Sciatica. How to relieve pain?

There are a number of diseases united by the collective concept of lumbar ischialgia, with painful attacks of a shooting nature and localization in the lumbar region of the spine, the cause of which is inflammation of the sciatic nerve. The pain can spread to the pelvic region, thigh, lower leg, foot.

The disease, as a rule, progresses against the background of pathological changes in the hip joints, spine, fascia and muscles and in the presence of chronic diseases of the internal organs.

When making a diagnosis, the disease must be differentiated from diseases that have a similar clinical picture.

The development of lumboischialgia occurs in cases where there are pain symptoms in the back of various origins. The disease most often affects people at the peak of physical activity, whose professions and activities involve a heavy load on the spine.

Symptoms

• shooting, burning, aching pain in the lumbar and back area, radiating to the leg;
• pain that intensifies when trying to straighten your back and when changing positions;
• rotation of the body in the lower back is limited;
• tension in the muscles of the back, lumbar region, leg muscles;
• blood flow in the lower extremities is impaired;
• changed color of the skin of the legs;
• decreased sensitivity in the legs;
• "Crawling of goosebumps";
• convulsions;
• numbness;
• bent back, leaning forward;
• skew of the body to the supporting leg side;
• the beginning of the development of lordosis, scoliosis;
• difficulty getting up from a lying position;
• Particularly severe cases lead to spontaneous urination.

Symptoms of lumboischialgia

Lumboischalgia manifests itself with various symptoms, which can last from one week to six months depending on the severity of the disease. The main symptom of lumboischialgia is burning or stabbing pain in the back, in the lumbar spine, radiating through the buttocks and the back of the thigh into the leg. In addition, sciatica is usually associated with very limited mobility of the spine to the extent of stiffness, numbness or even paralysis of the leg.

If persistent pain is concentrated only in the lower back, this condition is called radiculopathy, lumbosacral radiculitis. If the pain continues along the leg, being a sign of inflammation of the sciatic nerve, it is designated as “sciatica.”

Pain associated with lumboischialgia

Typical for lumboischialgia, back pain in the lumbar spine usually radiates through the buttocks and the back of the thigh to the lower leg and foot. Most often it occurs due to radiculitis. How far and significantly the pain in the leg extends depends on the strength of the irritation of the nerve roots in the lumbar spine: the stronger the irritation of the nerve, the further down the leg, along the sciatic nerve, the pain associated with lumbosacral radiculitis is prolonged. If the nerve roots are very strongly irritated in the lumbosacral spine, this leads to pain in the leg, reaching all the way to the foot, and with less developed compression of the nerve roots, the area of ​​pain may be limited only to the hips. There are forms of lumboischialgia with slight pain in the lower back, which only radiates slightly to the leg, but extreme forms of the development of pathology with intense, stabbing pain, accompanied by a burning sensation, are also common.

The pain is uneven, paroxysmal and asymmetrical, affecting only one leg, or moving from one leg to another; in severe cases, both legs are affected.

Pain associated with sciatica often occurs and is aggravated by movements such as lifting a leg or turning the body at some angle. In a very severe form of lumboischialgia, pain persists even at rest, when the patient is standing, sitting or lying down.

In severe cases, the pain no longer depends on the position of the body; any attempt to move or budge leads to its aggravation and severe suffering for the patient. The duration of symptoms varies significantly: from a week to 6 months, in severe cases - lifelong.

Decreased mobility with lumboischialgia

Patients suffering from lumboischialgia are severely limited in their ability to move. Due to pain, the muscles around the spine reflexively contract, muscle spasms are characteristic of all types of lumbar sciatica, which leads to muscle tension in the lower back, causing the formation of curvatures and stiffness of the spine. Thus, patients are unable to turn their torso, bend over, or stand upright; often, due to attempts to compensate for the pain, lateral bending of the spine is formed - scoliosis.

Neurological disorders in lumboischialgia

Areas affected by lumbar sciatica often exhibit symptoms of neurological deficits, such as numbness, tingling, and limited or even complete sensory loss. Sometimes this can be accompanied by muscle weakness and paralysis of the lower limbs. In addition, inflammation of the sciatic nerve also leads to deterioration of bladder and bowel functions. There is also a neurodystrophic type of lumboischialgia. For the pathology of this form of lumboischialgic syndrome, dystrophic lesions of large joints are typical in the presence of pain in the lumbar region: hip, knee, ankle, causing pain in the muscles, a feeling of heaviness in the legs.

