Sciatica or pinched sciatic nerve

29.01.2021

Inflammation of the sciatic nerve is the most common disease of a mononeuropathic nature, when the function of an individual nerve is impaired. Both middle-aged men and women suffer from it equally. The disease can deprive the patient of his ability to work for a long time, and in severe cases can lead to disability.

The sciatic nerve (n. ischiadicus) is the largest nerve column in humans. It is formed by the spinal nerves of the sacral and lumbar regions. It runs along the inner side of the pelvis, continuing between the joints of the thigh, the ischial tuberosity, and, going under the piriformis muscle, is divided into the peroneal and tibial nerves above the popliteal fossa. The sciatic nerve provides sensation to the thigh muscles that allow the knee to bend. The sciatic nerve does not form sensitive nerve branches.

Sciatica (sciatica, neuralgia, neuropathy) is pinching or irritation of the sciatic nerve, which is accompanied by burning, sharp and sharp pain in the back of the thigh, numbness, impaired mobility and sensitivity of the foot and lower leg.

Causes

Compression of the sciatic nerve can be caused by any inflammatory process along its path, starting with the exit of the nerve from the spinal canal. The appearance of nerve pathology is primarily facilitated by lesions of the lumbosacral region:

• intervertebral hernia in the lumbar region;
• osteophytes (bone growths) of the lumbar and sacral vertebrae;
• osteochondrosis;
• spondylosis;
• hematomas at the roots of the sciatic nerve;
• oncological diseases and metastases in the area of ​​exit of the sciatic nerve;
• displacement of the vertebrae in the lumbar or sacral region;
• scoliosis;
• spinal injuries;
• congenital disorders in the development of bone and muscle mass;
• joint damage in children (juvenile rheumatoid arthritis);
• physiological displacement of the pelvic bones during pregnancy in women.

In addition to lesions of the sacral and lumbar regions, pinching of the sciatic nerve is provoked by:

• infectious diseases (tuberculosis, malaria, syphilis, scarlet fever, typhoid, influenza);
• intoxication of the body with alcohol, salts of heavy metals, arsenic;
• metabolic disorders (gout, diabetes).

Very often, sciatica occurs as a concomitant disease of osteochondrosis, since this disease pinches the nerve endings, which causes the inflammatory process to begin.

Causes of a pinched nerve

Pinching can be caused by a number of reasons:

• Excessive physical stress on the back (playing sports, lifting weights).
• Pressure of the growing uterus on the spine during pregnancy.
• Overweight.
• Incorrect body position while working or sleeping.
• Inflammation of the joints.
• Past trauma.
• Hypothermia.

Compression of the nerve roots of the spine often occurs with osteochondrosis, protrusion and herniation of the intervertebral disc. Spasms of the spinal muscles are also a likely cause of pinching. Even short-term stress affects the tissues of the body and as a result of this impact, the muscles pinch the nerve. The most dangerous disease that causes pinching of a nerve is a tumor of the spine.

It is not recommended to take painkillers or anti-inflammatory drugs on your own. Without eliminating the main cause, the painful sensations will return again.

Symptoms

The disease makes you feel the whole range of possible pain sensations: from burning and aching to shooting and sore. The nature of the pain syndrome is unstable, the pain can subside and suddenly intensify, intensifying with any muscle tension. Pain appears along the sciatic nerve, moving to the buttock area. The following signs are added to it:

• swelling in the lumbar region;
• increased body temperature;
• numbness in the legs or pelvis;
• leg weakness;
• incontinence.

Depending on the cause, the pathology can develop at different rates and be characterized by different pain sensations.

In addition to pain, a clear sign of sciatica is paresthesia - a type of sensitivity disorder in which there is a sudden sensation of burning, pins and needles and tingling.

Location of pinched nerve

Symptoms vary depending on where the compression occurs. It also matters which nerve is pinched. When a sensory nerve is pinched, the back hurts, and pinching of a motor or autonomic nerve causes more dangerous consequences.

Common options for pinching localization:

• Lower back . Compression of the nerve in this area causes pain radiating to the buttock and thigh. In this case, the sciatic nerve may become inflamed, which is manifested by tingling, burning and a feeling of heaviness in the leg.
• Neck . Pain when a nerve root is compressed radiates to the shoulder blade, shoulders and forearms. Unpleasant sensations intensify when turning the head. This phenomenon can cause disruption of the blood supply to the brain. This causes headaches, dizziness, and tinnitus.
• Thoracic department . The pain is similar to an angina attack. Trying to take a deep breath may cause more intense tingling sensations; heart disease medications do not provide relief.

