Sciatica - causes, symptoms, treatment. Sciatica (inflammation) of the sciatic nerve - drug treatment What is sciatica?

There are no insignificant symptoms in medicine.

Even a little pain is already a signal to action for the doctor. At the same time, patients often ignore severe attacks of pain and self-medicate.

One such case is sciatica, an inflammation of the sciatic nerve. The disease affects patients over 30 years of age and requires mandatory professional examination and treatment.

There are many questions: what is sciatica, how dangerous is it for the patient, how to treat inflammation of the sciatic nerve and why this cannot be done without consulting a specialist - everyone who experiences neurological pain at rest or movement needs to know all this.

Inflammation of large nerves and their branches is called neuralgia. When we talk about the largest and most important nerve - the sciatic - a pain syndrome called lumbosacral radiculitis, or sciatica, is also mentioned.

Signs of sciatica are, first of all, pain of a certain nature and impaired mobility of the lower extremities.

NOTE! Sciatica is inflammation of the sciatic nerve. Signs of inflammation include pain and neurological symptoms. Treatment of sciatica should be entrusted to an experienced neurologist.

The human nervous system is unique. In it, the functions of consciousness and life support are divided between parts of the central nervous system - the brain and spinal cord.

The brain, protected on all sides by the cranium, is responsible for higher functions and regulation of the life of the body. And the spinal cord is responsible for maintaining vital functions: movement, reflexes, automatisms.

Sciatica: symptoms and treatment

With all the variety of symptoms of the disease, treatment for sciatica of the sciatic nerve consists of eliminating pinching, relieving inflammation, restoring nervous tissue and normal innervation of muscles and organs.

The nerves that leave the spinal cord and carry signals from the muscles and organs to it are responsible for helping a person stand, sit, breathe, and walk.

Injuries may result in loss of sensation and movement in parts of the body, depending on the location of the injury.

The sciatic nerve lies in the lower part of the body, and therefore most of the symptoms of its inflammation are associated with the legs and lower torso:

• Pain during inflammation of the sciatic nerve is usually characterized by patients as acute, occurring sharply and intensely, sometimes burning, shooting. The sensations are usually not symmetrical on the right and left; patients notice them in the gluteal region, on the back of the thigh. Severe sciatic neuralgia can even manifest as pain in the popliteal fossa and lower leg and down to the toes. not always;

How to relieve pain? Try not to drown out the pain with handfuls of pills. Be sure to tell your doctor what medications and in what dosages you took without prescription!

• Neurological disorders are universal manifestations of sciatica. The patient may suffer from impaired sensitivity of the skin on the legs, take a forced position for sleeping or working. Sciatica may result in incoordination when walking due to loss of mobility and sensation in the joints of the legs. Violation of reflexes and autonomic functions can even lead to death if the disease drags on for a long time;
• Profound consequences. With prolonged restriction of normal innervation of muscles, they begin to atrophy - decrease in size. A forced posture in a patient can lead to osteoporosis and bone curvature. It can also occur due to paralysis. Over time, the skin of the legs loses its normal color, becomes thinner, and dries out. Even your toenails can suffer from lack of nutrition.

Sciatica: what is it? Sciatica is a disease of older people. The disease has several names: lumbosacral radiculitis, sciatica, sciatic neuralgia, sciatica neuralgia and sciatica.

In any case, we are talking about inflammation of the nervous tissue of the sciatic nerve and accompanying symptoms in people over 30 years of age.

A nerve is a bundle of filaments consisting of different types of nerve cells. In addition to the nervous tissue itself, it needs a blood supply network and a shock-absorbing membrane that protects it from external influences.

In fact, considerable effort must be made to make the sciatic nerve vulnerable. Usually, the first signs of neuralgia are simply ignored or attributed to other diseases.

With sciatica, the entire nerve body is excited, and therefore the pain spreads to all organs and tissues along the path of the sciatic nerve tract. It itself originates in the sacral nerve plexus.

It is located at the level of the lumbar spine. The vertebrae there are large, strong, but movably connected to each other.

Between any movable vertebrae there is a spinal disc, which, with certain disorders, can completely or partially collapse, which leads to inflammation and pain.

And given that the spine in the lumbar region endures enormous loads, it is not difficult to understand why inflammation and pain most often occur at the level of this region.

Sciatica: treatment

Knowing the anatomical basis of the disease, the doctor correlates it with the symptoms described by the patient and prescribes sciatica treatment that meets two principles: individuality and maximum effectiveness.

Before treating sciatica, it is worth understanding the reasons for its manifestation in a particular patient. By eliminating the effects of these causes in the future, you can provide the patient with a healthy and happy life without pain.

