Sciatica: Evaluation and Management in Orthopedic Spine Patients

Sciatica is a common condition in middle-aged and older adults, typically presenting as unilateral low back and buttock pain radiating down the posterior leg. Additional symptoms may include paresthesia and weakness. Common causes include disc herniation, lumbar spinal stenosis, spondylolisthesis, vertebral fractures, and, more rarely, congenital stenosis or tumors. Patients frequently report inciting events such as heavy lifting. Initial evaluation includes radiographs to assess bony abnormalities, while magnetic resonance imaging remains the gold standard for identifying nerve root compression. Most cases resolve within 3 months with activity modification alone. Conservative management, such as physical therapy, oral medications, and epidural steroid injections, may be pursued for persistent symptoms, while surgery is reserved for progressive neurological deficits or significant functional impairment. Through multidisciplinary collaboration, orthopedic nurses play a key role in educating patients on proper biomechanics, managing symptoms, and monitoring for specific signs and symptoms that may indicate more serious pathology.