What is sciatica. Inflammation of the sciatic nerve: symptoms, causes and treatment

Sciatica is a pathology, expressed in violation of motor skills, sensitivity of the lower extremities and nerve endings. People over 30 years of age are susceptible to this disease and their attacks can occur several times a year. Gradually, a disease such as sciatica progresses and reminds of itself more and more often, spreading to various parts of the body. The main goal of both the patient and the doctor is to find the cause of sciatica and cure it.

A disease that occurs in the spine when the nerve endings of the sciatic nerve are compressed is called sciatic neuralgia, or sciatica. The sciatic nerves are the largest and longest nerves human body. They start at the waist, cross the coccyx, pass through the back of the pelvis and end at the feet.

The lumbosacral spine bears the greatest load, so any deviations cause pinching or irritation of the nerve. Therefore, with sciatica or another disease, pain occurs not only in the back, but spreads in the body along the course of the nerve.

Causes of inflammation

The sciatic nerve can be prone to inflammation and neuralgia due to its location and pathological processes occurring in the organs. genitourinary system and lower intestines. In addition, there are a number of other causes of inflammation of the sciatic nerve:

• Intervertebral hernia. Rupture of the disc membranes can compress the nerve roots that form the sciatic nerve, and the resulting pain can develop into an inflammatory process, neuralgia and sciatica.
• Infectious diseases(influenza, scarlet fever, syphilis, tuberculosis). This is a favorable environment for the reproduction of pathogenic bacteria, leading to damage to the sciatic nerve and subsequent sciatica.
• hypothermia. Cold activates the infection in the body and provokes an inflammatory process in the sciatic nerves, that is, sciatica.
• Vertebral osteophytes. Outgrowths on the bones in the form of cones, cones or spikes occur with osteoarthritis, osteochondrosis, spondylosis. Osteophytes compress the nerve roots of the spinal cord and cause inflammation.
• Tumors. Benign, malignant, intramedullary and extramedullary tumors of the spine and intervertebral discs can also lead to the development of sciatica.
• Spondylolisthesis. With sciatica, one of the vertebrae can move down. As a result, the nerve roots become thinner or flattened.
• Pregnancy. Sciatica during pregnancy is a common occurrence. During this period, especially in the later stages, a woman's body may not be able to cope with the load. Most often, this is due to underdeveloped muscles around the spine.

The development of neuritis of the sciatic nerve (sciatica) can also contribute to excessive physical exercise, spinal deformities, arthritis, gynecological diseases, thrombosis and Reiter's syndrome.

Even a short-term negative reaction causes a surge of high activity in nerve cells and leads them to combat readiness. In turn, this causes contraction and subsequent pinching and inflammation of the sciatic nerve.

As a rule, doctors identify one pathology, which can be the main cause of inflammation of the sciatic nerve, but sometimes the causes of sciatica can occur simultaneously.

Symptoms, signs of sciatica

Signs of inflammation of the sciatic nerve are quite diverse. The main manifestation of sciatica is pain in the lumbar region, extending to the lower part of the body (gluteal region, back of the thigh, calves).

The pain may be sharp, shooting, or tingling. Less commonly, other symptoms of sciatica appear - goosebumps, muscle weakness and burning. Pain attacks pass as suddenly as they appeared. Most often, they occur at night, after overstrain (physical, emotional) or hypothermia.

The sciatic nerve arises from the sacral nerve plexus, which is located near the sacrum. That is why painful sensations appear in the lower back, gluteal region and sacrum.

As a rule, pain occurs in one leg, but sometimes it can move to the other. Sciatica has symptoms such as numbness of the limbs and a decrease in their sensitivity. Because of this, some muscles can atrophy, and, as a result, there will be difficulty in bending the lower leg and lifting the feet.

Since the sciatic nerve consists of many nerve endings, other signs of sciatica can also be observed - incontinence, increased sweating, change in gait, thinning of the skin, impaired reflexes.

Diagnostics

For accurate diagnosis and prescription effective treatment with sciatica, first of all, you need to determine the cause of the pain syndrome. This will require a series of studies that can identify the severity and nature of sciatic neuralgia.

First, the examination is carried out by a neurologist, determining the sensitivity of the skin and assessing the damage. The doctor may identify the following signs:

• Decreased Achilles reflex. Its presence is checked by hitting the Achilles tendon (connection of the gastrocnemius muscle with the calcaneus) with a hammer. With sciatica, the reflex decreases or is completely absent.
• Deviation in the knee jerk. Since tendons with nerve endings are stretched between the patella and the tibia, involuntary extension of the leg is considered a normal reaction to a hammer blow. If the sciatic nerve is pinched, this reaction will be weakened or not detected.
• Lassegue syndrome. With sciatica, raising a straight leg up will cause severe pain in the back of the thigh and lower back.
• Cross Syndrome. On the Lasègue test, the pain also affects the other limb.

Depending on the results of a neurological examination, in order to understand how to cure sciatica, the doctor may additionally prescribe a comprehensive examination, consisting of clinical and biochemical tests, radiography of the sciatic nerves, computed tomography of the muscles, magnetic resonance imaging and electroneuromyography.

Patients often worry about how to treat sciatica. Such a disease is very difficult to treat, and all therapy is reduced to temporary anesthesia. Treatment of sciatica consists of medical and non-pharmacological methods.

Treatment of sciatica with drugs includes drugs that relieve inflammation. The main task at this stage is the relief of pain. Depending on the result of the diagnosis, the stage of inflammation of the sciatic nerve and symptoms, the neurologist selects one or more groups of drugs for treatment.

Not drug treatment It consists, most often, of physiotherapy, massage, physiotherapy exercises, treatment with the help of folk remedies. Sometimes acupuncture, manual therapy and other methods are used.

Medical

The most effective pain relievers for sciatic neuralgia are non-steroidal anti-inflammatory drugs (NSAIDs). These include analgin, diclofenac, ketorolac, ibuprofen, meloxicam, sulindac and others.