If you have any questions, ask our specialist! Ask a Question

Reasons for the development of lumboischialgia

In frequent cases, lumboischialgia is a disease of vertebrogenic origin. The cause of the painful condition is pathologies of the spine, affecting muscles, skin, and internal organs. In this case, such a painful attack is called vertebrogenic lumboischialgia.

The main reason for this condition lies in excessive physical activity, for example, lifting weights, systematically being in an uncomfortable position for a long time, in the presence of lesions of the spinal column, such as radiculitis, spondylosis, osteochondrosis, scoliosis, intervertebral hernia, pathological kyphosis of the spine.

When dangerously lifting heavy objects by bending rather than squatting, there is a sharp increase in the load on the lower back.

The risk is further increased when lifting heavy objects while turning.

Common causes of the pathological condition may be intervertebral protrusions or herniated discs.

The reasons for the development of lumboischialgia are also:

• listhesis - displacement of the vertebrae;
• lumbar spondyloarthrosis;
• pathology of bones and joints caused by coxarthrosis - arthrosis of the hip joint, rheumatism, osteoporosis;
• spinal injuries;
• hip injuries;
• infectious diseases affecting the nervous system;
• tumor processes in the pelvic organs;
• inflammation in the fascia and muscles;
• pathological processes that affect the circulatory system in the lumbar spine;

Factors that increase the likelihood of developing the disease:

• hypothermia;
• diseases of acute respiratory viral infections, sore throat, influenza;
• overweight;
• pregnancy.

Classification of lumboischialgia

The disease is classified based on the reasons that caused the pain syndrome, taking into account the prevailing symptoms, the nature and prevalence of pain, and the frequency of attacks.

Vertebrogenic lumboischialgia is a disease caused by lesions of the spinal column. In turn, vertebrogenic lumboischialgia is divided into:

• radicular, which occurs when the nerve roots in the spine are compressed;
• spondylogenic – the cause of which is osteochondrosis;
• discogenic - it is caused by a herniated disc.
• myofascial lumboischialgia - its cause is an inflammatory process in the muscular-ligamentous apparatus.
• angiopathic lumboischialgia - develops when blood vessels in the lower back and lower extremities are damaged.
• mixed - develops as a consequence of various causes and lesions.

The frequency and severity of painful attacks divides lumboischialgia into acute and chronic. According to the localization of the pain syndrome, lumboischialgia is divided into left-sided and right-sided and bilateral.

According to the predominance of characteristic complaints, lumbar sciatica is classified into:

• neurodystrophic,
• neurovascular,
• neuropathic,
• musculoskeletal.

Sign up for a free consultation +7

Types of sciatica

Lyubmoischialgia is divided into 4 types depending on the causes of the disease:

Angiopathic, which is formed as a result of damage to the arteries or veins responsible for nutrition of the lower extremities and lumbar region. Damaged blood arteries and veins do not deliver the required amount of oxygen, which causes oxygen deficiency and, at the same time, their ischemia.

Neuropathic manifests itself as a result of pinching or compression of the nerve trunks responsible for the innervation of the legs;

Musculoskeletal is formed as a result of certain problems in the area of ​​the lower extremities and spine associated with disruption of the musculoskeletal system;

Mixed sciatica means a combination of several types of diseases listed above.

Diagnostics

Diagnosis of the disease, based on the initial examination of the patient, the nature of his complaints of pain in the lower back and leg, is carried out by a neurologist. The doctor prescribes additional laboratory and instrumental examinations of the patient:

• X-ray examinations of the lumbar and pelvic area;
• computed tomography;
• magnetic resonance imaging of the lumbosacral spine;
• ultrasound examination of the kidneys and abdominal organs;
• lab tests.

Additional studies will allow you to assess the condition of bones and joints, determine the presence of intervertebral disc herniations; they are also needed for differential diagnosis, excluding fractures, tumor processes and diseases such as spondylitis, myositis of the back muscles.

Treatment

Complex methods are used to treat lumboischialgia. You should not self-medicate, as this can lead to disastrous consequences. Only doctors should prescribe a course of treatment for lumboischialgia, developing it individually for each patient.

