Causes, signs and symptoms of sciatica
- What is sciatica?
- Symptoms of sciatica
- Signs of sciatica
- Causes of sciatica
- Diagnosis of sciatica
- How is sciatica treated?
- The consequences of sciatica
- The consequences of sciatica
What is sciatica?
Radiculitis is an inflammation of the nerve roots that enter the intervertebral foramen. Radiculitis appears suddenly, and the pain is so strong that it is impossible to imagine it without experiencing it.
In 95% of cases, sciatica is a consequence of osteochondrosis, in the remaining 5% - the result of injuries, hernias, wear and deformation of the spinal column and intervertebral discs.
At risk of this disease are people who play sports, who lead a sedentary lifestyle.
There are the following types of radiculitis (radiculopathy):
Radiculitis can be acute - it appears suddenly, as a consequence of injury or overexertion, and after timely treatment, a person forgets about it for a long time, or chronic. The latter form occurs over time, due to ignorance of the disease.
Until recently, it was believed that mainly elderly people suffer from radiculitis, but today this disease is increasingly diagnosed in middle-aged people. This is due to the improper sedentary lifestyle, sedentary work, stress. According to statistics from the World Health Organization, this pathology is observed in every eighth inhabitant of the planet who has reached the age of forty-five.
Symptoms of sciatica
The main symptom of sciatica is, of course, pain. The pain depends on where your spine was injured:
- Cervical sciatica - when your neck hurts and any movement of your head makes the pain incredibly worse. And of course, there may be special cases associated with this disease, for example, you may feel dizzy, your hearing deteriorates, you do not walk smoothly.
- Chest sciatica. It is characterized by the following: pain that literally showered the entire chest.
- Lumbosacral radiculitis. Back pain when walking, when bending over.
The pain may dull for a while, after which it resumes with greater force. The main location of pain sensations depends on where the center of inflammation or pinching of nerve fibers is located. If the nerves are affected in the upper part of the spine, pain will appear not only in the neck and shoulders, but also in the back of the head. If sciatica is in the middle of the spine, then the pain can girdle the chest, felt in the hands. With lumbosacral radiculitis, the pain syndrome spreads to the buttocks, thighs, and feet.
The next common symptom of radiculitis is sensory loss, which can be partial or complete. A partial loss of sensation appears in the area of those places where the affected nerve is located. In severe cases, numbness of the limbs is observed. Symptoms such as weakness in muscles, malfunctions in their work up to atrophy, burning and tingling in soft tissues, headache, dizziness, impaired hearing and vision are often found, the reason for this is impaired blood supply to the brain. With radiculitis of the lower spine, malfunctions of the intestines and bladder may appear.
Signs of sciatica
Often, radiculitis can be confused with manifestations of other diseases: varicose veins, flat feet, trauma or diseases of internal organs, which are also characterized by girdle pain.
Radiculitis can be distinguished by the following features:
- pain comes on suddenly. It can also abruptly disappear, and after the resumption the pain is stronger;
- increased pain when a person, lying on his back, raises a straightened leg;
- the leg reflexively bends when the patient tries to sit up from a prone position;
- sharp pain when sneezing and coughing;
- increased pain when bending the head forward;
- it is difficult to be in one position for a long time, but in a motionless state the pain subsides;
- at night the patient's condition worsens;
- sweating appears, pallor of the face.
Causes of sciatica
Since sciatica is not a separate disease, but only a syndrome, it can be provoked by many reasons. As you know, our spine contains the spinal cord. From this brain there are many nerve endings that coordinate and control the movements of our body. As soon as the nerve endings are damaged or inflamed, then a disease such as sciatica occurs.
According to statistics, in about 95% of cases, radiculitis is a manifestation of osteochondrosis, and in the remaining 5% it is the result of an old spinal injury, including an intervertebral hernia.
During life, every second person is faced with the symptoms of this disease, "rejuvenated" in recent years (now it is often found in children). Osteochondrosis appears due to dystrophic changes in the spinal column, which, in turn, is caused by a sedentary lifestyle, improper distribution of physical activity. If you do not deal with the treatment of this disease, then over the years it turns into a more severe form, causing many inconveniences and unpleasant sensations.
Also radiculitis can be caused by intervertebral hernia, osteophytes (bone growths on the vertebrae), stenosis of the spinal canal, the appearance of tumors, the development of arthritis. Diseases of internal organs, cardiovascular and genitourinary systems are also capable of provoking changes in the spine, which leads to acute or chronic radiculitis.
What else can provoke sciatica?
Radiculitis can also be provoked by:
- Metabolic disease;
- Lifting weights.
Often, radiculitis appears in healthy people, as a result of injuries and physical exertion - lifting weights, for example. Excessive pressure on the vertebrae leads to pinched nerves, causing inflammation and pain.
Radiculitis also occurs in pregnant women, when unprepared muscles and the spine experience tension due to a sharp weight gain. Also, hormonal changes and metabolic disorders can provoke radiculitis.
Inflammatory and infectious processes in the body can cause inflammation of the nerve roots, and this is often the result of hypothermia, colds and flu. Radiculitis is common, and among those people who are often under stress, they experience depression.
Improper diet also affects the development of this syndrome. If a person eats a large amount of salt, it is deposited in the cervical spine, putting pressure on the nerve fibers.
