Sciatica is another name for lumbar radiculopathy. It is a common condition with a lifetime prevalence of approximately 5%-10%, with a peak incidence between the ages of 45 and 64. Risk factors for the development of sciatica include obesity, taller height, smoking, and occupational factors including jobs that involve frequent lifting or driving.
About 85% of cases are due to lumbosacral disk herniation compressing a nerve root, most commonly at L4-L5 or L5-S1. Other causes include spinal stenosis, spondylolisthesis, cauda equina syndrome, compression by pelvic tumors, trauma, and piriformis syndrome.
Sciatica usually resolves without treatment, with 75% of patients reporting improvement within 3 months. First-line therapy is conservative management including analgesic medication and physical therapy. Surgical interventions are typically reserved for patients with weakness or refractory pain.
M54.30 – Sciatica, unspecified side
23056005 – Sciatica
- Spinal disk herniation
- Spinal stenosis
- Peripheral neuropathy (eg, mononeuritis multiplex)
- Spinal or pelvic tumors
- Epidural abscess – associated with infectious signs such as fever
- Viral infection (eg, varicella zoster virus) – look for rash
- Piriformis syndrome
- Inflammatory disease (eg, sarcoidosis, chronic inflammatory demyelinating polyneuropathy, arachnoiditis, vasculitis)
- Guillain-Barré syndrome
- Vascular claudication / peripheral vascular disease
- Lumbar strain
- Sacroiliac joint dysfunction (see sacroiliitis)
- Hip fracture or dislocation
- Biceps femoris strain