Pinch of the sciatic nerve: symptoms, treatment, prevention, causes

The pinch of the sciatic nerve is a pathological condition that develops when the largest nerve in the body is squeezed in the musculoskeletal tunnel and is accompanied by severe pain in the leg.

Almost always pathology develops on the one hand;more risk to "earn" sciatica men engaged in heavy physical work. Diagnosis is not difficult. With the timely and comprehensive treatment, the disease is completely reversible.

A bit of anatomy

The sciatic nerve is a nerve fiber of considerable thickness, formed by the roots of the last two lumbar and all sacral spinal nerves. He exits the pelvic cavity through an opening in the muscle fibers and lies between the muscle groups that form the buttocks.

Then it passes through the posterior femoral surface to the popliteal fossa, where it divides into two nerves - tibial and peroneal. It is this nerve that innervates the hip and knee joints. It includes not only motor, but also sensitive fibers.

Causes of pinch of the sciatic nerve

Pinch of the sciatic nerve develops due to the following reasons:

1. 1) Intervertebral hernia in the lumbar region: the protruding jelly part of the intervertebral disc - jelly nucleus - squeezes the sciatic nerve at the exit.
   
2. 2) Osteochondrosis of the lumbar region, when the nerve is compressed between vertebrae, displaced due to changes in the thickness of the intervertebral disc.
   
3. 3) Pregnancy - squeezing of the sacral plexus, from which the sciatic nerve, the pregnant uterus in the III trimester.
   
4. 4) Injuries of the spine with displacement of the vertebrae: dislocations, subluxations, fracture.
   
5. 5) Abscesses of the rectum, located near the lumbar region.
   
6. 6) Nerve compression by spasmodic muscles that can develop due to significant physical exertion, trauma or inflammation of these muscles.
   
7. 7) Spondylosis of the lumbosacral spine.
   
8. 8) Tumors of the spine.
   
9. 9) Degenerative spondylolisthesis.

Risk factors for this condition are:

• lumbar supercooling.
  
• herpes zoster in the projection of the branches of the sciatic nerve.
  
• polyradiculoneuritis.
  
• tuberculosis of the spine.
  
• diabetes, leading to a disruption of the nourishment of the sciatic nerve.
  
• brucellosis.
  
• effects of neurotropic toxins, heavy metals.
  
• Multiple Sclerosis.
  
• excess weight.
  
• is an inflammatory disease of the pelvic organs, which can lead to inflammation of the pear-shaped muscle, and it can pinch the sciatic nerve at the exit.

Symptoms of pinch of the sciatic nerve

Pinch of the sciatic nerve, the first symptoms of which are characterized by the development of an attack of severe pain in the buttock and leg. Pain has such characteristics:

• is so intense that a person can lose consciousness;
  
• burning, cutting, stitching;
  
• requires you to look for a specific lying position;if it is necessary to stand, a person will not rely on a sore leg;
  
• begins often at night after a person has physically worked( especially if it was in the cold);
  
• is first localized on the posterior surface of the thigh, later "descends" to the shin and foot;
  
• is enhanced by prolonged standing, sitting on a hard surface, walking;
  
• is enhanced by sneezing, coughing, and laughing;
  
• after taking painkillers or spontaneous stifling of an attack, residual pain is localized in the lumbar region.

Pain is accompanied:

1. 1) Violation of gait;
   
2. 2) Sweating of feet;
   
3. 3) Tingling or burning in the shin and foot;
   
4. 4) Difficulty bending the leg in the knee;
   
5. 5) Violation of the bending of the fingers and the turn of the foot.

Diagnosis of pinch of the sciatic nerve

The inflammation of the sciatic nerve is indicated by a vivid clinical picture, described by the patient. Also, the doctor will note the change in tendon reflexes, as well as the sensitivity on the side of the lesion. This does not mean that you do not need to conduct other studies, because if you do not find out the reason, the pinching will be repeated again and again, and it will be more difficult to cure it.

