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Radial head subluxation (Nursemaid elbow)
Developmental dysplasia of the hip
Slipped capital femoral epiphysis
Osgood-Schlatter disease (traction apophysitis)
Rotator cuff tear
Radial head subluxation (Nursemaid elbow)
Thoracic outlet syndrome
Carpal tunnel syndrome
Iliotibial band syndrome
Anterior cruciate ligament injury
Patellar tendon rupture
Patellofemoral pain syndrome
Achilles tendon rupture
Degenerative disc disease
Spinal disc herniation
Osteomalacia and rickets
Paget disease of bone
Lordosis, kyphosis, and scoliosis
Juvenile idiopathic arthritis
Calcium pyrophosphate deposition disease (pseudogout)
Inclusion body myopathy
Lambert-Eaton myasthenic syndrome
Systemic lupus erythematosus
Mixed connective tissue disease
Limited systemic sclerosis (CREST syndrome)
Back pain: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Gout and pseudogout: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
Scleroderma: Pathology review
Sjogren syndrome: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Pediatric musculoskeletal disorders: Pathology review
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Samantha McBundy, MFA, CMI
Stefan Stoisavljevic, MD
Sciatica is a condition where there’s pain that starts in the lower back which then travels down the leg. Since the pain is associated with injury or compression of the sciatic nerve and follows the path of the sciatic nerve, it makes sense to name it sciatica.
The sciatic nerve is the longest and widest nerve in the body. It’s formed by the spinal nerves L4, L5, and S1-3, which leave the spinal canal through intervertebral foramen, an opening located between the vertebrae and behind the intervertebral discs. These nerves travel to the area in front of the sacrum, and join to make the sacral plexus.
All the nerves in the plexus, except S3 are split into two divisions: anterior and posterior. Anterior divisions of the L4, L5, S1, S2 and the entire S3 nerve create the tibial nerve, while posterior divisions of the L4, L5, S1 and S2 form the common fibular nerve. These two nerves are bound together by connective tissue and make up the sciatic nerve.
The sciatic nerve then passes beneath the piriformis muscle and through the greater sciatic foramen which is an opening formed by the pelvic bone, sacrospinous, and sacrotuberous ligaments.
It then travels down the back of the thigh to the back of the knee where it splits into the tibial and common fibular nerves. The sciatic nerve innervates the muscles in the back of the thigh. The Tibial nerve innervates the muscles of the posterior compartment of the leg and intrinsic flexors of the foot.
The Common fibular nerve is in charge of the muscles in the anterior and lateral compartments of the leg and intrinsic extensors of the foot. Now, each spinal nerve is in charge of the sensation of a specific area of the skin, called a dermatome.
Sciatica is a term used to describe symptoms of lower back pain, numbness, or tingling that originate in the lower back and travel down the sciatic nerve. It is often due to a spinal disc herniation pressing on one of the lumbar or sacral nerve roots. Other common causes are spinal stenosis, degenerative disc diseases. Treatment options include physical therapy, pain medication, exercise, and in some cases, surgery.
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