Despite the effectiveness, these drugs should be taken strictly as prescribed by the doctor and short course, since with prolonged use they have a negative effect on the gastric mucosa and blood clotting.

To prevent complications when the sciatic nerve is pinched, irritant ointments should be used that improve blood circulation, relieve spasm and pain. These include finalgon, verapin, viprosal.

In addition, anticonvulsants and tricyclic antidepressants may be prescribed to treat sciatica. If the drugs do not have the desired effect, doctors prescribe hormonal injections.

Non-drug

Physiotherapy relieves pain from inflammation of the sciatic nerve, but does not eliminate the true cause of the disease. Treatment of sciatica with this method may consist of various procedures- electrophoresis, vitamin therapy, ultra-high-frequency (UHF) therapy that acts with currents on the area of ​​the affected nerve, phonophoresis, electrosleep, magnetotherapy, paraffin applications. These techniques restore blood circulation, normalize metabolism and relieve swelling.

In the treatment of inflammation of the sciatic nerve, any massage will be useful. Just remember that at the acute stage of the disease, rubbing and stroking should be light. The intensity of movements should be increased gradually, depending on the pain. Well helps with sciatica acupressure, general or cupping massage in combination with properly selected essential oils and ointments.

During the period of remission of sciatica, therapeutic exercises should be performed. Symptoms and treatment of inflammation of the sciatic nerve are interconnected, so even the most difficult ones will bring relief. simple exercises- walking on the floor on the buttocks, exercise "bicycle", rotation of the pelvis.

One of effective exercises performed by the patient lying on a hard surface. Legs need to be straightened and slowly enough to pull them to the chest. At the same time, they need to be bent at the knees. After, return to the starting position.

Mud therapy, hydrotherapy in pearl, radon, hydrogen sulfide baths improves immunity and reduces the number of colds and is also often used in the treatment of inflammation of the sciatic nerve.

Today, acupuncture is actively used for sciatica, despite the fact that the effectiveness of this procedure has not been confirmed by medical research. Needles made of alloys of special metals improve blood circulation and tissue regeneration, relieve swelling and dilate small vessels.

At home

Folk remedies help relieve some of the symptoms of sciatica and pain when the sciatic nerve is pinched. Be sure to be careful before using home remedies. Each method or recipe has its contraindications. Here are some folk remedies:

Cream based on horse chestnut. It relaxes the muscles and helps with a pinched sciatic nerve.
A cake made from beeswax heated in a water bath. It reduces pain in the affected areas of the body.
Rubbing with a tincture of spruce buds, dandelions and pine needles. It relieves the symptoms of neuralgia. To do this, kidneys are placed in a jar, filled with vodka and stored in a dark place for a week.
Treatment with folk remedies for pinched sciatic nerve should be carried out in conjunction with medical prescriptions and only with the permission of a doctor.

Prevention measures

The main prevention of sciatic nerve neuralgia is maintaining an active lifestyle. Definitely need to give up bad habits- alcohol and tobacco use. During physical exertion, muscles are strengthened, the nervous system is activated and blood flow is normalized.

We should not forget that the causes of pinching can be excessive loads, leading to damage to the spine. Therefore, sciatica involves treatment with yoga, swimming, brisk walking.

If at work you sit in one place for a long time, get pillows for the lower back, do small workouts. You also need to take care of the bed and the right shoes.

What is sciatica, how is it related to the patient's neuralgic condition, why does it make life difficult for people who are sensitive to hypothermia, how to get rid of it? This question is asked by patients who have not been spared this disease. Let's try to figure out why this pathology is terrible, how to protect yourself from it and why the treatment of sciatica is not always effective.

Neuralgic sciatica disease is a disease of the sciatic nerve, accompanied by aching pains, which, in the presence of inflammation, radiate to the lower back, thigh of the leg. At the moment of “lumbago”, a person feels discomfort, it is difficult for him to stand on his foot, to walk. The gait looks like a "hunched old man." Signs of sciatica are easy to recognize by limping, hunched posture, leg pulling.

Everyone suffers from back pain from time to time. According to the adherents of Ayurveda, human thoughts are the cause of any problems in the body. The sources of energy are located at the base of the spinal column. And all diseases of the back are a reaction to the blocking of energy channels.

The reasons for the clamping of energy centers are:

• sexual problems (sexual orientation, puritanism);
• deceit;
• abuse of drugs, alcohol, smoking;
• psychological trauma of undeveloped relationships between a man and a woman.

According to statistics, a third of the population suffers from some form of sciatica. Moreover, the age category of patients is different: young people aged 28–36 years, pensioners, men working in hazardous conditions. Sciatica also occurs during pregnancy, during breastfeeding, in women for three to five years after the first birth.

For successful treatment, it is not enough to reconsider your behavior, change your daily habits. First of all, therapy is A complex approach to your mental health, then to your physical health. Sciatic neuralgia is often based on resentment, unwillingness to listen to your body. If you learn to live in harmony with the body, the causes of sciatica will go away as unexpectedly as they came.

The most common symptoms of sciatica are:

• pulling "lumbago" in the area of ​​the thigh, lower leg;
• pain in the right buttock, lower back;
• infringement of the sciatic nerve with sharp bends, turns, raising the legs;
• loss of sensation in the right leg;
• discomfort in a lying, standing position, during squats.

When “lumbago” spontaneously occurs, a person cannot eliminate them on his own, because he feels severe pain. Rubbing, massage do not bring relief. Bending of the legs and lower back is difficult, the right thigh goes numb, tingling is felt in the lower back and lower leg. With sciatica, one-sided pain is noted, rarely the disease affects both legs.

Bruises, hypothermia, clumsy movements injure the muscles, resulting in spasms, swelling, blood stasis. The brain receives an impulse about pain, an increase in blood pressure is observed, however, the muscles squeeze the vessels so much that it is not possible to avoid circulatory disorders. An inflammatory process develops. Information about muscle damage enters the brain from the area responsible for the site of inflammation, as a result of which, due to increased muscle inflammation, edema is observed in patients. Trying not to change the position, a person strives to reduce the number of movements, but such an action leads to a different effect - blood stagnation and the transition of the disease to the chronic stage.

