Inflammation (neuralgia) Of The Sciatic Nerve - Causes, Symptoms, Treatment, Where Is It?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-15 09:49

Inflammation (neuralgia) of the sciatic nerve

Content:

• Sciatic nerve inflammation symptoms
• Causes of sciatic nerve inflammation
• Diagnosis of sciatic nerve inflammation
• Treatment of sciatic nerve inflammation
• Prevention of inflammation

What is sciatic neuralgia?

Inflammation of the sciatic nerve is a defensive reaction to the action of an irritant, manifested in severe painful sensations in the lumbar region, buttocks and legs.

The sciatic nerve is one of the largest in the human body. It is he who has increased sensitivity and becomes inflamed more often than others. Its function is to be responsible for the movement of the lower limbs.

A nerve is a bundle of nerve fibers that are covered by a sheath called endoneurium. Endoneurium, in turn, is penetrated by the smallest blood vessels - capillaries. Under it is the second layer, called the perinevium. It also contains vessels, but they are larger. Each vessel is covered with a layer of connective tissue, it is she who protects the sciatic nerve from various kinds of damage, performing the function of a kind of shock absorber.

The nerve itself is located in the neural tube, which is very dense, since it is also covered with a connective tissue called epinervium.

According to statistics, inflammation of the sciatic nerve most often affects people who have crossed the threshold of 30 years. A quarter of the population suffers from back pain, and 20% of cases are caused by inflammation of the sciatic nerve.

In medicine, you can also find the term - sciatica, neuritis, sciatic nerve neuropathy or sciatica, which characterizes the same condition. It should be understood that inflammation of the sciatic nerve is not a separate disease, but a symptomatology that signals problems in the lumbar region and sacrum.

Where is the sciatic nerve located?

This largest nerve originates in the pelvic region, in the lumbar spine. Its length is large, so it covers most parts of the lower body. From the sacral part, the branch of the nerve exits into the pelvis through a special hole called the piriformis. Further, the nerve stretches under the gluteus muscle and branches into smaller processes that penetrate all the gluteal and femoral muscles. In addition, it affects all joints in this area.

Descending down to the popliteal fossa, the nerve branches into a pair of large processes. They are called the tibial branch and the peroneal branch. Thanks to these branches, the sensitivity of the skin of the lower leg and foot, as well as all joints and muscles in the lower extremities, is provided.

The sciatic nerve stretches along the entire length of the leg, thereby causing painful sensations of the entire lower limb with inflammation and with any other damage to it.

On the subject: Causes, symptoms and treatment of pinched sciatic nerve

Sciatic nerve inflammation symptoms

The symptoms of sciatic nerve inflammation cannot go unnoticed by a person.

This condition can be suspected by the following signs:

• Pain in the gluteus maximus muscle and the back of the lower limb. Pain is most often bilateral, but they are somewhat different. It will be more intense on the side where the inflammatory process takes place.
• The movement of pain is from top to bottom. It captures the buttocks, thighs, lower leg, lower back.
• It is difficult for a person to straighten out, especially if he is leaning forward. When bending over, the pain becomes less intense.
• When you try to turn around, the discomfort becomes more pronounced.
• Support on the limb in which the sciatic nerve is inflamed becomes impossible. When trying to step on it, a person experiences severe pain.
• Sometimes the inflammation is accompanied by bowel movements or urinary excretion that occurs involuntarily.
• The body temperature most often rises, but does not go beyond 38 ° C. This symptom occurs against a background of spasms and muscle pain. Moreover, both the body temperature in general and in the place of inflammation in particular rises.
• Physical activity becomes impossible.
• The skin along the inflamed nerve turns red and swells.
• Sometimes a person complains of muscle atrophy or slow weakening.

Since the clinical picture is pronounced, doctors are able to suspect inflammation of the sciatic nerve only on the basis of complaints from a patient who came to see the patient.

Pain with inflammation of the sciatic nerve

The pains can be of a different nature, sometimes they are burning and shooting, sometimes stabbing and pulling, sometimes aching. However, in most cases - paroxysmal. That is, a period of severe, practically unbearable pain is replaced by a period of relative rest, when it weakens for a while.

