Sciatica (neuralgia, lumbar sciatica) is a pain syndrome that spreads along the entire length of the sciatic nerve. The main reason for its appearance is compression of the nerve roots in the region of the lumbosacral spine. Sciatica most often overtakes patients after 30-35 years. The complexity of therapy is caused by the need for an urgent blockade of acute pain, only after this step can you begin to diagnose and prescribe medications, physiotherapy and other methods.
Causes
The sciatic nerve originates in the sacro-lumbar and descends along the line of the thigh to the knee, where it is divided into two branches - one of them goes to the shin, and the second to the foot. The patient experiences pain with sciatica because the nerve responds to irritation, the sources of which are in the spine. There are many reasons for the syndrome, and all of them relate to pathologies of the intervertebral discs or lesions of the nerve itself.
Causes of the disease:
- Intervertebral hernia. With the disease, the gelatinous body is affected, a hernia protrudes, pinching the roots of the sciatic nerve. Intervertebral hernias are found in 50% of patients, most of the hernias are the cause of neuralgia.
- Acute infectious diseases in which the sciatic nerve is infected with toxins released by microorganisms that cause disease (tuberculosis, typhoid, malaria, flu, syphilis, etc.). In this case, after the blockade of pain, treatment for the infection and the removal of complications of nerve inflammation are prescribed.
- Hypothermia. Sometimes it’s enough to walk in wet shoes or sit on a cold surface to get sciatic nerve neuralgia.
- Osteophytes. The growths of bone tissue resulting from degenerative pathologies of the spine (osteochondrosis, osteoarthrosis, spondylosis).
- Intoxication with decay products in case of poisoning with lead, mercury, arsenic and other substances. Endogenous intoxication in diseases of diabetes, alcoholism, gout, etc.
- Neoplasms of any etiology (osteoma, osteosarcoma, osteoblastoma, etc.).
- Cancer tumor metastases sprouted into the intervertebral discs and spinal cord.
- Tumors of the spinal cord and spinal column tissue.
- Spondylolisthesis - displacement of the vertebra relative to the main axis to the side or in relation to neighboring discs.
Symptoms
The main complaint of the patient with the disease is pain in the lower back and leg, this is the main symptom that distinguishes sciatica. Treatment is prescribed after diagnosis and clarification of the cause of the syndrome. During the survey, a specialist collects data on the nature of the pain. It is described as follows:
- Character - sharp, sharp, cutting, shooting, etc. Specialists use the concept of “dagger pain”.
- Prevalence - in which area is most noticeable, and where there are residual sensations (buttocks, back, side or front of the thigh, extended to the knee or to the foot). In the lumbosacral, pain is not always expressed.
- Duration - with sciatic nerve neuralgia, the pain is constant, chronic. In rare cases, manifested by seizures, intensifying and weakening, but always present.
- The intensity varies from acute to not pronounced. With severe pain, the patient can not take an upright position. In a horizontal position, the pain weakens, but also causes a lot of suffering.
- Symmetry - pain with sciatica spreads along one affected side. In rare cases, it is observed on both sides of the body.
Neurological disorders
During the acute course of the disease, the patient cannot concentrate on any observations, focusing on overcoming the pain syndrome, which most clearly characterizes sciatica. Symptoms, in the experienced opinion of the doctor, have other manifestations:
- Violation of the sensitivity of the skin of the leg, foot.
- Unnatural position of the body - the patient tries to take that position in which the pain will be least felt. The tone of the muscles of the lower back and legs changes.
- Gait change - there is a violation in the flexion of the knee, foot, the movements of the posterior group of the femoral and ankle muscles change.
- Atrophy is the result of impaired movements of certain muscle groups.
- Violation of reflexes.
- Vegetative disorders (sweating, palpitations, etc.).
- Osteoporosis - occurs in advanced cases of pathology. The bones of the foot are destroyed, the bones of the lower leg and thighs suffer.
- A change in the color of the skin - on the affected area, the epidermis fades or becomes red.
- Thinning, dry skin.
- Fragility, thinning of the nail plates on the legs.
- Intense sweating.
Diagnostics
Pain once appeared, signals a more global disease, where sciatica is considered as a symptom. Treatment is based on identifying the pathology that caused the sciatic nerve.
