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 broken. The sciatic nerve is the longest nerve in the human body, starting at the sacrum and reaching to the toes and heels. It contains highly sensitive motor and nerve endings that innervate the hip and knee joints.
Symptoms and treatment of infringement of the sciatic nerve will be considered in this article.
Main reason
Herniated discs are considered one of the main causes of this pathology. In most cases, the pinched nerve occurs in the region of the piriformis muscle, located in the lumen of the sciatic foramen or intervertebral discs. The disease is accompanied by severepain in the lower extremity. Most often, pinching is in the nature of unilateral inflammation, however, there are cases when both limbs are involved in pathological processes, but this is much less common. This condition can lead to an inflammatory process (sciatica), which is usually accompanied by a very strong and intense pain syndrome. The most susceptible to infringement of the sciatic nerve are men engaged in heavy physical labor.
Causes of the pathological condition
Infringement most often occurs during the implementation of any physical activity that involves sudden movements, as well as as a result of a long stay in uncomfortable positions, 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:
- Herniated discs.
- Spinal injury associated with displacement of the vertebrae.
- Pathological neoplasm either in the area of the sciatic nerve.
- Displacement of structures of the spinal column (spondylolisthesis).
- Osteochondrosis in the lumbosacral spine.
- Pathologies of an inflammatory nature in the pelvic organs;
- Sepsis.
- Hypercooling.
- Gout.
- Diabetes mellitus.
- Various infectious diseases (influenza, rubella, whooping cough, bone tuberculosis, malaria).
- Multiple sclerosis.
- Thrombosis.
- Acute intoxication.
Muscle spasms
In addition, muscle spasms along the course of the nerve can cause pinching of the sciatic nerve. In women, the sciatic nerve is often infringed during pregnancy due to increased pressure of the enlarged uterus on neighboring organs and increased load on the spinal column, due to a shift in the center of gravity, and also in cases where a woman often takes an uncomfortable position during pregnancy.
Another period of increased risk of pinching symptoms in women can be considered menopause, and this is 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.
Basic forms of pathology
Depending on the degree of severity of the disease observed in each case, there are three main forms of pathology of the sciatic nerve, which are considered to be severe, moderate and mild.
Severe form of nerve entrapment is usually accompanied by signs of disorders in the spinal cord and immobilization of the patient. Basically, the infringement is one-sided, less often both limbs are involved in such pathological processes.
Symptoms of disease
The main signs of infringement of the sciatic nerve can becount:
- Acute pain syndrome, which is the most characteristic manifestation of the infringement of this nerve. The pain in this case is of a different nature - sharp, shooting, aching, pulling, throbbing.
- In most cases, pain is observed in the buttocks and lower back. In this situation, along the back of the thigh, the pain descends to the lower leg and to the heel, and may radiate to the fingers of the limb.
- In some cases, there is numbness of the skin along the nerve, as well as tingling or burning.
- There may also be an increase in pain when sitting, laughing, coughing, muscle tension, etc.
- In addition to the pain syndrome, there is stiffness and difficulty when walking, standing for a long time, lameness may occur (with one-sided infringement - on one leg or on both - with bilateral pathology).
Pain syndrome is considered the main sign of a pinched nerve. In men, these symptoms may be similar to those of prostatitis. Signs of a pinched nerve in women vary depending on what caused this pathological process and the degree of damage to the sciatic nerve.
Women are known to have no lower back pain. The most common symptoms of a pinched nerve include:
- Muscle wasting.
- Muscle weakness.
- Violation of sensitivity - decrease or increase.
- Dry skin surface.
- Appearancea variety of pathological reflexes.
- Increase in foot sweating.
- Feeling crawling in the sacrum.
- Restriction and stiffness of 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. Specific signs of a pinched nerve thus include:
- Paresthesia (disturbance 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. As these symptoms progress, other types of sensitivity also decrease, up to their complete disappearance.
- Failures in motor functions that occur as a result of infringement of special motor fibers in the sciatic nerve. In humans, this may cause weakness of the femoral, gluteal and leg muscles and be expressed in a change in gait during unilateral inflammatory processes (limping on a diseased limb).
- Violation of the functions of some pelvic organs, which occurs due to compression of the fibers of the parasympathetic and sympathetic nervous systems passing through the sciatic nerve. Similar disorders appear in the form of changes in urination, for example, urinary incontinence, as well as defecation, for example, constipation. Such symptoms develop, as a rule, in severe cases of nerve entrapment with significantsqueezing the spinal roots.
With the development of the above symptoms, therapy for this pathology should be started immediately, since pinching of the sciatic nerve sometimes leads to an absolute loss of sensation in the lower extremities.
What diagnosis is made for symptoms of sciatic nerve entrapment?
Diagnosis of the pathological process
Diagnostic methods for determining infringement, as a rule, are classical 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. However, in order to avoid complications of the disease and its recurrence, it is necessary to determine the specific factors that contributed to the occurrence of infringement of the sciatic nerve. To determine the causes that led to 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.