Another distinguishing feature of pain in sciatic nerve damage is the direction in which unpleasant sensations arise. Pain arises in the lumbar region and gradually sinks lower, penetrating the entire limb right down to the toes.

If severe pain occurs in both legs, then doctors talk about bilateral neuralgia. This process is most painful for a person, however, it occurs infrequently. In most cases, sensations such as slight tingling and numbness, a feeling of goose bumps appear in the second leg.

In especially severe cases, the pain simply paralyzes a person. He becomes unable to move. Any attempt to move the body produces an excruciating spasm. The patient is unable to sleep, turn, bend over, or even stand. This is due to the very structure of the sciatic nerve, because it is penetrated by a huge number of sensitive receptors.

The acute form of sciatica is characterized by pronounced painful sensations that exhaust a person, preventing him from leading a normal life. With the transition of inflammation of the sciatic nerve to a chronic form, the pain becomes aching, in parallel there is a feeling of tingling and numbness in the legs.

Causes of sciatic nerve inflammation

There are several reasons that lead to inflammation of the sciatic nerve:

• Prolonged exposure to the cold wind, leading to hypothermia of the lumbar region and inflammation of the sciatic nerve. Moreover, this often happens in the warm season, when the lower back remains open.
• Frequent infections. First of all, these include neuritis, which leads to inflammation of the soft tissues that surround the sciatic nerve.
• Herpes infection, leading to the development of shingles and inflammation of the sciatic nerve.
• Lifting weights, excessive physical exertion that affect the condition of the spine in general and the deformation of the muscular frame in particular. All this becomes a prerequisite for sciatica.
• Abrupt and awkward movements.
• Osteochondrosis, which causes degenerative changes in the entire bone apparatus and leads to clamping of the largest nerve.
• Gout.
• Injury to muscles or organs located in the pelvic region.
• A herniated disc that causes a pinched nerve.
• Spondylosis, as a stage of osteochondrosis, leading to the development of growths along the edges of the spine.
• Spinal stenosis. This condition is especially common in older people.
• Spinal growths.
• Tumors, both benign and malignant.
• Spine injury.
• Piriformis syndrome. Its reflex tension causes compression of the sciatic nerve and its inflammation. Often this happens due to unsuccessful injections, as well as against the background of sciatica of the lumbar spine.
• Diabetes.
• Gynecological and urological diseases.
• Birth trauma.
• Pregnancy can cause inflammation of the sciatic nerve. This is due to the fact that the enlarged uterus presses on him, causing pain in the lower back and legs. Sciatica especially often develops in the third trimester and intensifies when the baby moves inside the womb. Moreover, symptoms of inflammation of the sciatic nerve can be present after childbirth, for 3 months.
• Lyme disease, fibromyalgia, Reiter's syndrome.
• Arterial and venous thrombosis.
• Poisoning the body with toxic substances, such as mercury and arsenic.

Diagnosis of sciatic nerve inflammation

Although the symptoms of sciatic nerve inflammation in most cases clearly indicate the occurrence of this condition, in some cases they are disguised as signs of another disease. Therefore, doctors perform a clinical and neurological examination of the patient. It boils down to determining a person's hypersensitivity to pain. For this, the patient is asked to lie down and raise his leg up without bending it.

If pain occurs along the nerve, which subsides when a person lowers a limb, then this makes it possible to suspect sciatica. This diagnostic technique is called the Lasegue test. Do not assume that this is the only way to identify sciatica. Doctors have a whole set of similar techniques, for example, the determination of the symptoms of Lerrey, Fayerstein, Bekhterev, etc.

Valsalva's test is indicative. The nose and mouth are closed to the person and forced breathing is offered. The result will be an increase in pressure not only in the chest, but also in the abdominal cavity. At the same time, the pain in the lower extremities disappears, but other neurological symptoms appear, indicating squeezing of one or another root. For example, impaired sensitivity of the calf, weakening of the knee reflex, impaired motor function of the foot or fingers, etc.

