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Pathology.—Chronic sciatica may be the result of the acute form, or may be chronic from the beginning and run a tedious, painful and protracted course—at times almost abating, to be again renewed with increased paroxysms of pain. It has been truly said of sciatica that "it is an unwelcome guest who returns when least expected." The points of greatest sensitiveness are the buttock, sacro-sciatic notch, post trochanteric line, head of fibula, outside of leg, maleolus, sole, outside and two-thirds of the dorsum of the foot.
There are two factors in the pathology of chronic sciatica, viz: one a neuralgia or neurosis, the other a neuritis or perineuritis, inflammation of the sheath and surroundings of the nerve trunk. The disease may be located in the peripheral or central portion of the nerve. Chronic sciatica may be the manifestations of a neurosis— functional derangement of a nerve centre found in neuropathic constitutions.
CARPENTER JG. THE PATHOLOGY AND TREATMENT OF CHRONIC SCIATICA. Read before the Section of Surgery and Anatomy, at the Fortieth Annual Meeting of the American Medical Association, at Newport, June, 1889. JAMA. 1889;XIII(11):365–370. doi:10.1001/jama.1889.02401080005001a
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