Inflammation of the sciatic nerve: causes

Degenerative processes in the vertebral discs develop and lead to pinching of the spinal nerve roots. When the sciatic nerve is pinched, the patient experiences extremely unpleasant symptoms of sciatica.

The disease manifests itself under the influence of both external and internal causes. For example, pay attention to the following causes of sciatica:

• Hernias. The hernial protrusion puts pressure on the spinal nerve roots in the lower back, thereby disrupting electrical conductivity and blood supply to the nerve tissue. Soon, inflammation occurs at the site of compression, accompanied by pain. Successful treatment of sciatica will be associated with;
• Infections. Whether the causative agent of the disease is a bacterium, a virus or a protozoan, if this pathogen produces toxins, the nervous system will definitely react to them. In this group we should mention influenza, tuberculosis, typhoid, sepsis, syphilis, malaria and scarlet fever. Most often, the infection becomes active during hypothermia and decreased immunity.
• Intoxication of a different origin can also trigger the development of nervous inflammation. Toxins of an internal nature enter the bloodstream during gout and diabetes, and from the outside they come from alcohol and drug abuse or chemical poisoning (arsenic, mercury, lead). To cure sciatica, you will first have to cleanse the blood;
• The growth of bone tissue beyond the natural contours in osteochondrosis and spondylosis creates pressure on the cord of the sciatic nerve, just like a hernia. A similar process occurs with . The hip nerve can become inflamed within a few hours, and sometimes does not make itself felt for several months.

A competent consultation with a doctor and a complex of modern research will help to reliably determine the cause of pain and its source. High-quality professional diagnostics has been and remains a determining factor in therapeutic success in medicine.

Methods that will have to be used in diagnosis. Determined by your doctor depending on the severity of your symptoms.

The average inflammation of the sciatic nerve, the symptoms and treatment of which we are considering, does not require complex diagnostics, but a visit to a general practitioner and a visit to a neurologist are necessary steps.

How to quickly cure neuralgia? Visit a doctor, undergo an examination, confirm the diagnosis and strictly follow all instructions during the period of treatment and rehabilitation.

The local therapist does not make decisions on the method of treating neurological diseases, so the patient is redirected to a more specialized specialist - a neurologist (for complicated inflammations - to an orthopedist, surgeon and other doctors).

The neurologist performs a series of tests to confirm the diagnosis:

• Testing the Achilles reflex. When the tendon is struck, contraction of the calf muscle does not occur or is noticeably weakened. This indicates a malfunction in the activity of the nerve pathways;
• Intensity of the knee reflex. A hernia between the 3rd and 4th lumbar vertebrae most often leads to a decrease or disappearance of the knee reflex;
• Is there a plantar reflex? If the patient does not flex his toes and foot during the test, then the neurologist can give another plus in favor of sciatica;
• Lying on your back, lift your straight leg up. Patients with sciatica experience pain in the hip and lower back.

This is the minimum required desk inspection. Next, the doctor may prescribe one of the hardware tests:

• X-ray will reveal pathologies of the bone and cartilage tissue of the spine, which means it will be able to indicate the source of sciatica in all cases, except pregnancy and obesity;
• CT - computed tomography allows you to study in detail the condition of each vertebra in the area under study, but soft tissues are not always visible;
• Electroneuromyogram is a specialized study that allows one to evaluate the conductivity of nervous tissue in a particular area of ​​the patient’s body;
• MRI – magnetic resonance imaging is a more informative and reliable method. Doctors will be able to examine all areas of interest in the nerve and spinal cord in relation to the condition of the bone tissue.

Based on the combination of symptoms and research results, doctors made a final diagnosis: inflammation of the sciatic nerve. Treatment is carried out in several directions simultaneously.

A professional doctor prescribes a whole range of therapeutic measures:

• Taking medications and injections (non-steroidal anti-inflammatory drugs, analgesics, vitamin supplements, ointments and creams, blockades);
• Physiotherapy and massage (electrophoresis, ultrasound, laser, magnetic therapy, acupuncture, massage of the lumbosacral region and below, including the limbs);
• Reflexology and therapeutic exercises (only outside the period of exacerbation!).

As auxiliary treatment methods, herbal medicine and homeopathy, specific procedures, yoga, psychotherapy, etc. are used. You should consult your doctor about the admissibility of using each of the non-medical methods.

Question from patients: how long does it take to treat sciatica? – You will have to take medications and perform procedures for 4 weeks or longer.

If treatment is incorrectly selected or recommendations are not followed, neuralgia is treated slowly. The pain on the outside of the reed, sometimes radiating into the pelvis, then disappears and then returns.

This is especially familiar to patients who are treated according to their own understanding and “advice from a neighbor”: taking analgesics gradually loses their effectiveness, and gymnastics also does not bring relief.

