Sciatica

Introduction

The “sciatic nerve“, colloquially known as the “sciatic nerve”, is one of the peripheral nerves of the nervous system, which serve to supply muscles and skin areas of the trunk and extremities. The peripheral nerve always lies outside the brain and emerges from the spinal canal in the immediate vicinity of its first supply area. The sciatic nerve (nervus ischiadicus) is assigned to a nerve plexus (plexus lumbosacralis) located at the level of the lumbar spine and is the thickest nerve in the entire body.

The sciatic nerve emerges from the spinal canal between the 4th lumbar vertebra and the 3rd sacral vertebra and from there runs across the hip in the direction of the legs. In the area of the hip it runs through a structure with holes (Foramen ischiadicum) and from there it reaches the extensor side of the hip joint. The sciatic nerve can then be found on the back of the thigh.

From there it moves to the hollow of the knee, where it splits into the two main nerves of the lower leg (nervus fibularis communis and nervus tibialis). In addition to some sensitive nerve fibers, it also sends out parts for motor innervation of many thigh muscles. These muscles include: Due to its specific course and the close proximity to the spine, buttocks and hip joint, compression of its nerve fibers can easily occur. The resulting clinical picture is generally known as “sciatica”.

  • The Musculi gemelli
  • The quadriceps femoris muscle
  • The Musculus obturator internus
  • The biceps femoris muscle
  • The Musculus semitendinosus and finally
  • The semimembranosus muscle.

Sciatica causes

One of the main causes of the clinical picture known as “sciatica” (sciatica/lumboischialgia) is traumatic injury or bruising of the nerve fibers of the sciatic nerve. Pinching of the sciatica can be caused by various previous illnesses and, in the majority of cases, by incorrect movement sequences; strong mechanical pressure can also lead to sciatica. In addition, a disease of the spinal column, spondylolisthesis (spondylolisthesis), often involves pinching of the sciatic nerve.

In the course of spondylolisthesis, the individual vertebral bodies shift towards each other in such a way that various nerves that emerge from the spinal canal at the level of the affected vertebral bodies can be pinched. Furthermore, inflammatory processes or gross pressure in the area of the nerve roots often lead to sciatica.

  • Pelvic Fractures
  • Thigh fractures and
  • Dislocations (dislocations) of the sacroiliac-iliac joint can affect the nerves and even lead to paralysis of the sciatic nerve.