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The sciatic nerve comprises nerve roots L4, L5, S1, S2, and S3 in the spine. [26] These nerve roots merge in the pelvic cavity to form the sacral plexus and the sciatic nerve branches from that. Sciatica symptoms can occur when there is pathology anywhere along the course of these nerves. [27]
Piriformis syndrome is often left undiagnosed and mistaken with other pains due to similar symptoms with back pain, quadriceps pain, lower leg pain, and buttock pain. These symptoms include tenderness, tingling and numbness initiating in low back and buttock area and then radiating down to the thigh and to the leg. [ 72 ]
A sciatic nerve injury occurs between 0.5% and 2.0% of the time during a hip replacement. [7] Sciatic nerve palsy is a complication of total hip arthroplasty with an incidence of 0.2% to 2.8% of the time, or with an incidence of 1.7% to 7.6% following revision.
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The sciatic nerve is highly mobile in the deep gluteal space with hip and even knee movements. [7] For example, hip flexion with knee extension (also called a straight leg raise) causes the sciatic nerve in the deep gluteal space to move 28mm towards the center of the body. [14] Hip movements may also create dynamic impingement between muscles.
The nerve roots from L4–S4 join in the sacral plexus which affects the sciatic nerve, which travels caudally (toward the feet). Compression, trauma or other damage to this region of the spinal canal can result in cauda equina syndrome. [citation needed] The symptoms may also appear as a temporary side-effect of a sacral extra-dural injection. [9]