It refers to radiating pain mainly distributed along the sciatic nerve area, including the buttocks, posterior thigh, posterolateral lower leg, and lateral dorsum of the foot. It is a symptom caused by various diseases and is classified into root and trunk sciatica.

bubble_chart Diagnosis

I. Medical History and Symptoms

Unilateral, more common in middle-aged males. Pain often radiates from the buttocks down to the foot, and actions such as coughing or sneezing frequently exacerbate the pain. To alleviate discomfort, patients often exhibit lateral curvature of the spine and slight knee flexion when lying down.
Radicular sciatica is mostly caused by conditions such as herniated discs, intraspinal space-occupying lesions, lumbosacral radiculitis, or spinal arthritis. Non-radicular (dry) sciatica is often due to sciatic neuritis or hip joint diseases. Differential diagnosis should be emphasized during history-taking and physical examination.

II. Physical Examination Findings

1. Tenderness points: Tenderness is present along the sciatic nerve distribution areas, such as the lumbar region, iliac point, gluteal point, popliteal point, fibular point, and ankle point.

2. Positive sciatic nerve traction signs, such as Kernig's sign, Lasegue's sign, and Bonnet's sign. 3. Varying degrees of motor, sensory, reflex, and autonomic dysfunction within the sciatic nerve's innervation area. This may manifest as weakened dorsiflexion of the toes on the affected side, reduced pain sensation in the lateral calf, absent Achilles tendon reflex, and decreased muscle tone in the gluteal region.

III. Auxiliary Examinations

Erythrocyte sedimentation rate (ESR) may be elevated, and anti-"O" or rheumatoid factors may show abnormalities. Spinal X-rays, lumbar CT, or MRI may reveal corresponding changes. If an intraspinal space-occupying lesion is suspected, lumbar puncture CSF examination often shows elevated protein levels. Myelography may be performed if necessary for definitive diagnosis.

1. Disease Cause Treatment:

For sciatica caused by sciatic neuritis, bed rest for 3 weeks during the acute phase is recommended. Oral analgesics such as Fenbid 0.3 three times a day, aspirin 0.3 three times a day, diazepam 2.5mg three times a day, and vitamins can be administered. Short-term use of hormones is also an option. If the condition is caused by lumbar disc herniation or intraspinal lesions, the primary disease should be actively treated.

2. Block Therapy:

Intrasacral injection of 1% Novocaine 10ml and prednisolone 0.5ml for block therapy has shown good efficacy.

3. Other Treatments:

Methods such as tuina, traction, physiotherapy, and acupuncture can also be employed.