Also, such modern research methods as computed tomography, MRI, X-ray come to the aid of doctors. An additional diagnostic method is electroneuromyography, which allows assessing the speed of nerve impulses during nerve stimulation.

However, it is not only important to determine that a person is suffering from nerve inflammation. It is necessary to establish the cause that led to this condition. This is what will make it possible to carry out effective treatment and save the patient from the problem.

Treatment of sciatic nerve inflammation

Therapy primarily consists in eliminating the pain symptom and relieving inflammation. For this, a person is prescribed anti-inflammatory and analgesic drugs. After the pain has been arrested, you can begin to eliminate the cause of sciatica.

Physiotherapeutic procedures are often used, in particular electrophoresis, magnetotherapy, UHF, etc. Also, modern conservative methods include the use of fixation belts, muscle stimulation with electrical impulses, acupuncture, manual therapy.

If the inflammation was caused by infectious pathogens, then the person is shown antibacterial and antiviral treatment for inflammation of the sciatic nerve. When the reason lies in diseases of the pelvic organs, then the underlying disease should be eliminated.

When sciatica is caused by a herniated disc or neoplasm, surgery cannot be avoided. So, microdiscectomy is an effective and modern way to get rid of many pathologies of the intervertebral disc that cause sciatica.

A doctor who deals with the therapy of sciatic nerve inflammation is a neurologist or neuropathologist. If necessary, a person is sent to other specialists - to a gynecologist, urologist, oncologist, etc.

Whatever the cause leading to inflammation of the sciatic nerve, a person needs complete rest. Bed rest is indicated until the acute period has passed.

The prognosis for recovery directly depends on the cause that caused the inflammation and the timely visit to the doctor.

Sciatic nerve treatment (medications)

There are several areas of drug therapy:

NSAIDs. For the treatment of inflammation of the sciatic nerve, nonsteroidal anti-inflammatory drugs are primarily used. The most commonly prescribed are aspirin, ibuprofen, naproxen, ketoprofen, paracetamol, diclofenac, tolmetin, dexibuprofen. In order to minimize the effects of oral ingestion of these funds, it is necessary to use them with meals. This will reduce the risk of side effects from the gastrointestinal tract, however, it may slightly reduce the effect of pain relief.

Do not exceed the dose recommended by the doctor, as this increases the risk of complications. The person may experience an upset stomach, high blood pressure, headache, drowsiness, and other symptoms. In addition, taking only one NSAID will not affect the cause of inflammation, and their long-term use increases the risk of developing stomach ulcers.

Tramadol is another effective pain reliever prescribed for sciatica. It does not cause persistent dependence and addiction like NSAIDs. It is indicated when it is impossible to take non-steroidal anti-inflammatory drugs. A drug such as Ultraset, which combines tramadol and paracetamol, allows you to quickly achieve the desired effect and relieve pain in the shortest possible time.

• Steroidal anti-inflammatory drugs. Steroid anti-inflammatory drugs are also used, among which hydrocortisone, dexamethasone, cortisone, prednisolone can be distinguished. In some cases, epidural steroid injections are used. They are injected into the epidural space for immediate pain relief.
• Antidepressants. Antidepressants will help normalize sleep and calm a person. They are used in combination with other medicines and strictly under medical supervision.
• Vitamins. It is mandatory to take vitamin complexes, which can accelerate the recovery of damaged nerve fibers and normalize the functioning of the nervous system as a whole.
• Local pain relievers. Various ointments are used as means for local anesthesia, for example, Voltaren, Nise gel, Nurofen, Finalgel, Dolbene.

If it is not possible to take a person with sciatica to the hospital, then it is worth giving him first aid on the spot. First of all, he must be laid on his stomach on any hard surface. A low pillow should be placed under the chest. You can insulate the patient with a blanket. But at the same time, it is strictly forbidden to apply any warm compresses or heating pads to the site of inflammation, as this can increase the swelling and increase the intensity of pain. After that, you need to call a doctor or deliver a person to a medical facility yourself. Do not knead the sore spot or apply ointment to it. All therapeutic measures are permissible only after consulting a doctor.