To determine the cause of the pinch of the sciatic nerve, the following tests are performed:

1. 1) Radiography of the spine: it can reveal a rough bone pathology: bone "spines"( osteophytes), displacement of the vertebrae, fractures or dislocations;
   
2. 2) Computed tomography of the lumbosacral spine is a more accurate radiological method that allows diagnosing even minimal changes in the spinal column;
   
3. 3) Instead of computer( with contraindications to it), magnetic resonance imaging can be used;
   
4. 4) Ultrasound( in some cases, computed tomography) study of pelvic organs with suspicions of the pathology of localized organs there;
   
5. 5) Radioisotope scanning of the spine with suspected tumor.

Treatment of pinch of the sciatic nerve

There are two main approaches to the therapy of pinch of the sciatic nerve - conservative and operative. Begin treatment conservatively, with the help of several methods( integrated approach).

Mode - in the acute period, bed rest is necessary( at the same time the person needs to lie on a hard mattress).Motor activity is minimal. Going to the toilet, carrying out hygiene measures are carried out with support. When the pain subsides, the regime expands, you can only walk with a cane.

Diet - at home, the observance of a special diet is necessary only in the acute period when a person should lie: food should be warm, not spicy, not smoked or fried, the priority use of liquid food( milk, meat and vegetable soups, milk porridges).So you can avoid constipation and the associated deterioration of the condition.

Drug therapy

1. 1) The main group of drugs used to treat the pinch of the sciatic nerve are nonsteroidal anti-inflammatory drugs: Orthofen, Ibuprofen, Denebol, Dexalgin, and Ketanov. Initially, they are injected intramuscularly, then they switch to taking drugs from this group, which are produced in tablets and capsules. Supplement the treatment can be ointments and gels: "Finalgon", "Voltaren", "Diclofenac."
   
2. 2) The above preparations are taken together with medicaments that protect the gastric mucosa from their adverse effects: "Ranitidine", "Kwamatel" or "Nolpase", "Rabeprazole" are taken with Almagel, "Fosfalugel" or "Maalox"
   
3. 3)B-group vitamins for improving the interaction of a inflamed, clamped nerve with tissues: "Milgamma", "Neurorubin".
   
4. 4) With a strong spasm of the muscles of the back, legs or buttocks, the purpose of the drugs that remove this spasm is shown: "Midokalm", "Sirdalud".
   
5. 5) With severe pain, novocain blockades can be used.

LFK

On the second day of illness, exercises of therapeutic gymnastics are prescribed, which in this case include finger and foot movements. In a subacute period, a person is selected a complex( depending on the cause of the pathology), which can consist of the following types of exercises:

• walking on the buttocks on the bottom( performed in a horizontal position);
  
• flexion of the legs in the knee;
  
• lying on the back with legs raised at right angles, while the buttocks rest against a wall or other fixed surface;
  
• "bicycle" with a gradual increase in the amplitude of the rotations.

During the recovery phase, you can not do without half-squats with support, rotation of the hips, lifting the legs in an upright position.

Physiotherapy

Such treatment is very important to use, as it will not only achieve good results, but also enhance the effect of drugs, reduce their dosage.

So, apply:

• electrophoresis with no-shpoy, midokalmom, novocaine;
  
• UHF;
  
• paraffin applications;
  
• magnetotherapy;
  
• phonophoresis;
  
• UFO ill area;
  
• magnetic laser therapy.

At stihanii inflammatory process and absence of contraindications have proved the efficiency:

• massage;
  
• application of needle applicators( such as Kuznetsov);
  
• canned massage;
  
• acupuncture;
  
• moxibustion of biologically active points;
  
• hirudotherapy.

Sanatorium treatment

Such treatment is effective beyond the period of exacerbation. The following methods are used:

• mud treatment;
  
• baths: radon, pearl, hydrogen sulphide;
  
• underwater traction;
  
• climatotherapy.

Prevention

In order to prevent pinch of the sciatic nerve, follow these rules:

• learn how to squat correctly.
  
• do x-ray or CT of the spine, treat vertebral diseases.
  
• periodically take courses of general massage.
  
• watch the weight.
  
• sleep on a hard bed.
  
• do not lift heavy weights without preparation.
  
• follow the posture.
  
• perform the minimum daily charge.

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