The most common symptoms

The main symptom of pathology in sciatica is pain. Other signs of the disease do not make themselves felt for a long time or are completely absent. When sciatica is first diagnosed in a person against the background of the cause of muscle tone damage, the spasm lasts from 2 to 5 minutes, later the duration of spasms increases and in critical situations can reach 8–10 minutes.

Important diagnostic criteria for sciatica are:

• The intensity of pain sensations (pain can occur spontaneously and be pronounced, or it can be mild, short in time, without causing discomfort to the body). Severe pain makes every movement so unbearable that it is difficult for a person to stay in one position. Down to the sciatic nerve, the pain changes intensity. Patients may feel conditions as if the skin is numb, tingling, or goosebumps run through it. In addition, pain can occur with minimal physical activity.
• The nature of the pain threshold (sensations can be very different: from sharp burning to intense with “shoots”).
• Impact on other organs (most often, pain spreads to the lower back, popliteal fossa, buttocks, less often occurs along the entire length of the leg, from the fingers to the collarbone. Painful spasms may radiate to the lower back, or may be completely absent.
• Symmetry (discomfort, as a rule, is one-sided. Pain is felt either on the left or on the right side. Only in cases of an advanced form, the disease acquires irreversible consequences, which are accompanied by severe pain on both sides at the same time, accompanied by “backaches”.
• Frequency (depending on the form and stage of the course of the disease, the pain is constant, with attacks, of a chronic nature).

Classification of disorders in sciatica

Dysfunction of coordination of movements, inhibition or lack of reflexes, loss of sensitivity are the main conditions that can occur with a pathology such as the treatment of sciatic neuralgia.

Sciatica has a negative effect on the nervous system (patients are characterized by neurostenosis, muscle atrophy, problems with sensitivity, limitation of movements, changes in muscle tone, neuralgia).

The most dangerous diseases that sciatica can subsequently lead to are:

• damage to the bones of the lower extremities;
• hyperthyroidism;
• malfunctions of the autonomic function;
• fragility of the nail plate;
• dry skin;
• skin color distortion.

Since sciatica is accompanied by compression of the sciatic nerve in the direction of the nerve fiber, patients show symptoms in the form of neurological pathologies, pulling pains in the lower back, tissue malnutrition.

Less common is the progression of sciatica without pain. In such cases, there is a pronounced symptomatology of the disease, which manifests itself in:

• pain radiating to the fingers;
• the occurrence of paralysis of the lower extremities;
• Achilles prolapse;
• numbness of the lower leg;
• lack of sole reflexes.

Similar symptoms indicate a violation of the function of the blood supply to the radicular arteries in the first sacral segment, as a result of which such a type of sciatica as paralytic occurs. This is explained by concomitant radicular inflammation of the fifth lumbar segment, which "slows down" motor processes, weakening the function of the pelvic apparatus and leads to immobility of the limbs (complete paralysis).

Characteristics of pain in sciatica

Often it is unbearable pain that is the only sign of an insidious disease. This sign is characterized by sharp "shoots" of prolonged intensity, reminiscent of sharply inflicted stab wounds. Localization occurs along the nerve, affecting the back of the thigh, right buttock, popliteal cup, back of the leg.

Attacks of pain can be intermittent or constant. The strength and duration of pain depends on the form of the disease, the age of the person, the dynamics of the course of the disease. At the initial stage, sciatic nerve neuralgia is accompanied by mild bouts of pain, so the person does not take this symptom seriously, thus ignoring the disease. The further development of sciatica is of a pronounced painful nature, intense pain exhausts a person, violating mental condition because the patient is trying to find any way to eliminate discomfort.

Sciatica disease can be provoked by uncomfortable postures when moving, lifting heavy things, and ordinary hypothermia. Prolonged spasm in sciatica makes it difficult for the patient to move, each step is difficult for him, minor changes in body position are fraught with sharp pain in the lower back, thigh.

Symptoms against the background of neuralgia

Neuralgic disorders are dangerous due to incorrect conduction of reflexes from the base of the spine to the affected leg. Symptoms of neuralgia do not depend on the duration of the disease, however, they are expressed in different ways, for example, patients may:

• decrease in the Achilles reflex (the severity of the function of flexion of the foot decreases or completely disappears in response to a shock reaction with a hammer on the Achilles tendon);
• no response to the plantar reflex;
• there is intense tingling pain in the buttock (usually observed when a person tries to cross one leg or put a limb bent at the knee joint on the inside of the lower leg of the second leg);
• weaken the knee jerk.

As soon as a person is faced with such a disease as sciatica, immediate treatment should be the main goal on the road to recovery. Otherwise, complications of the disease can cause disability. It is advisable to consult a doctor at the first ailments, the pain is still weak, and the reaction to impulses is within the normal range. This guarantees the effectiveness of the therapy.

What is the danger of lack of coordination

Infringement of the sciatic nerve is fraught with a decrease in the function of sensitivity, incorrect passage of impulses from the affected nerve. Such violations are accompanied by such symptoms:

1. numbness of the foot, right thigh, right shin;
2. tingling in the lumbar region, reminiscent of "goose bumps");
3. curvature of body position.
4. incorrect bending of the ankle, knee joints;
5. atrophy of the muscles of the back of the leg, thigh.

Outwardly, a person has a visual decrease in the size and volume of the leg. Complete muscle atrophy can develop into paralysis only in the case of a serious condition of the patient, when sciatica gives complications to the spine.

As a rule, complete paralysis entails immobility of the leg in the thigh area. Sometimes it also happens that the patient, even with the slightest physical exertion, does not feel the leg in the foot, lower spine, or lower leg.

