Our body feels and moves, our internal organs work in their own way, without requiring volitional control from us. Everything happens, as if by itself, if not for one small "but".
When this small "but" fails, the whole harmony of the organization of the human body falls apart and it becomes obvious that the body is, first of all, the thinnest network of intertwined nerve fibers with a single control center.
With sciatica, the spinal nerves become inflamed.
Each nerve supplying one or another part of the body originates from the spinal cord (individual nerves from the brain), and is responsible either for motor function, or for sensory function, or for ensuring the work of internal organs.
Before going beyond the vertebral column, which is the bony sheath of the spinal cord, nerves with different functional loads are combined into a bundle or root (radiculus). The root, before splitting into branches, passes through the intervertebral foramen.
The inflammatory process that accompanies any damage to the nerve root is called sciatica.
The spinal cord has 5 segments, respectively, the spinal nerves emerging from one segment or another regulate a strictly defined area of the body.
Having a general idea of the structure of the nerve root, now you can find out what causes sciatica. The widespread philistine opinion that sciatica occurs from a draft is only half true. In fact, hypothermia refers to the resolving factors, as well as physical overstrain of the back muscles. The immediate causes of sciatica, in most cases, are diseases of the spine.
For more information about what sciatica is, see the video:
The first in frequency of occurrence, as a causative factor, is osteochondrosis. Even by the definition of a causal relationship, it is clear what is the difference between sciatica and osteochondrosis.
Osteochondrosis is a disease characterized by degenerative changes in the intervertebral cartilaginous disc, as a result of which the height of the vertebrae one above the other decreases and, as a result, the intervertebral foramen narrows.
In the future, there is an infringement of the nerve root with impaired blood circulation and the development of aseptic inflammation. Thus, radiculitis is a complication of osteochondrosis.
Other causes of sciatica can be:
- Deforming, which refers to the vertebrogenic causes of damage to the nerve root, that is, depending on the state of the vertebrae;
- Trauma;
- Acute and chronic infectious processes. Especially often the infectious cause of inflammation of the nerve root is herpes zoster;
- Various neoplasms;
- Congenital malformations of the spinal column.
Acute or chronic process
An attack of acute sciatica occurs either for the first time, or characterizes a picture of exacerbation of chronic radiculitis. The very definition of "acute" speaks of a vivid clinical symptomatology that occurs suddenly, without precursors.
Chronic sciatica is characterized by an endless series of improvements with exacerbations.
If we talk about the time division of an acute and a chronic disease, then if the cure of the process is within a month, then we are talking about an acute course of the disease, if signs of suffering persist even after 4 weeks, then the pathological process takes on a chronic course.
How long an attack of radiculitis will last depends on the cause that caused the inflammation of the root, and on the concomitant pathology, and on the therapeutic measures taken. In most cases, with an uncomplicated course and the adequacy of the measures taken, it is possible to cope with the disease in 7-10 days.
But it is not possible to cope with the causes of radiculitis in such a period. For the most part, these are chronic diseases that require long and ambiguous treatment.
Clinic of the disease depending on the level of damage
Common symptoms of nerve root inflammation are divided into three groups:
- Painful;
- Neurological;
- Muscle-tonic or reflex.
Pain with radiculitis is acute, sharp in nature, like an electric shock, is localized on the side of the infringement and can spread along the nerve. The pain is often accompanied by paresthesias, i.e. tingling, burning, or numbness of the supplied area of the body and causes protective muscle tension.
Pain occurs due to inflammation of the nerve roots and causes muscle tension
Symptoms of cervical radiculitis, in addition to those described above, include vertebral artery syndrome, which occurs due to vascular infringement in the lumen of the transverse processes of the cervical vertebrae, which is the cause of vertebro-basilar insufficiency.
Vertebrobasilar insufficiency manifests itself with dizziness, headache, impaired vision, hearing, nausea until vomiting.
Considering the fact that the brachial plexus originates from the cervical segment of the spinal cord, with cervical radiculitis there is a weakening of muscle strength and muscle tone of the upper extremities, reflexes caused by the hands are reduced, and the symptom of "frozen shoulder" appears.
Autonomic disorders (dryness, pallor of the skin with an emphasized vascular pattern, a decrease in local body temperature) join motor and sensory disorders with the development of Horner's triad: constriction of the pupil, palpebral fissure and some retraction of the eyeball.
Symptoms of thoracic sciatica are manifested by pain between the shoulder blades, in the intercostal spaces and may be accompanied by a disorder of the work of internal organs, which has to be differentiated from true somatic pathology.
For thoracic radiculitis, as for any other, a forced posture of the patient is characteristic (bending over to the side of the infringement of the roots with minimal physical activity), which reduces pain.
Chest sciatica may be accompanied by a disorder of the work of internal organs
Symptoms of radiculitis of the thoracic region often become a manifestation of nerve damage by the herpes zoster virus. In this case, and with any other infectious lesions with radiculitis, the temperature rises. The height of the numbers depends on the pathogenic force of the microorganism and on the reactivity of the diseased organism.
Cervicothoracic radiculitis is accompanied by mixed symptoms of damage to both cervical and thoracic nerve roots.
And yet, the maximum percentage of clinical symptoms of sciatica falls on the lumbosacral spine.
This fact is due to high physical exertion in the lower back.
It is not difficult for a person who is familiar with the shooting pain in the lower back to explain what sciatica lumbar is, which among the people "walks" like sciatica.
Almost every fourth inhabitant of the planet is familiar with the clinic of sacral sciatica. Regardless of at what level, at the lumbar or sacral, the nerve roots were infringed, the clinical picture will generally be of the same type.
What pain will be with sciatica depends on the speed and intensity of the onset of circulatory disorders in the root. Lumbago characterizes an acute process with pronounced edema of the perineural tissues and a lack of blood supply to the nerve root.
Symptoms of sciatica of the sacral region are familiar to many
In a chronic process, when some adaptation of the suffering tissues to a lack of oxygen occurs, the pain is dull and, depending on the degree of damage to the nerve fibers, the neurological deficit will come to the fore, manifested in muscle atrophy, disorders of independent movement and the work of the pelvic organs.