Research Methods:
- Radiography - diagnoses pathologies of the vertebrae that caused compression of the roots of the nerves.
- Computed tomography (CT) scan. It reveals changes in the spinal column, gives a more accurate picture of the state of nerves and tissues by sections or in a three-dimensional model.
- Magnetic resonance imaging (MRI) visualizes changes in tissues more clearly than CT, and allows you to see the causes of lumbar radiculitis associated with changes in the spinal cord and its membranes.
- Electroneuromyography evaluates nerve conduction in case of complications leading to loss of sensation and movement disorders.
The doctor prescribes therapy, having received all the data on the picture of the disease, including the cause that led to inflammation of the nerve, and the developed complications of sciatica. Treatment is implemented as part of a comprehensive program where the main attention is paid to eliminating pathology and normalizing the functioning of the sciatic nerve.
Therapies
In most cases, the patient experiences acute pain, the first stage of therapy involves the removal of the pain syndrome that accompanies sciatica. The treatment of the disease has several directions:
- The use of medications.
- Massotherapy.
- Physiotherapeutic procedures.
- Acupuncture.
- Exercise therapy, osteopathy.
- Using traditional medicine methods.
- Effective special methods (pyelotherapy, hirudotherapy, etc.).
The causes of sciatic nerve neuralgia are several. After identifying the causative agent or the circumstances that led to the disease, a set of measures is prescribed to overcome sciatica. The treatment is long-term and includes preventive measures to avoid relapse.
Anesthetize, calm, recover
At the first stage, the specialist makes appointments designed to relieve pain, which is the main symptom of sciatica. Medication includes the use of external, intramuscular and oral drugs.
To relieve pain, the patient is prescribed painkillers. Treatment for sciatica involves taking non-steroidal drugs. These are such means:
- Analgin. The most commonly used pain reliever for sciatica. Available in the form of tablets, injections for intramuscular or intravenous administration into the body environment.
- Combined drugs. Pentalgin, Baralgin, Andipal, etc.
- A strong pain reliever is novocaine blockade with sciatica. The procedure is carried out by an experienced specialist who knows where the bundles of nerve endings are located in the lumbar region.
Drugs to relieve pain, inflammation and swelling:
- "Diclofenac", "Voltaren", "Rapid", etc. The range of products is wide, drugs are available in tablets, injections, ointments. Injections with sciatica more effectively and quickly relieve symptoms and have a therapeutic effect. External use provides prolonged assistance, removing the external manifestations of the disease in the tissues.
- "Meloxicam" - is prescribed for very severe pain. Quickly and effectively relieves inflammation, soothes. Release form - tablets.
Inflamed nerves must not only anesthetize, relieve inflammation, but also restore to normal functionality. For these purposes, a specialist prescribes vitamin complexes indicated for the treatment of sciatica. Medical treatment involves taking B vitamins in injections, the dosage is selected individually.
In addition to these measures, the doctor may prescribe distracting drugs. Their action irritates the skin, dulling the feeling of pain. An additional property of this group of products is that after their introduction into the skin, they secrete biologically active substances and endorphins. This family of drugs includes ointments for sciatica based on capsicum, turpentine, bee or snake venom.
Massage
Most patients are interested in the question: "Is it possible to massage with sciatica?" Experts believe that this type of procedure is indicated at any stage of the pathology. For the successful implementation of this type of therapy, it is necessary to adhere to certain rules, namely:
- In the acute phase, stroking, rubbing movements are used.
- During the period of pain decay, a more intense intervention is indicated - point, kneading, reflex-segmental, can massage is possible.
- Lumbosacral inflammation (sciatica) allows manipulation of the lumbar, gluteal regions, massage of the lower leg, thigh, and foot is recommended.
- During the session, it is permissible - to enhance the effect - the use of essential oils that cause relaxation of the nervous system.
The duration of the session is not more than 35 minutes, the total number of procedures in the course is 10.
Physiotherapy
Physiotherapeutic procedures have a positive effect on the course of therapy. Treatment for sciatica is carried out with the following methods:
- Electrophoresis, UHF.
- Laser therapy, magnetotherapy.
The purpose of the procedures is the removal of pain and inflammation in the tissues, the restoration of the functionality of the sciatic nerve. What kind of physiotherapy the patient needs is determined by the attending physician. Any events are held during the period of remission. The acute phase of the disease, with proper therapy, disappears after 7 days, after which measures aimed at eliminating inflammation are prescribed.