Exercises for inflammation of the sciatic nerve

Therapeutic gymnastics is another effective method of therapy and prevention of sciatic nerve inflammation. It is important to do them daily to train different muscle groups and avoid future pain. The load should be gradual, as you train, it must be increased. However, one should not overstrain, gymnastics should not cause discomfort and even more pain. Its purpose is to maintain muscle tone, normalize their blood supply, and relieve inflammation. Any set of exercises can be supplemented with other feasible loads, for example, swimming, cycling, walking.

However, you should not assume that gymnastics does not allow you to achieve an effect. This is one of the ways to treat sciatica, so it should be approached responsibly. It is important to work out the muscle groups that caused the sciatic nerve to pinch. Need exercises for the legs, buttocks, outer and inner thighs. It is worth starting to perform them carefully. If painful sensations arise, you need to take a break and rest. In the event that the pain does not go away or even intensifies, it is worth stopping the complex altogether and seeking advice from a doctor. When choosing the most effective exercises, it is necessary to take into account the presence of other diseases so as not to provoke their exacerbation.

It is advisable that the complex was compiled by a doctor or exercise therapy instructor. He will tell you how to move and breathe correctly. After that, you can start implementing the exercises at home.

The following exercises are most often recommended for execution:

• Lying on your back, always on a firm surface, you need to raise your legs and pull them up to your chest, while holding your buttocks with your hands. In this position, you should hold out for at least 30 seconds, then straighten your legs. You need to repeat at least 10 times.
• Remaining on the floor, you need to roll over to one side. Bend your legs and press them to your chest, while stretching your socks. Then the legs return to their original position. The number of repetitions, as in the first exercise. If you do it at a fast pace, it will warm up your muscles and prepare for further exercises.
• Without getting up from the floor, you need to roll over onto your stomach and raise your upper body as high as possible. At the same time, the legs do not bend. Since the exercise is difficult to use for beginners, initially 5 repetitions will be sufficient. Then they can be gradually increased.
• You need to get up off the floor and sit on a chair. The leg must be placed crosswise. The back should be straight and the arms should be behind the head. From this position, you need to make turns with the body in different directions, you should generally make 10 turns.
• Then from the chair you need to move to the floor, while kneeling. Hands are located above the head, fingers are interlocked. From this position, a tilt is made forward with a maximum extension of the arms. After the palms have touched the floor, you can go back.
• After a little rest, you need to sit on the floor. Raise your arms to shoulder level and spread in different directions, and stretch your legs. Then the hands are pulled back as much as possible with light springy movements and returned back. Repeat at least 5 times.
• Remaining sitting on the floor, you need to spread your legs wide apart, then lie on your back, and raise your limbs. In this case, put your hands behind your head. Press the shoulder blades to the floor. Stretching your legs to the ceiling, you need to reach the maximum height and fix it, then return to its original position, repeat at least 5 times.
• After a little rest, you need to get up off the floor and spread your legs shoulder-width apart. Lower one hand, and stretch the friend up and lean in her direction. Then change your hand and tilt in the opposite direction. In this case, you need to bend as low as possible. In general, the number of tilts is 10.

How to relieve sciatic nerve inflammation in 2 minutes:

Ointments for inflammation of the sciatic nerve

There are a huge number of ointments used for sciatic nerve inflammation.

They can be divided into five large groups, each of which has its own advantages and disadvantages:

• Pain relief ointments. Their effect is based on enhancing blood circulation, oxygenation of problem areas. Such ointments help to cope well with the inflammation of the nerve, which was caused by decompression and hypothermia. This group includes funds such as Nikoflex, Kapsikam, Apizartron, Finalgon, Efkamon and others. The active ingredients can be of both synthetic and natural origin (pepper tincture, bee venom, etc.). Ointments from this group cannot be used in childhood and during pregnancy, as well as in the presence of wounds and other injuries on the skin. Do not exceed the therapeutic course for more than 10 days.
• Chondroprotective ointments. Effective for nerve inflammation caused by osteochondrosis. The active substances that have a therapeutic effect are glucosamine and chondroitin sulfate. You can choose one of the following products: Honda cream, Chondroxide, Teraflex M, Sofia, Chondroitin gel. However, it is worth considering that they are rather difficult to penetrate into the affected area, therefore, they have a minimal effect, and they can also cause local allergic reactions.
• Pain relief ointments that include NSAIDs. These drugs are highly effective in treating sciatic nerve inflammation, however, they should not be used without a doctor's recommendation. The maximum period for using such ointments is 4 days. These funds should not be used in childhood, during pregnancy, in the presence of diabetes mellitus, stomach ulcers, skin diseases. These drugs include: Voltaren, Butadion, Diklovit, Diclofenac, Fastum gel, Dolgit, ibuprofen and some others.
• Combined ointments. They have both anti-inflammatory and analgesic effects. Strengthen the regenerative processes of tissues. With inflammation of the sciatic nerve, Dolobene is often prescribed. This ointment can be used for injuries, edema, neuralgia. However, you should not use it during pregnancy, if you have kidney, lung and heart disease.
• Another group of ointments is homeopathic remedies. Among them are Traumeel S, Objective T. They are able to improve metabolism in tissues, relieve pain, and increase immunity. However, the evidence base for the effectiveness of these ointments has not yet been fully collected.

It should be understood that each of the listed ointments can be freely purchased at the pharmacy. However, this does not indicate their safety and the possibility of uncontrolled use. Before starting to treat sciatica, you should first consult your doctor.

Massage for inflammation of the sciatic nerve

Massage for inflammation of the sciatic nerve can be used for treatment only when the acute phase of the disease ends. However, it must be performed by a qualified professional. Self-massage can be hazardous to health.

The massage is prescribed by a doctor and is performed in courses that will not be effective if not completely completed. The minimum number of sessions in one course is 11 visits to the masseur. For a therapeutic purpose, neurologists prescribe acupressure, which allows you to affect specific areas. It allows you to eliminate pain, accelerate blood circulation, improve the general well-being of the patient, relieve all the unpleasant symptoms characteristic of sciatica.

At the same time, it is precisely the acupressure that will allow you to purposefully affect the inflammation focus, relax one muscle group and strain another, and increase the blood flow to the problem area. Acupressure massage used for inflammation of the sciatic nerve is called acupressure.

Prevention of inflammation

Neuropathologists claim that preventive measures aimed at preventing the development of inflammation of the sciatic nerve can reduce the risks of its primary and recurrent occurrence by 80%.

Therefore, it is so important:

• Avoid overloading the spine and its injuries. If a person is not involved in professional sports, then his spine is not prepared to lift weights. Once having broken the structure of the sciatic nerve, in the future a person will constantly suffer from bouts of pain. Therefore, before lifting an unusual load, it is worth considering the consequences of such an act.
• Avoid hypothermia of the lumbar region. The sciatic nerve becomes inflamed from exposure to the flow of cold air, and not from general hypothermia of the body. Therefore, it is so important to cover the lumbar region with clothing and keep it warm.
• The muscular and ligamentous apparatus of the back must always be kept in good shape. This can be achieved through regular exercise. This is especially true for people with a sedentary lifestyle. Perfectly allows you to train your back muscles by regular swimming and running.
• It is necessary to monitor posture from childhood. It is worth sitting with a straight back, so that it is parallel to the back of the chair. In addition, you should avoid any asymmetrical back positions and carrying weights on one shoulder.
• If you suspect an inflammation of the sciatic nerve or the disease that causes it (first of all, it is osteochondrosis and tumor processes), you should seek medical help without trying to cope with the problem yourself.

Observing all these recommendations, you can protect yourself from inflammation of the sciatic nerve and from the severe pain that this pathological process causes.

Which doctor treats sciatica?

There are two doctors who treat sciatica. This is a neuropathologist who prescribes pharmacological symptomatic therapy, and a chiropractor who eliminates the very cause of the pathology.

A vertebrologist can also help

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".