“I always heal on my own!” – young patients exclaim. - “Why run to doctors at 30 years old!?” And in order not to start the development of the disease.

Nerve inflammation (neuritis) of an infectious or toxic nature can spread to other parts of the nervous system.

In this case, the patient is taken by surprise, not knowing what to do. Therefore, doctors strongly recommend contacting medical institutions at the first signs of ill health.

BY THE WAY! Sciatica is rarely treated surgically. But some patients manage to bring themselves to the point of needing such intervention.

Morning exercises are useful for everyone: both those recovering and those who are healthy. Moderate physical activity, and even more so a set of exercises, provides the spine with a sufficient number of multidirectional movements.

The effect is obvious: there is no stagnation in the muscles, no curvature of posture, no pinching or hernias.

In the evening after work, there is no better way to prevent neuralgia and scoliosis than a comfortable orthopedic pillow and a high-quality mattress.

Sciatica is an inflammatory disease. Otherwise - neuralgia of the sciatic nerve, which is expressed in acute pain. Unpleasant sensations are localized in the lower extremities (buttock, thigh, lower leg on one or both sides). The disease is typical for people over 30 years of age.

A neurologist knows better than anyone how to cure sciatica. In complicated cases, an orthopedist, surgeon, osteopath and even a psychotherapist are involved in treatment. Self-medication for sciatic neuralgia is dangerous due to the development of spinal cord pathologies and loss of mobility in the lower part of the body.

After receiving a diagnosis, patients ask: what is sciatica? It's just that some doctors, instead of the general term inflammation of the sciatic nerve, use a shorter and clearer one - sciatica. A small number of people know what inflammation of the sciatic nerve is, and even more so the symptoms and treatment of sciatica. The human body is a very complex mechanism, consisting of tissues and numerous nerve networks. The longest is the sciatic nerve. It is formed from five pairs of spinal roots. If one of them is pinched, the symptoms begin almost immediately. This pinching is called sciatica.

The sciatic nerve is quite long, formed in the iliosacral plexus and passes down along the femoral area. In the popliteal fossa it divides, one part goes into the lower leg, the other into the foot. Pain due to inflammation of the sciatic nerve cannot be ignored. Some inexperienced specialists in some cases confuse this disease with osteochondrosis. Most often this happens when the patient cannot accurately describe his pain sensations and show the exact location of the lesion. The main difference between inflammation of the sciatic nerve and osteochondrosis is the localization of pain. In the first case, it can manifest itself only on one side of the body, in the second case, the pain is girdling.

Causes of inflammation

As noted above, signs of inflammation of the sciatic nerve appear quite sharply and are very difficult to tolerate. There are many reasons for their appearance:

• Complications that arose due to incorrect treatment of osteochondrosis;
• Formations of different sizes in the area of ​​intervertebral discs;
• Fresh or old mechanical injuries of the spine;
• Complication after severe hypothermia.
• The sciatic nerve can become inflamed even after short-term overheating;
• Arthritis;
• Infections of various origins in the pelvic cavity;
• Abscesses;
• Thrombosis.

Sciatica, the cause of which is an infectious disease, can be an indirect “culprit” of poisoning of the entire human body. If the patient’s immunity is reduced, then additional treatment will be needed to overcome pathogens. With sciatica, the piriformis muscle may become inflamed. Such cases are rare and difficult to identify. There is a separate medical term: piriformis syndrome. The pain is localized in the gluteal region, lower leg and upper thigh, and groin. The signs of sciatica in piriformis syndrome resemble.

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Neuralgia of the sciatic nerve can also occur with spondylolisthesis - displacement of the vertebrae. This disease can be congenital or acquired. The sciatic nerve also becomes inflamed due to the progression of the spinal cord tumor. This is quite a rare occurrence. Also, inflammation of the sciatic nerve, the main causes of which cannot be identified for a long time, often leads to serious complications, including the development of oncology and disability.

The symptoms of sciatica can vary greatly. It all depends on the severity of the disease, the general condition of the body, the area of ​​tissue damage and nerve muscles. The main clinical symptom is severe pain.

Nerve endings are found throughout the body and have a large number of receptors that are very sensitive to any impact or damage. That is why, when pinched, the patient experiences almost unbearable pain.

The pain is felt in the gluteal area and spreads throughout the leg, sometimes reaching the toes. In such cases, the attending doctor recommends limiting physical activity as much as possible. At rest, the pain subsides and is rather aching in nature. If an individual decides to take a walk, even slightly strains the sore muscles when bending forward or to the side, or coughs, then the pain syndrome intensifies, and shooting pains are possible. Symptoms of sciatica also manifest themselves in the phenomenon of numbness in the legs.