In severe forms of sciatica, accompanied by muscle atrophy, prolonged paralysis, there may be violations of the reflex function, problems with defecation, destruction bone tissue hip, ankle joints, urinary retention.

When a person is affected by a disease such as sciatica, the main symptoms and treatment are complicated. The disease develops quickly enough, as a result of which the symptoms appear in various combinations. At the same time, the manifestation of sciatica is noted differently in different patients. The exception is pain in the area of ​​one limb. Despite the different symptoms, most patients have similar symptoms, the main sign of which is localization in a particular area.

Medication treatment

After diagnosing the disease, the question arises of how to treat sciatica so that the therapy gives the maximum result in restoring motor functions. Most often, patients try to relieve pain on their own, resorting to exercise, rubbing, the use of Aspirin. Sometimes such procedures are enough to return to normal life, but in most cases, the pain becomes more active after a couple of days, and you can’t do without a doctor. A preventive visit to a specialist should take place at least 2 times a year, regardless of whether the person has complaints or not.

Drug treatment is the most affordable way. The patient goes to the pharmacy, buys drugs, takes them until the symptoms disappear. The first-aid kit of people with sciatica is overflowing with anesthetic ointments, gels, injections, and creams. In it you can find restorative vitamins and medicines designed for unexpected attacks.

Among the drug treatments, the most practical and effective are:

• drugs for pain relief (Diclofenac, Amidopyrine, Tryptophan, Acecardol are sold without a prescription, relieve pain, inflammation, discomfort);
• chondroprotective drugs (their action is aimed at restoring cartilage tissue, Arthro-Active, Teraflex, Advance, Chondroxide, Rumanol quickly eliminate the symptoms of sciatica, are quickly absorbed, usually not addictive);
• muscle relaxants (Diplacin, Mydocalm, Flexin are designed to eliminate spasms, normalize muscle tone, have a number of contraindications, their components contribute to addiction, dependence);
• nootropics (neurometabolic stimulating drugs) - Nootropil, Phezam, Pantogam affect the patient's psyche, eliminating the psychological problems that caused sciatica; in this case, the treatment has a side effect, constant use is addictive).

Do not forget that the frequent use of drugs is addictive and side symptoms. Treatment of sciatica should last exactly as long as the course of therapy is prescribed by the attending physician.

Medicines quickly eliminate pain, improve the condition of the joints, relieve stress, and normalize blood circulation. But besides this, they have a number of side effects, as a result of which patients become dependent on them. The disadvantage of medications is their inefficiency, tk. they do not eliminate the causes of the disease. With sciatica, it is quite possible to do without pills. This will require complex long-term therapy. How long does it take to relieve pain? With strict adherence to the doctor's prescriptions, recovery can follow quickly. On average, medical treatment of sciatica is 2-4 months, taking into account the characteristics human body and the severity of the disease.
Do not self-medicate, as this can harm the state of health, aggravating the process of sciatica. The right decision is to seek advice from a doctor who will diagnose, identify the problem and prescribe the appropriate treatment.

Ointments, tablets, creams are effective only on initial stage diseases. It is advisable to start therapy with non-steroidal anti-inflammatory drugs, such as Ketanov, Naproxen-Akri, Dynastat, Celebrex.

Non-steroidal drugs should be taken with caution, because. their improper use is fraught with exacerbation of ulcers, duodenal ulcers, gastritis. Do not neglect the advice of a doctor before using such funds. Severe pain in sciatica can be eliminated with painkillers such as Tramadol, Methadone, Ibuprofen, Fentanyl.

Also, in the treatment of sciatica, phytotherapeutic agents can be used, for example, based on bee venom, turpentine, hot pepper, camphor. They normalize blood circulation, relieve inflammation, dull pain. The active ingredients that make up their composition contribute to irritation of the skin receptors, as a result of which the pain disappears. In the future, as a preventive measure, it is recommended to undergo a course of physiotherapy.

Alternative therapy

Modern medical institutions practice the simultaneous use of conventional and alternative medicine procedures for sciatica. Effectively help in the treatment of sciatica:

• acupuncture (aimed at relieving muscle fatigue, normalizing blood flow, eliminating spasms; it is prescribed strictly individually by the attending physician, has prone reviews from patients who, after undergoing a course of rehabilitation, managed to eliminate symptoms, restore movement activity);
• kinesiotherapy (the task of this technique is to activate movements through constant muscle training; exercises are performed according to a special system with a daily increase in load);
• manual therapy (performed to relax spasmodic muscles, eliminate pain, muscle strain; involves a gentle effect of the manual operator on the active points responsible for blocking a certain muscle group; has positive results to relieve the symptoms of sciatica).

Activity is an important part of life. Even minimal physical activity involves the work of the muscles of the lower back, ensuring the pumping of blood to the necessary organs, the supply of oxygen to the cells. Kids are very active, they do not sit still for a minute, making thousands of muscle contractions. Older people who are not involved in sports find it difficult not only to run, but even to move around. Their muscles are atrophied, their light gait resembles “dragging” with their feet.

It is quite possible to cure sciatica if you take care of your health, seek help from your doctor in a timely manner, follow the recommendations of specialists, and undergo periodic rehabilitation. Age is an indicator that cannot be adjusted, however, constant movements- a factor that repeatedly slows down the aging process of the body. Do not give up fortifying vitamins, stick to a diet, lead healthy lifestyle life. Movement in the background general recommendations doctors are able not only to relieve patients of the symptoms of the disease, but also to completely cure the disease.

Sciatica is pain in the area of ​​the sciatic nerve. It is often referred to as sciatica. A disease appears due to compression of the root in the spinal cord in the lumbar region. Usually sciatica occurs only after 30 years. It is necessary to know the main causes of the onset of the disease, as well as possible methods of treatment.

