How to treat sciatica: medication and physiotherapy

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Osteochondrosis, sciatica, lumbago

Osteochondrosis of the lumbar spine is a disease in which pathology of intervertebral discs and vertebrae develops, and their gradual degeneration. 50% of cases of osteochondrosis occur in the sacral and lumbar regions. The peculiarity of this localization is its effect on the spinal column itself, and on the nerves and blood vessels. In this case, different sets of symptoms may occur:

vertebral syndrome: manifestations that affect the spine itself. These are muscle strain, pain in the lumbar region, stiffness and impaired mobility, curvature of the spine;
extravertebral syndrome: symptoms not directly related to the spine, affecting blood vessels and nerves. Based on the set of symptoms, it may refer to reflex or radicular syndrome.

Radicular syndrome occurs after injury or other impact on the nerves that exit the spine. It is manifested by muscle weakness, decreased sensitivity, impaired reflexes, and pain. The exact symptoms depend on which segment of the spine is affected. Usually the most mobile areas that bear the heaviest load are affected. Osteochondrosis in such cases may manifest itself:

pain, numbness in the anterior thigh;
the knee reflex becomes less pronounced;
weakness of the calf and levator muscles;
attacks of pain in the buttock or lateral thigh;
painful sensations in the lower leg;
difficulties in maintaining a certain position (difficulty standing on your heels or toes).

The appearance of such a syndrome is dangerous and requires urgent diagnosis. If spinal deformation provokes an impact on the radicular arteries, the development of a spinal stroke with subsequent paresis or paralysis is possible.

Reflex syndrome in osteochondrosis is manifested by pain in the lumbar region. They can be constant, tugging or sharp, occurring after physical activity or awkward movements. Stiffness is possible in the morning, and muscles may be overstrained. Symptoms often spread to the legs: burning, tingling, numbness, pins and needles or lumbago, and soreness. Because of this, coordination of movements and gait change. In case of severe disorders, malfunctions in the functioning of internal organs may occur: bladder, intestines. Manifestations of reflex syndrome include sciatica and lumbago.

Symptoms of inflammation of the sciatic nerve: the nature of the pain and its location

Sciatic nerve diseases are diagnosed quite often.
They occur both when a damaging factor (infection, cooling) directly affects the nerve, and when the nerve is involved in the inflammatory process due to pathologies of surrounding organs and tissues. The sciatic nerve is the longest in the human nervous system. It begins in the sacrum and passes through the buttock down the leg to the foot. Therefore, if the sciatic nerve is pinched, the pain spreads from the lower back along the back of the thigh, then to the lower leg, heel and toes. A pinched sciatic nerve is when it is compressed and causes irritation of the nerve tissue. Most often, compression occurs in the area of the piriformis muscle gap or spinal discs.

What is lumbago?

Lumbago is a complex of symptoms that arise suddenly and are acute. The main one is severe lower back pain. If sciatica involves “regular” pain, then with lumbago the symptoms appear due to awkward movements, heavy lifting, due to the associated tension of muscles and ligaments, displacement of the intervertebral disc or exacerbation of already existing osteochondrosis.

Symptoms:

sharp pain in the lower back: tearing or throbbing. The source of soreness seems to be located deep in the muscles or bones;
the person cannot move until the attack ends. A strong muscle spasm appears in the lumbar region; any attempts to move intensify the pain. The attack can last from several minutes to several days. Pain sensations decrease at rest if the patient lies on a hard surface.

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Treatment of pinched sciatic nerve

The cause of pinching can be diseases of the spine, in which the nerve roots are compressed by intervertebral hernias and bone growths that appear during osteochondrosis. Compression is often a consequence of severe curvature of the spine and displacement of the lumbar vertebrae. Sciatica (pain along the sciatic nerve) can be caused by soft tissue injury in the area where the nerve passes, a tumor of the spine or surrounding soft tissue, inflammatory processes, general or local hypothermia, and physical exertion. In women, sciatica sometimes occurs late in pregnancy.

Symptoms of inflammation of the sciatic nerve are pain, first concentrated in the sacral area, and then covering the back of the leg, numbness, tingling, weakness in the leg. During the examination, the doctor identifies characteristic pain points, loss of sensitivity in certain areas, vegetative-trophic disorders (impaired blood supply to soft tissues, sweating, and so on).

Treatment for a pinched sciatic nerve includes:

use of medicines;
physical therapy classes;
massage;
physiotherapeutic procedures.

