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Sciatica is pain going down the leg from the lower back. [1] This pain may go down the back, outside, or front of the leg. [3] Onset is often sudden following activities such as heavy lifting, though gradual onset may also occur. [5] The pain is often described as shooting. [1] Typically, symptoms are only on one side of the body. [3]
Symptoms may include pain and numbness in the buttocks and down the leg. [2] [3] Often symptoms are worsened with sitting or running. [3] Causes may include trauma to the gluteal muscle, spasms of the piriformis muscle, anatomical variation, or an overuse injury. [2] Few cases in athletics, however, have been described. [2]
The diagnosis is confirmed when the patient reports a significant change in relief from pain and the diagnostic injection is performed on two separate visits. Published studies have used at least a 75 percent change in relief of pain before a response is considered positive and the sacroiliac joint deemed the source of pain.
The sartorius muscle can move the hip joint and the knee joint, but all of its actions are weak, making it a synergist muscle. [4] At the hip, it can flex, weakly abduct, and laterally rotate the femur. [4] At the knee, it can flex the leg; when the knee is flexed, sartorius medially rotates the leg.
Symptoms commonly include prolonged, inflammatory pain in the lower back region, hips or buttocks. [1] [4] However, in more severe cases, pain can become more radicular and manifest itself in seemingly unrelated areas of the body including the legs, groin and feet. [citation needed] Symptoms are typically aggravated by: [citation needed]
Bertolotti's syndrome is characterized by sacralization of the lowest lumbar vertebral body and lumbarization of the uppermost sacral segment. It involves a total or partial unilateral or bilateral fusion of the transverse process of the lowest lumbar vertebra to the sacrum, leading to the formation of a transitional 5th lumbar vertebra.
Patients also frequently report persistent or intermittent pain or dysthesias in posterior hip, buttocks, or thigh. [4] Unlike discogenic sciatica (caused by the spine), patients with deep gluteal syndrome report exacerbation of symptoms with pressure in the buttocks, such as tenderness or pain on deep palpation, or pain on prolonged sitting.
It passes through psoas major muscle, and emerges from its lateral border. [3] It crosses the iliacus muscle obliquely, toward the anterior superior iliac spine (ASIS). [1] It is crossed by the deep circumflex iliac artery and the deep circumflex iliac vein. [3]