The disease may start as a result of pathological conditions:

• Hernia in the intervertebral region;
• Infectious diseases in the body. These include influenza, typhoid, tuberculosis, syphilis and malaria;
• Poisoning in the body with alcohol intoxication;
• Manifestation of gout and diabetes;
• Severe hypothermia of the body;
• The occurrence of osteophyte in the vertebrae;
• Benign and malignant tumors in the spine;
• manifestation of spondylolisthesis.

The main symptoms of the disease

The main symptom of sciatica is severe back pain. Depending on the stage of the disease, seizures can be chronic or isolated. The pain may be different strength, often has one location.

You should also be aware of other symptoms that can occur with sciatica:

1. Loss of sensation;
2. Disorders in motor activity;
3. Atrophy in the muscles;
4. Problems with the reflex system;
5. skin color changes;
6. Dryness of the whole body;
7. The skin becomes thinner;
8. Nails thin and break;
9. The patient has excessive sweating.

Symptoms of sciatica of a neurological nature

During a neurological examination of a patient, doctors can detect such symptoms characteristic of sciatica:

• Decrease in the Achilles reflex;
• Decreased plantar and knee reflex;
• Lassegue's symptom, which is manifested by severe pain in the thigh;
• Cross syndrome with severe pain in the leg.

At the first symptoms of sciatica, you should immediately consult a doctor and begin complex treatment.

Methods for diagnosing sciatica

Doctors first refer the patient to an x-ray. This diagnostic method will help to immediately detect sciatica. However, it must be remembered that radiography is prohibited during pregnancy, with severe obesity and with the patient's psychological anxiety.

Computed tomography can be used for diagnosis. The study will show the exact causes of sciatica and make a three-dimensional model lumbar indicating the pain zone. During pregnancy this species surveys are also prohibited.

Doctors often order an MRI scan. The procedure will show accurate images of the tissues, spinal column, and discs. It will be possible to see three-dimensional images of the spinal cord and understand the extent of damage. MRI will help to see the state of blood vessels, roots and nearby tissues.

In rare cases, diagnostics by electroneuromyography is prescribed. The procedure will help to see the nerve conduction and show the patient's sensitivity at the moment of movement. Special electrodes will be applied to the muscles, which will mark the passage of impulses along the nerves.

Treatment methods for sciatica

To fully cope with the disease and relieve the pain attack, it is necessary to use complex therapy. The doctor prescribes such methods of treatment:

1. Taking pills;
2. massage procedures;
3. Physiotherapy;
4. Acupuncture in active points;
5. Osteopathy;
6. The use of therapeutic exercises;
7. Folk methods of treatment;
8. Procedures using beneficial mud and leeches.

Only a doctor can prescribe the exact procedures and dosage for taking pills. Self-medication in this case is unacceptable.

Treatment with drugs

Most often, doctors prescribe non-steroidal drugs to relieve a severe attack of pain. This task will do just fine. It must be taken in tablet form or intramuscular injection. You can use combined non-steroidal drugs, as their effect will be more active. Here are some of them:

• Andipal;
• Pentalgin;
• Tempalgin.

These medications should be taken only as prescribed by a doctor in exactly the indicated dosage.

Also, to relieve an attack of inflammation, drugs are prescribed, which include Diclofenac. It is an effective analgesic and anti-inflammatory agent. The doctor may prescribe Voltaren and Rapid for sciatica.

To restore work nervous system must be taken vitamin complexes. For the treatment of symptoms of sciatica, the drug B1 and B6 are used.

Irritating drugs are used to distract the nervous system from the pain and dull the attack. These include Turpentine ointment and Camphor gel. Medicines will irritate the skin and relieve pain from the nerve root. Besides useful material in the composition will restore blood circulation, have a positive effect on swelling and inflammation.

At the most extreme stage of the attack, Novocaine blockade is prescribed in the painful area. The drug contacts with nerve receptors and reduces the manifestation of pain impulses. Only a doctor should perform injections. He will introduce Novocaine at the required point and will be able to accurately adjust the dosage. Such blockades are not prescribed for individual intolerance to the drug.

The use of medicinal ointments

To alleviate the symptoms of sciatica, it is necessary to use local ointment therapy. Such drugs speed up the recovery process and relieve severe inflammation.

It is necessary to use warming ointments to increase blood circulation in the painful area. Medicines will dilate blood vessels and enhance tissue nutrition. After applying the ointment, swelling and pain disappear, the healing process is accelerated. Warming ointments include, and. The drug should be applied twice a day to the painful area. The course of therapy lasts no more than 10 days.

Anesthetic ointments relieve a strong attack of inflammation and swelling. The doctor may prescribe Butadion and Ibuprofen for treatment. The medicine is applied to the skin 3 times a day with a thin layer. The course of treatment is determined by the doctor.

Massage treatment

At any stage of sciatica, massage treatments can be used as a treatment. But in order not to harm the body, you must follow these rules:

1. At the time of pain in the lumbosacral zone, massage is done on the buttock and thigh;
2. With exacerbation of sciatica, you can not do hard and abrupt massage movements. Doctors allow only small vibrations and pats;
3. After pain relief, you can do acupressure and cupping massage of the damaged area;
4. At the time of the procedure, it is recommended to use natural essential oils;
5. During massage, you can take therapeutic warming ointments
6. The duration of a standard massage is half an hour;
7. The course of treatment consists of 10 massage procedures.

After treatment with massage in the painful area, blood circulation and muscle tone will improve. The procedure perfectly relieves swelling and inflammation. After massage, active biological components are formed in the tissues. They speed up the healing process, relieve pain and inflammation.

Acupuncture Treatment

With sciatica, acupuncture has proven to be effective. The doctor will insert thin stainless steel needles into active areas on the skin. After the procedure, you can see the following results:

• Endorphins enter the skin, which relieve an attack of pain;
• Increases tissue regeneration and improves immunity;
• The vessels expand, and the process of blood circulation improves;
• The edematous state is completely eliminated.

It must be remembered that acupuncture is not performed for infectious diseases in a patient, as well as for oncological diseases. Do not insert a needle if the skin is damaged.

