Multifactorial Approach to Sciatica: Clinical Assessment and Evidence-Based Management

Abstract - Sciatica is a common and often functionally limiting condition characterized by radiating leg pain caused by irritation or compression of the lumbosacral nerve roots. It is most frequently associated with lumbar disc herniation or spinal canal stenosis. Symptoms can persist over time, often affecting mobility and overall well-being. The aim of this review is to summarize the available knowledge about pathophysiology, risk factors, diagnostic methods, and treatment strategies for low back pain with sciatic radiation, with an emphasis on clinical relevance and management options. The literature available in the PubMed database was reviewed, based on 30 studies published between 2011 and 2024 and identified through a systematic search. Sciatica is a multifactorial condition requiring a multidisciplinary, patient-centered diagnostic and therapeutic approach. While conservative treatment remains first-line, surgical options offer promising outcomes in refractory cases. Preventive strategies targeting modifiable lifestyle and occupational risk factors are critical for reducing incidence. Further research into the pathomechanisms of sciatica is essential for optimizing clinical management and improving long-term quality of life.