If you do not heal, but just dull the pain
The consequences of vertebral lumbosacral radiculitis can be:
- Paresis or paralysis of the lower limbs;
- Trophic ulcers of the skin of the lower extremities;
- Incontinence of urine and feces;
- Sexual disorders.
The lower back is a place of reflected pain
Despite the fact that back pain is the main complaint with inflammation of the nerve roots, it should be remembered that the lumbar region is also a zone of pain projection in case of kidney damage.
Urolithiasis, pyelonephritis often signify back pain. But there is no answer to the question of how to distinguish nephroptosis from radiculitis. Because nephroptosis, by itself, does not hurt.
And only in the presence of an inflection of the ureter, leading to acute expansion and inflammation of the pelvis, there is a precedent for differential diagnosis with sciatica.
Positive symptoms of tension will speak in favor of sciatica. But even in this case, it is possible to exclude the parallel course of two pathologies only with a complete clinical and laboratory examination of the patient with inclusion.
Men and women with sciatica, is there a difference
The question of signs of radiculitis of the lumbar spine in women can be attributed to provocative questions. In these cases, more often it is not about the symptoms of sciatica in women, but about whether the lower abdomen can hurt with sciatica. The lower abdomen is a sacral female area and, hypothetically, it can be assumed that the source of pain lies in the infringement of the sacral nerve roots.
As a rule, sciatica does not manifest itself as pain in the lower abdomen.
But in practice, pain in the lower abdomen is caused by inflammation, often chronic, of the internal female genital organs.
The occurrence of sciatica during pregnancy can be assumed, due to the increased load on the lower back, in late gestation.
But internal changes in a woman's body during pregnancy are multifaceted and their influence on the course of a particular disease is unpredictable.
In some cases, a pregnant woman receives an aggravation after an aggravation that endangers the bearing of a child, and in others, the lower back reminds of itself only during the period of labor.
If there are any pathological conditions of the spine identified earlier in pregnancy, you should start attending aqua aerobics classes for pregnant women, sleep with special orthopedic devices, wear comfortable shoes, and avoid physical activity that requires back strain.
If we talk about the second half of humanity, then the signs of sciatica in men do not differ from those in women, with the only caveat that the symptoms of damage to the nerve roots of the lumbosacral region include the clinic of impotence and erectile dysfunction.
Muscle clamping as a result of negative emotions that have not been eliminated
Back (neck) pain is the main complaint with which people come for a diagnosis at an appointment with a neurologist. But, often manifestations of sciatica are directed by psychosomatics.
It has been noticed that stressful tension in persons prone to the accumulation of negative emotions is manifested by prolonged muscle spasms, of all muscles that can only be contracted.
Muscle clamps of the back can lead to infringement of the roots, although not with such severe manifestations and consequences, as if the cause was an organic pathology of the spine.
When the bath is a lifesaver
In matters of treatment of acute conditions and at the onset of the disease, one should resort to qualified assistance. But sciatica is a complication of an often chronic, long-term underlying disease.
And in this case, with an established diagnosis and mild manifestations (like a shot, somewhere sipping), it makes sense to try folk methods to alleviate your condition instead of absorbing suggestive amounts of painkillers.
Do not forget about the sauna with a birch or coniferous broom.
The bath will ease the pain of sciatica
And for those who have doubts about whether it is possible to take a steam bath with radiculitis, one can authoritatively say: "Not only is it possible, but also necessary." Again, remember the severity of the pathological process.
If the condition is acute, accompanied by a sharp pain syndrome, from which the eyes become numb, you should urgently consult a doctor.
Remember, heat dilates blood vessels, which can contribute to an increase in edema of perineural tissues and aggravate the deficiency of blood supply to the nerve roots.
Prophylaxis
The prevention of sciatica is the hygiene of physical labor and the avoidance of drafts. But everyday life is full of surprises and devoid of conventions, so sooner or later you can get either under a stream of cold air, or tear off a heavy object from the floor, which will provoke another attack of sciatica.
In terms of longer-term prophylaxis, it is important to compensate for the underlying disease leading to nerve root inflammation.
Hanging on the bar is a good prevention of sciatica
In case of osteochondrosis, to stretch the distance between the vertebrae and prevent compression of the roots, hanging on the bar can be performed as prevention of sciatica.
Conclusion
Sciatica has no clinical features depending on the sex of the patient, with the exception of sexual dysfunction. Its manifestations fit into a certain structure of symptoms.
Clinical manifestations depend on the level of compression of the nerve roots, but do not depend on the cause that caused them.
Treatment of radicular syndrome should be started only after examination and after listening to the recommendations of the attending physician.
Radiculitis- This is an inflammatory process in the nerve roots that extend from the spinal cord (from the Greek. Radix - "root", it is - "inflammation"). Depending on the level of the lesion, there are cervical, lumbar, sacral sciatica. Basically, sciatica occurs in older people, after 30 years.
As statistics show, the most susceptible to radiculitis are the most mobile parts of the spine - the cervical and lumbar. The lower back is especially often affected, since it experiences the greatest stress in connection with a person's upright posture.
Anatomy of the spinal column, spinal cord, spinal nerve roots
The vertebral column consists of individual vertebrae, of which there are about 33 in the human body. The vertebral column is divided into sections, and the vertebrae in each section have their own characteristics.Spine sections:
- Cervical- consists of 7 vertebrae, which are the smallest. The cervical spine is mobile, so pathological changes occur relatively often in it.
- Pectoral the department includes 12 vertebrae, which are connected to the ribs and therefore rigidly fixed. In this segment of the spine, the occurrence of pathological changes is less likely.
- Lumbar the department is 5 vertebrae, which are more massive than all overlying ones, and are movably connected to each other. The lumbar segment of the spine is mobile and takes on the bulk of the body, so it is more susceptible to lesions than others.
- Sacral the department consists of 5 accrete vertebrae.
- Coccyx- usually 3 - 5 of the smallest vertebrae.
There are special notches in the arches of the vertebrae. When the notches of the overlying vertebra are connected to the notches of the underlying vertebra, they form openings through which the roots of the spinal cord exit outward.
Between the bodies of all adjacent vertebrae are intervertebral discs.
