Neuralgia refers to severe sharp pain occurring along the course of a nerve. The sciatic nerve is the largest nerve in the body, and pain felt from the nerve may range from a level of discomfort to intense and excruciating sensations.

Neuralgia may be caused by pressure on the nerve trunks, faulty nerve nutrition, toxins, or inflammation.

This condition occurs more frequently in men. The pain is present in the lower back and posterior surface of the leg, or it may be limited to the sacroiliac area and buttocks. Occasionally, the pain may involve the calf of the leg and the outer surface of the foot. On the affected side, straight leg raising is limited, and any movement that stretches the nerve is painful.

Diagnostic tests most likely include: lumbosacral, hip, pelvic and sacroiliac x-rays; cerebrospinal fluid (CSF) examination; computed tomography (CT) scan; magnetic resonance imaging (MRI); electromyography (EMG) studies; angiography; muscle-strength testing; and reflex testing.

Essentially, treatment is aimed at the underlying cause. Therapeutic measures may include: use of crutches; back brace; heat; walker; physical therapy; analgesics and electrical stimulation. Sciatica associated with arthritis (see Diagnostic Code: 5003 Arthritis, degenerative) may be treated by bedrest for a few weeks.

The course of sciatica depends on the underlying disorder. In many patients, the symptoms last for weeks to months and disappear, only to recur within months or even years later.

• If the Veteran is a former prisoner of war and was interned or detained for not less than 30 days, this disease shall be service connected if manifest to a degree of disability of 10% or more at any time after discharge or release from active military, naval, or air service even though there is no record of such disease during service, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309(c) Disease subject to presumptive service connection].

• If the Veteran was exposed to an herbicide agent during active military, naval, or air service, this disease shall be service-connected if the requirements of 38 CFR 3.307(a)(6) are met even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 CFR 3.309(e). Disease subject to presumptive service connection.

• This disability shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied.  38 CFR 3.309(a)

• Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected nerve.  38 CFR 4.124 Neuralgia, cranial or peripheral.

• With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves] 38 CFR 4.124a Schedule of ratings—neurological conditions and convulsive disorders