How is sciatica treated? Causes and symptoms
What is sciatica?
Sciatica is an inflammation of the sciatic nerve. With this pathology, pain occurs in the lumbar region. They spread to the thigh, to the foot, and become more intense when coughing and when walking. Symptoms of sciatica in the early stages of development may mimic lumbodynia, lumbago, and lumbar ischialgia.
In people with this disease, exacerbation often occurs two to three times a year. People endure pain, walking around with it for several days and forgetting about the illness until the next attack, they do not rush to see a doctor.
A negligent attitude towards sciatica leads to the fact that very soon the disease simply does not give a person a normal life. The sciatic nerve is the largest in the body. It starts in the lumbar spine and descends down the leg, where it splits into small nerves.
It is for this reason that sciatica pain can appear in a wide variety of places. Most often, a person feels a "lumbago" from the lower back to the heel through the entire leg. But there are options when there is no pain in the lower back itself, and discomfort is felt only in some part of the leg.
Content:
- Sciatica symptoms
- Sciatica diagnosis
- Sciatica causes
- Sciatica treatment
Sciatica symptoms
The variety of causes that cause sciatica, provides a lot of manifestations of this disease.
Sometimes the pain can be local - only in the lower back, but even in this case, its manifestations can be varied. The patient may stab, burn or "shoot" in the back. Sometimes there is a feeling of numbness or "goose bumps".
Very often sciatica makes itself felt with pain along the entire length of the leg, starting in the lumbar spine and extending through the buttock and thigh to the very tips of the fingers. There are times when only one part of the leg hurts, for example, there is discomfort in the knee or the toes become numb.
In any case, the pain can be so unbearable that the person cannot walk, sit, or bend over. At the same time, he involuntarily tilts the body slightly forward and to the side, the gait becomes asymmetrical.
Sciatica most often affects one leg, but there are times when pain manifests itself in both limbs at the same time.
When the attack passes, pain persists in the 5th lumbar and 1 sacral vertebrae, under the knee and in the center of the buttock. Sometimes the pain is so severe that a person can lose consciousness. Other symptoms include increased sweating, swelling and flushing of the skin. The pain becomes more intense if the person is in an upright position for a long time, walks or sits on a hard surface.
The attack forces him to take a forced pose. He focuses on the healthy leg. The patient's gait also changes.
If the disease is severe, it can lead to a decrease in the gluteal, gastrocnemius, or femoral muscles. It will be difficult for a person to bend the leg, as the muscle is immobilized. He wiggles his toes with difficulty and turns his foot.
Sciatica diagnosis
Sciatica can accompany various pathologies. Therefore, before starting treatment, you need to find out the cause of its occurrence.
To begin with, a neurologist examines the patient, checks reflexes and skin sensitivity. This allows you to assess the degree of damage to the nervous tissue.
Then the patient is sent for x-ray. This study allows you to identify pathologies of bone tissue.
If there is not enough information, then the patient will be prescribed an MRI or CT scan. When a doctor suspects a cancerous growth, a radioisotope scan of the spinal column should be performed. Such a study is indicated for patients with HIV and those taking corticosteroids.
Sciatica causes
The causes of sciatica are numerous. This disease can manifest itself as a result of hypothermia or become a complication after an infection - flu or tuberculosis. Injuries and diseases of the spine - such as osteochondrosis, deformation or degeneration of the intervertebral discs, the formation of hernias, tumors, any changes in the shape of the vertebrae - can lead to pinching or injury to the nerve roots. Also, the list of causes of sciatica includes diabetes, arthritis, constipation and gynecological diseases (including birth injuries).
Next, an interesting theory will be considered, which, in our opinion, is the true cause of sciatica. If you understand it, it will not be difficult to cope with the disease.
As a rule, the treatment of the disease is reduced to anesthesia of the affected area. When risk factors begin to affect the body, for example, hypothermia or physical overload, the symptoms of pathology return.
A person cannot by an effort of will control the tone of the muscles of the back, buttocks, piriformis muscle. The pain occurs precisely at the time when their spasm develops and the sciatic nerve is pinched. A person can strain these muscles, but he is not able to relax them.
For muscle relaxation, those brain structures that are responsible for human emotions are responsible. All internal organs, blood vessels and tissues are controlled by the brain stem and hemispheres. Positive emotions contribute to the relaxation of the listed muscles, and negative experiences, on the contrary, provoke their tension.
Even a momentary but strong negative emotion can tone muscles and tissues. This leads to spasm and pinching of the nerve. It is especially vulnerable in people with osteochondrosis, spinal hernias, spondylolisthesis and other diseases of the spinal column. Information on this can be found in any medical publication.
