Latin sciatica means pelvic pain. Sciatica is a pinched sciatic nerve with its subsequent inflammation. Pathology is not a separate nosology and is considered a manifestation of diseases of the spine, in which pathological changes occur in tissues, bones and muscles located next to the sciatic nerve. They put pressure on the nerve bundle, causing pain. The longer the effect, the more painful the pain will become.
Anatomy Excursion
The sciatic nerve is the largest, longest and thickest; in men it reaches 1 cm in diameter. It begins in the lumbar region from the sacral nerve plexus, leaves the spine, through the coccyx and the surface of the pelvis descends along the back surface to the legs. Here it is divided at the tibia into 2 bundles and each of them goes to one leg to the feet. Thus, his nerve branches touch many areas, and pains during his inflammation are felt in different parts of the body. Its functions are providing the sensitive and motor innervation of the lower extremities.
Causes and factors for the development of sciatica
The most common causes of sciatica are:
- Osteochondrosis, osteoarthritis of the intervertebral joints. In this case, spines are formed on the vertebrae, which provoke inflammation.
- Intervertebral hernia. With them, a protrusion of the disk occurs and the roots that make up the nerve are pinched.
- Tunnel neuropathies.
- Piriformis Syndrome (it is the muscle responsible for the movement of the hips). We have to talk about it because it is close to the sciatic nerve.
- Stenosis of the spinal canal.
- Tumors and neoplasms.
- Infectious diseases. The nerve is affected by the toxins of infections such as TB, typhoid, malaria, syphilis. After that, he becomes inflamed.
- Overcooling can become a provoking factor when the body's defenses are weakened.
Symptomatic manifestations
Manifestations of pinching of the sciatic nerve - the appearance of sharp pain along the nerve endings. They begin with the lower back, go down to the buttock, and then along the back of the leg to the foot, amplify with movements and loads of any kind, sneezing, coughing, laughing. At night, a person is forced to wake up to change his posture. Later, pain can block any movement.
The most characteristic manifestation is a symptom of tension. When bending the legs in the hip joint, tilting the head, torso, the pain intensifies sharply.
Other signs of inflammation:
- Numbness of the skin and burning, creeping creeps on the back of the leg.
- Decrease in tactile sensitivity and increase in pain.
- Change in gait (movement on straight legs).
The important thing is that regardless of the reasons, the symptoms of sciatica are the same, but the treatment is always different.
Pain characteristic
Painful sensations can conditionally be divided into the following characteristics:
- Localization. The pain is usually one-sided. The other side only tingles or a slight numbness is felt.
- Intensity. Depends on the degree of inflammation and pinching. At the initial stage, the pains are mild, relieved by conventional analgesics. A prolonged course of the disease leads to atrophy of the muscles of the affected side. If untreated, inflammation spreads to adjacent tissues and affects new nerve fibers.
If you have correctly identified the symptoms of sciatica sciatica, and its treatment becomes necessary, this should be done by a specialist, since different reasons require different treatment.
Diagnostic measures
If the pain does not disappear in 2-3 days, but only increases, you need to consult a doctor. With sciatica, reflexes become abnormal and weaken.
Neurological symptoms of diagnostic value:
- The reflex of the Achilles tendon decreases. When hit in the tendon area above the heel of the foot, it bends slightly or does not react at all;
- Reduced knee reflex.
- Decreased or absent plantar reflex.
When you lift your legs up, the pain intensifies sharply due to muscle tension. Severe pains are also felt when pressing on some points under the buttock, on the thigh (Vallee points).
For a complete diagnosis, you need a blood test, x-ray, MRI, CT.
Radiography allows you to determine the condition of the intervertebral joints and the condition of the intervertebral discs. To do this, the images are carried out in 2 projections - in the vertical position and horizontal. MRI examines pathological changes in the soft tissues (this is not visible on x-rays).
Principles of Therapy
Treatment of sciatica is only complex - general and local. It is supplemented by non-drug therapies. It should be noted that the treatment of lumbago and sciatica is almost identical. The following objectives are pursued:
- Restoring mobility and elasticity of affected muscles.
- Pain relief.
- Restoration of conduction of nerve trunks.
- Improving the nutrition of affected neuromuscular tissues.
For the treatment of sciatica, it is better to use injectable drugs, tablets are ineffective.
Therapy algorithm
Firstly, the mode is important. It means complete peace. You need to lie on a bed with a hard, even mattress, then the load on the spine and pressure on the nerve bundle are minimal.