Intervertebral disc structure:
- nucleus pulposus- the central part, which springs and softens the vibrations of the spinal column while walking;
- fibrous ring- serves as an external frame for the nucleus pulposus and, having high rigidity and strength, does not allow it to go beyond its normal form.
The spinal cord is surrounded by membranes, which are composed of connective tissue.
Causes of sciatica
Intervertebral hernia
Herniated discs are the most common cause of sciatica. It usually occurs in people after 30-40 years.Causes of intervertebral hernias:
- Long-term intense physical activity
- Work associated with constant standing in a standing position, especially in an uncomfortable position, intense static loads on the spine.
- Trauma
- Congenital malformations of the spine
- Osteochondrosis and other degenerative diseases
Osteochondrosis
Osteochondrosis is a degenerative disease of the vertebrae and intervertebral discs, which is characterized by their destruction and premature aging. Basically, it is common after the age of 40, but in clinical practice there are cases in 6 - 7 - year old children.The causes of compression of the spinal roots and radiculitis in osteochondrosis:
- due to degeneration of the intervertebral discs, their height decreases and, as a result, the size of the intervertebral foramen, through which the roots of the spinal cord go out;
- with a long course of the disease, bone growths form on the vertebrae - osteophytes, which can also squeeze the roots;
- the inflammatory process joins, which leads to edema and even greater compression.
Previous spinal injuries
Sciatica can be the result of a fracture or dislocation of the vertebra suffered in the past. It is especially likely if the injury was severe enough and the bone fusion did not occur quite correctly.In this case, the existing deformities and cicatricial process lead to compression of the spinal root.
Spine malformations
According to statistics, in 50% of children, some congenital anomalies in the development of the spinal column are determined. And they persist in 20-30% of adults.Malformations of the spinal column, which are detected in patients with sciatica:
- deformation or splitting the body of the vertebra, when it becomes higher on one side and lower on the other, and thus the prerequisites for its sliding from the overlying vertebra are created;
- splitting of the vertebral arch and its non-union with the body- in this case, the vertebra is poorly held in place and can slide forward - this condition is called spondylolisthesis.
Spinal column tumors
Tumors that can lead to the development of sciatica:- benign and malignant tumors originating from the vertebrae;
- benign and malignant tumors originating from intervertebral discs;
- benign and malignant tumors originating from the spinal cord and its membranes;
- neurinomas - tumors that develop from the very roots of the spinal cord;
- metastases to the spine from other tumors;
- tumors in the vertebrae that have a different origin - for example, hemangiomas - vascular tumors.
Inflammatory and infectious processes
Often when the patient is asked to say after which he developed symptoms of sciatica, he replies that he was "blown away".Sometimes the development of this pathological condition, in fact, strongly resembles the development of a cold. The inflammatory process in the root occurs as a result of the penetration of pathogenic bacteria and viruses into the body during infectious diseases:
- flu and sometimes other acute respiratory infections;
- for sexually transmitted infections: syphilis, trichomoniasis, herpesvirus infection, etc.;
- with purulent-inflammatory diseases: sepsis (generalized infection spreading throughout the body), vertebral osteomyelitis, abscesses (abscesses) in the spine;
- with various chronic foci of infection in the body.
Diseases of the intervertebral joints
In rare cases, sciatica is a consequence of joint pathologies, with the help of which the processes of the vertebrae are connected to each other.Joint diseases that can lead to sciatica:
- rheumatism- autoimmune joint damage provoked by beta-hemolytic streptococcus;
- spondyloarthritis- inflammatory changes in the intervertebral joints caused by infection or autoimmune reactions;
- spondyloarthrosis- degenerative lesions of the intervertebral joints;
- ankylosing spondylitis ankylosing spondylitis.
Vascular disease
The defeat of the roots of the spinal cord with radiculitis can be caused by a violation of their nutrition from the blood vessels. For example, with diabetes mellitus, vasculitis (autoimmune vascular lesions), etc.Signs of sciatica
Pain with sciaticaPain with sciatica is the main symptom. It occurs in different places, depending on which part of the spine was affected.
Types of sciatica depending on the affected spine and the spread of pain:
- cervical sciatica
- cervicobrachial sciatica
- cervicothoracic sciatica
- chest sciatica
- lumbar sciatica
Pain with radiculitis is provoked by physical exertion, prolonged stay in a monotonous position, hypothermia. It is noted in the lower back, back or neck and radiates to other areas of the body along the major nerves. With cervical and thoracic radiculitis, the pain radiates to the shoulder girdle, arms, head, under the scapula. Sometimes it may seem to the patient that he has a heartache, although in fact it is a manifestation of sciatica. With sciatica lumbar - in the legs. Sometimes the pain is so strong that a person cannot move normally and get out of bed, his sleep is disturbed.
Impaired movement and sensitivity
The nerve roots of the spinal cord, which extend from the spine, contain both motor and sensory nerves. They form nerve plexuses, and then pass into the nerve trunks. If the root is compressed, then there are violations of movement and sensitivity in the area of its innervation. For example, with cervico-brachial radiculitis, disorders are noted from the side of the arms, and with lumbar - from the legs.Movement and sensitivity disorders in sciatica:
- Weakening of muscles. Their strength decreases, and during the examination, the neurologist can easily identify this. Reduced muscle tone. If sciatica is accompanied by severe damage to the nerve roots and continues for a sufficiently long time, then muscle atrophy occurs - they decrease in size.
- Reducing all types of skin sensitivity: tactile, temperature, pain, etc.
- The appearance of a feeling of numbness in the area that is innervated by the affected root;
- The onset of unpleasant sensations: "creeping creeps", tingling, feeling of cold snap.
Neurological examination for sciatica
During the examination of a patient with sciatica, a neurologist can reveal many symptoms that clearly indicate the presence of the disease. All of them can be divided into two large groups: symptoms of tension and weakening of reflexes.Pulling symptoms
At certain positions of the body, certain nerves are stretched, in connection with which painful sensations arise or intensify.Symptoms of tension that your doctor can check for:
- The patient lies on his back, while the doctor asks him to raise the straightened leg or raises it himself. There is pain in the lower back and on the back of the thigh, which is caused by sciatica.