For drug treatment of inflammation of the sciatic nerve, the following is used:

NSAIDs of local and systemic action. Injections for sciatic neuralgia with severe pain are preferable to oral medications. Therefore, treatment usually begins with intramuscular administration of drugs prescribed by a doctor;
warming ointments/gels;
muscle relaxants – drugs that reduce muscle tension;
B vitamins;
in severe cases - hormonal agents.

A sciatic nerve block is performed when the standard treatment regimen is ineffective. The doctor injects medications (solutions of novocaine, lidocaine, diclofenac and others) directly into the affected area.

How are medications selected?

Back pain can occur at any age in all clinical groups of patients. Usually this is not an independent pathology. As a rule, pain is a concomitant symptom of certain disorders of the body.

Injections for pain in the back and lower back are prescribed by the doctor after collecting complete information for the medical history. After identifying existing diseases, you can prescribe treatment that will help stop pain, remove inflammation, relieve swelling and enhance recovery. What injections for back and lower back pain can alleviate the patient’s condition?

How to treat sciatica

Physiotherapy for sciatica helps reduce inflammation and helps relieve pain and muscle spasms.

For sciatica, the following are indicated:

magnetic therapy;
UHF therapy;
electro- and phonophoresis using drugs;
paraffin applications.

How to treat sciatica when the acute period is over? During the recovery period, manual therapy sessions are indicated. Massage of the sciatic nerve area during the acute period is recommended to be carried out only on the healthy side, and as the patient’s condition improves, gradually increase the volume and intensity of the procedures. Manual therapy and massage are aimed at preventing the recurrence of sciatica.

Exercises for pinched sciatic nerves help restore normal function of the lower limb. The patient is also taught proper gait. For preventive purposes, exercises should be performed regularly. Read more about the exercise therapy complex for the prevention of sciatica on our website

Muscle relaxants

Quite often, back pain occurs as a consequence of muscle spasms. There are usually two different types based on etiology:

spasticity resulting from damage to brain activity;
muscle pain and spasms due to musculoskeletal disorders.

Injections of muscle relaxants are prescribed to enhance the effect of NSAIDs and steroid medications. Injections should be carried out in full compliance with the dosage and administration rules.

Mydocalm

Relaxes the spinal muscles, blocks nerve endings and relieves back and lower back pain. Contains an active substance - tolperisone, which provides a local anesthetic effect. May cause allergies in patients intolerant to lidocaine.

Atarax

This drug is a piperazine derivative. Intramuscular injections relax the vertebral and smooth muscles of the back with a moderate effect on the gastrointestinal tract.

Contraindications: pregnancy, hypersensitivity to components, arrhythmia and renal failure.

Baclofen (Baklosan)

The main therapeutic component is baclofen, which helps reduce the excitability of sensitive nerve endings and impulses, relieving pain in the lower back and back. Contains contraindications for patients with Parkinson's disease, muscle cramps, epilepsy and intolerance to the components.

Hydroxyzine

The active ingredient is hydroxyzine. Injections help relieve muscle tone in the lower back and neurotic pain in the back. Its effects are similar to Atarax, since it is a piperazine derivative. Should be used with caution in patients with renal failure.

Tizanidine

The main substance in the composition is tizanidine. Reduces the aggravated tone of the skeletal muscles, removes spasms in the back, reduces muscle resistance during inert movements, and increases the power of free contractions. May have side effects at higher doses.

Sirdalud

Derived from tizanidine. Relieves various muscle tones, lower back pain of various etiologies, providing an analgesic effect.

Prevention of sciatica

Prevention of inflammation of the sciatic nerve consists of timely treatment in the initial stages of the disease. After sciatica, all measures are aimed at preventing relapses. Patients are advised to avoid hypothermia: do not sit on a cold surface, do not swim in cold water, and wear warm underwear in winter. It is advisable to gradually harden the body and regularly perform a complex of exercise therapy.

Patients prone to frequent respiratory diseases should not endure them on their feet. You should also avoid strenuous physical activity if possible. For sciatica, which is based on congenital changes in the spine or its acquired curvature, it is recommended to wear a fixing corset.

Doctors also advise maintaining a normal weight, since obesity is a common cause of pinched sciatic nerve. You should monitor your posture and lift heavy objects correctly, that is, keeping your back straight and crouching towards the load, and not leaning towards it. It is advisable to sleep on hard mattresses.

Related services: Physical therapy (physical therapy) Physiotherapy

Steroid drugs

Hormonal drugs create a strong anti-inflammatory effect, but at the same time they have a large number of side reactions. Steroid injections for back and lower back pain are prescribed for the following diseases:

spinal intervertebral hernias;
progressive radiculitis;
ankylosing spondylitis;
rheumatoid arthritis.

