Indeed, the term has been described as ‘an anachronism and should be abandoned’. 72 The term ‘sciatica’ may cause confusion as it has been used to describe any pain, including referred, felt in the leg along the distribution of the sciatic nerve.
72 According to these definitions, sciatic neuralgia is clearly a form of radicular pain, and is described as a disease of the peripheral nervous system.
72 Radicular pain is defined as ‘pain perceived as arising in a limb or the trunk caused by ectopic activation of nociceptive afferent fibres in a spinal nerve or its roots or other neuropathic mechanisms’. Sciatic neuralgia is defined as ‘pain in the distribution of the sciatic nerve due to pathology of the nerve itself’. The ongoing issue of the role of epidural steroid injection in the treatment of this condition is also discussed, as well as potential hazards of this procedure and the direction that future research should take. An abnormal immune response and possible mechanical factors are also proposed as factors that may mediate pain. The influence of herniated nucleus pulposus and the probable cytokine-mediated inflammatory response in lumbar and sacral nerve roots is discussed. Epidemiological factors found to influence incidence of sciatica included increasing height, age, genetic predisposition, walking, jogging (if a previous history of sciatica), and particular physical occupations, including driving. Hand searches of relevant journals were also performed. A Medline search was performed to obtain the published literature on the sciatica, between 19. This review discusses the history, epidemiology, pathophysiology, and natural history of sciatica. However, the condition has the potential to become chronic and intractable, with major socio-economic implications. Fortunately, the majority of cases resolve spontaneously with simple analgesia and physiotherapy. The lifetime incidence of this condition is estimated to be between 13% and 40%. Radicular pain in the distribution of the sciatic nerve, resulting from herniation of one or more lumbar intervertebral discs, is a frequent and often debilitating event.
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