- The patient lies on his stomach, the doctor lifts his leg. If there is pain on the front of the thigh, it means that there is lumbar sciatica.
- In a patient lying in bed, the head is raised so that the neck is bent and the chin is brought to the chest. There is a pulling pain in the neck and back.
Weakening reflexes
In neurology, reflexes are often checked - muscle responses that occur, as a rule, in response to hammer blows in different areas of the body. With sciatica, the nerves are compressed, so reflexes are always weaker in one area or another. For ease of comparison, reflexes are always checked on the right and left.Reflexes that are checked to identify different forms of radiculitis:
- Knee reflex: with a light blow to the tendon of the knee joint, unbend the bent leg at the knee.
- Achilles reflex- a similar reaction of the feet when hitting the Achilles tendon.
- Tendon ray reflex- flexion and rotation of the forearm inward when hitting the periosteum of the radius in the area of the wrist joint;
- Biceps and triceps reflex: when a hammer is struck on the tendon of the biceps and triceps muscles, which are located respectively on the anterior and posterior surfaces of the shoulder, near the elbow joint, flexion and extension of the arm at the elbow is carried out.
Examination for suspected sciatica
X-ray
X-ray is a study with which you can examine all parts of the spinal column. Usually, pictures of the spine are taken in two projections: frontal and lateral.Causes of sciatica, which helps to identify radiography:
- herniated disc
- vertebral injuries(fractures, dislocations)
- vertebral malformations
- displacement of the vertebrae relative to each other
MRI
MRI, or nuclear magnetic resonance imaging, is a study that helps to obtain a clear image of the area of interest. Moreover, it shows not only the vertebrae and intervertebral discs, but also other tissues. This allows you to identify those causes of sciatica that are not visible during an X-ray.CT scan
Computed tomography helps to identify the same causes of sciatica as radiography. But it allows you to get more accurate and clear images, during this study there is less radiation exposure to the patient's body.Computed tomography is prescribed in the case when using a conventional X-ray it is not possible to identify the causes of sciatica.
Radiculitis treatment
| The use of drugs | ||||
| Type of treatment | Purpose of treatment | How is the treatment carried out? | ||
| Novocaine blockade | Novocaine is an anesthetic that inhibits the sensitivity of nerve endings. The purpose of novocaine blockade is to eliminate pain caused by sciatica. | The manipulation can only be carried out by a doctor. Novocaine should be injected into the tissues in such places and to such a depth at which it reaches the nerve endings and causes a pronounced anesthetic effect. | ||
| Diclofenac | Anti-inflammatory and pain reliever. It can be used in the form of injections, tablets or ointments. | Application as an ointment: Take a small amount of Diclofenac ointment and rub in the place where the patient is worried about pain. Perform 3-4 times a day. Application in the form of injections: Application in tablets: |
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| Vitamin preparations | Many vitamins, in particular of the B group, are actively involved in the processes that occur in the nervous system. Therefore, they help to reduce the severity of neurological disorders that are characteristic of sciatica. | Application in pills, tablets, capsules: Any multivitamin preparations are prescribed. Intramuscular injection: |
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| Pain medications(analgin, aspirin, etc.) | They are a method of symptomatic treatment, since they do not eliminate the causes of the disease, but only fight the pain. They are able to significantly improve the patient's condition. | Pain relievers can be given as pills, intramuscular and intravenous injections. They are often added to systems for intravenous drip administration of medicinal solutions. The dosage depends on the type of anesthetic drug and the severity of the pain syndrome. For example, for analgin, the average daily dose is 1 gram, the maximum is 2 grams. (Catalog of medicines radar) |
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| Physiotherapy | ||||
| Treatment of sciatica with a laser | The laser beams penetrate deep into the tissues and exert their therapeutic effect in them: they relieve pain and inflammation, pathologically increased muscle tone. Sometimes laser treatment of different types of radiculitis shows a more pronounced positive result than the use of medications. | Indication to the use of a laser is pain syndrome with radiculitis. 10 procedures.
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| Radiculitis treatment with UHF waves | UHF waves help relieve swelling and inflammation, reduce pain, and improve blood flow in the affected area. | UHF indication- pain and inflammation with sciatica. Duration of treatment- 10 procedures. Contraindications- pustular processes, malignant and benign processes on the skin at the site of exposure, other lesions. |
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| Electrophoresis | Electrophoresis is the introduction of medicinal substances through the skin using an electric current. In this case, the drug is delivered directly to the site of inflammation and acts more effectively. | During electrophoresis, pain relievers and anti-inflammatory drugs are used. The average duration of one procedure is 15 minutes. The average duration of the course of treatment is 10 sessions. | ||
| Acupuncture | ||||
| Acupuncture is a method of treating sciatica using special needles that are inserted into special biologically active points on the human body. Providing a reflex effect, acupuncture helps relieve pain, swelling, increased muscle tone. | Sciatica is a direct indication for acupuncture. Duration of treatment- 10 sessions. Contraindication - skin lesions at the injection site (tumors, dermatological, pustular diseases). |
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| Massage | ||||
| Massage improves blood circulation and lymph flow in the affected area, increases the tone and tissue resistance. Kneading and vibration of muscles relieve increased tension and normalize their functions. During the massage, a large amount of biologically active substances are released in the skin and tissues that are located deeper. | Usually a massage course consists of 10 sessions. It can be performed in a hospital, in a clinic or at home. Depending on the level of the lesion, a therapeutic massage is performed on the neck, back or lower back. In case of damage to the cervical and thoracic spine, massage of the shoulder girdle, arms, chest is performed. If the lumbar region is affected, massage of the buttocks, thighs and lower legs may be prescribed. |
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| Folk remedies for the treatment of sciatica | ||||
| Rubbing the affected spine | The most common types of rubbing:
| These funds increase blood flow in the affected area, help relieve inflammation. Essential oils have a pleasant aroma and a calming effect, helping to relieve increased muscle tone. |
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| The use of medicinal teas | For radiculitis, medicinal teas are used from the bark of verbena, orchis, birch leaves. | They have a calming, anti-inflammatory, analgesic effect. | ||
| Wearing a dog hair belt | Has a warming effect. | |||
Prevention of sciatica
The main preventive measures for sciatica:
- Compliance with the optimal regime of work and rest... The condition of the spine is very badly affected by prolonged hard physical labor, constant stay in a monotonous uncomfortable position in which the muscles of the back are in tension.
