Sciatica: symptoms, causes, treatment, prevention

What is this - one of the most common diseases among pathologies of spinal and autonomic nervous plexuses, is ishias, or a disease with the usual name - sciatica.

Characterized by a painful manifestation of the symptom complex in the region of sciatic nerves.

As a result of complete identity in terms of sciatica, medical practice is classified as neuralgia of the sciatic nerve or lumbosacral radiculitis.

What is sciatica?

In the human body the sciatic nerves are the longest, occur as a result of the union of nerve spinal roots with nerve fibers of the last - the fourth and fifth, lumbar, and the first, second and third, the initial sacral spinal roots.

Starting from the five-level segment of the lumbosacral section, each of them, going down the legs, branching along the way, is supplied with small nervous processes - hips, shins and knees, feet and fingers.

And since, on the sacral spine is the main load, then with various lesions that cause infringement, squeezing or irritation of the main trunk of sciatic nerves or their roots, irradiation of pain can spread to any areas during the course of its "following".

Causes of sciatica

Due to its location, the trunk of sciatic nerves is prone to inflammation as a result of pathological processes occurring in adjacent organs located in the pelvic region - the lower part of the intestine or the organs of the genitourinary system. But the main causes of sciatica are various diseases and their complications:

1. 1) In most cases, neuralgia manifests as a complication of lumbar osteochondrosis as a result of dystrophic changes in the intervertebral discs - their deformation and flattening, fouling by osteophytes. The lumen between the vertebrae narrows, which leads to pinching of the nerve sciatic roots, causing inflammation and swelling in the surrounding tissues.
   
2. 2) Intervertebral hernia in the lumbar region - the damage to the roots occurs as a result of ruptured disc shells - fibrous disc rings, and protrusion through the rupture of pulpous nuclei into the spinal canal. The formation of such hernias causes various kinds of trauma to the nerve endings.
   
3. 3) Instability of the spine - spondylolisthesis - as a result of displacement of the vertebral discs, or their slippage, as a result of thinning, compression or flattening occurs, sometimes several roots forming part of the sciatic nerve forming an inflammatory focus and edema of adjacent tissues.
   
4. 4) As a result of the syndrome of facet joints - spondyloarthrosis, their main function is broken - stabilization and support of the spine. This process speeds up the degeneration of the discs, and the expansion of facet joints leads to a narrowing - the stenosis of the spinal canal, from which the rootlets branch out, as a result - the defeat of sciatic nerve endings.
   
5. 5) As a result of spasm of pear-shaped muscle, located under the gluteus muscle. The sciatic nerves passing under or through it undergo stretching or irritation, which causes irradiation pain.

In addition to the main causes of inflammation contribute:

• excessive load;
  
• vertebra deformation;
  
• diabetes and tumor formation;
  
• arthritis and abscess;
  
• exposure to severe cold;
  
• infectious and gynecological diseases:
  
• fibromyalgia and thrombosis;
  
• tick-borne infections;
  
• uretrookulosynovial syndrome Reiter

Classification of the disease

In medical practice, the classification of sciatica occurs according to the location of the lesion of the sciatic nerves:

1. 1) In the upper sciatica, the roots are affected, directly at the exit from the spinal canal.
   
2. 2) With average sciatica, the lesion is noted in the area of ​​the plexus.
   
3. 3) In the lower sciatica, extensive lesion occurs not only in the trunk, but also in the branches of the sciatic nerves.

Given the nature of the disease and the cause, the disease is divided into the following species:

1. 1) The primary view includes sciatica provoked by: infections, as a result of hypothermia or intoxication.
   
2. 2) Secondary type of sciatica provokes diseases of tissues or organs located in close proximity to sciatic nerves, their roots or plexus. Or with pathologies in the hip joints and bones.

Depending on the number of nerve lesions, the disease is divided into forms:

1. 1) The unilateral form of sciatica is defined by a single lesion.
   
2. 2) Two-sided form - includes simultaneous damage of both nerve branches

Symptoms of sciatica

Pain localized in the lumbar region and radiating to the lower part of the body - the main symptoms of sciatica. Pain is expressed in different intensity. Going down the sciatic nerve, accompanied by various manifestations:

• a violation of sensitivity;
  
• "running chills" and tingling;
  
• by burning and numbness;
  
• muscle weakness;
  
• painful manifestations even with minor movements of

It is possible to develop sciatica and its symptoms in a different scenario - without pain in the lower back, but with the presence of the listed symptoms. Or the pain and manifestation of this symptomatology can manifest only by reaching the level of the knees.

