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Radiating pain along the sciatic nerve, from the lower back down the leg, often due to nerve compression.
Sciatica is a characteristic type of pain that radiates along the path of the sciatic nerve, which is the largest single nerve in the body. It originates in the lower back, extends through the buttocks, and travels down the back of each leg, often reaching the foot and toes. Sciatica is not a condition in itself but rather a symptom of an underlying problem that is irritating or compressing the sciatic nerve or its roots in the lower spine. The most common cause of sciatica is a herniated disc in the lumbar spine that presses on one of the sciatic nerve roots. Other potential causes include spinal stenosis (narrowing of the spinal canal), spondylolisthesis (slippage of one vertebra over another), piriformis syndrome (compression of the sciatic nerve by the piriformis muscle in the buttock), and, less commonly, tumors or infections affecting the spine. The pain associated with sciatica can vary widely in intensity and character, ranging from a mild ache to a sharp, burning, or shooting sensation. It may be intermittent or constant and can be accompanied by other symptoms such as numbness, tingling, and muscle weakness in the affected leg and foot. The pain may worsen with certain activities like sitting, standing for long periods, coughing, or sneezing. Diagnosis typically involves a physical examination, including specific tests to assess nerve function, such as the straight leg raise test. Imaging studies like MRI scans are often used to identify the underlying cause of the sciatic nerve compression. Treatment for sciatica focuses on relieving pain and addressing the underlying condition. Conservative measures are usually the first line of treatment and may include rest, pain medications (over-the-counter and prescription), nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, physical therapy to improve posture, strengthen core muscles, and increase flexibility, and epidural steroid injections to reduce inflammation around the nerve root. In cases of severe or persistent sciatica that does not improve with conservative treatment, or if there are progressive neurological deficits, surgical options such as microdiscectomy (for herniated disc) or laminectomy (for spinal stenosis) may be considered to relieve the pressure on the sciatic nerve. Rehabilitation plays a vital role in recovery and preventing future episodes.