- Ultrasound.
- Radioisotope scanning of the spinal column, which is usually performed in cases of suspected benign or malignant neoplasms.
- Electroneuromyography.
- Biochemical blood test.
Diagnosis of a pinched sciatic nerve includes a mandatory x-ray of the pelvis and lower back. The study of reflexes is also carried out, the presence of the Lasegue symptom and the Bonnet symptom is determined, the decrease in Achilles, plantar and knee reflexes is carried out, and the level of sensitivity in the affected area of the sciatic nerve is also assessed.
Pain syndrome can be considered the most characteristic manifestation of a pinched nerve. In this case, differential diagnosis is necessary to exclude the presence of a herniated disc, which is characterized by a longer development of the pathological process and exacerbation of some neuralgic manifestations. What is the treatment for a pinched sciatic nerve?
Therapeutic Methods
Treatment of this kind of pathologies most often consists in the traditional scheme, which involves the simultaneous use of physiotherapy methods and drug therapy.
Surgical intervention may be required in some cases. In cases of mild and moderate disease, hospitalization of the patient is not required. Subject to the doctor's instructions, this pathology can be treated at home. With acute pain that prevents a person from walking or standing for a long time, bed rest is indicated.
When a fixed body position is required during acute pain, a firm mattress is recommended.
Drugs
In the treatment of pathologies of the sciatic nerve with drugsare anti-inflammatory nonsteroidal drugs that can be prescribed in tablet form or in the form of intramuscular injections.
With oral use of non-steroidal anti-inflammatory drugs, there is a high probability of some problems with the gastrointestinal tract, such as the development of gastritis or stomach ulcers, therefore, the appointment of proton pump inhibitors is indicated for patients.
If during pinching the patient has muscle spasms, the therapeutic effect can be achieved by using medical products that improve blood circulation in the vessels - the so-called "venotonics". If severe muscle spasms occur, antispasmodic drugs and muscle relaxants are also prescribed.
In addition, the intake of any vitamin complexes, as well as drugs that improve metabolism in the body.
General treatment of pathology is supplemented by local ones - anti-inflammatory and warming medicines are used in the form of ointments and gels. What else is the treatment for a pinched sciatic nerve?
Physiotherapy
Physiotherapeutic therapies are also prescribed to supplement the action of essential drugs. These include:
- Electro-, phonophoresis of medicinal substances.
- UHF therapy.
- Magnetotherapy.
- Paraffin application.
- Laser therapy.
- Mud treatment.
- Hirudotherapy.
- Hydrogen sulfide or radon baths.
- Ultraviolet irradiation of the affected area of the nerve.
Acupressure and acupuncture as well as manual therapy may also be used.
In the rehabilitation period, a good effect can be achieved with the help of physiotherapy exercises, swimming, yoga, or Pilates, but these methods can be used only if the patient does not have acute pain.
Exercises for pinched sciatic nerve
Start with five reps, finish with fifteen reps after a while.
- 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 tilts. First, to the right and to the left, in the absence of pain, forward bends are performed.
- Lying on your back with your legs straight, pull your 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 leg to the side, then the left.
- Lying on your side, lower leg bent at the knee, upper leg extended forward. Then the top leg is pulled back. The exercise is performed on each side.
Treatment of pinched sciatic nerve at home can be effective.
Home treatments
Besides exercising and taking medication, it will not be superfluous to use local medicines. Used to treat pinching at hometopical non-steroidal anti-inflammatory drugs:
- "Betalgon" - as a result, blood supply to the skin in the affected area is activated.
- "Viprosal" - reduces pain and inflammation.
- "Karmolis" - pain syndrome stops very quickly.
- "Finalgon" - eliminates pain, relieves inflammation.
You can also purchase the video program "Infringement of the sciatic nerve" by Alexandra Bonina at Skladchina (warehouse for courses, trainings, seminars). This is a CD with video lessons on treatment and recovery using exercise therapy methods.
The seminar contains all the necessary knowledge to treat the very cause of sciatic nerve entrapment. 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 combat this problem and its causes. A set of exercises was compiled by a competent physiotherapist. As part of exercises that everyone can do.
Seminar "Infringement of the sciatic nerve" by Bonina, according to reviews, is very popular.
Consequences and complications of pathology
If the treatment is not carried out comprehensively, it threatens with consequences. Infringement of the sciatic nerve is sometimes complicated by the following phenomena:
- Intense pain.
- Violation of the functions of some internal organs.
- Insomnia.
- Decreased libido.
- Violationmenstrual cycle.
- Infertility.
- Exacerbation of certain chronic diseases.
- Violation of the evacuation functions of the bladder and intestines.
- Decrease in motor activity.
- Immobilization.
We looked at the symptoms and treatment of a pinched sciatic nerve. Drugs were also presented.
