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Sciatica's Meaning and Symptooms

blue-light / 2011-02-21
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Sciatica occupies the first place in all kinds of internal neuralgia, which is a common disease.

But sciatica is only a symptom of the disease, which itself is not an independent disease. The onset of the disease stands in the age of 20 ~ 60 years old and it is most common at about 40. The disease is rare among the people who are before 20 or after 60 years old. According to the 1982 National Survey in six cities, the disease prevalence rate is 121 .8/100,000.


Sciatica refers to the pain of the sciatic nerve passages with the region around them. This means that the pain of the buttocks, posterior of thighs, sural side and lateral edge of feet caused by anything can be called sciatica. Sciatica can be divided into two categories, namely primary sciatica and secondary sciatica with different causes.

1. Primary sciatica: Primary sciatica is mainly caused by the direct damage to the sciatic nerve due to infection or poisoning. It is also called sciatic nerve inflammation, which is rare in clinical cases. It is often attacks with myositis, muscle fiber angina simultaneously. Catching cold or wetness can be the predisposing factors.

2. Secondary sciatica: Secondary sciatica is the pain caused by the sciatic nerve passages stimulated, oppressed or damaged by the lesions of adjacent tissue. Most clinical cases of sciatica belong to secondary sciatica. The common causes include the points below: 

(1) Spinal lesions oppress the lumbosacral nerve root, such as spinal cord tumors, inflammation, vascular malformations, trauma, and rheumatoid spinal arachnoid.

(2) Spinal diseases invade the lumbosacral nerve root: lumbar disc herniation, spinal joint disease, spinal inflammation, tuberculosis, cancer, dislocation, spinal stenosis, spina bifida and so on.

(3) The diseases of pelvis and pelvic disorders invade the sciatic nerve stem: sacroiliac joint disease, inflammation, tuberculosis, dislocation, pelvic inflammatory disease and cancer, pelvic uterine inflammation and cancer, uterine pregnancy oppression.


 The sciatica caused by neurocanal diseases and spinal lesions is the “root” sciatica; The sciatica caused by the diseases of pelvis and pelvic disorders is the “stem” sciatica. In all these causes, lumbar disc herniation is the most common.


he onset of sciatica often follows the trauma, physical labor and catching a cold, or it recurs because of the things above. Most cases get the pain in a side, some individuals get the pain in two sides. The typical symptoms of sciatica include the pain of the waist and hip in one side that radiates to the posterior of thigh and lateral of leg and lateral of foot. Walking and changing the body posture can aggravate the pain, and raising the ill leg is limited when keeping recumbent.


1. The Root Sciatica: In early stage of the disease, its performance is not typical, and many cases include lower back pain in a side, waist tingle, fearing cold that in deep position. This low back pain often appears after activities and disappears after a rest. The back pain aggravates gradually later to transform into the persistent pain. The pain is aggravated after activities, which radiates to the buttocks, thigh posterior, posterolateral leg, foot lateral, accompanied by numbness or paresthesia. Coughing, sneezing, feces can aggravate pain, most patients describe the pain is in the form of current, which radiates from the waist along the sciatic nerve running to the distal. Patients walk on the body tilt forward to the healthy side, lying off with crooked knees and hip, as it can ease the pain.


Most patients have marked tenderness point in the lower waist next to the affected side. When oppressing this point, the pain often radiates form the local part to the side leg. Sometimes there is tenderness in central parts of the affected side, and the sciatic nerve under the buttocks has little tenderness. Such patients get a positive result in a chest chin test (i.e. the patients keep supine and crook the head forward passively to make the chin touches the chest wall; the lower extremity pain appears or it is aggravated), and they get a positive result in the test raising the leg straight.


2. The Stem Sciatica: The pain is in the parts of the buttocks, posterior thighs, posterolateral legs and feet. The pain is persistent and paroxysmally intensified, sometimes it is burning or knife-like, it is aggravated at night and after activities. Coughing and sneezing movements will not aggravate the pain. The sciatic nerve traveling region get obvious tenderness, but the lumbar spine gets no tenderness. The patients get a positive result in the test raising the leg straight, i.e. the patients keep supine with two legs extended to maintain the affected limb in straight extended knee, the pain will appear in less than 70 degrees (normal people can bend the hip joint for 90 degrees).


Whatever type of sciatica can bring about the muscle relaxants of the buttocks and legs. For the patients in the long course, there will be those parts of the muscle atrophy that the ipsilateral buttocks become smaller; the legs become thinner. There will be the abnormal feeling in the painful parts; Achilles tendon reflex is weakened or disappeared. Individual patients may also get the skin of the ill lower limb cool, dry and less sweating or much sweating.

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