With exacerbation, nonsteroidal and steroidal anti-inflammatory drugs, muscle relaxants are used to treat sciatica. Antispasmodics, opioid analgesics, epidural therapy and vitamin complexes are also indicated.
For the treatment of sciatica sciatica and relief of pain, a local effect is also used: gels, ointments, patches, applications. Therapy is supplemented by physiotherapy, homeopathy, exercise therapy, massage.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Their action is based on the fact that the production of prostaglandins, the substances responsible for the appearance of pain, is blocked.
When symptoms of sciatica appear for treatment, many anti-inflammatory drugs will have the best effect. They are divided into fast and slow acting. Some are available at any pharmacy, others are strictly prescription.
The most commonly used: Ibuprofen, Voltaren, Diclofenac, Aspirin, Ketoprofen, Motrin, Anseid, Seraktyl, etc. All of them have one unpleasant property - to irritate the gastric mucosa, therefore take them better after eating. They also reduce blood coagulation.
Contraindications to NSAIDs
NSAIDs are prohibited in the following cases:
- Stomach ulcer.
- Anemia.
- Tendency to bleeding.
- High blood pressure.
- Problems with the heart, kidneys, liver.
Steroidal Anti-Inflammatory Drugs (PCA)
Another category of remedies for the occurrence of symptoms of sciatica is treatment with steroid medications. These hormonal compounds are designed to produce the hormone hydrocortisone and relieve swelling and inflammation well. Similar drugs have side effects:
- Weight gain.
- Stomach ulcer.
- Osteoporosis.
- Swelling of the face.
- Increased blood coagulation.
- Weakened immunity.
The course of treatment for sciatica sciatica with steroid drugs is prescribed for a maximum of 2 weeks. This is done to avoid side effects.
Epidural therapy
Treatment of sciatica with drugs of different groups is supplemented by epidural injections. They began to be used since 1952. Drugs are introduced into the spinal canal - the cavity where the roots of the nerve branches are located.
The dose may be less than therapeutic, because the medicine immediately enters the site of the focus. The risk of side effects is therefore reduced. The pain is relieved quickly, but not for long.
Opioid agents
Drug treatment of sciatica can be carried out with drugs, which include elements of a narcotic nature. These funds are the strongest. They absorb pain, blur the perception.
Opioids can be used today in the form of adhesives. Their action from this is enhanced. The most commonly used are Tramadol or Ultram. Side effects of opiates are lethargy, delusional disorders, lethargy and drowsiness.
Muscle relaxants - Midokalm, Relanium, Sirdalud, Baclofen.
First aid for sciatica
At the time of the attack, the treatment of sciatica sciatica at home consists in the complete immobility of the patient. You need to lie on your back, on a hard mattress. You can not bend the spine. Something should be placed under the knees - this will reduce the level of sciatic nerve tension and reduce pain. You can not lift any weights, sit on soft surfaces.
You can drink "Ibuprofen", "Aspirin" and other NSAIDs if the patient has not taken blood-thinning drugs for treatment. Pentalgin or Analgin may help. Locally, apply cold. Ice cubes can make kneading movements.
For the treatment of sciatica sciatica at home, the following rules should be followed:
- Sit no more than 2 hours.
- Do not wear high heel shoes.
- Eat more foods with B vitamins.
- Sleep with pain on the side in the fetal position.
- Do not lie on your back.
At home, you can also use anti-inflammatory ointments or gels based on bee or snake venom: Apizartron, Sofya, Nayatoks, Ketoprofen, Voltaren.
From folk remedies, a good effect in the treatment of sciatica at home is bear and badger fat, essential oils - fir, camphor, tea tree, red pepper. When stopping pain, you can switch to chondroprotectors. It is important to remember that no treatment of sciatica at home does not cancel the trip to the doctor.
Physiotherapy
It is a compulsory supplement to medicines. Physiotherapy is used when the acute period ends. Its action is aimed at relieving edema and reducing pain, warming up a nerve, improving blood circulation, and relaxing muscles.
The following procedures are usually prescribed:
- Diadynamic currents.
- Magnetotherapy.
- UHF
- Electrophoresis and phonophoresis.
- Paraffin treatment.
- Ozokerite.
Lumbar Massage
Massage can only be performed without exacerbations of the inflammation process. It is done only by a specialist. Massage can increase the conductivity of an inflamed nerve, improve lymph flow and blood flow, and prevent muscles from hypotrophy. Strong muscles can maintain the strength of the spinal column and maintain body weight, and this will unload the vertebrae.
Surgical treatment
Surgery is used only in the most extreme cases when all conservative therapy has been ineffective. Spinal surgery is considered the most difficult technically and should only be performed by experienced surgeons in large centers.