Shooting pain in the foot and toes, loss of Achilles and plantar reflexes, numbness of the shin and hips indicate a violation of blood circulation in the radic arteries of the first sacral segment, and the manifestation of paralytic sciatica.

Attachment to such a disturbance radicular inflammation in the fifth lumbar segment provokes the pathology of the motor functions of the limb and the functions in the pelvic apparatus, which can lead to paralysis.

See also, pinched sciatic nerve.

Diagnostics

Various diagnostic methods are used to accurately diagnose the disease, determining the site of the lesion and the nature of the disease, taking into account the symptoms. The diagnosis of sciatica is based on:

• X-ray study;
  
• ultrasound, MRI and CT;
  
• manual diagnosis;
  
• neurological and electroneuromyographic examination;

A more accurate diagnosis, through the manifestation of pain, is based on the tests:

1. 1) Symptom of landing - determining the patient's ability to sit down after a lying position, without bending the knee. Pain increases throughout the course of the sciatic nerve
   
2. 2) Symptom of LAGES - determining the localization of pain by lifting up the straightened leg of a recumbent patient. The disappearance of pain with the simultaneous bending of the leg in the knee indicates damage or inflammation in the sacro-lumbar region.
   
3. 3) Symptom of Sikar - the definition of the damaging segment by traction pressure when the straightened leg is raised in the reclining position and the thumb is extended simultaneously - a symptom of tension, causes pain in the sciatic nerve along the entire path of its course.

Treatment of sciatica

An important condition in the treatment of sciatica is early diagnosis and a well-designed treatment plan, taking into account the use of complex methods - medical and physiotherapy, aimed at eliminating the underlying cause of the disease, and relieving the patient of clinical symptoms.

The first stage of treatment of sciatica is aimed at arresting painful manifestations and reducing inflammatory processes with anti-inflammatory and analgesic drugs. Physiotherapy procedures - electrophoresis and magnetotherapy, UHF sessions

As additional prescriptions,

• acupuncture is used;
  
• manual therapy;
  
• electrical muscle stimulation;
  
• fixation of vertebrae with special belts.

In parallel, methods should be used:

• etiotropic therapy - to eliminate the source of the disease;
  
• antibacterial and antiviral therapy - for infectious causes of inflammation.

To the second stage of treatment of sciatica pass with the inconsistency of conservative treatment. If the appearance of sciatica is caused by mechanical damage to the nerve roots, intervertebral hernia or tumor - surgical intervention is inevitable.

These can be methods - lumbar discectomy, laminectomy or microdiscectomy. The purpose of the operation is to eliminate the cause of compression on the spine, by extracting a part of the disc that pressurizes or irritates the nerve endings.

Prophylaxis of sciatica and exercise therapy

The basis for the prevention of sciatica is an active, without bad habits, lifestyle. If the work is associated with a long stay in a sitting position, you need to make small breaks for warm-up and stretching muscles. Avoid heavy loads on the vertebra. If possible, enroll in a yoga class. Avoid supercooling. Women need to give up shoes with high heels.

Gymnastics plays a big role in the restoration of lost functions. Certain exercises improve blood circulation, contributing to the saturation of muscles with blood supplying them with oxygen and nutrients, which activates and normalizes metabolic processes. As a result, the products of inflammation decay and exit from the body. Even doing several exercises a day will, in time, bring significant relief.

1. Exercise # 1 - is aimed at stretching the sacro-lumbar muscles. It is necessary to lie on a hard surface. Stretched legs, slowly pulling to the chest bent at the knees. Wait a minute and return to the starting position.
   
2. Exercise number 2 - lying on your stomach and bending your arms in the elbows, slowly straighten them, rise, maximally bending, stretch your back. We stay in this position for 10 seconds and slowly return to the original position.
   
3. Exercise number 3 - lying on your back, maximally strain your muscles and, as close as possible, cuddle to the surface of the floor.

Exercises of each kind are performed for ten times. To prevent attacks, focus on stretching exercises.

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