Infringement of the sciatic nerve is a painful pathological condition that develops as a result of compression of this nerve, but the myelin sheath is not disturbed. The sciatic nerve is the longest nerve in the human body, which begins in the sacrum and reaches the toes, as well as the heels. It contains highly sensitive motor and nerve endings that innervate the hip and knee joints.
The symptoms and treatment of sciatic nerve infringement will be considered in this article.
main reason
Hernia of the intervertebral disc is considered one of the main causes of this pathology. In most cases, nerve infringement occurs in the region of the piriformis muscle, located in the lumen of the sciatic foramen or intervertebral discs. The disease is accompanied by severe pain in the lower limb. Most often, pinching is one-sided inflammation, however, there are cases when both limbs are involved in pathological processes, but this is noted much less often. This condition can lead to an inflammatory process (radiculitis), which is accompanied, as a rule, by a very strong and intense pain syndrome. Men who are engaged in heavy physical labor are most prone to pinching the sciatic nerve.
The causes of the pathological condition
Infringement most often occurs during the implementation of any physical activity involving sudden movements, as well as a result of a long stay in uncomfortable poses, limitation of physical activity, increased load in the lumbar region. Often, the infringement is formed against the background of some other pathologies, which, as a rule, include:
- Hernia of the intervertebral disc.
- Spinal injury associated with displacement of the vertebrae.
- Pathological neoplasm either in the area of the sciatic nerve.
- Displacement of the structures of the spinal column (spondylolisthesis).
- Osteochondrosis in the lumbosacral spine.
- Pathologies of an inflammatory nature in the pelvic organs;
- Sepsis.
- Hypothermia.
- Gout.
- Diabetes.
- A variety of infectious diseases (flu, rubella, whooping cough, bone tuberculosis, malaria).
- Multiple sclerosis.
- Thrombosis.
- Acute intoxication.
Muscle cramps
In addition, muscle spasms along the nerve can cause sciatic nerve infringement. In women, the sciatic nerve is often infringed during pregnancy due to increased pressure of the uterus increased in size on neighboring organs and increased load on the spinal column, due to a shift in the center of gravity, as well as in cases when a woman during pregnancy often takes an uncomfortable position.
Menopause can be considered another period of increased risk of symptoms of pinching in women, and this happens due to changes in hormonal balance.
Risk factors
Risk factors can also include:
- Alcohol poisoning.
- Intoxication with heavy metals or any neurotropic toxic poisons.
- Smoking.
- Herpes zoster in the sciatic nerve.
- Obesity.
- Lack of minerals.
The main forms of pathology
Depending on the severity of the disease in each particular case, there are three main forms of sciatic nerve pathology, which are considered to be severe, medium and light.
A severe form of nerve infringement is accompanied, as a rule, by signs of disturbances in the spinal cord and immobilization of the patient. In general, the infringement is one-sided, less often both limbs are involved in such pathological processes.
Symptoms of the disease
The main signs of infringement of the sciatic nerve can be considered:
- Acute pain syndrome, which is the most characteristic manifestation of infringement of a given nerve. The pain in this case is of a different nature - acute, shooting, aching, pulling, throbbing.
- In most cases, pain is observed in the buttocks and lower back. In this situation, on the back of the thigh, the pain falls to the lower leg and to the heel, and can radiate to the fingers of the limbs.
- In some cases, numbness of the skin along the nerve, as well as tingling or burning, are observed.
- There may also be an increase in pain in a sitting position, with laughter, coughing, muscle tension, etc.
- In addition to the pain syndrome, stiffness and difficulty arise when walking, long standing, lameness may occur (with unilateral infringement - on one leg or on both - with bilateral pathology).
Pain is considered the main sign of pinching of this nerve. In men, this symptomatology may be similar to the manifestation of prostatitis. Signs of nerve infringement in women vary depending on what caused this pathological process and on the degree of damage to the sciatic nerve.
It is known that women may lack back pain. The most common symptoms of pinching this nerve include:
- Amyotrophy.
- Muscle weakness.
- Sensory impairment - decrease or increase.
- Dryness of the surface of the skin.
- The appearance of a variety of pathological reflexes.
- Strengthening sweating feet.
- Sensation of creeping in the sacral region.
- Restriction and stiffness of the movements of the legs or one leg.
In addition to pain, there are other characteristic symptoms of the inflammatory process in the sciatic nerve, which becomes an integral part of the infringement, and they are usually associated with impaired conduction of nerve impulses along sensory and motor fibers. The specific signs of nerve infringement, therefore, include:
- Paresthesia (violation of sensitivity) - at the initial stage, it can be manifested by a feeling of tingling of the skin of the buttocks, numbness of the leg along its back surface. With the progression of such symptoms, other types of sensitivity also decrease, up to their complete disappearance.
- Disruptions in motor functions that occur as a result of pinching of special motor fibers in the sciatic nerve. In this case, people may experience weakness of the femoral, gluteal and shin muscles and be expressed in a change in gait during unilateral inflammatory processes (limping on a sore limb).
- Dysfunction of some organs of the pelvis, which occurs as a result of compression of the fibers of the parasympathetic and sympathetic nervous systems passing through the sciatic nerve. Similar violations appear in the form of a change in urination, for example, urinary incontinence, as well as bowel movements, for example, constipation. Such symptoms develop, as a rule, in severe cases of nerve infringement with significant compression of the spinal roots.
With the development of the above symptoms, therapy of this pathology should be started immediately, since pinching of the sciatic nerve sometimes leads to an absolute loss of sensitivity in the lower extremities.
What is the diagnosis of sciatic nerve infringement?