- Adequate physical activity... To maintain the health of the spinal column, you need to visit the gym at least once a week, on weekends.
- Proper nutrition... Overweight should not be allowed, as extra pounds exert additional stress on the spinal column.
- Comfortable bed... If a person constantly sleeps in an uncomfortable position, then the muscles of his back are constantly tense in a dream. The result is back pain and feeling fatigued in the morning.
- Timely treatment of diseases, which are the reasons for the development of radiculitis: scoliosis, osteochondrosis, intervertebral hernias, infections, etc. Cope with any pathology is always much easier in the initial stages, until it has become chronic and has not led to pronounced changes in the body.
Acute and chronic sciatica, what are the features?
On its own course sciatica can be acute or chronic.Acute sciatica, as a rule, occurs unexpectedly after some kind of spinal injury or strenuous physical activity, a sharp turn of the torso, and so on. After treatment, this form of radiculitis disappears and does not occur again. Back pain usually lasts no more than 3 weeks.
Chronic course radiculitis is more common and accompanies a person all his life. Usually the chronic course has periods of exacerbation and remission. An exacerbation proceeds with acute pain, as in acute radiculitis, and the number of exacerbations can be several times a year. Even the smallest physical activity, any infectious disease or minor hypothermia can lead to an exacerbation of chronic sciatica. Some back pain does not leave at all (for example, with severe osteochondrosis or multiple intervertebral hernias).
Nevertheless, in the development of an acute or chronic course of radiculitis, the cause of the disease is the basis. As you know, sciatica is often not a separate pathology, but a consequence or manifestation of other diseases of the spine or nervous system. In acute radiculitis, the cause is “fixable” conditions of the spine (trauma, muscle contracture, operable swelling, and so on), while in chronic radiculitis, chronic pathologies of the spine that do not disappear anywhere (osteochondrosis, osteoporosis, intervertebral hernias, malformations, progressive scoliosis etc).
Principles of treatment of acute and exacerbations of chronic radiculitis the same. It is very important to properly cure acute sciatica, because it can become chronic. So, in acute radiculitis, there is always muscle spasm, which disrupts the blood circulation of the intervertebral joints and, as a result, this can lead to osteoporosis (destruction of the vertebrae), which can cause chronic sciatica.
In chronic sciatica, it is necessary to treat the underlying disease of the spinal column, since its progression will increase the frequency of attacks of back pain, up to the development of constant pain and stiffness of movements. In addition, severe forms of diseases of the spinal column can lead to paralysis of the lower extremities, heart and lung diseases. In severe cases, with damage to the cervical and thoracic spine, paralysis of the respiratory muscles may develop.
Intercostal neuralgia with radiculitis of the thoracic spine, how to distinguish it from other diseases and how to treat it?
Intercostal neuralgia- This is one of the manifestations of radiculitis of the thoracic spine. Neuralgia means pain along the peripheral nerve. The intercostal nerves feed the muscles of the same name located in the spaces between the ribs. All intercostal nerves extend from the thoracic spine. With the location of osteochondrosis, trauma, hernia and other pathologies in the thoracic spine, the entire intercostal nerve is pinched or inflamed. The clinical picture of intercostal neuralgia is very similar to other diseases of the chest cavity and even renal colic. And often patients think that they have had a heart attack or other "accident".
Let's try to figure out how to recognize intercostal neuralgia and differentiate it from other diseases of the chest organs.
Symptoms of intercostal neuralgia and differential diagnosis with other diseases.
| Symptom | How can it manifest | What other diseases can be confused with? |
| Pain | The nature of the pain:
| 1. Angina pectoris, coronary heart disease, heart attack, pericarditis
(fluid in the pericardium): it is often impossible to immediately distinguish neuralgia from heart disease, therefore it is necessary to urgently call an ambulance, the doctor can use an ECG to determine whether there are heart problems or not. Also, a trial intake of Nitroglycerin often helps in the diagnosis - with angina pectoris, this drug quickly relieves pain, with no neuralgia. 2. Pleurisy (fluid in the pleural cavity) in most cases is accompanied by symptoms of intoxication (fever, weakness, vomiting, and so on), often with shortness of breath. But the doctor can put the last point in the diagnosis by listening to breathing over the lungs, with pleurisy on the affected side, breathing is deaf or not audible, you can hear the pleural friction noise. 3. Pneumothorax (air in the pleural cavity) is always accompanied by shortness of breath and palpitations. When listening to the lungs - the absence of breathing from the affected side, changes in percussion (tapping) over the lungs. 4. Broken ribs develops after trauma, pain is localized in a certain area in the fracture, often you can feel the "irregularities" in the rib. 5. Renal colic often gives to the abdomen and thighs, is observed positive tapping symptom or Pasternatsky(when tapping in the area of the projection of the kidneys, the pain increases sharply). 6. Hepatic colic - sharp pains in the right hypochondrium, which radiate to the abdomen, right arm and even to the region of the heart. Renal colic is often accompanied by nausea, vomiting, fever, yellowing of the skin and visible mucous membranes. 7. Perforated stomach ulcer develops against the background of gastric ulcer, which manifests itself, in addition to pain, nausea, vomiting, stool disturbance and other symptoms. With a perforated stomach ulcer, peritonitis develops, and the general condition of the patient will be disrupted. |
| Loss of sensation and numbness | In the course of the affected nerve, there may be no skin sensitivity, the patient does not feel painful stimuli (tingling, tickling, warmth, cold). Some patients experience numbness in a specific area of the skin (creeping sensation). | The symptom characteristic of the defeat of the intercostal nerves does not occur in other cases. |
| Twitching of the intercostal muscles | Seen with the naked eye, usually local twitching. Associated with hyperexcitability of the nerve and muscle spasm. | A symptom characteristic of the pathology of the intercostal nerves. |
| Increased sweating and increased or decreased blood pressure. | These are characteristic symptoms for intercostal neuralgia associated with damage to the autonomic part of the intercostal nerve. The autonomic nervous system is responsible for the work of the heart, blood vessels, glands, and more. | Vegetovascular dystonia accompanied by these symptoms, and aching squeezing pains in the region of the heart are possible. Vegetovascular dystonia is often chronic and not acute. |
In addition to acute symptoms, intercostal neuralgia greatly impairs the patient's quality of life, and when a chronic course of the disease is acquired, the patient often experiences psychosis (even acute), depression, apathy, sleep disturbance, as a result - chronic stress. Some people resort to strong and even narcotic drugs to relieve pain (this pain is so unbearable). But it is important, if possible, to eliminate the cause of intercostal neuralgia, and not to suppress the pain with pills and injections.
