Ischias( sciatica), in Greek means sciatica nerve inflammation. This is one of the most common diseases of the peripheral nervous system, which affects, as a rule, people of working age( from 30 to 50 years).However, sad statistics say that every year the disease is getting younger, and sometimes you have to deal with 5-6 year old patients who have the symptoms of sciatica.
Sciatica is a disease in which the nerve roots of the lumbosacral spine and sciatic nerve are affected, most commonly called lumbosacral radiculitis. Due to the large length of the sciatic nerve and its close relationship with the surrounding pelvic organs, spinal column and spinal cord, it assumes the main axial load in the process of human vital activity. The sciatic nerve is considered the most important element of the lumbosacral plexus. It is he who ensures the full functioning of all the organs of the small pelvis. It should be noted that in the human body there are 2 sciatic nerve( one for each leg).
When the pain occurs after physical overstrains, as well as due to microtraumas of the lower vertebrae, transmitted infections and irritation of the meningeal nerve, a lumbago with sciatica is diagnosed. This disease has several forms. Acute form - lumbago, subacute - lumbulgia and chronic( lumboeishalgia).Most often, the main symptoms occur only in the chronic stage of the disease.
Causes of sciatica
Ishalgia, or sciatic nerve neuralgia arises from a variety of causes.
1. Lumbosacral osteochondrosis
As a rule, sciatica occurs due to the progression of lumbar osteochondrosis arising from degenerative-dystrophic changes of the intervertebral discs. The cause of this can be a violation of metabolic processes and the appearance of bone growths on the body of the vertebrae( osteophytes).This leads to a reduction in the distance between the vertebrae and compression of the sciatic nerve leading to inflammation and edema of nearby tissues.
2. Intervertebral lumbar hernia
The intervertebral disc is a kind of gasket that softens the load that the vertebrae experience. In the case of a hernia, the pulpous core of the disc protrudes because of a rupture of the fibrous ring( disk shell).As a rule, the hernia protrudes toward the vertebral canal, squeezing the spine and causing inflammation of the sciatic nerve.
3. Spine instability( spondylolisthesis)
This condition causes slipping or displacement of the vertebrae relative to each other. As a result, there is an infringement of the nerve roots of the sciatic nerve, which also leads to the development of inflammation.
4. Pear-like muscle syndrome
Pear-shaped muscle is located under the gluteus gluteus, and directly behind or through it passes the sciatic nerve. In this syndrome, the sciatic nerve is irritated by the pear-shaped muscle. The cause of this condition is most often osteochondrosis of the lumbosacral department.
5. Stenosis of the lumbar spine of the lumbar region
Stenosis is the narrowing of the spinal canal through which the spinal cord passes. As a rule, this is due to excessive formation of soft tissues, leading to increased pressure of the intervertebral discs on the nerve roots, which leads to inflammation.
6. Violation of the articular function of the sacroiliac joint
Infringement or irritation of the root of the sciatic nerve can occur due to dislocation or subluxation of the joint.
Also the cause of ishalgia can be various inflammatory processes, traumas and intoxications, tumors and infectious allergic conditions, as well as congenital anomalies of the spine, etc.
Symptoms of sciatica
The most important symptom of sciatica is one-sided paroxysmal pain in the loin of shooting or burning nature,in the buttock and in the leg.
Sometimes, there may be a sensitivity disorder along the sciatic nerve. Emerging in the lumbar region, the pain spreads along the descending path. In this case, there is a feeling of numbness, tingling, burning, and also there is a muscle weakness in the groin, legs or toes. Sometimes there is no pain in the lower back, but all other symptoms are available. In states that proceed according to the type of lumbosacral radiculitis, painful sensations are present only in the upper part of the leg above the knee.
Sciatica, among other things, affects the work of muscles. This is due to the fact that the innervation of the muscles of the lower limb occurs at the expense of the sciatic nerve. As a consequence, muscle weakness develops, as well as paralysis and paresis( if the spine is damaged).
Another of the most characteristic symptoms is the forced position of the patient's body. In this case, the spine is bent forward and on the sore side because of the protective tension of the muscles of the affected area. Also, a person is forced to occupy certain poses when sitting, in a lying position and when lifting.
Neuralgia of the sciatic nerve has a paroxysmal character. Factors provoking the onset of an attack may be hypothermia, emotional stress, as well as any sudden movements( laughter, coughing, sneezing, etc.).
Most often, pain sensations appear only in one leg. However, in the case of the development of bilateral sciatica, both extremities are involved in the process, bringing severe suffering and pain to a person.
Because the sciatic nerve is directly related to the operation of the pelvic organs, in severe cases, the patients have various sexual disorders, and also incontinence of urine and urine, etc.
Diagnosis and treatment of
Before the appointment of a qualified treatment, it is necessarycorrectly establish the diagnosis of the disease.
After a preliminary examination, an X-ray examination, as well as CT and MRI, is prescribed. In the event that there is a suspicion of a tumor in the region of the spine, a radioisotope study is performed.
With symptomatic therapy aimed at relieving severe pain, non-steroidal anti-inflammatory drugs( NSAIDs) are used. These include indomethacin, ibuprofen, nais, etc. The modern pharmacological industry produces a number of long-acting drugs that are taken once a day. It should be noted that the reception of such drugs should be done under the supervision of a specialist, since their uncontrolled use can lead to stomach diseases and even to the appearance of ulcers.
With prolonged non-relieving pain during sciatica, corticosteroids are prescribed( hormonal drugs that relieve edema and inflammation, and reduce pain syndrome).
Physiotherapeutic procedures are well proven in the treatment of sciatic nerve neuralgia. In this state, electrophoresis with medicinal preparations, thermal procedures with the use of paraffin, mud and ozocerite, and UHF are prescribed. It should be noted that all physical procedures can be performed only after a complete examination, in order to avoid the occurrence of complications.
Further treatment depends on the cause that caused the isalgia. In the inflammatory process, anti-inflammatory drugs are prescribed, in case of an intervertebral hernia, spinal traction or surgical treatment is recommended.
- Diagnosis and treatment
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