Diagnosis of the pathological process
Diagnostic methods for determining infringement, as a rule, are classic due to the fact that the clinical picture of such a disease is very specific. As a rule, a specialist can make a diagnosis during an objective examination of the patient, as well as collecting an anamnesis and complaints. Nevertheless, in order to avoid complications of the disease and its relapses, it is necessary to determine specific factors that contributed to the occurrence of infringement of the sciatic nerve. To determine the reasons for the development of such a pathological process, the following laboratory and instrumental diagnostic methods are used:
- General tests - urine and blood.
- X-ray examinations of the pelvis and lower back.
- Magnetic resonance or computed tomography of the lumbar region.
- Ultrasonography.
- A radioisotope scan of the spinal column, which is usually performed when there are suspicions of benign or malignant neoplasms.
- Electroneuromyography.
- Blood chemistry.
Diagnosis of the strangulated sciatic nerve includes compulsory radiography of the pelvic and lower back areas. A study of reflexes is also carried out, the presence of Laseg symptom and Bonnet symptom is determined, Achilles, plantar and knee reflexes are reduced, and the level of sensitivity in the area of sciatic nerve damage is assessed.
Pain syndrome can be considered the most characteristic manifestation of pinching of this nerve. In this case, differential diagnosis is necessary to exclude the presence of a hernia of the intervertebral disc, which is characterized by a longer development of the pathological process and an exacerbation of some neuralgic manifestations. What is the treatment for sciatic nerve infringement?
Therapeutic methods
The treatment of such pathologies most often lies in the traditional scheme, which involves the simultaneous use of physiotherapeutic methods and drug therapy.
In some cases, surgical intervention may be required. In cases of mild to moderate disease, hospitalization of the patient is not required. Subject to the prescription of the doctor, it is possible to treat this pathology at home. In acute pain that prevents a person from walking or standing for a long time, bed rest is indicated.
When a fixed body position is needed during an acute pain syndrome, the use of a hard mattress is recommended.
Preparations
In the treatment of sciatic nerve pathologies, the drugs are anti-inflammatory non-steroidal drugs that can be prescribed in tablet form or in the form of intramuscular injections.
With the oral use of anti-inflammatory non-steroidal medications, there is a high probability of some problems with the gastrointestinal tract, for example, the development of gastritis or stomach ulcers, therefore, it is indicated that patients are prescribed proton pump inhibitors.
If muscle cramps are observed in a patient during pinching, the therapeutic effect can be achieved by using medications that improve blood circulation in the vessels - the so-called “venotonic”. When severe muscle cramps occur, spasmolytic drugs and muscle relaxants are also prescribed.
In addition, it shows the intake of any vitamin complexes, as well as drugs that improve the metabolism in the body.
The general treatment of the pathology is supplemented by the local one - anti-inflammatory and warming medicines in the form of ointments and gels are used. What else is the treatment for sciatic nerve infringement?
Physiotherapy
Physiotherapeutic treatments are also prescribed to supplement the action of essential drugs. These include:
- Electro-, phonophoresis of drugs.
- UHF therapy.
- Magnetotherapy.
- Paraffin application.
- Laser Therapy
- Mud therapy.
- Hirudotherapy.
- Hydrogen sulfide or radon baths.
- Ultraviolet irradiation of the nerve lesion area.
Acupressure and acupuncture, as well as manual therapy, can also be used.
During the rehabilitation period, a good effect can be achieved using physical therapy, swimming, yoga, or Pilates, but these methods can only be used if the patient does not have acute pain.
Exercises for pinching the sciatic nerve
The exercises begin with five repetitions, and end after fifteen.
- Walking in place with knees high. Smooth execution is important.
- Standing straight, facing the wall, lean on it with your hands, swing your legs to the side and back.
- Torso First, to the right and left, in the absence of pain perform forward bends.
- Lying on your back with straightened legs, pull the socks towards you as much as possible. Then make circular movements with each foot in turn clockwise.
- Lying on your back, bend your knees, first take your right foot to the side, then the left.
- Lying on its side, the lower leg is bent at the knee, the upper is extended forward. Then the upper leg is retracted. Exercise is performed on each side.
Treating sciatic nerve infringement at home can be effective.
Home Therapies
In addition to exercises and taking medications, the use of local medicines will not be out of place. For the treatment of pinching at home, the following non-steroidal anti-inflammatory drugs of local use are used:
- "Betalgon" - as a result, blood supply to the skin in the affected area is activated.
- “Viprosal” - pain and inflammation decrease.
- "Karmolis" - the pain syndrome is very quickly stopped.
- "Finalgon" - pain is eliminated, inflammation is relieved.
You can also purchase the video program “Injury to the sciatic nerve” by Alexandra Bonina at Skladchina (warehouse of courses, trainings, seminars). This is a disk with video lessons on treatment and recovery using exercise therapy methods.
The workshop contains all the necessary knowledge to treat the very cause of sciatic nerve infringement. Alexandra Bonina believes that problems with the lumbosacral spine are eliminated with the help of special exercises.
The complex includes the most effective, most appropriate exercises to deal with this problem and its causes. A set of exercises was made by a competent doctor of exercise therapy. As part of the exercises that everyone can do.
The seminar “Pinch of the sciatic nerve” by Bonina, according to reviews, is very popular.
The consequences and complications of pathology
If treatment is not carried out comprehensively, it faces consequences. Infringement of the sciatic nerve is sometimes complicated by the following phenomena:
- Intense pain.
- Impaired function of some internal organs.
- Insomnia.
- Decreased libido.
- Menstrual irregularities.
- Infertility.
- Exacerbation of some chronic diseases.
- Violation of the evacuation functions of the bladder and intestines.
- Decreased motor activity.
- Immobilization.
We examined the symptoms and treatment of sciatic nerve infringement. Drugs were also presented.