Patients mistakenly turn to a cardiologist with such pain, but such disorders fall under the competence of other specialists.

Diagnostics

A neurologist diagnoses and treats sciatica. He studies the nature of the pain syndrome, under what circumstances it occurs, and how long it lasts. In addition to pain, the presence of sciatica is determined by the symptoms of Sicard and Lasegue. The first involves pain in the popliteal fossa when trying to bend or straighten the foot, the second means pain in the lower back, back of the thigh and lower leg when lifting a straight leg in a lying position. Both symptoms appear when the nerves of the spinal roots are tense, as is the soft tissue surrounding them.

To determine the cause of sciatica, especially in cases where symptoms persist for 6 weeks, the following is prescribed:

• computed tomography and magnetic resonance imaging to identify structural abnormalities leading to sciatica and spinal stenosis;
• electrodiagnostics to determine the degree of damage to the nerve roots and differentiate the pathology from other conditions with a similar clinical picture.

But, despite the high information content of these research methods, they are contraindicated for some patients. MRI is not possible if:

• the patient has metal implants or devices (for example, a pacemaker);
• the patient has a fear of closed spaces;
• the patient suffers from epilepsy;
• the patient is in position.

In this case, an ultrasound is prescribed: the procedure has no contraindications, it can be used many times during the course of treatment, the images give a fairly clear picture of the condition of the soft tissues.

Diagnosis of a pinched nerve

A pinched nerve is the compression of nerve fibers by the intervertebral disc or vertebral bodies and muscles, which is accompanied by sharp or aching pain. When we talk about a pinched nerve, we usually mean an attack of acute pain in the neck, lower back or back. However, a pinched nerve can manifest itself not only as pain, but also as a change in the functioning of internal organs, numbness in the area of ​​innervation of the pinched nerve. Symptoms depend on which nerve is pinched - motor, sensory or autonomic.

If a sensory nerve is pinched, the main symptom is pain and this is a reason to immediately consult a doctor, but pinching of motor and autonomic nerves can remain unattended for some time, which can lead to complications.

Treatment of pinched nerve.

In order to eliminate a pinched nerve, it is necessary to release it from the pinched state. For this purpose, medical practice uses a whole range of therapeutic manipulations: reflexology, physiotherapeutic treatment, manual therapy, osteopathy, therapeutic massage, biopuncture and a number of other treatment methods.

If there are no complications in the form of intervertebral hernias or protrusions, then pinched nerves and associated pain can be eliminated quite quickly. In many of these cases, a few sessions of reflexology and manual therapy are usually sufficient.

However, it is more important not only to quickly eliminate the pain itself, but also to restore the function of the nerve, that is, the free passage of impulses along the nerve. Well, and most importantly, it is necessary to remove the root cause due to which the pinched nerve occurred. That is why, if a nerve is pinched, it is recommended to undergo treatment to restore the health of the entire spine.

A distinctive feature of the treatment of pinched nerves at the PROXIMED clinic is the duration and durability of the results achieved, since our specialists not only relieve the pain caused by a pinched nerve, but also significantly reduce the risk of their reoccurrence.

Symptoms of a pinched nerve vary depending on three main factors:

• Causes of pinched nerve.
• Locations of pinched nerve (lumbar, cervical, thoracic).
• The functions performed by the pinched nerve (sensory, motor or autonomic).

The main symptom of a pinched sensory nerve is pain at the site of compression of the nerve and along the path of its passage, these pains can be either burning or stabbing, shooting, or paroxysmal or constant. Symptoms of a pinched nerve in the lumbar region can have the character of an acute painful “lumbago” ( called lumbodynia or lumbago) and aching constant pain, often unilateral, radiating to the buttock or thigh (the so-called sciatica, or sciatica). In the case of ishalgia, symptoms of a pinched nerve are usually accompanied by numbness and a feeling of heaviness in the leg.

If a nerve is pinched in the cervical spine, then the symptoms are intense pain in the neck, which can radiate to the shoulder, or forearm and under the shoulder blade; as a rule, such pain intensifies when turning the head and neck.

