Where is the sciatic nerve pain located?

Sciatica is a relatively common disease manifestation. It refers to a comprehensive manifestation of pain in the sciatic nerve and its distribution area. Most of the time, it is caused by lesions in the sciatic nerve and its surrounding area. Because nerve stimulation leads to compression and damage, the patient experiences abnormal pain. At this time, corresponding examinations should be carried out in time, such as imaging examinations, electrophysiological examinations, etc.

General symptoms

(1) The pain is mainly limited to the sciatic nerve distribution area, the posterior thigh, the posterior and lateral part of the calf, and the foot. Patients with severe pain may adopt a unique posture: bending their waist, bending their knees, and standing on their toes. If the lesion is located at the nerve root, the pain will worsen when the pressure in the spinal canal increases (coughing, straining). (2) The degree of muscle weakness can vary greatly depending on the cause, location of the lesion, and the extent of the damage. The muscles innervated by the sciatic nerve may be completely or partially weak or paralyzed. (3) There may or may not be tenderness over the sciatic nerve trunk at the sciatic notch.

Sciatica examination

1. Imaging examinations play an important role, including X-rays of the lumbar spine and sacroiliac joints, spinal MRI, and myelography plus CT. In addition to clinical pelvic physical diagnosis, pelvic CT or MRI can be performed. 2. Electrophysiological examination ① EMG of paraspinal muscles can help differentiate radicular sciatica from distal lesions. ② EMG of the short head of the biceps femoris can help differentiate between lateral sciatic nerve and common peroneal neuropathy. ③ Patients with pelvic or femoral fractures are difficult to undergo routine physical examinations, and EMG can assist in evaluating neurological function. ④ The motor nerve conduction velocity and F wave of the femoral nerve and common peroneal nerve may be abnormal, and the sciatic nerve conduction velocity is difficult to stimulate the proximal end of the lesion. 3. Other applications: Corticosteroids or local anesthetics are injected into the piriformis muscle. If the pain is relieved, it will help diagnose piriformis syndrome.