Patients with chronic back diseases know exactly the concept of sciatica and what it is. It is this category of citizens who often complain of periodic paralysis of the lower extremities.

Only a doctor can make an accurate diagnosis. To do this, he must know the exact clinical picture of the disease, its signs, and ask the patient in detail about his condition. How to treat inflammation of the sciatic nerve tells a neurologist. Only special equipment will help determine the exact location of inflammation of the sciatic nerve and the severity of the damage:

• X-ray. The patient receives a referral for x-rays in the first place. With its help, you can accurately determine all the disorders that have formed in the spine, and it is also good to view possible changes;
• Computer tomography. It is recommended when standard X-ray is unable to detect abnormalities. The device scans all affected tissues layer by layer, looking for the main foci of inflammation;
• Magnetic resonance tomography;
• Ultrasound research. When using “it,” the doctor can examine in detail the condition of joints, tendons, cartilage, and ligaments. Study them to identify neoplasms that can become a direct cause of inflammation.

It should be noted that it is after the ultrasound procedure for sciatica, the symptoms of which are quite vague and easily recognized, that the doctor receives accurate information about the location of the disease and its severity. The advantages of this procedure: safety for the body, no radiation exposure; has no contraindications; able to "examine" even the smallest vessels and fibers.

Treatment methods

Inflammation of the sciatic nerve and its treatment are prescribed only by the attending doctor and are selected strictly individually. Therefore, it is impossible to say exactly how long a particular case of the disease will take to be treated. Treatment depends on the general picture of the disease, severity, health status of the patient, and age. In most cases, complex therapy is used.

Medicines

Treatment of sciatica begins with pain relief, a powerful effect on the main foci of inflammation with the help of medicinal medications. In this case, ortofen, diclofenac, and rheumoxicam, which have been proven over the years, are prescribed. They have a good anti-inflammatory effect, successfully anesthetize. To quickly deliver the drug into the body, medications are administered intramuscularly or intravenously. Chondroprotectors will help cure the disease, relieve inflammation, and restore damaged tissues.

Physiotherapy

For sciatica, which was initially treated with medications and yielded positive results, the following stage of sciatica treatment is allowed: . Most often this is a course of electrophoresis or magnetic therapy. If the doctor sees improvement, additional physical therapy is prescribed. The set of exercises for each patient is individual and specific. The program development specialist takes into account the causes of the disease, severity, level of physical fitness of the patient, and age characteristics.

At home

It is allowed if home therapy is carried out in the form of prevention. The patient is discharged from the medical institution if the main foci of the affected tissue are restored and the pain is practically not bothered. Drug exposure can already be significantly reduced. When diagnosed with sciatica, acute inflammation of the sciatic nerve, most individuals actively use healing recipes of traditional medicine. This is allowed, but on the condition that the patient tells the attending physician in detail about this and he gives his recommendations on how to cure the disease to the end.

We list the most well-known components of home treatment:

• Honey. Treatment of sciatica is rarely complete without a healing honey massage. You can carry out the procedure yourself or ask your loved ones for help. For sciatica, the treatment of which is quite complex, it “requires” that the product be natural and liquid. You will need 250-300 g, heat it up and add 40-50 g of alcohol infusion. Cool the liquid and use as directed. But it is worth remembering that massage of the lumbar region should not be painful, as it can injure muscles or joints.
• Beeswax. Warming applications are made with propolis. They warm up well and relieve pain.
• Balm infused with herbs. For sciatica, for cooking you can take celandine, hot pepper, aloe in equal proportions, about a large spoon. Stir and dilute the mass with vodka, 200-250 g. What to do next: leave in a dark place for 7-8 days. We treat the pain localization every day, the course is no more than 7-10 days.
• Agave leaves. We apply it to the affected areas, wrap it tightly, and cover it with a scarf or scarf on top.
• Ledum infusion. Pour 2 large spoons with 5 identical tablespoons of pure vegetable oil. Leave the resulting mixture for 12-14 hours and use as directed, that is, rub the affected areas.
• Healing baths with the addition of pine tincture. Pour boiling water over fresh pine needles and simmer over low heat for half an hour. Take a bath with pine tincture for no more than 15 minutes.
• Hirudotherapy (treatment with leeches). Sciatica is a disease that provokes an inflammatory process in the body. Modern medicine has proven that leeches can relieve inflammation after just one session.

It is worth remembering that no matter how much one or another folk treatment method is praised and told how to treat sciatica quickly and without consequences in this way, folk therapy may have its contraindications. In particular, an allergic reaction may occur.

Medical nutrition

In case of inflammation of the sciatic nerve, symptoms and treatment, the doctor must draw up an individual nutrition plan. Treating sciatica requires making significant changes to your diet. It is better to eat little by little, 5-6 times a day. The diet must contain foods containing fiber, calcium, magnesium, iron, vitamins A, C, E.