Often, a pinched nerve in the cervical spine is accompanied by symptoms of deteriorating blood supply to the brain:

• headache
• dizziness
• "jumps" in pressure
• hearing and vision impairment

A pinched nerve of the thoracic spine usually manifests itself as chest pain and resembles the symptoms of intercostal neuralgia.

But pinching of the autonomic nerves in the thoracic spine manifests itself as a symptom such as pain in the heart, which often pushes some doctors along the wrong path of treatment; when the autonomic nerve is pinched in the lower back, pain occurs in the stomach, which can also cause a diagnostic error .

Treatment of pinched nerves at the PROXIMED clinic:

Doctors at the PROXIMED clinic have effective methods for quickly and effectively eliminating pinched nerves and the resulting pain syndrome.

These methods are completely safe, and have virtually no side effects or contraindications, while providing a lasting therapeutic effect.

Methods of the PROXIMED clinic, which are used for pinched nerves and allow:

• release the nerve and restore the passage of nerve impulses through it;
• eliminate muscle spasms resulting from a pinched nerve;
• eliminate the inflammatory process, if present in this case;
• increase the intervertebral distance and the cushioning capacity of intervertebral discs;
• improve blood supply and delivery of nutrients to the intervertebral discs.

As a result, after completing a course of treatment at the PROXIMED clinic, you will receive:

• Quick and effective elimination of pain in the lower back, back and other pain caused by a pinched nerve.
• Restore spine mobility
• Improve your physical activity
• Improve your well-being
• Increase your performance
• Prevent osteochondrosis and its complications
• Prevent the recurrence of pain associated with a pinched nerve.
• Improve spinal health and internal organ function

Causes of a pinched nerve

• spinal osteochondrosis and its complications (disc protrusion and intervertebral disc herniation)

In this case, the pinched nerve is associated with a decrease in the distance between the vertebrae and, as a result, its compression by the vertebral bodies or processes of neighboring vertebrae. Osteochondrosis is also responsible for prolapse or protrusion of the disc, then the nerve is pinched by the intervertebral disc.

• spasm of the back muscles, both an independent cause and a consequence of osteochondrosis, can lead to pinched nerves between muscle fibers.

The massage used in the PROXIMED clinic as part of complex therapy, together with physiotherapeutic effects and reflexology, allows you to relax the muscles, completely eliminate increased muscle tone and spasms, eliminate pain, restore the passage of impulses along the nerve fibers and improve blood supply. Thanks to this effect, not only the pinched nerve itself is eliminated, but also active prevention of osteochondrosis is carried out.

If a pinched nerve occurs due to displacement or subluxation of the vertebrae, then the main method of pain relief will be manual therapy and osteopathy.
That is why, if there is pinching of the sciatic nerve, treatment should be carried out only if there is an image obtained by magnetic resonance imaging. It must also be emphasized that relieving pain from a pinched nerve is only the first step of treatment. In order to effectively and permanently get rid of pain in the back, neck and lower back, it is necessary to undergo a full course of treatment for osteochondrosis. Sharp and acute pain in the back above the lower back can tell a lot about the state of your health: a timely and accurate diagnosis can protect you from terrible consequences.

Causes of a pinched nerve in the spine

Clamping of nerve endings occurs due to the following phenomena:

1. Progressive osteochondrosis, which leads to a significant narrowing of the distance between the vertebrae and is accompanied by muscle spasms. As a result, the intervertebral discs pinch the spinal cord nerve roots.
2. Muscle spasms. Together with the nerve, the muscles also pinch the blood vessels, so over time, inflammation of the nerve (sciatica) and partial tissue atrophy occur. Lack of treatment is fraught with loss of sensitivity in the problem area and disruption of the functioning of internal organs.

The classification of pinched spinal nerves is based on the location of the nerve lesion. Compression of the nerve branches in the neck is called cervicalgia. If the pain radiates to the arm, then the diagnosis sounds like cervicobrachialgia. Damage to the nerves of the lumbar spine is called lumbodynia, and in the case when the pain radiates to the buttocks and thighs - lumboischialgia.

Etiological factors

Pinched nerves in the cervical spine, lower back and other places most often occur due to:

• osteochondrosis;
• body weight that does not meet the norm;
• infectious diseases;
• fast or awkward movement;
• traumatization: pinching can be caused by a dislocation, fracture, bruise, etc.;
• vertebral displacements: pinching of the cervical nerve is often observed precisely for this reason;
• heavy load on the spine;
• hormonal imbalance in the body.