatment of acute sciatica. J Am Board Fam Med. 2008;21:469-74 pubmed publisher
    Many physicians use prednisone to treat acute sciatica with the hope of speeding recovery. There is little clinical evidence to support this practice...
  2. Murata Y, Ogata S, Ikeda Y, Yamagata M. An unusual cause of sciatic pain as a result of the dynamic motion of the obturator internus muscle. Spine J. 2009;9:e16-8 pubmed publisher
    ..Some of these pathophysiologies have been diagnosed clinically and sometimes by exclusion...
  3. Luijsterburg P, Lamers L, Verhagen A, Ostelo R, van den Hoogen H, Peul W, et al. Cost-effectiveness of physical therapy and general practitioner care for sciatica. Spine (Phila Pa 1976). 2007;32:1942-8 pubmed
    ..A total of 135 patients were randomly allocated to physical therapy added to general practitioners' care (n = 67) or to general practitioners' care alone (n = 68)...
  4. Le Manac h A, Rousselet M, Massin P, Audran M, Levasseur R. Extraspinal sciatica revealing late metastatic disease from parotid carcinoma. Joint Bone Spine. 2010;77:64-6 pubmed publisher
    b>Sciatica is a clinical symptom usually caused by a disk herniation and less often by other conditions such as tumors, infections, or inflammatory diseases...
  5. Hancock M, Koes B, Ostelo R, Peul W. Diagnostic accuracy of the clinical examination in identifying the level of herniation in patients with sciatica. Spine (Phila Pa 1976). 2011;36:E712-9 pubmed publisher
    ..Cross sectional..
  6. Wassenaar M, van Rijn R, van Tulder M, Verhagen A, van der Windt D, Koes B, et al. Magnetic resonance imaging for diagnosing lumbar spinal pathology in adult patients with low back pain or sciatica: a diagnostic systematic review. Eur Spine J. 2012;21:220-7 pubmed publisher
    ..Consequently, this review aimed to summarize the available evidence on the diagnostic accuracy of MRI for identifying lumbar spinal pathology in adult low back pain (LPB) or sciatica patients.
  7. Ashworth J, Konstantinou K, Dunn K. Prognostic factors in non-surgically treated sciatica: a systematic review. BMC Musculoskelet Disord. 2011;12:208 pubmed publisher
    When present sciatica is considered an obstacle to recovery in low back pain patients, yet evidence is limited regarding prognostic factors for persistent disability in this patient group...
  8. Pinto R, Maher C, Ferreira M, Ferreira P, Hancock M, Oliveira V, et al. Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis. BMJ. 2012;344:e497 pubmed publisher
    To investigate the efficacy and tolerability of analgesic and adjuvant pain drugs typically administered in primary care for the management of patients with sciatica.
  9. Ohtori S, Miyagi M, Eguchi Y, Inoue G, Orita S, Ochiai N, et al. Efficacy of epidural administration of anti-interleukin-6 receptor antibody onto spinal nerve for treatment of sciatica. Eur Spine J. 2012;21:2079-84 pubmed publisher
    ..However, efficacy of inhibition of IL-6 for sciatica in patients with lumbar spinal stenosis has not been clarified...
  10. El Barzouhi A, Vleggeert Lankamp C, Lycklama A Nijeholt G, van der Kallen B, Van Den Hout W, Jacobs W, et al. Magnetic resonance imaging in follow-up assessment of sciatica. N Engl J Med. 2013;368:999-1007 pubmed publisher
    Magnetic resonance imaging (MRI) is frequently performed during follow-up in patients with known lumbar-disk herniation and persistent symptoms of sciatica. The association between findings on MRI and clinical outcome is controversial.
  11. Gibson J, Waddell G. Surgical interventions for lumbar disc prolapse: updated Cochrane Review. Spine (Phila Pa 1976). 2007;32:1735-47 pubmed
    ..An updated Cochrane Review...
  12. Meknas K, Kartus J, Letto J, Flaten M, Johansen O. A 5-year prospective study of non-surgical treatment of retro-trochanteric pain. Knee Surg Sports Traumatol Arthrosc. 2009;17:996-1002 pubmed publisher
    ..It appears that a supervised stretching programme renders significant short and long term decrease in symptom for patients with retro-trochanteric pain...
  13. Grøvle L, Haugen A, Ihlebaek C, Keller A, Natvig B, Brox J, et al. Comorbid subjective health complaints in patients with sciatica: a prospective study including comparison with the general population. J Psychosom Res. 2011;70:548-56 pubmed publisher
    ..The aims of this study were to investigate if patients with specific back pain, that is, sciatica caused by lumbar herniation, report higher rates of subjective health complaints (SHCs) than the general ..
