Sciatica (neuralgia, lumbar sciatica) is a pain syndrome spreading along the entire length of the sciatic nerve. The main reason for its appearance is the 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 one proceed to the diagnosis and prescription of drugs, physiotherapy and other methods.
Reasons
The sciatic nerve originates in the sacro-lumbar region and descends along the thigh line to the knee, where it divides into two branches - one of them goes to the lower leg, and the second to the foot. The patient experiences sciatica pain because the nerve responds to irritation that originates in the spine. There are many reasons for the occurrence of 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. When the disease affects the gelatinous body, occursprotrusion of a hernia, clamping the roots of the sciatic nerve. Intervertebral hernias occur in 50% of patients, most of the hernias are the cause of neuralgia.
- Acute infectious diseases in which the sciatic nerve becomes infected with toxins secreted by pathogenic microorganisms (tuberculosis, typhoid, malaria, influenza, syphilis, etc.). In this case, after the blockade of pain, the treatment of infection and the removal of complications of inflammation of the nerve are prescribed.
- Hypothermia. Sometimes walking in wet shoes or sitting on a cold surface is enough to get sciatic neuralgia.
- Osteophytes. Bone growths resulting from degenerative pathologies of the spine (osteochondrosis, osteoarthritis, spondylosis).
- Intoxication with decay products in case of poisoning with lead, mercury, arsenic and other substances. Endogenous intoxication in diseases of diabetes mellitus, alcoholism, gout, etc.
- Neoplasms of any etiology (osteoma, osteosarcoma, osteoblastoma, etc.).
- Metastases of a cancerous tumor that have grown into the intervertebral discs and spinal cord.
- Tumours of the spinal cord and tissues of the spinal column.
- Spondylolisthesis - displacement of a 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 the diagnosis and finding out the cause of the syndrome. During the interview, the specialist collects data on the nature of the pain. She is described as follows:
- Character - sharp, sharp, cutting, shooting, etc. Experts operate with the concept of "dagger pain".
- Prevalence - in what area is most noticeable, and where there is residual sensation (buttocks, back, lateral or front of the thigh, extended to the knee or to the foot). In the lumbosacral region, pain is not always expressed.
- Duration - with neuralgia of the sciatic nerve, the pain is constant, chronic. In rare cases, it manifests itself in attacks, intensifying and weakening, but it is always present.
- Intensity varies from acute to mild. With a strong pain syndrome, the patient cannot take a vertical position. Lying down relieves the pain, but also causes a lot of suffering.
- Symmetry - sciatica pain 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 that most clearly characterizes sciatica. Symptoms, in the experienced view of the doctor, have other manifestations:
- Violation of the sensitivity of the skin of the lower leg, foot.
- Unnatural body position - the patient tries to take the position in which the pain will be the least noticeable. The tone of the muscles of the lower back and legs changes.
- Change in gait - violations occur inbending the knee, foot, the movements of the posterior group of the femoral and ankle muscles change.
- Atrophy is the result of impaired movement of certain muscle groups.
- Impaired reflexes.
- Autonomic 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 thigh suffer.
- Change in the color of the skin - in the affected area, the epidermis turns pale or turns red.
- Thinning, dry skin.
- Fragility, thinning of the nail plates on the legs.
- Intensive perspiration.
Diagnosis
Pain syndrome, once it appears, signals a more global disease, where sciatica is considered as a symptom. Treatment is based on the identification of the pathology that caused the damage to the sciatic nerve.
Research methods:
- X-ray - diagnoses pathologies of the vertebrae that caused compression of the nerve roots.
- Computed tomography (CT). Detects changes in the spinal column, gives a more accurate picture of the state of nerves and tissues in slices or in a three-dimensional model.
- Magnetic resonance imaging (MRI) visualizes changes in tissues more clearly than CT, allows you to see the causes of lumbar sciatica associated with changes in the spinal cord and its membranes.
- Electroneuromyography evaluates nerve conduction in complications that lead to losssensitivity and movement disorders.
The doctor prescribes therapy, having received all the data on the picture of the disease, including the cause that led to the inflammation of the nerve, and the developed complications of sciatica. The treatment is implemented as part of a comprehensive program, where the main focus is on eliminating the pathology and normalizing the functioning of the sciatic nerve.
Therapy Methods
In most cases, the patient experiences acute pain, the task of the first stage of therapy is to relieve the pain syndrome that accompanies sciatica. Treatment of the disease has several directions:
- Medication use.
- Healing massage.
- Physiotherapy treatments.
- Acupuncture.
- exercise therapy, osteopathy.
- Using traditional medicine methods.
- Effective special methods (pyelotherapy, hirudotherapy, etc.).
There are several reasons for sciatic neuralgia. After identifying the pathogen or the circumstances that led to the disease, a set of measures is prescribed to overcome sciatica. Treatment is long term and includes preventive measures to avoid relapse.
Anesthetize, soothe, restore
At the first stage, the specialist makes prescriptions designed to relieve pain, which is the main symptom of sciatica. Medical treatment includes the use of external, intramuscular and oral drugs.