The use of therapeutic exercises

With exacerbation of sciatica, it is forbidden to make sharp active movements. Doctors prescribe only bed rest. However, after removing the pain attack and improving the general condition, gymnastics is prescribed. Here are some exercises to treat sciatica:

1. Exercise number 1. Lie on your back and slowly pull your legs up to your chest in a bent position. Perform 8 times;
2. Exercise number 2. Lie down on your stomach and begin to lift the body as with push-ups. Make movements slowly, without jerks. Repeat 7 times;
3. Exercise number 3. Stand up straight and tilt your body to the right and left. The number of repetitions - 10 times on each side;
4. Exercise number 4. Lie on your back and lift your straight legs up. Hold them in the air for a couple of seconds and slowly lower. Repeat 7 times.

Therapeutic exercises should be prescribed only by the attending physician. It determines the types of exercises and their number per day. It is necessary to perform the first 2-3 workouts under the supervision of a specialist. Otherwise, an attack of sciatica can sharply worsen.

Disease prevention

To prevent sciatica from manifesting itself in the body, it is enough to follow simple preventive recommendations:

• Give daily a moderate load on the body. It is enough just to walk so that the pain does not appear. Remember that at the time of the load, muscle tone improves and the work of the nervous system is activated. You can play sports under the supervision of a coach. Give preference to yoga, swimming and Pilates;
• If you have a permanent sedentary job, take short breaks with a warm-up on your back. When sitting for a long time, you need to wear a corset. Also purchase a quality chair with orthopedic properties;
• Sleep on a quality mattress. It should not sag from body weight or be too rigid. It is important that the surface at the time of sleep is perfectly flat, without bumps and deflections. Recommended to purchase orthopedic pillow and mattress;
• Try not to lift weights after being sick. If you need to lift a heavy object, then be sure to squat and lean slightly in the process. At this point, the back should be straight. Distribute any weight evenly on both hands;
• Follow the rules of nutrition, avoid overeating. Incorporate fruits, vegetables, and grains into your diet. Try to avoid fast food, spicy and fried foods. Drink a large number of water per day;
• Stop smoking and drinking alcohol.

Complications of sciatica

If sciatica long time pinches the sciatic nerve, it negatively affects the entire body of the patient. Blood circulation in the muscles decreases, there are complications for others internal organs. Sciatica can lead to such negative consequences:

1. The skin on the painful area becomes very thin and overdried;
2. Muscles gradually atrophy, their sensitivity decreases;
3. Fingernails and toenails become brittle and weak;
4. If the pains radiate to the limbs, then the strength of the muscles in the legs may decrease;
5. The patient's gait changes and mobility in the knee joint disappears;
6. There is a strong paresis, all movements are limited;
7. Problems with the work of the pelvic organs, the patient may begin to incontinence or urinary retention.

To prevent dangerous consequences, sciatica should be treated at the first manifestations. It is necessary to follow the doctor's recommendations in the complex in order to speed up the healing process.

Surgery for sickness

If sciatica was detected at an advanced stage, then conservative treatment may no longer be effective. The doctor will definitely prescribe an operation if sciatica has begun to move into such stages of complications:

• The occurrence of a malignant tumor in the vertebral zone;
• Manifestation of a benign tumor;
• Violation of the pelvic organ;
• Prolonged pain that is not relieved by drugs for more than 5 weeks.

The operation is assigned individually to each patient after determining the exact diagnosis. In some cases, surgical intervention is strictly prohibited. Here full list contraindications:

1. Problems in the respiratory and cardiac system;
2. Any trimester of pregnancy;
3. If the patient has infectious diseases for more than 2 weeks;
4. Diabetes.

Postoperative period

If the operation for the treatment of sciatica was successful, you do not need to immediately abandon the treatment measures. The doctor necessarily prescribes additional procedures in the postoperative period. Follow these recommendations so that sciatica does not occur again in the spine:

• Attend procedures prescribed by your doctor. Usually magnetotherapy or electrophoresis is used. You can go for a relaxing massage and do therapeutic exercises. The duration of each procedure is determined by the attending physician;
• After the operation, it is necessary to wear an orthopedic corset to fix the back. It should be of medium hardness. Duration of wearing is 2 months. Only a doctor can choose the necessary model for each patient individually;
• Gradually increase the load on the spine, avoid excessive activity after surgery. You can start swimming in the pool, then the load will be evenly distributed over the entire back;
• After a major operation, the patient must be taught how to sleep properly, get out of bed and lie down. This is done so that the disease does not worsen again.

In medical terms, sciatica is a pinching or inflammation of the sciatic nerve (hence the second name of the disease - sciatic nerve neuralgia). The main cause is a herniated disc, but there may be the formation of osteophytes of the vertebrae, tumors of the spine, spondylolisthesis, hypothermia, infectious diseases committing sudden movements, lifting weights.

Sciatica - symptoms

All signs of sciatica boil down to prolonged pain. It can be acute or aching at the initial stage. The specificity of the sciatic nerve is such that it stretches almost along the entire body, starting from the spine and along the entire leg. Pain can occur in the region of the lower back, buttocks, back of the thigh, lower leg, during movement or while sitting. Pain can be caused by a muscle tightly clamping a nerve. If left untreated, reflex impairment, sensory impairment, and movement disorder are possible. In children, the symptoms are mild and develop gradually.

Treatment

If the sciatic nerve is infringed, it is necessary to exclude physical activity. Treatment for sciatica inflammation of the sciatic nerve involves bed rest and drug treatment in conjunction with other types, including folk remedies. Perhaps the appointment of spa treatment and treatment of sciatica at home. The treatment of inflammation of the sciatic nerve itself is negotiated with the attending physician and is possible only if all its requirements are met.

The list of non-traditional means includes apitherapy, hirudotherapy (with a special formulation of medical leeches), mud therapy, osteopathic methods. Physiotherapy, acupuncture, acupuncture are widely used. Sciatica can be diagnosed using computed tomography, electroneuromyography, magnetic resonance imaging, and radiography. In severe and advanced cases, surgery is needed.