  14. Haugen A, Grøvle L, Brox J, Natvig B, Keller A, Soldal D, et al. Estimates of success in patients with sciatica due to lumbar disc herniation depend upon outcome measure. Eur Spine J. 2011;20:1669-75 pubmed publisher
    The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs...
  15. Arts M, Peul W, Koes B, Thomeer R. Management of sciatica due to lumbar disc herniation in the Netherlands: a survey among spine surgeons. J Neurosurg Spine. 2008;9:32-9 pubmed publisher
    Although clinical guidelines for sciatica have been developed, various aspects of lumbar disc herniation remain unclear, and daily clinical practice may vary...
  16. McMorland G, Suter E, Casha S, du Plessis S, Hurlbert R. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010;33:576-84 pubmed publisher
    The purpose of this study was to compare the clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica secondary to lumbar disk herniation (LDH).
  17. Valat J, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Clin Rheumatol. 2010;24:241-52 pubmed publisher
    b>Sciatica is a symptom rather than a specific diagnosis. Available evidence from basic science and clinical research indicates that both inflammation and compression are important in order for the nerve root to be symptomatic...
  18. Bell J. Massage therapy helps to increase range of motion, decrease pain and assist in healing a client with low back pain and sciatica symptoms. J Bodyw Mov Ther. 2008;12:281-9 pubmed publisher
    This study evaluated the effectiveness of massage therapy as a component in increasing range of motion (ROM), decreasing pain and assisting in healing of a client with low back pain (LBP) and sciatica symptoms.
  19. Zhang Z, Song L, Meng Q, Li Z, Pan B, Yang Z, et al. Morphological analysis in patients with sciatica: a magnetic resonance imaging study using three-dimensional high-resolution diffusion-weighted magnetic resonance neurography techniques. Spine (Phila Pa 1976). 2009;34:E245-50 pubmed publisher
    A prospective observational study of patients with sciatica.
  20. Luijsterburg P, Verhagen A, Ostelo R, van den Hoogen H, Peul W, Avezaat C, et al. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up. Eur Spine J. 2008;17:509-17 pubmed publisher
    A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical ..
  21. Lin H, Chen J, Liu Y, Cho D. Sciatica caused by pseudomyxoma peritonei. J Chin Med Assoc. 2009;72:39-41 pubmed publisher
    Many etiologies may cause sciatica, and intra-abdominal masses usually affect the lumbosacral plexus by local invasion or distal metastases...
  22. Visser L, Nijssen P, Tijssen C, van Middendorp J, Schieving J. Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis. Eur Spine J. 2013;22:1657-64 pubmed publisher
    To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with ..
  23. Wei M, Mo S, Nabar N, Chen Y, Zhang J, He Q, et al. Modification of rat model of sciatica induced by lumber disc herniation and the anti-inflammatory effect of osthole given by epidural catheterization. Pharmacology. 2012;90:251-63 pubmed publisher
    One of the most treatable causes of lower back pain and associated sciatica is lumbar disc herniation (LDH), which is characterized by rupture of the hard outer wall (annulus fibrosis) in a lumbar intervertebral disc...
  24. Cohen S, White R, Kurihara C, Larkin T, Chang A, Griffith S, et al. Epidural steroids, etanercept, or saline in subacute sciatica: a multicenter, randomized trial. Ann Intern Med. 2012;156:551-9 pubmed publisher
    ..Perineural inhibitors of tumor necrosis factor have recently generated intense interest as an alternative to epidural steroid injections for lumbosacral radiculopathy...
  25. Goupille P, Mulleman D, Paintaud G, Watier H, Valat J. Can sciatica induced by disc herniation be treated with tumor necrosis factor alpha blockade?. Arthritis Rheum. 2007;56:3887-95 pubmed
  26. Sanal H, Kocaoglu M, Bulakbasi N, Yildirim D. Pelvic hydatid disease: CT and MRI findings causing sciatica. Korean J Radiol. 2007;8:548-51 pubmed
    Pelvic masses, especially hydatid disease, rarely present with sciatica (1, 2)...
  27. Cohen S, Bogduk N, Dragovich A, Buckenmaier C, Griffith S, Kurihara C, et al. Randomized, double-blind, placebo-controlled, dose-response, and preclinical safety study of transforaminal epidural etanercept for the treatment of sciatica. Anesthesiology. 2009;110:1116-26 pubmed publisher
    ..One variable that may have contributed to poor outcomes is low drug levels at the site of nerve inflammation. To date, no studies have evaluated the efficacy or safety of epidurally administered anti-tumor necrosis factor agents...
  28. Arts M, Brand R, van den Akker M, Koes B, Bartels R, Peul W. Tubular diskectomy vs conventional microdiskectomy for sciatica: a randomized controlled trial. JAMA. 2009;302:149-58 pubmed publisher
    Conventional microdiskectomy is the most frequently performed surgery for patients with sciatica due to lumbar disk herniation...
