ABSTRACT
Common sciatica is the most frequent radicular pain syndrome of spinal origin. It is usually linked to irritation of a spinal nerve root associated with disk herniation at L4-5 or L5-S1.
The onset is often traumatic. Exertion or a forced movement results in acute low back pain, followed by referral to the leg. Often this is exacerbated by standing, sitting, exertion, coughing, and sneezing, and relieved by lying down. Its referral pattern follows that of the L5 or S1 territory: for L5, the buttock, anterior aspect of the thigh, lateral malleolus, dorsum of the foot, great toe or the three first toes (Fig. 43.1); for S1, the buttock, posterior aspect of the thigh, knee, leg and heel, to the sole or lateral side of the foot, up to the fifth toe (Fig. 43.3). In the distal limb, pain may be replaced by tingling or numbness.
