16 June 2013

Arthroblog No 12 - Sciatica


In 1764, Dominicus Cotunnius published a booklet wherein he distinguished two varieties of sciatica – ischia nervosa, a swelling or irritation of the sciatic nerve, and nervous hip gout arising from inflammation of the hip joint. According to Dr Samuel Johnson (1709-1784), who suffered from the former type, ischia nervosa is one of the most acute pains known to mankind. It was thought due to “rheumatism of the cellular element of the great sciatic nerve” and is characterized by “an excruciating pain, extending from the loins down the back part of the thigh, particularly urgent during the night, and totally preventing sleep.”* Some authorities attributed sciatica to “the combined influence of cold and moisture.” Although we still use the term sciatica, most cases are really due to lumbar nerve root irritation, usually in association with inter-vertebral disc prolapse.
*George Gregory, Elements of the Theory and Practice of Medicine, 1839

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