Sciatica/herniated Disc

Sciatica/herniated Disc is a topic covered in the 5-Minute Emergency Consult.

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  • Pain that radiates from the back into buttocks and lower extremity distal to knee, with or without sensory or motor deficits:
    • 95% sensitive, 88% specific for herniated disc (HD)
    • 3–5% lifetime prevalence
    • Peaks 4th to 5th decade
    • 2–10% of low back pain
    • 95% L5 or S1 nerve root
    • 90% improve with conservative management
    • Radicular symptoms usually resolve within 6 wk
    • 5–10% require surgery


  • Protrusion of colloidal gel (nucleus pulposus) through weakened surrounding fibrous capsule (annulus fibrosis)
  • Risk factors:
    • Smoking
    • Repetitive lifting/twisting
    • Vehicular/machinery vibration
    • Obesity
    • Sedentary lifestyle

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