Understanding Lesion of sciatic nerve: Causes, Symptoms, and Management

What is it?

Sciatic nerve injury occurs due to trauma (pressure, stretching or cutting) to the nerve and can cause symptoms such as paresthesias, loss of muscle power and pain. These symptoms are similar to those caused by sciatica, however, the term "sciatica" is typically used to refer to conditions where the sciatic nerve is irritated or compressed, rather than being injured directly. Please read our Sciatica page for more information.

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Additional names

This group contains additional names:
- Piriformis

Signs & symptoms

The common symptoms are pain and abnormal gait pattern. However, pain intensity is difficult to quantify or rate particularly in the paediatric population but facial expression is quite helpful. Other clinical signs include:
* Foot drop
* External rotation and abduction contracture of the hip
* Equinovarus or Equinus deformity
* Muscular weakness/atrophy
* Motor and sensory deficit such as paraesthesia and numbness

Diagnosis

Sciatic neuropathy is more of a clinical diagnosis. Well, a detailed subjective and objective examination is the golden rule. Electro-diagnostic studies include;
* Electromyography
* Magnetic Resonance Imaging

Treatment

In most cases, symptoms of Sciatic Nerve injury does not respond to the use of non-steroidal anti-inflammatory drugs (NSAIDs), opioids and myorelaxants. However, the use of methylprednisolone via transacral block was effective to manage the neuropathic pain, motor and sensory deficits. In addition, a recent study showed beneficial use of methylprednisolone via both intravenous and oral routes.
Surgery is opted for patients that did not improve beyond 3 months of sustaining injection palsy. Common procedures include neurolysis and grafting with serial clinical and electrophysiological monitoring. Patients with foot deformity can opt for elongation of the tendon Achilles, osteotomy and capsulotomy. Although, conflicting findings are comparing conservative and surgical interventions.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital