Sciatica

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Sciatica

• Pain felt down back and outer side of thigh, leg, foot

Differential diagnoses

• Intermittent claudication
• osteoarthritis of hip
• anterior tibial compartment syndrome
• cauda equina claudication

History

• pain in back, down buttock and thigh
• May be sudden onset
  • +/- twisting / lifting movement
• back stiff and painful
• no characteristic relationship to exercise
• may be accompanied by numbness and weakness

PMH

• disc lesion
• back trouble

Examination

• limited straight leg raising
• neurological signs
  • wasting
  • loss of power
  • reflexes diminished
  • reduced sensation

Causes

•  usually degeneration of intervertebral disc

Treatment

• bed rest
• may need surgery

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