To saturate the body with calcium, you need to eat: fish, nuts, seafood, cauliflower, nuts, liver.

Magnesium is found in avocados, peas, beans, and pistachios. Iron is found in lentils, peas, corn, and wheat. Vitamin A is found in broccoli, garlic, and cottage cheese. Vitamin C is found in kiwi, sea buckthorn, black currant, orange, and lemon. Vitamin D: liver, sour cream, chicken egg, butter. It will be necessary to remove or significantly limit smoked foods, sweets, salty and fatty foods from the diet. It is this category of food that contributes to excess weight gain, which is extremely undesirable for sciatica.

Prevention

Cure inflammation of the sciatic nerve is only half the success. To prevent the disease from progressing and the pain to no longer appear, it is necessary to follow the general rules of prevention. With the right approach and a great desire to be healthy, this is not at all difficult:

• Keep your back straight (posture);
• Try to avoid mechanical damage and falls;
• Keep your weight under control;
• Do not overheat or overcool;
• Prevent the development of infectious diseases.

The question of how to quickly cure sciatica definitely cannot be answered by any doctor. The disease progresses individually and may have completely different signs and symptoms. Therefore, treatment may take some time.

Your feedback on the article

The disease sciatica, the symptoms and treatment of which is determined by the doctor after differential diagnosis, is a pathology of a neurological nature. The sciatic nerve is affected, and pain symptoms occur. Its localization depends on the area of ​​inflammation. Sciatica, what it is and how to get rid of it will be discussed further. How long the disease is treated depends on the stage of its progression.

The disease often occurs with pronounced symptoms. What sciatica is is of interest to many people who have faced a similar diagnosis. This pathology develops in one of the sections of the sciatic nerve. A characteristic inflammatory process appears.

Sciatica disease occurs due to a number of provoking factors. Pathology can occur at almost any age. The causes of sciatica can be different. It is not an independent disease, but often becomes a consequence of other pathologies.

Sciatica, the causes of which may lie in degenerative processes in the spine, is manifested by pain of varying intensity. Main factors:

• osteochondrosis;
• intervertebral hernia;
• tumors;
• pinching;
• injuries;
• curvature of the spine.

Secondary factors for such symptoms may be inflammatory diseases of the uterus and appendages. Sciatica during pregnancy often occurs when there is significant pressure on the spine, which develops as a result of increased weight of the fetus.

Sciatic neuralgia can appear as a result of persistent tension in the lumbar region. This occurs for various reasons. One of them is long-term physical activity, the basis of which falls on the sacral area. Lifting heavy weights can also trigger a similar syndrome. Everything is explained by the special vulnerability of the lumbosacral zone.

The fact is that, unlike the thoracic region, which is also protected by the rib frame, the lower back experiences the greatest load, and does not have any support from other joints.

Neuralgia of the sciatic nerve is not difficult to diagnose. It is very easy to determine, and this manipulation is not difficult for an experienced specialist.

Symptoms of the disease

Sciatica has different symptoms, the main ones being pain in the sciatic nerve. Discomfort originates from the lumbar region. Then it smoothly moves to the gluteal area, from there to the thigh, calf and foot. Sciatica is accompanied by burning, stabbing and shooting pain that can last for a long time.

Factors that can trigger an exacerbation of symptoms are the following:

• hypothermia;
• excessive physical stress on the lower back;
• abrupt awkward movements;
• stretching;
• psycho-emotional shocks;
• constipation

With sciatica, pain can spread throughout the entire leg or be present only in a certain area. Many people are interested in how long an attack usually lasts. It all depends on the start of treatment and the stage of the underlying disease.

The attending physician also determines the signs of sciatica by the numbness that occurs in the lower extremities. Discomfortable sensations often appear with various movements of the leg, bending the knee. There is a feeling of tension, the duration of which depends on the time spent in the uncomfortable position.

Sciatica disease cannot go away on its own. A long-term pathological process often provokes the occurrence of lameness. The symptoms of sciatica are supplemented by some atrophy of the muscles of the causative limb. Timely consultation with a doctor is very important in this pathological process. The sooner it is carried out, the better the treatment prognosis will be.

If you go through this syndrome for a sufficient amount of time and the pathology starts, extremely unpleasant symptoms arise in the form of urinary and fecal incontinence. Quite often, such a disease affects one limb. Although there are cases of bilateral lesions that bring terrible discomfort.

The presence of such a disease requires the following types of diagnosis:

• interviewing the patient;
• X-ray of the spine;
• Magnetic resonance imaging.