Diagnosis of sciatica
As soon as you feel pain in the vertebra, you should go to the doctor, and specifically to the neurologist. A neurologist will listen to you and examine you. His task is to identify the disease, for which he will send you to an x-ray. After that, the specialist will be able to more accurately say what is causing your back pain. X-rays will also reveal how badly and where exactly your spine is damaged, after which a course of treatment will be prescribed.
Spinal diseases are diagnosed by a neuropathologist. The first stage is examination and collection of anamnesis, the specialist interviews the patient in order to identify the symptoms and causes of the disease.
After the examination, the doctor prescribes tests and studies. The main method is X-ray examination, if it is not enough, magnetic resonance imaging and computed tomography, radionuclide scanning (scintigraphy) are prescribed. In addition to studying the patient's bone tissue, an ultrasound examination of the abdominal cavity and pelvis, radiography of the lungs, ECG can be performed. Necessarily - blood and urine tests.
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How is sciatica treated?
First of all, when treating sciatica, the patient needs to ensure peace, to limit his physical activity as much as possible. For several days, a person must give up any physical activity, spend most of the time in bed. In this case, the bed should be flat, not bend under the person. Usually a rigid base is placed under the mattress. It is important to restrict the movement of that part of the spine that has been damaged; for this it is convenient to use a fixation corset.
To reduce the intensity of the pain syndrome, analgesics, anti-inflammatory nonsteroidal drugs, muscle relaxants (diclofenac, naproxen, nimesulide, ibuprofen, and others) are used. For severe pain, pain relievers are administered intramuscularly, in milder cases, they are limited to tablets, suppositories, creams and ointments. In a medical institution, a novocaine blockade of the damaged nerve can be performed. But anesthesia of the affected area is the first stage of providing assistance, after the relief of pain, treatment is carried out, procedures are prescribed.
It is important to remember that prolonged use of painkillers irritates the digestive tract, leads to ulceration of the gastric mucosa, and increases the risk of heart attacks and kidney disease. And some powerful analgesics are addictive. Therefore, it is so important to carry out precisely the treatment, and not the elimination of symptoms.
Modern methods of treating sciatica
Modern methods include: drug treatment, physiotherapy procedures, various types of therapy. An effective remedy for sciatica is an ointment based on snake venom (for example, "Viprosal B"). The tool relieves pain on joints, has an antiseptic effect, relieves inflammation. The result is an improvement in blood supply in tissues, relief of the general condition of the patient, relief of the disease. Other ointments / gels with the effect of local irritation and a medical patch are also used.
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Manual therapy is effective in the treatment of sciatica - flexion, stretching of the spine using the strength of the hands, massage. Such procedures release pinched nerves, increasing the space between them. But you should only seek such help from a specialist, since absolutely any manipulations with the spinal region require caution. You cannot stretch the spine yourself with the help of a horizontal bar - this can lead to an exacerbation of diseases. The traction should be performed by a doctor.
Along with drugs and manual therapy, alternative treatments are used: acupuncture, reflexology, laser therapy, the use of galvanic current, phonophoresis (ultrasound treatment), hot paraffin and mud applications, radon baths, various warming ups. In severe cases, when the patient has been tormented by pain for a long time, antidepressant treatment is prescribed. As a rule, sciatica, depending on the stage, heals in a period from several days to several weeks.
If within 3-4 months of treatment the patient's condition has not improved, the doctor suggests surgical intervention. A small open operation (microdiscectomy) is the removal of one of the intervertebral discs that press on the vertebral nerve. Laminectomy (lumbar surgery) is prescribed if stenosis of the spinal canal is detected and the patient cannot even tolerate normal physical activity.
During the operation, the part of the bone that is pinching the nerve is removed. But they try to avoid surgical treatment, using it in extreme cases - when the patient loses control over the functions of the intestines and urinary bladder, has difficulty moving.
The consequences of sciatica
If you do not deal with the treatment of diseases of the spinal region in time, then the disease can become chronic and disturb a person throughout his life. The patient will experience severe discomfort, which will seriously impair performance.
In the future, there is the likelihood of complications that lead to a spinal cord infarction or paralysis of the limbs, and this often ends up with disability. With regular exacerbations, it is better not to experiment with folk remedies, but to contact a specialist who will establish the causes of the disease and prescribe a course of treatment.
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Prevention of sciatica
As a prevention of sciatica, it is recommended to carry out therapeutic exercises (but not during an exacerbation). This is necessary to strengthen the muscles, which will remove unnecessary stress from the spine, create a natural muscle corset. Swimming is beneficial for the spine, but in this case it is necessary to avoid hypothermia and sudden movements. It is advisable to fight overweight, which increases the pressure on the vertebrae. It is better to do heavy physical work in a corset, try not to lift weights, and do not stay in an inclined position for a long time.
It is also important to monitor your posture and proper nutrition. First of all, reduce the amount of salt in the diet, increase the intake of fiber (eat more raw vegetables, fresh salads). It is better to cook steamed, avoiding fatty, fried, spicy. Sweets, coffee and strong tea, if possible, should also be excluded. Garlic, lemon juice, bananas are useful. Sometimes sciatica is exacerbated due to a lack of vitamin B12 in the body - it is advisable to add it and other food additives to the diet.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".