One more fact can be cited to confirm the validity of this theory. Women and men have differences in the structure of the brain, they react differently to stress. Therefore, pain in sciatica is also different for them, for no one is it a secret. So, in 80% of women, pain occurs in the right buttock, right thigh, knee and foot. In men, the left half of the body is affected in 80% of cases.
The right hemisphere controls the left side of the body, and the left hemisphere controls the right lobe. There are also gender differences in the prefrontal cortex. This site is responsible for the control of decision making. There is a difference in the frontal lobes of the brain. All these differences relate to the amygdala (it is responsible for the emergence of emotions and for the ability to remember them). Therefore, the male amygdala communicates with the right hemisphere, and the female with the left hemisphere.
Scientist Larry Cahill monitored the brain functioning of men and women under stress while watching a horror movie. He noticed that during negative emotions in men, the left hemisphere remained at rest, and the maximum reaction was observed precisely on the right side of the hemisphere. In women, on the contrary, the left hemisphere became more active.
All this explains the fact that in women during stress, the right side is more spasmodic, and in men - the left.
If we take into account all these facts and analyze the experienced emotions, we can understand what caused sciatica in a particular person. It is likely that emotional balance and a positive attitude will help cope with the disease.
Sciatica can be triggered by factors such as:
- Injuries, hypothermia, excessive physical activity.
- Diseases of an infectious nature that negatively affect the functioning of the nervous system. First of all, this refers to tuberculosis, herpes zoster, brucellosis.
- Allergic reactions of the body.
- Multiple sclerosis.
- Intoxication of the body with poisons, medicines, heavy metals, toxins that appear due to the decomposition of cancerous growths.
- Diabetes mellitus, alcohol abuse, metabolic disruptions.
Sciatica most often manifests due to the effects on the body of several factors at once. This pathology mainly affects the elderly, who suffer from diseases of the spinal column, from vascular pathologies. Therefore, it is not surprising that sciatica never develops in childhood.
Sciatica treatment
Sciatica is treated by a neurologist who prescribes therapy after an examination.
- Physiotherapy. Physiotherapy methods can reduce the intensity of pain, but they cannot cope with the cause of sciatica. The doctor can prescribe electrophoresis to the patient with antispasmodics, vitamins, muscle relaxants, drugs for inflammation, UHF, laser treatment, phonophoresis, paraffin therapy, UFO, electrosleep. All these techniques make it possible to improve tissue nutrition, reduce swelling and cope with pain.
-
Massage and reflexology. When the acute inflammation is relieved, you can attend massage courses. General massage, cupping massage, acupressure, acupuncture, moxibustion help well. You can also use Kuznetsov's home applicator. Its use can reduce pain, relieve muscle tone.
Regardless of the type of massage, it leads to an improvement in blood flow, helps to eliminate lymph congestion, and relieves pain. The nerve begins to work correctly, which prevents muscle damage.
-
NSAIDs and pain management. Drugs from the NSAID group can reduce pain, which perfectly relieve inflammation. These can be drugs such as: Diclofenac, Indomethacin, Ibuprofen, Ortofen, Naproxen, Ketorolac, etc. When taking these drugs, you need to take into account that they irritate the mucous membrane of the digestive system, affect the kidneys and thin the blood. Therefore, it is not recommended to use them for a long time.
To a lesser extent, such drugs as: Movalis, Nimesulide, Arkoxia irritate the stomach. Therefore, you can take them longer. Perhaps the doctor will recommend you to drink Omeprazole in parallel.
If the attacks get worse, corticosteroid hormones may be prescribed. Treatment should be short-lived. They are unable to deal with the cause of the disease and have many side effects.
- Other medications for sciatica. The doctor may prescribe B vitamins, vitamin E, or complex supplements to the patient. In addition, the therapy can be supplemented with drugs to relax the muscles.
- Exercise therapy. Physical activity helps to improve a person's well-being. You can do it at home. Exercise "bicycle" and stretching have a good effect. You can start classes only after the acute phase of inflammation has been arrested.
Sciatica injections
With sciatica, drugs such as: Analgin, Tramadol, Ksefokam can be used. They can relieve pain. Also, injections of hormonal drugs are prescribed: Prednisolone, Hydrocortisone. They are not used often, only with severe swelling and inflammation.
Injections are given only in case of intense pain attacks, which cannot be dealt with due to taking pills. After the acute stage of the disease begins to subside, the patient is transferred to oral medication.
He can also be assigned blockades with Novocaine or Ultracaine. They are inserted into the bundle of the sciatic nerve. This allows you to completely block it and get rid of pain.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