Physical exercise
A useful measure to strengthen the spine, develop damaged nerve and tissues, restore blood flow is a complex of physiotherapy exercises. Sciatica exercises are performed in different positions. At the first stage, a gentle attitude to the back is recommended, so most of the initial gymnastic complexes are designed to be performed in a supine position. After strengthening the muscles in the lumbar region, the complex becomes more complex.
Patients are advised to conduct several workouts under the supervision of a physical therapy specialist, it is especially useful to do this at the first stage. Further exercises can be performed at home, adhering to the basic principles - constancy and gradual increase in load. The complex often includes such exercises:
- Half-bridge - lying on your back, bend your legs and pull your heels closer to the buttocks, raise your pelvis and hold the pose for 5-7 seconds (expiration time), carefully lower yourself to the starting position. The exercise is performed in a calm rhythm up to 10 sets.
- Sitting on the floor, legs stretched forward. Do not stoop your back, try to reach your toes with your hands. In this position, the main emphasis is on the back, as the muscles and ligaments are stretched, the abdomen, and then the chest should lie quietly on outstretched legs. The exercise is performed without jerking, gradually stretching the entire back surface of the body.
- Standing exercise. Set your feet shoulder-width apart, spread your arms to the sides and slowly lean to the right and left. When making sure that the tilt plane does not go forward or backward. Exercise is performed with caution, gently stretching the side surfaces of the body.
All exercises with sciatica are performed with extreme caution and under the supervision of a specialist. In the complex, as the muscle corset strengthens and inflammation decreases, yoga elements are introduced.
Folk methods
Sciatica (in the ICD-10 disease is assigned the code M54.3) is treated for a long time. The patient, while in the acute phase, can be both in the hospital and at home, where there is an opportunity for therapy (injections, bed rest, taking medications, etc.). Mandatory medical supervision is necessary only in case of very acute pain.
Alternative methods of treatment can successfully overcome sciatica. Treatment at home can be supplemented by repeatedly proven means. For instance:
- Infusion to reduce pain. Make a collection of herbs - 1 tbsp. l flowers of viburnum, calendula, thyme herbs and 2 tbsp. l horsetail. In 0.5 l of water, boil 2 tbsp. l collection, boil for 5 minutes, cool, strain. Take 0.5 cup 3 times a day before meals.
- Ointment. Mix the ingredients in a glass bottle - 5 glasses of black radish juice, 1 glass of honey, 1 tbsp. l salt, 250 ml of vodka. Shake well and mix thoroughly before use. The composition to rub the lumbosacral region and thigh, the procedure is carried out 2 times a day.
- Compress. Grated black radish to apply to the sore spot. The compress is applied with a cloth and fixed with a warm bandage. The duration of the action is 15 minutes, the number of repetitions is 2 times a day.
Prevention
A healthy lifestyle and the absence of bad habits cannot guarantee absolute health, a situation may occur in which inflammation of the sciatic nerve (sciatica) occurs. Treatment is recommended according to the doctor's recommendations until complete recovery. But, once it happened, neuralgia tends to return. The catalyst for its appearance can be a stressful situation, an awkward movement, hypothermia or a common cold.
Prevention helps minimize the risks of recurrence. The package of measures includes:
- Moderate physical activity at work and during fitness classes. Most patients note that simple exercises sometimes do more good than medicines. Doctors recommend taking time to walk, run at a steady pace, cycling, swimming, yoga. During such exercises, myocardial activity is normalized, blood enters all tissues, stiffness of joints goes away, ligaments improve elasticity.
- Production gymnastics. If during the working day you need to constantly sit or stand, take the same position, it is recommended that specialists take breaks to warm up. To equip the workplace with chairs with orthopedic qualities, to purchase special shoes, corsets, bandages, etc.
- Sleep right. The place for night rest should be provided with a hard orthopedic mattress, pillows. The legs of the head are recommended to be slightly raised.
- Weight lifting is carried out with the help of muscle tension in the arms, legs, but not the back. To do this, bend your knees slightly, bend with a straight back and lift a heavy object. In this case, all the voltage will be distributed correctly, and the lower back will not suffer.