Intercostal neuralgia treatment carried out according to the same schemes according to which other types of radiculitis are treated. As a first aid to reduce pain, a nerve blockade with novocaine or lidocaine is performed. This manipulation should not be carried out often, it can eventually lead to a chronic course of intercostal neuralgia and aggravate the inflammatory process in the nerve fiber.
It is important not to be mistaken in the diagnosis, because the help for neuralgia and diseases of internal organs is fundamentally different. It is advisable to immediately consult a doctor so as not to miss a heart attack or colic, because these diseases can lead to irreversible consequences.
Can the body temperature rise with radiculitis?
For most cases of radiculitis, an increase in body temperature is not typical and can be observed in a small number of patients, and the temperature is usually low, subfebrile (from 37.1 to 37.5 0 C) and in most cases is a reaction to the inflammatory process in the body (namely in nerve). But hyperthermic syndrome can cause other diseases that have caused the development of sciatica:
- rheumatic diseases;
- osteomyelitis of the vertebrae caused by spinal trauma;
- spinal tuberculosis, syphilitic lesion of the vertebrae;
- cancerous tumors of the spine and surrounding tissues;
- infectious diseases;
- autoimmune vasculitis (damage to the vascular wall by its own immunity) and other diseases.
- diseases of the kidneys and urinary system (pyelonephritis, urolithiasis);
- gynecological "accidents" (rupture of the tube during an ectopic pregnancy, apoplexy (rupture) of the ovary);
- inflammatory processes in the heart (myocarditis, pericarditis);
- diseases of the lungs and pleura (pleurisy, pneumothorax, tuberculosis);
- liver disease (cholelithiasis);
- perforated stomach ulcer and so on.
Radiculitis during pregnancy, how to identify and treat?
Pregnancy is a special period for any woman and a completely physiological state. But not all of them run smoothly and without problems. Radiculitis during pregnancy is a fairly common occurrence. The reasons for the development of sciatica during pregnancy:
1. Fetal weight with amniotic fluid, placenta and enlarged uterus
at 38-40 weeks of gestation (before childbirth) is more than 10 kg.
2. Possible swelling of soft tissues
, often accompanying women (with toxicosis in the second half of pregnancy, their volume can be 5-10 liters).
3. Gained excess weight
.
4. Change of center of gravity and posture
.
5. Normally, any woman preparing for childbirth has changes in the bones of the pelvis
, and almost all pregnant women in the last trimester constantly experience pelvic pain. In this case, there is an expansion of the internal pelvis, a discrepancy in the joint between the sacral and lumbar spine. And all this puts a huge load on the spine, pelvis, lower limbs and their vessels.
6. The hormonal background of pregnant women helps to reduce the tone of muscles and ligaments
, so the body prepares for childbirth and easier passage of the baby through the birth canal. Muscle tone also decreases and the ligamentous apparatus of the spine is weakened, which can lead to the development of scoliosis, intervertebral hernias, and so on, and as a result - sciatica.
7. Stress, decreased immunity, lack of calcium
etc.
Heavy load and all these factors significantly increase the risk of developing acute sciatica in a woman, which can become chronic after childbirth. Indeed, with the birth of a baby, a woman continues to load her spine with weights (a child living in her arms, milk-filled mammary glands, strollers and household life). 
Photo:
a schematic representation of the causes of pelvic pain in pregnant women.
So, almost all pregnant women experience back pain, but only a few of them suffer from sciatica.
Radiculitis during pregnancy can be confused with other causes of back pain:
- expansion of the pelvis;
- stretching the muscles of the back and pelvic ligaments (normal in the second half of pregnancy);
- increased tone of the uterus (its back) with the threat of premature birth and precursors of childbirth;
- kidney disease, such as chronic pyelonephritis;
- osteoporosis of the spine (due to calcium deficiency);
- compression of the nerve roots by an enlarged uterus during movements or changes in fetal posture;
- exacerbation of chronic pancreatitis; peptic ulcer of the stomach and duodenum;
- exacerbation of chronic inflammation of the ovaries and fallopian tubes.
Characteristic signs and features of sciatica during pregnancy:
- the woman suffered from chronic sciatica even before pregnancy - there is a high probability that back pain is associated with sciatica;
- in pregnant women more often sciatica of the lumbar spine , while lower back pain can radiate down the abdomen and legs, that is, there is sciatica - damage to the sciatic nerve;
- pains wear sharp character , often shooting, paroxysmal;
- muscle back in the affected area tense ;
- more rapid cessation of seizures , which is due to the peculiarity of the hormonal background of a pregnant woman;
- no data for other diseases (pancreatitis, pyelonephritis, stomach ulcer, uterine hypertonicity, and so on).
As you know, many drugs are contraindicated during pregnancy, especially in the early stages. Therefore, treating any pathology during pregnancy is always problematic and should be carried out only under the supervision of a doctor, self-medication can lead to the threat of miscarriage or the appearance of developmental anomalies in the child.