To relieve pain, the patient is prescribed painkillers. Treatment for sciatica involves the use of non-steroidaldrugs. These are the 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.
- Strong painkiller - novocaine blockade for sciatica. The procedure is performed 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 funds is wide, the drugs are available in tablets, injections, ointments. Injections for sciatica more effectively and quickly relieve symptoms and have a therapeutic effect. External application 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 be anesthetized, relieve inflammation, but also restored to normal functionality. For these purposes, the 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 activities, the doctor may prescribe distracting drugs. Their action irritates the skin, dulling the feeling of pain. An additional property of this group of agents is that after their introduction into the skin, they release biologically activechemicals 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 do massage with sciatica?" Experts believe that this type of procedure is indicated at any stage of 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 attenuation, more intensive intervention is indicated - point, kneading, reflex-segmental, can massage is possible.
- Lumbosacral inflammation (sciatica) allows for manipulations on the lumbar, gluteal areas, massage of the lower leg, thigh, foot is recommended.
- During the session, it is permissible - to enhance the effect - to use essential oils that cause relaxation of the nervous system.
The duration of the session is no 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 of sciatica is carried out by the following methods:
- Electrophoresis, UHF.
- Laser therapy, magnetotherapy.
The purpose of the procedures is to relieve pain and inflammation in the tissues, restore the functionality of the sciatic nerve. What type of physiotherapy the patient needs is determined by the attending physician. Any activities are carried out during the remission period. The acute phase of the disease, with proper therapy, passes after 7 days, after which measures are prescribed to eliminate inflammation.
Physical activity
A useful measure for strengthening the spine, developing a damaged nerve and tissues, restoring blood flow is a complex of physiotherapy exercises. Exercises for sciatica are performed in different positions. At the first stage, a sparing 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 complicated.
Patients are advised to have several workouts under the guidance of an exercise 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 - the 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 your buttocks, lift your pelvis and hold the position for 5-7 seconds (exhalation duration), carefully lower yourself to the starting position. The exercise is performed in a calm rhythm up to 10 sets.
- Sitting on the floor with legs stretched forward. Do not hunch your back, try to reach your toes with your hands. In this position, the main focus is on the back, as the muscles and ligaments are stretched, the stomach, and then the chest should lie quietly on the outstretched legs. The exercise is performed without jerking, gradually stretching the entire back surfacebody.
- Standing exercise. Set your feet shoulder-width apart, spread your arms to the sides and slowly lean to the right and left. When performing, make sure that the plane of inclination does not go forward or backward. The exercise is done with care, gently stretching the sides of the body.
All exercises for sciatica are performed with extreme caution and under the supervision of a specialist. Yoga elements are introduced into the complex as the muscle corset strengthens and inflammation subsides.
Folk methods
Sciatica (in the ICD-10 the 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, medication, etc.). Mandatory medical supervision is necessary only in case of very acute pain.
Folk treatments allow you to successfully overcome sciatica. Treatment at home can be supplemented by repeatedly proven means. For example:
- Infusion to reduce pain. Make a collection of herbs - 1 tbsp. l. flowers of viburnum, calendula, thyme herb and 2 tbsp. l. field horsetail. In 0.5 liters of water, boil 2 tbsp. l. collection, boil for 5 minutes, cool, strain. Take 0.5 cups 3 times a day before meals.
- Ointment. Mix the ingredients in a glass bottle - 5 cups of black radish juice, 1 cup of honey, 1 tbsp. l. s alt, 250 ml of vodka. Shake well before use and mix thoroughly. Composition rublumbosacral region and thigh, the procedure is carried out 2 times a day.
- Compress. Apply grated black radish to the sore spot. The compress is applied with a cloth and fixed with a warm bandage. Duration - 15 minutes, the number of repetitions - 2 times a day.
Prevention
A he althy lifestyle and the absence of bad habits cannot guarantee absolute he alth, a situation may arise in which inflammation of the sciatic nerve (sciatica) occurs. Treatment is recommended to be carried out according to the doctor's recommendations until complete recovery. But, once happened, neuralgia tends to return. A stressful situation, an awkward movement, hypothermia, or a common cold can become a catalyst for its appearance.
Prevention helps to minimize the risks of recurrence. The set of measures includes:
- Moderate exercise at work and in fitness. Most patients note that simple exercises are sometimes more beneficial than medication. Doctors recommend taking time for walking, running at a calm pace, cycling, swimming, and yoga. During such exercises, myocardial activity normalizes, blood enters all tissues, joint stiffness disappears, ligaments improve elasticity.
- Production gymnastics. If during the working day you need to constantly sit or stand, take the same position, experts recommend taking breaks to warm up. Equip the workplace with orthopedic chairsqualities, purchase special shoes, corsets, bandages, etc.
- Sleep properly. A place for a night's rest should be provided with a hard orthopedic mattress and pillows. It is recommended to raise the headboard legs a little.
- Lifting weights is done by tensing the muscles of the arms, legs, but not the back. To do this, you need to slightly bend your knees, bend over with a straight back and pick up a heavy object. In this case, all the tension will be distributed correctly, and the lower back will not suffer.
