Sciatica (from the Greek word “Ischion” that means thigh) is a disease (that is to say, neuralgia or neuritis) of the sciatic nerve, which is mainly characterized by pain in the area of this nerve and its branches. Sciatica is one of the most frequent diseases of the peripheral nervous system. It occurs in middle and old ages. It may be as primary and secondary. Primary sciatica is caused by various infections (such as influenza, rheumatism, malaria, syphilis, brucellosis, tuberculosis etc.), with intoxication (for instance, by an alcohol), because of metabolic reasons (gout, diabetes, vitamin deficiency), as well as injuries. Secondary sciatica occurs in diseases of the spine, intervertebral discs, sacroiliac joint, hip joint, spinal cord and its membranes, as well as gynecological and urological diseases. Cooling and physical strain are often contributing factors.

When there is sciatica, chronically low back pain, the pain in the leg along the sciatic nerve and its branches (posterior surface of the femur, tibia and the outer surface of the foot) are felt. The pressure on the sciatic nerve on its course is painless. Its tension with unbending of a leg is vice a versa sharply painful, with head bent forward, coughing, sneezing, low back pain and that in leg amplifies. With prolonged duration of sciatica tendon reflexes decrease or disappear; there are also numbness on the affected leg and lowering of the tone (that is to say, the natural tension) in thigh and lower leg. When there is sciatica, curvature of the spine (scoliosis) is often observed. Sometimes there are changes of cerebrospinal fluid.

Duration of the disease lies between a few days and weeks and several months. Secondary sciatica may recur.

In order to clarify the causes of sciatica, patients should do an x-ray of the lumbosacral spine, so as hip and pelvic bones sometimes. In chronic cases and in the secondary sciatica patients should also do an analysis of cerebrospinal fluid.

Speaking about the prevention we should mention that it is important to avoid cooling and physical overstrain. Considering treatment it should be said that bed rest and painkillers (such as aspirin, headache tablets with analginum etc.), thermal procedures (hot-water bottle, blue light irradiation of a quartz lamp) should be conducted in acute period, in the future patients have to deal with electrotherapy, novocaine injection along the nerve. In chronic cases spa treatment such as that with mud, hydrogen sulfide and radioactive baths must be conducted.

Sensory disturbances in sciatica show themselves with a sense of numbness and “paresthesia crawling” on the skin. Motor impairment is caused by atrophy of muscles innervated by sciatic nerve, which is evident by decline in force until the complete paralysis. A man can not walk on foot and feels that the leg does not obey “the master”. There are involuntary muscle contractions during passive leg lifting sometimes.

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