Flosteron

It contains a glucocorticosteroid. Injections are used mainly for severe forms of musculoskeletal diseases, when non-steroidal medications do not have an effect. The dosage is selected individually, taking into account the severity of the disease and the patient’s response to treatment.

Diprospan

The potent substance in betamethasone is a broad-acting steroid hormone. It has a large number of side effects, which the attending physician should warn about. Negatively affects the functioning of the adrenal glands. May be addictive if used frequently.

Hydrocortisone

Intravenous injections are prescribed for back pain of any nature, in particular rheumatic and intervertebral hernia. The dosage should be determined by the doctor individually, comparing the patient’s health status with contraindications.

Prednisolone

A drug from the group of glucocorticosteroids. Prescribed for back and lower back pain, diseases of the spinal column of various types. It has a fairly large number of side effects. The dosage is prescribed by the doctor as prescribed.

Kenalog

Contains triamcinolone acetonide. It is used as injections for various arthrosis, relieving inflammation and back pain. Has side effects.

Combined painkillers

After completing a course of injections for back and lower back pain, the patient may be prescribed other forms of medications - ointments, tablets, suppositories. These drugs will have a supporting effect and prevent the development of possible complications.

The fight against back pain is a long-term and complex process. Anesthetic injections give a good and lasting result, but they should only be used under the supervision of a doctor.

Ways to relieve sciatic nerve pain

It is important to pay attention to emerging symptoms in a timely manner and not to start the problem. Coping with the task at the initial stage will be much easier and much cheaper.

We offer simple options for eliminating sciatic nerve pain:

1. Cat pose. You need to squat down, place your palms under your shoulders, knees under your hips. As you inhale, raise your head, look at the ceiling, lowering your stomach down. As you exhale, arch your back and look at your hips with your head. The exercise should be repeated 10 to 20 times.

2. Hamstring stretch. You need to sit on the floor, stretch your legs forward. We bend the right leg at the knee, the foot is located on the inside of the opposite thigh.

You need to reach as low as possible towards your left foot with your hands, without bending your knee. After 30 seconds, return to the original position. The exercise is performed 2-3 times for each leg.

Stretching activates the thigh muscles, relieves tension, and reduces pain.

3. Dog pose. You need to get on all fours, place your palms under your shoulders, place your knees under your hips. With your back and pelvis motionless, stretch your right arm forward and your left leg back. After a second, return to the original position. When this exercise is performed systematically, your posture straightens, pressure on the lower back disappears, and the muscles of the buttocks become stronger.

Chondroprotectors

Medicines in this group are prescribed to quickly restore connective tissue, regenerate the structure of the spine and reduce inflammation in the back.

Chondroitin sulfate

The active substance in the form of chondroitin is used to eliminate destruction of bone and cartilage tissue. During the course of injections, inflammation and pain in the lower back go away, and joint mobility is normalized.

Alflutop

Injections are given intramuscularly to relieve pain in the back and lower back. Included in the list of the best chondroprotectors. It regenerates cartilage and fights intervertebral hernia.

We will help you cope with pain and inflammation!

Our clinic specialists have all the necessary skills to relieve pain and other unpleasant consequences of sciatica. We treat our patients using advanced techniques and combine the best methods to achieve the desired result.

In our clinic, consultations are carried out by certified specialists with extensive experience. A doctor is consulted with the patient, as a result of which optimal diagnostic methods are prescribed.

We offer our patients favorable terms of cooperation. Please note that we not only provide clients with comfortable treatment conditions and pleasant discounts, but also create some of the most affordable prices for diagnostics in the capital. Come to our medical center and we will show you what it means to live without pain.

What is sciatic neuralgia?

The disease is an aseptic inflammation in the nervous tissue and surrounding tissue. There are only two main causes of neuralgia: compression by bone or connective tissue fragments of the human skeleton or insufficient blood supply to the affected area. Often both causative factors are combined. An important condition for the development of the disease is the presence of provoking situations. These include the following conditions:

sudden physical activity with muscle tension in the lumbar region;
local or general hypothermia;
consumption of low-quality alcoholic beverages;
traumatic injury to the sciatic nerve or lumbar region;
the presence of neoplasms or congenital vascular pathologies in the lumbosacral area;
diabetes mellitus without adequate treatment with high glycemia or other metabolic diseases.

Since the sciatic nerves are quite long and large, due to these anatomical features, situations that provoke aseptic inflammation occur frequently. Therefore, any person may experience a painful condition, which will require contacting a specialist and targeted treatment.