The largest nerve in the body, formed from L4–S3 roots, exiting the pelvis below piriformis to descend the posterior thigh before dividing into tibial and common peroneal nerves above the knee.
Sciatica from disc herniation is far more common than true sciatic nerve compression. Piriformis syndrome involves deep gluteal entrapment. The long course makes it vulnerable to stretch and injection trauma.
Radicular pain from L4–S1 compression radiating down the posterior leg, most commonly from lumbar disc herniation.
Deep gluteal sciatic irritation reproduced by resisted hip external rotation, diagnosed by excluding lumbar pathology.
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