In sciatica – colloquially called sciatic pain – (synonyms: Acute sciatica; Acute sciatica with root irritation; Acute lumboischialgia; Chronic lumboischialgia; Sacroiliac joint pain; Infectious sciatica; Sciatica; Sciatica with lumbago; Sciatica with lumbago; sciatica; sciatic pain; sciatica syndrome; sciolumbalgia; L5 syndrome; lumbar neuritis; lumbar radicular neuropathy; lumbar radiculitis a. n.k. ; lumbar radicular syndrome; lumbar vertebral local pain syndrome; lumbar root compression syndrome; lumbar root irritation syndrome; lumbar root irritation; lumboischialgia; lumboischialgia with blockage; lumbosacral neuritis; lumbosacral radicular neuropathy; lumbosacral radiculitis a.n.k. ; lumbosacral root irritation syndrome; lumbosacral plexus neuralgia; spinal nerve root neuritis; sciatic nerve neuritis; brachial plexus neuritis; radicular neuropathy n.e.c. ; radicular syndrome n.e.c. ; radiculitis; radiculopathy; spinal neuralgia; S1 ischialgia; S1 syndrome; sacral root irritation syndrome; sacral root compression; sacral root irritation; spinal radicular pain; spinal root pain; spinal nerve neuritis; thoracic neuritis a. n.k. ; thoracic radicular neuropathy a.n.k. ; thoracic radiculitis a.n.k. ; vertebral radiculitis; root compression syndrome; root neuritis – see also radiculitis; root irritation syndrome; lumbar spine root irritation; root syndrome a. n.k. ; ICD-10-GM M54.3: Sciatica) is a painful condition in the area supplied by the sciatic nerve, usually caused by irritation of the nerve roots. If there is concomitant pain in the lumbar spine (LS), the condition is referred to as lumboischialgia (synonyms: lumboischialgia; lumboischialgia with block; ICD-10-GM M54.4: lumboischialgia). The cause of sciatica/lumboischialgia is usually a herniated disc (Latin: prolapsus nuclei pulposi, discus hernia, discus prolapse, also intervertebral disc prolapse, BSP), which can occur suddenly in the event of disc damage (discopathy). More than two-thirds of the population of Germany has complained of back pain at some time. 50% of working people report having back pain at least once a year. Back pain is considered the most common cause of disability in young people under 45 years of age. Back pain can be classified as follows:
- Acute uncomplicated back pain – dorsalgia (back pain), lumbago (so-called “lumbago”).
- Radicular low back pain – pain originating from a spinal nerve root, such as ischialgia.
- Complicated low back pain – pain due to tumor disease, fracture (broken bone), or similar; occurs in 1% of patients
The discogenic (disc-related) triggered specific back pain can be divided into two subgroups:
- Localized back pain discogenically caused – usually triggered by median lying disc prolapse (BSP/disc herniation; breakthrough of the annulus fibrosus/fibrous ring), more rarely by pure protrusion (disc protrusion; partially or completely preserved annulus).
- Radiculopathy (irritation or damage to nerve roots) – resulting from a herniated disc (BSP) with mediolateral (“from the center toward the side”) or lateral (“to the side”) location; thereby compressing descending fibers or the radices (roots) of spinal nerves.
Sex ratio: men are more often affected by sciatica than women. Frequency peak: the disease occurs predominantly between the 20th to 50th year of life. The incidence (frequency of new cases) of sciatica is about 150 diseases per 100,000 inhabitants per year (in Germany). Course and prognosis: Back pain can be acute or chronic. One speaks of acute back pain if the pain does not last longer than 12 weeks. It is usually harmless and disappears spontaneously (by itself). Chronic back pain is when the pain recurs (comes back) in the short term or persists for more than three months. If the back pain lasts longer than three days, medical clarification should be sought. If the back pain is accompanied by paralysis, tingling or sensory disturbances in the legs, immediate medical consultation is required. Therapy of sciatica/lumboischialgia includes pharmacotherapy (analgesics (painkilling drugs) and anti-inflammatory drugs) as well as physiotherapeutic measures.Surgery may be required for radicular and complicated causes (e.g., nucleus pulposus prolapse/herniated disc). Often, the pain stops spontaneously (by itself) after a few days to six weeks at the most. Preventive efforts should focus on strengthening the back muscles and back-friendly behaviors.