Sciatica - medical treatment

Non-steroidal anti-inflammatory drugs are used in the treatment of sciatica. These medicines give a stable therapeutic effect:

• elimination of inflammation;
• removal of edema;
• short-term or long-term pain relief.

Medical treatment of the sciatic nerve includes the use of steroidal anti-inflammatory drugs. They are chosen already when non-steroidal drugs do not give the desired effect. Dosage form drugs can be any: candle, capsule, tablet. Depending on the general tolerability of a particular medicinal substance by the patient, a course of treatment is selected that will provide the maximum effect.

Ointment

It is mainly used in the lumbar region. Ointment for sciatica is good to anesthetize, relieve inflammation because it acts locally and does not adversely affect other organs of the body. There are a sufficient number of ointments that treat and alleviate the symptoms of sciatica. They are divided according to the mode of action:

• non-steroidal anti-inflammatory drugs of local action;
• chondroprotectors (used for osteochondrosis);
• homeopathic ointments (calling the body to actively counteract the disease);
• distracting and irritating drugs;
• combination drugs.

injections

For this purpose, steroid anti-inflammatory drugs are used. Injections for sciatica are prescribed if the disease has taken an acute form. Their advantage is that they are effective, do not cause much harm to the body, have little side effects. Treatment with injections minimizes the risk of intoxication or poisoning of the body. Such a medicine acts much faster than others at the site of inflammation. Sciatica - the symptoms and treatment of this disease should be determined only by a doctor based on all examinations.

Painkillers

Painful attacks with sciatica can be very strong and constantly interfere (because of the pain it is impossible to sleep). All tablets should be prescribed by a doctor after appropriate examinations. Only he can prescribe the correct medication, dosage, duration of treatment. Painkillers for sciatica with pinching or inflammation of the sciatic nerve are very important, their task is to block prostaglandins (substances responsible for pain). There are many such painkillers and they have different active ingredients. The most famous of them:

• ibuprofen;
• Analgin;
• Ketoprofen;
• Diclofenac;
• Piroxicam etc.

Exercises

Exercises are effective in the treatment of sciatica, while absolute caution must be observed in movements. Therapeutic exercises for sciatica are useful, effective and prevent blood stasis. In total, there are several types of therapeutic exercises, including standing and lying exercises. Their implementation does not require special training or readiness for strong physical exertion:

1. Lying exercises. Performed by bending the legs at the knees. It is necessary to lie on your back, pulling your knees as close to your chest as possible, while you need to clasp your buttocks with your hands and hold the position for about 30 seconds.
2. Sitting exercises. In a sitting position on the floor, you need to stretch your legs forward, while smoothly bringing your hands behind your back, connecting the shoulder blades. Repeat up to 5 times.
3. Standing exercise. Standing on the floor, you need to put your feet shoulder-width apart, and then raise one hand up and lower the other down. Raising your hands in turn, you need to tilt in different directions.

Massage

In case of pathology of the sciatic nerve, massage is performed carefully: all movements should be carried out evenly and smoothly. Contraindicated strong physical impact. Massage is contraindicated in the acute course of the disease. At correct execution massage anesthetizes, makes the body generally more relaxed, relieves muscle tone.

Therapeutic massage for sciatica is of two types:

• point (carried out by acting on special points of the body, which quickly relieves pain, improves blood flow and metabolism);
• vacuum (prevents lymph stagnation, helps relieve pain when the sciatic nerve is pinched).

Treatment of sciatica according to Bubnovsky

The bottom line is that sciatica is caused by concomitant diseases that are associated with the musculoskeletal system (for example, osteochondrosis). Treatment of sciatica according to Bubnovsky is considered successful when all these diseases are eliminated. With the help of extensive diagnostics, pathologies are revealed, kinesitherapy (therapy with the help of movements) is prescribed. Bubnovsky developed a whole system of programs to restore the normal functioning of the musculoskeletal system.

Sciatica - treatment with folk remedies

There are many ways to treat sciatica with folk remedies at home:

• herbal baths;
• herbal infusions;
• alcohol solutions for rubbing.

For example, a bath with coniferous decoction, thyme herb and herb horsetail, local compress. Salt baths are recommended (for sciatica and nervous diseases useful sea salt). To cure inflammation and relieve pain at home, calendula flowers, horse chestnut, burdock roots, elecampane, viburnum flowers, agave are used for infusion - pour hot water and then insist. Agave juice lubricates sore spots. For rubbing - flowers of white acacia, lilac, bay leaf, honey, black radish are mixed with vodka and infused for several days.

sciatica during pregnancy

Due to the increase in the size of the uterus during pregnancy, a woman may begin to suffer from sciatica (the uterus presses on the sciatic nerve, thereby pinching it and causing pain). Since many medicines are prohibited during pregnancy, doctors recommend doing special therapeutic exercises, applying massage, eating right, watching your posture, and sleeping on a hard bed. All this can be done at home: it will help keep the muscles in good shape and establish normal blood circulation, thereby preventing sciatica in pregnant women and smoothing out its symptoms.

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Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.

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Sciatica (in some sources - ischias) - an inflammatory process that affects the sciatic nerve, neuritis of the sciatic nerve. The term itself is derived from the Greek word ishia, meaning seat. Nervus ishiadicus is translated from Latin as the sciatic nerve.

The paired sciatic nerve is the most powerful nerve in the human body. It has the greatest length and thickness. The sciatic nerve originates from the sacral nerve plexus.

It is formed by the nerve nuts of the two lower pairs of lumbar (lumbar) spinal nerves (L 4 -L 5), and the upper three pairs of sacral (sacral) spinal nerves (S 1 -S 3). Thus, the roots of 5 pairs of spinal nerves take part in the formation of the sciatic nerve.

The main trunk of the nerve, formed by these roots, descends from the lower back through the gluteal region, and further along the back of the thigh to the popliteal fossa. Along the way, it gives off sensory and motor branches to the muscles of the gluteal region, perineum, and thigh.

