I think this is simply a basic "most common cause of" problem. The MCC of sciatica is herniated or bulging disk.
I went with the muscle tear because piriformis muscle injuries can mimic sciatica, but that wouldn't explain the low back pain since piriformis origin and insertion are the internal surface of the sacrum and the superior border of the trochanter of the femur, respectively. It's also not a common muscle injury in weight lifting.
In general, when NBME gives you a bogus question without a lot of details like this, it's a "most common cause" problem.
cassdawgMy main thoughts on this is that an actual tear in the sciatic nerve is extremely difficult and further it would present with motor weakness to the muscles innervated by the sciatic nerve as well (the hamsrtings and adductor magnus, FA2020 p452). The sciatica pain that you are referring to is more common with injury to the nerve via herniated disc.+5
azharhu786I also thought he was too young for the intervertebral disc rupture so picked sciatica tear :(+5
sexymexican888Golijan also talks about this in his lectures he mentions how weight lifting and holding your breath increases intra-abdominal pressure and this pressure will be transferred to the CSF in the spinal cord cause a disc herniation. The pressure in the spinal cord will also go up when you do an LP and ask the patient to do valsalva or hold their breath +3
submitted by โchaosawaits(92)
I think this is simply a basic "most common cause of" problem. The MCC of sciatica is herniated or bulging disk.
I went with the muscle tear because piriformis muscle injuries can mimic sciatica, but that wouldn't explain the low back pain since piriformis origin and insertion are the internal surface of the sacrum and the superior border of the trochanter of the femur, respectively. It's also not a common muscle injury in weight lifting.
In general, when NBME gives you a bogus question without a lot of details like this, it's a "most common cause" problem.