Treatment regimen for sciatica during pregnancy:
- rest and bed rest (required);
- use of insulated bandages for partial unloading of the muscles of the lower back and thermal effects on the nerve roots;
- B vitamins (Neurovitan, Neurobeks, 1 tablet a day after breakfast);
- Diclofenac during pregnancy, it is used only with severe pain syndrome, it is better to use it in the form of ointments, gels, cream, and in the third trimester (after 27 weeks) of pregnancy, Diclofenac is absolutely contraindicated in any form (and for external use too);
- Ibuprofen, Nimesulide and many other non-steroidal anti-inflammatory drugs during pregnancy and lactation, they are not used due to possible side effects in relation to the fetus, from this group, only paracetamol and aspirin in small doses is possible (aspirin can only be up to 35 weeks);
- avoid hypothermia and drafts;
- at any stage of pregnancy do not overheat, especially in the lumbar region, this can lead to a threat of miscarriage or premature birth;
- physiotherapy not recommended in the first half of pregnancy;
- thereafter - avoid heavy physical exertion, prolonged stay on your feet, hypothermia, sudden rise from bed, you must wear only comfortable shoes (heels are contraindicated), sleep on a comfortable mattress;
- after 12 weeks of pregnancy possibly yoga, exercise therapy and relaxing massage;
- monitor weight and swelling , do not overeat and limit the amount of fluid, since excess weight further increases the risk of developing repeated exacerbations of sciatica.
What doctor treats sciatica, is a sick leave indicated and how much?
Scientists deal with sciatica to a greater extent doctors neuropathologists.If sciatica is a manifestation of diseases of the spine (intervertebral hernias or discogenic sciatica, spinal injuries, and so on), Doctors can help:
- vertebrologists;
- orthopedic traumatologists;
- neurosurgeons.
- reflex therapists;
- physiotherapists;
- chiropractors.
As has been repeatedly noted, with sciatica, it is very important to observe bed rest. It is clear that working people should be released from work until they recover, especially if a person is involved in hard physical work (lifting weights, staying on their feet for a long time, etc.). And sedentary work also negatively affects the condition of the spine and nerve roots.
Therefore, the state, namely the state insurance service, provides a sick leave for the duration of sciatica.
Sick leave or certificate of incapacity for work is issued in case of temporary disability
by the attending physician, and if the sick leave is more than 10 days by the medical advisory commission or the LCC. With constant (persistent or long-term) disability a medical and social expert commission (MSEC or VTEK) assigns disability
.
Indications for issuing a sick leave:
- acute sciatica;
- exacerbation of chronic sciatica.
There are no specific restrictions on the timing of release from work. But the treatment of sciatica usually lasts at least 2 weeks, and issuing a sick leave for a shorter period is meaningless, because early going to work with sciatica can lead to the development of chronic sciatica.
1. acute sciatica and exacerbation of chronic sciatica
mild to moderate severity
- not less than 14 days;
2. sciatica and neuralgia
(sciatic nerve neuralgia or sciatica, intercostal neuralgia and other types of neuralgia) - at least 18-20 days;
3. prolonged sciatica
(rapid onset of repeated exacerbation) - 28-30 days.
The average period of disability with sciatica is 18-20 days.
The nature of the job also affects the duration of the disability. So, in heavy industries, the sick leave period is increased by an average of 10 days.
If a person with chronic sciatica is busy at work that involves heavy physical activity, then a special commission considers the need to transfer the employee to less heavy work (temporarily or permanently).
When is a patient with radiculitis sent to MSEC for disability appointment?
- Failure of treatment for 4 months;
- often recurring exacerbations of sciatica associated with the main profession of a person;
- the inability to transfer to work that is within the power of the patient with sciatica;
- development of paralysis;
- condition after surgery for diseases of the spine, which caused the development of radiculitis.
What is the first aid for sciatica?
1.
Place the patient in a comfortable, hard bed. This is often problematic, it is necessary to hold the patient and let him lean with his hand, after all the procedures, it is better for the patient to take a position lying on his back with his legs raised on the pillow or on his side, it is necessary to cover it with a blanket. In the future, restrict movement in the spine, that is, ensure bed rest. 2. Anesthesia. For this, analgesics are more effective: Ibuprofen, Indomethacin, Nimesulide, Pyramidon, Diclofenac and others. It is preferable to inject drugs, they quickly relieve pain, but if it is impossible to give an injection, they give drugs inside.
3. The doctor, as a first aid, performs novocaine blockade of nerve roots (this procedure requires a qualified hand). Applications with anesthetics are possible, namely Lidocaine (ready-made form - a patch), but only in the absence of an allergy to Novocaine or Lidocaine.
4. Give drugs of group B (Neurovitan, Neurorubin).
5. Fixation of the spine with bandages, belts, sheets or towels and other available means.
6. Calm down the patient with a word and / or a sedative (valerian, Novo-Passit, motherwort tincture and others).
7. The use of ointments in the area of pain (anti-inflammatory, warming, combined).
8. Relaxing massage is possible.
9. It is forbidden to independently "adjust the vertebrae", to carry out sharp movements in the limbs and to carry out other receptions of a chiropractor.
10. Call a doctor!
Ointment for sciatica, what are the effective external agents (ointment, gel, patch) for sciatica?
With radiculitis, external agents are very effective, which can have various effects, but, one way or another, contribute to the treatment of sciatica and relieve pain. It is difficult to cure sciatica without local treatment. External remedies can be used for any type of radiculitis (cervical, thoracic, lumbar, sacral), both in acute and chronic sciatica. External remedies for the treatment of sciatica.