In the popliteal fossa, the sciatic nerve divides into two main branches - the tibial and peroneal nerves. These nerves give off smaller branches that innervate knee-joint, lower leg, foot, and toes. Thus, this most powerful nerve has the largest area of ​​innervation.

Causes

In essence, sciatica is a sciatica that develops against the background of various structural changes in the lumbosacral spine. Among these changes:

• Displacement of the intervertebral discs - disc herniation;
• Spondylosis - the appearance of marginal bone growths, osteophytes of the vertebral bodies;
• Spondylolisthesis - displacement of the vertebrae relative to each other;
• Mechanical damage to the spine and spinal nerves;
• Some types of dysplasia (malformations) of the vertebrae.

With all these structural disorders, mechanical compression and subsequent inflammation of the roots of the lumbosacral plexus occur. These disorders may be the result of such pathological conditions as:

• Lumbar osteochondrosis (most common cause sciatica);
• Curvature of the spine - scoliosis, changes in lumbar lordosis;
• Congenital anomalies in the structure of the lumbosacral spine;
• Traumatic injuries of the spine;
• Tumors of the spine;
• Damage to the spine in various types of specific and non-specific infections (tuberculosis, syphilis, sepsis).

However, for the occurrence of sciatica, it is not at all necessary that the infection affects the spine directly. In some types of severe generalized infection, the nerves of the sacral plexus may be exposed to bacterial toxins or damaged by viruses. Therefore, sciatica can complicate the course of influenza, scarlet fever, malaria, typhoid tick-borne encephalitis.

Fortunately, many of these diseases are now rare. Sometimes inflammation of the sciatic nerve develops against the background of chronic systemic diseases or metabolic disorders (rheumatism, diabetes, gout) or intoxication (alcohol abuse, chronic poisoning with salts of heavy metals at work), as well as due to various household and professional hazards (hypothermia, drafts, vibration).

In women, the appearance of sciatica may be preceded by inflammatory diseases of the pelvic organs (endometritis, adnexitis). Sometimes sciatica is observed in pregnant women in the later stages, when, due to a large fetus, with initially weak muscles of the back and lower back, the static load on the spine increases.

From all this it follows that sciatica is not an independent disease. Rather, it is a syndrome that complicates the course of many other pathological conditions.

Symptoms

The leading symptom of inflammation of the spinal nerves is sciatica - pain along the sciatic nerve. In most cases, sciatica and associated sciatica is one-sided - the sciatic nerve becomes inflamed on one side.

Many mistakenly identify sciatica with sciatica. This is not true. Sciatica, in addition to pain, is accompanied by other sensory, motor and trophic disorders. Although for the most part, pathology declares itself precisely as pain.

Typical pain in sciatica is intense, burning, spreads from the lower back to the gluteal region, can radiate to the genitals, and then down the back of the thigh and lower leg to the plantar part of the foot.

Although the intensity of pain, as well as localization, often varies widely. The pain is aching or has the character of a lumbar backache. Sometimes the pain is limited to any one anatomical area, such as the lower back or knee.

In the latter case, it is often mistaken for knee arthritis pain. Along with pain in the zone of innervation, sensory and motor disorders develop.

Changes in sensitivity often have the character of paresthesia - sensations of coldness, burning and numbness in the corresponding skin area. Movement disorders are manifested by difficulty in bending lower limb in the knee, hip, and lameness.

For sciatica, symptoms of tension are characteristic - increased sciatica when the head is tilted forward and the lower limb is bent, when the muscles of the back and lumbar region are stretched. The muscles themselves with sciatica are tense, their tone is increased. Because of this, they increase the content of lactic acid, which exacerbates pain and local trophic disorders.

Sometimes severe sciatica is combined with cauda equina syndrome, compression of the lumbar and sacral nerve fibers in the spinal canal. This syndrome, in addition to burning pain, is manifested by deep inhibition of sensitivity and movements in the lower extremities, urinary and fecal incontinence, and in men - erectile dysfunction.

Ultimately, with advanced sciatica, the trophism of the lower limb suffers, which is manifested by a decrease in muscle volume and thinning of the skin. At the same time, the ability to move is almost completely lost.

Diagnostics

Diagnosis of sciatica is carried out on the basis of complaints and specific neurological symptoms determined during the examination. X-rays are taken to confirm the diagnosis. More information can be obtained during modern methods examinations - computer and magnetic resonance imaging.

Treatment

Therapeutic measures for sciatica are aimed at eliminating inflammation and pain, as well as expanding the range of motion in the spine and lower extremities.

Of paramount importance in sciatica is drug treatment, which is based on NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs (Diclofenac, Movalis, Ibuprofen) can be used in combination - in injections, in ointments, and in tablets.

It should be borne in mind that many of these drugs adversely affect the gastrointestinal tract, can cause bronchospasm, and slow down blood clotting. Nevertheless, these remedies perfectly eliminate neuritis and the sciatica associated with it.

If the pain is severe, then it can be eliminated through blockades with Novocain or some other local anesthetic. The analgesic effect of novocaine blockades is powerful, but short-lived. In addition, local anesthetics, eliminating pain, in no way affect its cause - a local inflammatory process.

To eliminate the accompanying muscle spasm, local muscle relaxants are used (Sirdalud, Mydocalm). Immunostimulators, vitamins have a general strengthening effect, and Pentoxifylline (Trental) improves blood circulation.

After the acute stage of sciatica is gone, and sciatica is eliminated, you can proceed to the next stage, in addition to medicines, which includes massage, recreational gymnastics and physiotherapy procedures (amplipulse, electrophoresis, magnet).

The purpose of all these methods is to strengthen the muscles, eliminate pathological muscle tension, and expand the range of motion. Massage, like physiotherapy, carried out in a gentle manner. Usually, several courses of massage and exercise therapy are carried out lasting about 10 days with the same break.