  29. Floyd J, Keeler E, Euscher E, McCutcheon I. Cyclic sciatica from extrapelvic endometriosis affecting the sciatic nerve. J Neurosurg Spine. 2011;14:281-9 pubmed publisher
    ..The authors describe a woman with catamenial sciatica caused by endometriosis affecting the sciatic nerve trunk in the upper thigh...
  30. Peul W, Arts M, Brand R, Koes B. Timing of surgery for sciatica: subgroup analysis alongside a randomized trial. Eur Spine J. 2009;18:538-45 pubmed publisher
    Surgery speeds up recovery for sciatica. Prolonged conservative care with surgery for those patients with persistent sciatica however, yields similar results at 1 year...
  31. Korovessis P, Repantis T, Zacharatos S, Baikousis A. Low back pain and sciatica prevalence and intensity reported in a Mediterranean country: ordinal logistic regression analysis. Orthopedics. 2012;35:e1775-84 pubmed publisher
    ..this retrospective cross-sectional study was to estimate the 6-month prevalence and severity of low back pain and sciatica in a representative sample of an adult Mediterranean population...
  32. Hofstede S, Marang van de Mheen P, Assendelft W, Vleggeert Lankamp C, Stiggelbout A, Vroomen P, et al. Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study. Implement Sci. 2012;7:55 pubmed publisher
    b>Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression...
  33. Grøvle L, Haugen A, Keller A, Natvig B, Brox J, Grotle M. The bothersomeness of sciatica: patients' self-report of paresthesia, weakness and leg pain. Eur Spine J. 2010;19:263-9 pubmed publisher
    The objective of the study was to investigate how patients with sciatica due to disc herniation rate the bothersomeness of paresthesia and weakness as compared to leg pain, and how these symptoms are associated with socio-demographic and ..
  34. Niu C, Lai P, Fu T, Chen L, Chen W. Ruling out piriformis syndrome before diagnosing lumbar radiculopathy. Chang Gung Med J. 2009;32:182-7 pubmed
    Piriformis syndrome (PS), a rare cause of sciatica, is usually diagnosed only after excluding all other possibilities...
  35. Tong H. Specificity of needle electromyography for lumbar radiculopathy in 55- to 79-yr-old subjects with low back pain and sciatica without stenosis. Am J Phys Med Rehabil. 2011;90:233-8; quiz 239-42 pubmed publisher
    The aim of this study was to determine the specificity of needle electromyography for lumbar radiculopathy in subjects with low back pain and sciatica without stenosis.
  36. Younes M, Korbaa W, Zrour S, Bejia I, Touzi M, Bergaoui N. [Sciatica due to unusual causes: Tarlov cysts and nerve roots anomalies]. Rev Neurol (Paris). 2009;165:282-7 pubmed publisher
    ..impingement (disc hernia, spondylolisthesis or lumbar canal stenosis) these anomalies can be responsible for sciatica, motor deficit and bladder sphincter dysfunction...
  37. Hirose K, Iwakura N, Orita S, Yamashita M, Inoue G, Yamauchi K, et al. Evaluation of behavior and neuropeptide markers of pain in a simple, sciatic nerve-pinch pain model in rats. Eur Spine J. 2010;19:1746-52 pubmed publisher
    ..Upregulation of the pain-marker expression in the nerve-injury model suggested it could be used as a model of pain. However, it was not considered as suitable for long-term studies...
  38. Rivinoja A, Paananen M, Taimela S, Solovieva S, Okuloff A, Zitting P, et al. Sports, smoking, and overweight during adolescence as predictors of sciatica in adulthood: a 28-year follow-up study of a birth cohort. Am J Epidemiol. 2011;173:890-7 pubmed publisher
    Lifestyle factors such as smoking, obesity, and level of physical activity predict low back pain (LBP) and sciatica. The authors investigated whether participating in sports, smoking, and being overweight or obese at 14 years of age ..
  39. Legrand E, Bouvard B, Audran M, Fournier D, Valat J. Sciatica from disk herniation: Medical treatment or surgery?. Joint Bone Spine. 2007;74:530-5 pubmed
    Disk-related sciatica is a common disorder that resolves without surgery in 95% of patients within 1 to 12months...
  40. Ohtori S, Miyagi M, Eguchi Y, Inoue G, Orita S, Ochiai N, et al. Epidural administration of spinal nerves with the tumor necrosis factor-alpha inhibitor, etanercept, compared with dexamethasone for treatment of sciatica in patients with lumbar spinal stenosis: a prospective randomized study. Spine (Phila Pa 1976). 2012;37:439-44 pubmed publisher
    ..Prospective randomized trial...