As a rule, a disease can be identified from the patient’s words. In this case, a simple test is carried out, which consists of tilting the body towards straight legs. If such manipulation is difficult for the patient and causes significant pain, then a diagnosis can be made. Additional research methods are used to identify the cause of the disease that caused similar symptoms.

Often pain in the leg is accompanied by similar sensations in the spine, especially in the lumbar region.

Therapeutic measures

Treatment of sciatic neuralgia consists of a set of measures that allow:

• eliminate pain;
• release pinched nerve endings;
• relieve the inflammatory process;
• improve motor activity;
• strengthen weakened muscles.

Only a doctor can tell you how to cure sciatica. Main methods of therapeutic intervention:

1. Drug treatment. Aimed at eliminating pain, improving motor activity of the spine and eliminating degenerative processes. Non-steroidal anti-inflammatory drugs are often used for treatment: Diclofenac, Ibuprofen, Indomethacin. Such remedies help relieve swelling and pain. Novocaine and Lidocaine are often used for local blockade. Treatment of sciatica to improve the condition of nerve fibers and metabolism in them involves taking vitamin complexes.
2. Physiotherapy and massage. Treatment of sciatica involves various types of stimulation: UHF, phonophoresis, paraffin therapy. These procedures allow you to relieve inflammation by gently affecting the nerve fibers. Physiotherapy and massage are contraindicated during pregnancy, high blood pressure, tuberculosis and malignant tumors.
3. Physiotherapy. Treatment of sciatica involves performing a set of physical exercises that help relieve pain, strengthen muscles and improve the mobility of the affected leg. With regular repetition of the complex, improvement occurs quite quickly.

Many people wonder how to treat sciatica if the cause is osteochondrosis. The answer is clear. First of all, you need to see a doctor who will prescribe manual therapy, as well as chondoprotectors that can stop the destructive process in the intervertebral discs.

Sciatica treatment involves comprehensive treatment. Acupuncture is often used, which stimulates metabolic processes in nerve fibers and relieves pain.

Most people are interested in how to quickly cure a disease and whether it is possible. Unfortunately, a protracted pathological process is eliminated over several months, or even longer. In the initial stages, things are much simpler.

Which doctor should I contact when the first signs appear? It is advisable to visit several specialists at once: a surgeon and a neurologist.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Sciatica is a syndrome manifested by severe pain in the areas where the sciatic nerve passes. The syndrome is caused by compression of the spinal cord roots in the lumbar region or parts of the nerve itself. Since there can be many reasons for compression of the roots of the spinal cord and nerve, the manifestations of the syndrome, in addition to pain along the sciatic nerve, can also be very diverse and polymorphic.

Currently, the term "sciatica" is used only to designate the syndrome, and the disease manifested by its development is called lumbosacral radiculitis. Also, to designate variants of sciatica caused by different causes, the terms radiculopathy, radiculoischemia and radiculomyeloischemia can be used.

Sciatica (sciatic nerve sciatica)

Since the term “sciatica” itself is translated from Greek as “inflammation of the sciatic nerve,” the names “sciatic sciatica” and “sciatic nerve sciatica” are an example of excessive specification - that is, what is called “butter oil” in everyday speech. Therefore, such “common”, “expanded” terms are incorrect. After all, when they talk about sciatica, they always mean that the problem is in the sciatic nerve, since the very name of the pathology already contains an indication of this particular nerve.

Which nerve is affected in sciatica?

With sciatica, non-inflammatory damage (compression) occurs to the sciatic nerve, which is the largest and longest in the human body, since it starts from the sacral nerve plexus and passes through the soft tissues to the very feet.

Essence and brief characteristics of the disease

Sciatica is a non-inflammatory lesion of the sciatic nerve that occurs as a result of its compression in any area. Accordingly, the causes of sciatica can be any factors that lead to compression of the tissue areas through which the sciatic nerve passes, such as, for example, injuries to the legs, pelvis, lumbar or sacral spine, compression of the nerve during prolonged immobility, pinching by fibrous cords , tumors, hematomas, etc. Most often, sciatica develops in people aged 40–60 years, which is due to pathological changes accumulated in the body, which can cause compression of the sciatic nerve.

To clearly understand and imagine what causes the clinical manifestations of sciatica, you need to know how and where the sciatic nerve passes. This nerve originates in the sacral nerve plexus, which is located in the sacrum, next to the vertebrae. The nerve plexus is formed by the roots of the spinal cord, which are not inside the spinal canal formed by the vertebrae standing on top of each other, but outside. That is, these roots are located on the sides of each vertebra and are very closely approximated to each other, as a result of which the area of ​​​​their localization was called the sacral nerve plexus.

