Sciatica

Pseudo-sciatica is common. Fortunately, true sciatica is uncommon. Less than 0.5% of the low back pain sufferers experience sciatica – a pinch or entrapment of a portion of the sciatic nerve root as it exits the spinal column. The sciatic nerve goes down the leg and is made up of 5 nerve roots, the L3 L4 & L5 lumbar nerve roots and the S1 & S2 sacral nerve roots. Any of these nerve roots can get pinched by a herniated disc in the lower lumbar spine and can cause leg pain. Figure 3 illustrates an entrapment of the S1 nerve root by a herniation of the L5-S1 disc. Note the dull ache to shooting pain pattern, figure 4, follows the nerve from the sacroiliac joint, over the hip, down the posterior lateral thigh to the calf and heel. There is an area of numbness to pin prick, figure 5, in the back of the calf and the lateral heel, foot and toe. The ankle jerk reflex is also diminished or absent, figure 6. With pinching of S1 nerve the patient may have difficulty walking on their toes.

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