Gymnastics and exercise therapy
Without exacerbating the process, exercise therapy and gymnastics are applicable. Exercise will help stimulate metabolic processes and relieve inflammation.
Contraindications to exercises:
- Exacerbation of sciatica.
- Pregnancy.
- Alcohol or drug addiction.
- Cancer Diagnosis.
- Internal bleeding.
- Violation of the integrity of the skin.
Hirudotherapy
Leech saliva contains many biological active substances that can improve blood circulation in the area of inflammation and provide tissues with proper nutrition. Their impact is not only local, but also general - the walls of the vessels are cleaned of cholesterol, swelling is removed.
Homeopathy
Homeopathic remedies are slower, but often more effective. In addition, these drugs have a natural composition.
Some homeopathic medicines:
- RhusToxicodendron. It is taken with sciatica in the supine and sitting position.
- Aesculushippocastanum. Assign with prolonged dull pain.
- Colocynthis. It is prescribed for aching, pulling pain, worse when touched.
- Nuxvomica. Effective for pain and backache in the sacral region, with paresthesias.
- Berberisvulgaris. Accepted for morning pain.
ethnoscience
Herbal medicine is the use of compresses, decoctions, mixtures, ointments. Among the recipes:
- Warmly wrapping a sheet soaked in a solution of vinegar and salt, a woolen blanket on top. Lie wrapped 1.5 hours.
- A decoction of aspen leaves. 1 tbsp. l herbs in 200 ml of water, boil and drink 3 times a day.
- St. John's wort broth. Used as compresses and added to the bath. For cooking, 2 tbsp. l brew herbs in 1 liter of water. In the bath, you can add a thick decoction of needles.
- Preparation of medicinal ointment from honey, vodka and fresh radish juice. All components are taken in equal proportions and mixed. Apply the product on the sick side.
- For rubbing apply fir oil, eucalyptus. Sciatica eliminates the use of mustard plasters.
- Salt. It is heated to 37.5 degrees and applied in bags to the lesion site until it cools.
- Wax is mixed with propolis 1:10. Applied in the form of cakes for an hour and a half.
- The raw potatoes are rubbed, add horseradish. This application is kept for 30 minutes.
- Kalanchoe and aloe. The juices of these plants are added to the mixture of rye flour and honey. Impose in the form of cakes, insulate with a woolen cloth on top. Hold 30 minutes.
- For trituration, alcohol tincture of white acacia flowers is also used - it is insisted for a week and rubbed 2 times a day.
- You can make compresses with radish juice and honey - a ratio of 3: 1.
- Application of turpentine and egg white. Hold until discomfort. Repeat the procedure after 6 hours.
- Compresses are also made from scalded leaves of cabbage, burdock or birch.
For oral administration, decoctions of leaves of aspen, viburnum, Kalanchoe (diluted juice), calendula, horsetail, thyme are used.
Bathtubs
Baths with a temperature of no higher than 38 degrees Celsius have a good effect. Take them no more than 15 minutes. Young pine branches, broth of horsetail, grated horseradish in a bag are added to the bath.
Medical kerosene. Mix 100 ml with horseradish and radish, insist 9 days, in the form of applications, apply for an hour 2 times a day.
Egg white is added to the grated mass of half of the laundry soap. Apply the product with a compress for 2 hours.
Treatment Efficiency Criteria
Performance criteria are:
- Reducing the severity of pain, then their disappearance.
- Decreased neurological symptoms.
With symptoms of sciatica, the best treatment (according to patients' reviews) are:
- NSAIDs - Ibuprofen and Arcoxia.
- Muscle relaxants - "Midokalm".
- Homeopathic remedies.
- Dephanotherapy.
- As an anesthetic - "Thiodine", vitamin B1, dorsaplast.
Prevention
If sciatica has passed, it is important to prevent it from recurring. To do this, the following rules are observed:
- The bed should be moderately tight and even.
- You can’t sit still for a long time.
- The workplace should be equipped with quality furniture.
- If necessary, use orthopedic corsets, it is advisable to wear orthopedic shoes.
It is also important to treat scoliosis in childhood, joint pathologies, strengthen the spine. Periodically, back massage and physiotherapy should be performed to prevent deformation of the spinal column.
It is necessary to regularly engage in therapeutic exercises. For prevention, take vitamins, immunostimulants. It is advisable to abandon bad habits.
When sitting at the computer, you need to get up every hour to warm up and sip. If necessary, special pillows should be used for the back. In the cold season, hypothermia should be avoided.