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The sciatic nerve supplies sensation to the skin of the foot, as well as the entire lower leg (except for its inner side). Sensation to skin to the sole of the foot is provided by the tibial nerve, and the lower leg and upper surface of the foot via the common fibular nerve. [2]: 422–4 The sciatic nerve also innervates muscles.
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]
A heavily scrutinized anatomic variation involves sciatic nerve branching around the piriformis using the 6 category classification first described by Beaton and Anson. In this classification, the normal anatomy (type A) seen in about 80% of people is where the sciatic nerve passes under the piriformis muscle at the greater sciatic notch.
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.
Piriformis syndrome occurs when the piriformis irritates the sciatic nerve, which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve. [8] This referred pain is known as sciatica. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle.
That pressure on nearby nerves can cause lower back pain. Other symptoms include sciatica (nerve pain that runs down from the lower back to the legs), back stiffness, numbness, and difficulty walking.
The common fibular nerve is the smaller terminal branch of the sciatic nerve. The common fibular nerve has root values of L4, L5, S1, and S2. It arises from the superior angle of the popliteal fossa and extends to the lateral angle of the popliteal fossa, along the medial border of the biceps femoris.
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