Sciatica is pain caused by irritation of the sciatic nerve, which runs from the lower back down the back of each leg. Common causes include herniated discs pressing on the nerve, spinal stenosis where the spine narrows and compresses the nerve, and spondylolisthesis where a vertebra slips out of place. Symptoms include pain running down the leg, numbness, and walking difficulties. Diagnosis involves physical exams like the straight leg raise test and imaging like MRI. Treatment includes medications, physiotherapy, and sometimes surgery to decompress the nerve. Preventive measures focus on back health through exercise and posture.

1. SCIATICA
(DEFENITION,CAUSE ,MANAGEMENT, PREVENTION)
MARTIN SHAJI
PHARM D

2. - Sciatica is pain in the
lower extremity resulting
from irritation of the
sciatic nerve. The pain of
sciatica is typically tilt
from the low back
(lunar area) to behind
the thigh and radiating
down below the knee &
may reach the foot .
DEFINITION

3. I)Disc herniation:
may occur in different levels
of lumbosacral vertebrae .
but the most common are
L5orSl .
ETIOLOGY

4. 2) Spinal stenosis:
is a narrowing within the
vertebrae of the spinal
column that results in
too much pressure on
the spinal cord . The
most common causes of
spinal stenosis are
related to the aging
process in the spine

5. 3) Spondylolisthesis
degenerative cause of spinal
stenosis which Is anterior
or posterior displacement
of vertebra .

6. • 4) other causes :
include irritation of the nerve from
adjacent
bone, tumors, muscle, internal
bleeding,
infections, injury, and other causes.
Sometimes
sciatica can occur because of irritation
of the
sciatic nerve during pregnancy.

7. 1- pain:
The most common
symptom from sciatica.
Most people describe a
deep, severe pain that starts
low on one side of the back
and then shoots down the
buttock and the leg with
certain movements.
CLINICAL FEATURES

8. • In most people, the pain is made worse by
sneezing, coughing, laughing, or a hard bowel
movement. Bending backward can also make
the pain worse.
• You may also notice a weakness of the leg or
foot, along with the pain. The weakness may
become so bad patient can’t move his foot.

9. 2. Numbness.
3. Walking difficulty.

10. • The physical
examination of sciatic
patients should include:
observation, palpation,
determination of the
- L
range of motion of the
spine, a root tension test
and evaluation of the
neurological status of the
lower limbs .
EXAMINATION

11. • straight leg raising test “Lasègue sign” :
stretches the L5 and S 1 roots, and this test is
regarded positive if leg pain is aggravated
when the affected leg.

12. • In most people, the pain is made worse by
sneezing, coughing, laughing, or a hard bowel
movement. Bending backward can also make
the pain worse.
You may also notice a weakness of the leg or
foot, along with the pain. The weakness may
become so bad patient can’t move his foot.

14. The most helpful
investigation is rvIRI,
c Also ve can use CT
scan .
• X ray to see losing of
normal lardosis.
INVESTIGATION

15. 1- medical:
if there is no Neuro defect.
• Sciatica Pain Relief
Pain is best treated with a non-steroidal anti
inflammatory drugs (NSAID) such as ibuprofen or
codeine (in acute cases).
• Physiotherapy. _____________
• Muscle relaxant

16. 2- Surgery
Some patients with sciatica may find significant
relief from surgery. In cases of herniated discs, a
surgical procedure called a laminectomy may be
performed. In this procedure, a portion of the
posterior arch is removed to relieve pressure on
pinched nerve tissues.
In cases of spinal stenosis, the portion of bone that
is putting pressure on the sciatic nerve system can
be removed.

17. MARTIN