الفهرس 
صفحة الغلاف العربيOnly 14 pages are availabe for public view
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Abstract
Sciatica is defined as unilateral, well-localized leg pain which approximates to the dermatomal distribution of sciatic nerve and normall radiates to the foot or toes. It is often associated with numbness or paraesthesia in the same distribution. It is a common condition that is associated with significant pain and disability. The lifetime prevalence is at least 5.3% in men and 3.7% in women, representing 6% of total work disability. Sciatica has traditionally been regarded as a self-limiting condition with a good prognosis for complete recovery; however, 30% of patients still have a significant symptom at 1 year, with 20% out of work and 5-15% requiring surgery (Arden et al., 2005).Sciatic nerve suppliesMotor: all muscles below knee and some hamstringsSensory: posterior thigh, ankle, and footHerniation of part of lumber intervertebral disc is a common cause of combined back pain and sciatica, it is often precipitated by injury but spontaneous age related degeneration is probably an important predisposing factor, the discs between L4 and L5 and between L5 and S1 are those most often affected. It occurs in patients aged between 18 and 60 years(Adams and Hamblen, 1996). Peoples who have spinal stenosis, when a herniated disc occurs, the space for the nerves are further diminished, so irritation of nerve results (Stieber J., 2009).Compression on nerve roots or dorsal root ganglions (DRG) by the herniated nucleus pulposus (HNP) has been regarded as the cause of radicular pain, although HNP could be found incidentally in 20% to 36%, depending on the age of asymptomatic subjects.Lumber spinal stenosis is a disease that is caused by a gradual narrowing of spinal canal, this narrowing happens as a result of the degeneration of both the facet joints and the intervertebral discs, In this condition, bone spurs, called osteophytes, which develop because of the excessive load on the intervertebral disc, grow into the spinal canal. The facet joints also enlarge as they become arthritic, which contributes to a decrease in the space available for nerve root The ligaments of the spinal column, especially the ligamentum flavum, become stiff, less flexible, and thicker with age, which also contributes to spinal stenosis. These processes narrow the spinal canal and may begin to impinge and put pressure on the nerve roots and spinal cord in dorsal or cauda equina in lumbosacral vertebrae, creating the symptom of spinal stenosis.