Acute period of lumbar ischialgia:

• compliance with bed rest with limited movements and physical activity;
• it is necessary to reduce fluid consumption in order to relieve tissue swelling;
• to relieve lower back pain and prescribe analgesics and anti-inflammatory drugs, including in the form of gels, creams and ointments;
• novocaine blockade is indicated for severe pain;
• severe muscle spasms are relieved with the help of antispasmodics and muscle relaxants.

After the acute manifestations of the disease subside, the doctor prescribes comprehensive treatment, which may consist of the following procedures:

• therapeutic gymnastic exercises,
• osteopathic procedures,
• gentle manual therapy,
• massotherapy,
• acupuncture,
• physiotherapeutic procedures,
• special orthopedic products – corset, corrective belt.

Acute lumboischialgia is quickly relieved.

Chronic lumboischialgia

A chronic process often has a complex prognosis, which is influenced by the cause and severity of the disease.

The course of treatment for a chronic vertebrogenic disease is prescribed individually for each patient. The therapy is aimed at strengthening the back muscles along the spine, reducing the load on the hip joints and spinal column. In many cases, the doctor tries to prescribe medications to a minimum; the main treatment is restorative physical therapy. Therapeutic gymnastics, physiotherapy, a course of massage procedures, and manual therapy are prescribed.

Physical therapy can be performed at home, outside the hospital, but it is still more useful to conduct classes with a specialist.

If you are overweight, a special diet is prescribed in order to reduce body weight, which represents an additional load on the spinal column.

In cases where lumboischialgia occurs due to intervertebral hernia, various spinal injuries, lower paraparesis, compression of the spinal roots, sometimes they resort to surgical intervention, with disectomy or other correction.

Treatment of lumboischialgia at home

You should not self-medicate so as not to aggravate the situation. But the doctor may recommend doing some activities aimed at treating lumbar sciatica at home. This may be a complex with simple gymnastic exercises in order to strengthen the back muscles and in order to reduce weight, and the doctor may also prescribe a certain diet.

Physiotherapy

Therapeutic exercise plays an important role in the treatment of lumboischialgia. First of all, it is aimed at eliminating muscle spasms, relieving muscle swelling and venous stagnation. Then it is necessary to force the spine to work correctly, without excessive overload of its individual segments. This will prevent premature destruction of intervertebral discs, the formation of new or enlargement of old protrusions. The physical therapy complex is built taking into account the patient’s characteristics – his posture, the presence and location of hernias and disc protrusions. Exercise therapy in combination with manual therapy is the prevention of relapses of the syndrome and osteochondrosis.

If you are worried about back pain, do not delay receiving quality medical care - contact the Kuntsevo Medical and Rehabilitation Center. Qualified doctors with extensive experience will advise you and prescribe the necessary types of diagnostics, which can be completed directly at the center. The availability of such accurate diagnostic methods as MRI and ultrasound will make it possible to establish an accurate diagnosis. And classes in a modern and equipped exercise therapy room will help maintain health after treatment.

The content of this article has been checked and confirmed for compliance with medical standards by a neurologist, reflexologist Oleg Mikhailovich Sysuev

Prevention

• it is necessary to promptly treat diseases and get rid of problems in the joints, blood vessels, and spine;
• Avoid situations with hypothermia and injuries if possible;
• control of correct posture and weight control;
• wear comfortable shoes;
• you need to lift heavy objects correctly, and it is better to avoid lifting heavy objects;
• sedentary work requires a comfortable workplace, short breaks and warm-up for a few minutes;
• if the activity involves long car trips, you need to stop more often to warm up;
• lead a healthy active lifestyle;
• chronic lumbar ischialgia requires regular sanitary and spa treatment;

Any form of lumbar ischialgia requires a mandatory clinical examination. At the “Medical Center YES!” The neurologist, after examining and collecting anamnesis, will definitely prescribe additional instrumental and laboratory examination of the patient, necessary to assess the condition of the spine, bones and joints, in order to differentiate the disease, to identify, if any, pathologies of the blood vessels of the abdominal cavity and lower extremities . Additional studies help exclude fractures, tumor processes and other conditions and diseases.

Make an appointment with a neurologist at the “YES Medical Center!” possible by phone or by filling out the form on the website.

Our licenses for medical activities

All rights reserved by copyright law. No part of the contents of the site may be used, reproduced, transmitted by any electronic, copying or other means without the prior written permission of the copyright owner.