From this sacral nerve plexus, a large sciatic nerve departs, which then exits the pelvic cavity to the posterior surface of the buttock, from where it descends along the posterior surface of the thigh to the very lower leg. In the upper part of the lower leg, the sciatic nerve divides into two large branches, the peroneal and tibial, which run along the right and left edges of the posterior surface of the lower leg (see Figure 1). The sciatic nerve is a paired organ, that is, it is present on the right and left. Accordingly, two sciatic nerves depart from the sacral nerve plexus - for the right and left legs.

Picture 1– Schematic representation of the sciatic nerve on the right.

With sciatica, as a rule, only one of the two nerves is affected, as a result of which the symptoms affect only the right or left limb.

The main symptom of sciatica is a strong and sharp pain that occurs on any part of the leg or buttock along the nerve. In addition, along the course of the affected nerve, paresthesia (numbness and a “pins and needles” sensation) and weakness appear on the posterior surface of the corresponding limb and foot. Paresthesia, numbness and weakness can persist for years, gradually progressing.

Upon examination with sciatica, pain is detected on the back surface of the leg from the side of the affected nerve, as well as neurological symptoms, such as decreased reflexes of the knee, Achilles tendon, Lasegue symptoms, etc. In about a third of cases, a person has increased sensitivity of the outer edge of the foot, in half of the cases - weakness muscles of the leg and foot. When trying to internally rotate a leg bent at the hip and knee, a sharp pain is detected in the buttock.

For diagnostics sciatica, an X-ray examination and magnetic resonance imaging of the lumbar spine are performed to determine at what level the spinal cord roots are pinched, as well as what caused their compression (tumor, hematoma, herniated disc, etc.).

For treatment For sciatica, various medications are used from the groups of antioxidants, metabolites, minerals and vitamins, agents that improve blood circulation and microcirculation, muscle relaxants and NSAIDs. In addition, as part of complex therapy, in addition to drug treatment, massage, physiotherapy, post-isometric relaxation, novocaine or hydrocortisone blockades are used. All means and methods of treating sciatica are aimed at eliminating compression of the spinal cord roots, as well as at relieving the painful manifestations of the syndrome for humans, such as pain, numbness and weakness of the limbs.

Causes of the disease

The causes of sciatica can be any condition or disease that compresses the roots of the spinal cord at the level of the lumbar spine or certain areas of the sciatic nerve. Such possible causative factors of sciatica include the following diseases and conditions:

1. Herniated disc in the lumbar spine (the herniated protrusion compresses the roots of the spinal cord, where the sciatic nerve originates, and thereby causes sciatica).

2. Infectious diseases (the sciatic nerve is affected by toxins secreted by pathogens):

• Sepsis (blood poisoning);
• Typhoid or typhus;

3. Intoxication with various toxic substances, such as:

• Alcohol (sciatica can occur due to chronic alcoholism or after one-time consumption of a large number of low-quality drinks);
• Heavy metal poisoning (mercury, lead);
• Arsenic poisoning.

4. Chronic systemic diseases in which unresolved toxic metabolic products are deposited in tissues:
5. Episodes of severe hypothermia of the body (as a rule, cooling contributes to the activation of a chronic infection, which, in fact, provokes sciatica).

Surgical treatment with sciatica, it is extremely rare - only in cases where the syndrome is provoked by tumors of the spine or herniated disc, which infringes on the spinal cord or spinal cord roots. In this case, after pain relief, a planned operation is performed, after which the disease is completely cured, since its cause is eliminated. Also, surgical treatment of sciatica is performed in cases where, due to a malfunction of the sciatic nerve, a person suffers from severe disorders of urination and defecation (for example, urinary or fecal incontinence).

Sciatica Treatments

For complex symptomatic, etiological and maintenance therapy of sciatica, the following agents are currently used:

• Medications(used to relieve pain, normalize microcirculation, sensitivity and mobility of the limb).
• Massage and manual therapy (used to relieve pain, relax and normalize muscle tone, as well as to restore the correct position of the vertebrae, as a result of which it is possible to achieve long-term remissions or even completely cure sciatica).
• Physiotherapy(used to improve microcirculation, conduct nerve impulses, restore sensitivity and strength of muscle contractions and, accordingly, limb mobility).
• Acupuncture (acupuncture) is used to relieve pain, improve microcirculation and nourish both the tissues of the affected limb and the strangulated roots of the spinal cord. By improving nutrition, the condition of the roots of the spinal cord and leg tissues improves, and as a result, the functions of the sciatic nerve are restored up to normal.
• Physiotherapy– used during periods of remission to relax the muscles in the spine and improve blood supply to the spinal cord, its roots and the sacral nerve plexus.
• Apitherapy (treatment with bee stings) is used to relieve pain and relax muscles in order to eliminate pressure on the sciatic nerve.
• Hirudotherapy (treatment with leeches) is used to relieve swelling in the area of ​​a pinched nerve, as a result of which the volume of tissue decreases, the nerve is released from the clamp and begins to function normally.
• Sanatorium treatment (use of therapeutic mud, baths, etc.).