  41. Boyajian O Neill L, McClain R, Coleman M, Thomas P. Diagnosis and management of piriformis syndrome: an osteopathic approach. J Am Osteopath Assoc. 2008;108:657-64 pubmed
    ..The authors note that several nonpharmacologic therapies, including osteopathic manipulative treatment, can be used alone or in conjunction with pharmacotherapeutic options in the management of piriformis syndrome...
  42. Liu H, Hung G, Yen H, Hsieh M, Chiou T. Acute sciatica: an unusual presentation of extramedullary relapse of acute lymphoblastic leukemia. Int J Hematol. 2007;86:163-5 pubmed
    ..This case represents a rare neurologic complication of what is currently an uncommon presentation for relapse of acute lymphoblastic leukemia, with acute sciatica and without coexisting epidural or leptomeningeal leukemia.
  43. Chen M, Wang P, Cheng G, Guo X, Wei G, Cheng X. The warming acupuncture for treatment of sciatica in 30 cases. J Tradit Chin Med. 2009;29:50-3 pubmed
    To observe the relation between the pain threshold and the therapeutic effects of acupuncture for sciatica.
  44. Aykanat V, Gentgall M, Briggs N, Williams D, Yap S, Rolan P. Intradermal capsaicin as a neuropathic pain model in patients with unilateral sciatica. Br J Clin Pharmacol. 2012;73:37-45 pubmed publisher
    This study compared the responses between patients with unilateral sciatica and pain-free volunteers following administration of intradermal capsaicin...
  45. Jacobsen L, Schistad E, Storesund A, Pedersen L, Rygh L, Røe C, et al. The COMT rs4680 Met allele contributes to long-lasting low back pain, sciatica and disability after lumbar disc herniation. Eur J Pain. 2012;16:1064-9 pubmed publisher
    ..A functional polymorphism in the gene encoding this enzyme, i.e. the COMT Val158Met SNP that reduces enzyme activity, has previously been linked to pain sensitivity...
  46. Bertolini G, Artifon E, Silva T, Cunha D, Vigo P. Low-level laser therapy, at 830 nm, for pain reduction in experimental model of rats with sciatica. Arq Neuropsiquiatr. 2011;69:356-9 pubmed
    ..was to evaluate the effects of two doses of low-level laser, at 830 nm, on pain reduction in animals subjected to sciatica. Eighteen rats were used, divided into three groups: GS (n=6), sciatica and simulated treatment; G4J (n=6), ..
  47. Sayegh F, Kenanidis E, Papavasiliou K, Potoupnis M, Kirkos J, Kapetanos G. Efficacy of steroid and nonsteroid caudal epidural injections for low back pain and sciatica: a prospective, randomized, double-blind clinical trial. Spine (Phila Pa 1976). 2009;34:1441-7 pubmed publisher
    ..Prospective, double-blind, randomized, case-control study...
  48. Peul W, Brand R, Thomeer R, Koes B. Improving prediction of "inevitable" surgery during non-surgical treatment of sciatica. Pain. 2008;138:571-6 pubmed publisher
    A randomized trial showed that surgery speeds up recovery of patients suffering sciatica for 6 weeks but prolonged conservative care yields similar results at one year...
  49. Scaia V, Baxter D, Cook C. The pain provocation-based straight leg raise test for diagnosis of lumbar disc herniation, lumbar radiculopathy, and/or sciatica: a systematic review of clinical utility. J Back Musculoskelet Rehabil. 2012;25:215-23 pubmed publisher
    The purpose of this study was to investigate the diagnostic accuracy of a finding of pain during the straight leg raise test for lumbar disc herniation, lumbar radiculopathy, and/or sciatica.
  50. Peul W, Brand R, Thomeer R, Koes B. Influence of gender and other prognostic factors on outcome of sciatica. Pain. 2008;138:180-91 pubmed publisher
    b>Sciatica caused by a lumbar disk herniation is a frequently diagnosed disorder with a favorable natural course. While most prognostic studies focus on good outcome, patients might experience unsatisfactory results...
  51. Stafford M, Peng P, Hill D. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth. 2007;99:461-73 pubmed
    ..This review discusses the history, epidemiology, pathophysiology, and natural history of sciatica. A Medline search was performed to obtain the published literature on the sciatica, between 1966 and 2006...
  52. van Tulder M, Peul W, Koes B. Sciatica: what the rheumatologist needs to know. Nat Rev Rheumatol. 2010;6:139-45 pubmed publisher
    b>Sciatica is a set of symptoms rather than a specific diagnosis, and is caused by a herniated lumbar disc in the vast majority of cases. The most important symptom is lower limb pain radiating below the knee and into the foot and toes...
  53. Haugen A, Grøvle L, Keller A, Grotle M. Cross-cultural adaptation and validation of the Norwegian version of the Tampa scale for kinesiophobia. Spine (Phila Pa 1976). 2008;33:E595-601 pubmed publisher
    ..Translation, cross-cultural adaptation, and validation of a self-report questionnaire...