Drug treatment of sciatica

The following groups of drugs are used in the treatment of sciatica:

Massage

It is used during periods of remission and allows to improve blood flow to tissues and nerves, eliminate swelling and stagnation of lymph, relieve high muscle tone and relieve pain. For sciatica, massage is used in the lumbar and gluteal areas, as well as the back surfaces of the thigh, lower leg and foot. To obtain a good and lasting effect, it is necessary to conduct approximately 10 massage sessions lasting 30 - 35 minutes. It is recommended to combine massage with the application of ointments and therapeutic exercises.

Exercises (gymnastics)

It is recommended to perform therapeutic gymnastic exercises during the period of remission in order to prevent attacks of sciatica in the future.

So, gymnastics for sciatica includes performing the following exercises:

1. From a lying position on your back, pull your legs bent at the knees to your chest. Do 10 repetitions.

2. From a lying position on your back, lift your straight legs up, fix them in this position for a few seconds, and then lower them to the floor. Do 5 repetitions.

3. From a position lying on your stomach, raise the body on your hands, placed with your palms under your shoulder. Do 5 repetitions.

4. From a sitting position on a chair, turn your body alternately to the right and left. Perform 5 turns in each direction.

5. From a sitting position on your knees, bend over with your arms raised above your head. Do 5 repetitions.

6. From a standing position with feet shoulder-width apart, tilt the body to the right and left. Perform 5 bends in each direction.

All exercises should be performed slowly and carefully, avoiding sudden movements.

Sciatica: gymnastics (recommendations from a specialist in physical therapy) - video

Sciatica: therapeutic exercises - video

Treatment of sciatica at home

At home, for the treatment of sciatica, you can only take medications. In principle, this, as a rule, is enough to relieve pain and achieve remission, but the lack of complex treatment, including massage and physiotherapy, leads to the fact that sciatica attacks recur episodically.

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, sudden movements, weight lifting.

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 that tightly pinches the nerve. If left untreated, reflexes, sensitivity, and movement may be impaired. In children, symptoms are mild and develop gradually.

Treatment

If the sciatic nerve is pinched, physical activity must be avoided. Treatment for sciatica, inflammation of the sciatic nerve, involves bed rest and drug treatment in combination with other types, including folk remedies. It is possible to prescribe spa treatment and treat sciatica at home. The treatment of inflammation of the sciatic nerve itself is discussed with the attending physician and is possible only if all his requirements are met.

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

Sciatica – drug treatment

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

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

Medical treatment of the sciatic nerve includes the use of steroidal anti-inflammatory drugs. They are chosen even when non-steroidal drugs do not provide the desired effect. The dosage form of the drugs can be any: suppository, capsule, tablet. Depending on the patient’s overall tolerance to a particular medicinal substance, a course of treatment is selected that will provide maximum effect.

Ointment

It is mainly used in the lumbar region. Ointment for sciatica is good for pain relief and inflammation because it acts locally and does not have negative effects on 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 their mode of action:

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

Injections

Steroidal anti-inflammatory medications are used for this purpose. 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, and have few side effects. Treatment with injections minimizes the risk of intoxication or poisoning of the body. This medicine acts much faster than others at the site of inflammation. Sciatica - the symptoms and treatment of this disease should only be determined by a doctor based on all examinations.

Painkillers

Painful attacks due to sciatica can be very severe and constantly disturb (the pain makes it impossible to sleep). All tablets must be prescribed by a doctor after conducting appropriate examinations. Only he can prescribe the correct medication, dosage, and duration of treatment. Painkillers for sciatica due to 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 treating sciatica, but absolute caution must be used in movements. Therapeutic exercises for sciatica are useful, effective and prevent blood stagnation. There are several types of therapeutic exercises, including standing and lying exercises. To perform them, no special training or readiness for intense physical activity is required:

1. Lying exercises. Performed by bending the legs at the knees. You need 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 placing your hands behind your back, connecting your 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 arms one by one, you need to bend 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. Strong physical impact is contraindicated. Massage is contraindicated in acute cases of the disease. When performed correctly, massage anesthetizes, makes the body generally more relaxed, relieves muscle tone.

There are two types of therapeutic massage for sciatica:

• 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 pine decoction, thyme herb and horsetail herb, a local compress. Salt baths are recommended (sea salt is useful for sciatica and nervous diseases). 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 infuse. Agave juice is used to lubricate sore spots. For rubbing - white acacia flowers, lilac flowers, bay leaves, honey, black radish are mixed with vodka and infused for several days.

Sciatica during pregnancy

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

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

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