| Group of drugs | Trade names | How is it applied? |
| Anti-inflammatory and analgesic drugs |
||
| Non-steroidal anti-inflammatory drugs. These drugs inhibit the biologically active substances that cause the symptoms of inflammation. | Diclofenac:
| Rub in a thin layer up to 3 times a day. |
Ibuprofen:
| 5-10 cm of gel is applied to the affected area and rubbed in, up to 4 times a day. | |
Nimesulide:
| Apply 3 cm of gel to the most painful area, do not rub. Used 4 times a day. | |
Ketoprofen:
| Apply in a thin layer 2 times a day (cherry fruit volume). |
|
Piroxicam:
| Rub in up to 4 times a day (volume with a walnut). | |
Salicylic acid derivatives:
| Rubbed in a thin layer 3 times a day. | |
| Local irritating external agents |
||
| Warming ointments, gels and creams give an immediate result of pain relief, which lasts a short time, pain relief occurs due to improved blood circulation, removal of edema and irritation of nerve endings in the skin. Many preparations contain different essential oils, some of which combine essential oils with niacin, which effectively dilates blood vessels. Also, some preparations are based on the components of hot pepper. |
| Apply to the skin with a thin layer, especially for the first time, then the dose can be slightly increased. These preparations must be applied to cleansed skin. It is recommended to apply warming ointments up to 3-4 times a day. These drugs can cause allergic dermatitis. |
| Ointments with snake or bee venom promote warming, reduce inflammation, effectively relieve pain and treat sciatica. The main mechanism of action is to increase blood circulation and increase the permeability of the vascular wall, as a result - the removal of edema and other signs of inflammation. Also, these drugs have antiallergic and antiseptic effects. Many preparations of such poisons also contain an anti-inflammatory component - salicylic acid. | Viper Venom:
| Such ointments are applied to previously cleansed skin, at first they are not rubbed. Wait a few minutes until a burning sensation appears, and then rub in and put on a warming belt thoroughly. Recommended 2-4 rubbing per day. The course of treatment is usually up to 10 days. The use of such poisons can lead to the development of severe side effects, especially in the presence of allergies, kidney or liver failure. Therefore, when using these types of ointments, you should consult your doctor. |
| Other types of external drugs for the treatment of sciatica |
||
| Combined drugs: Anti-inflammatory + warming and irritating effects. Combined ointments and gels are quite effective and do not require a combination of different groups of drugs. |
| Apply in a thin layer 2-4 times a day. |
| Nayser (3 types of NSAIDs + menthol) | Apply, without rubbing, a thin layer of gel 3-4 times a day. | |
| 1-2 times a day | |
| Hondrofen (chondroitin + diclofenac + dimethyl sulfoxide) | 2-3 times a day, the ointment is applied without rubbing, it is absorbed completely after a few minutes. | |
Homeopathic remedies have a fairly wide range of therapeutic effects:
|
| Rub in 3-5 times a day, the course of treatment is 3-4 weeks. |
| Preparations that restore the cartilage tissue of the joints, treat mostly not radiculitis, but the causes of its occurrence (osteochondrosis, osteoporosis and others). These drugs contain chondroitins and glucosamines - components of cartilage tissue. These substances cannot completely restore cartilage, but they partially improve its condition and prevent the progression of the process. |
| Rub in easily 2-3 times a day. |
| Plasters and applications can be pain relieving and warming or distracting. The advantage of these types of external agents is a longer therapeutic effect. |
| Plasters and applications are carried out once a day at night, before going to bed. |
* NSAIDs - non-steroidal anti-inflammatory drugs.
All external drugs for the treatment of sciatica have their own contraindications and features. Many drugs are contraindicated for use during pregnancy and childhood. The more effective the drug, the more likely it is to develop a local allergic reaction to it.
A combination of several types of ointments and gels is often used. But at the same time, it is necessary to consult a doctor, since some drugs are not compatible with each other.
According to patient reviews, the most effective drugs are:
- Nise gel;
- Nizer;
- Nikoflex;
- Viprosal;
- Capsicum;
- Diclofenac and Voltaren, Rumacar;
- Apizartron;
- Hondrofen and others.
Medicinal and alternative methods for treatment at home, how to quickly cure sciatica at home?
Radiculitis is not a mandatory indication for hospitalization, and most patients go through this difficult period at home.Indications for hospitalization in the hospital:
- frequent exacerbations in chronic radiculitis;
- severe pain syndrome, which cannot be relieved by traditional means;
- paralysis, significant limitation of movement;
- the need for treatment of severe and progressive diseases of the spine, which led to the development of sciatica.
For people who do not visit doctors and want to fight on their own, imagine basic principles of radiculitis treatment at home.
1.
First aid with acute pain syndrome (prescribed).
2.
Bed rest, limiting physical activity to relieve an attack of back pain. When the pain has passed, remedial gymnastics is necessary.
3.
Warming the sore back: woolen belt, band-aids, wrapping with a blanket, warm woolen shawl, heating pad, shawl with heated salt and so on.
4.
Drug treatment, scheme:
- non-steroidal anti-inflammatory drugs in the form of tablets, powders or injections (Diclofenac, Ibuprofen, Nimesulide, Piroxicam, Indomethacin and others);
- B vitamins (Neurovitan, Neurorubin, Milgamma and others);
- ointments, gels, topical creams with anti-inflammatory, analgesic, warming or distracting effect).
6. Cartilage restoration drugs in the form of injections, tablets or creams (Mucosat, Glucosamine chondroitin, Teraflex, Alflutop, Chondroitin, Chondroxil and others).
7. Traditional medicine.
Traditional medicine
Traditional methods are best combined with traditional medicines, but in some cases, these methods are effective without pills.
1.
Rubbing with diluted vinegar and essential oils
fir, menthol.
2.
Rubbing with honey
in pure form or stir honey with furacilin solution.
3.
Horse chestnut appliques
... Grind horse chestnut into powder, combine with camphor oil (1: 1). Apply the resulting mixture to a thin piece of bread and apply to the affected area, wrap it on top. This procedure is performed before bedtime.
4.
Compresses with black radish for the night:
grate the radish, strain, soak the fabric with the resulting juice and apply to the sore area of the back.
5.
Rubbing with garlic.
Chop the garlic and add the lard (1: 2), rub the back with the resulting mixture.
6.
Larkspur compresses.
Grind the dried larkspur root into powder, add hot water and add a few drops of any vegetable fat. The resulting paste in a warm form is applied to the disturbing area and covered with a cloth, on top with a towel and a belt. Such a compress is left for several hours, it is possible for the whole night.
7.
Compresses with potatoes.
Boil 500.0 g of peeled potatoes, mash and add 1 teaspoon of baking soda. Apply gruel to the lower back and wrap it with oilcloth, cover with a blanket on top.
8.
Turpentine bathrooms.
0.5 liters of boiling water + 750 mg of aspirin + 30.0 g of baby soap (grate). Add this mixture to the container where the turpentine is located (its volume depends on the volume of the bathroom, 20-40 ml per 1 liter of water). The resulting emulsion is added to a bathroom with warm water. The patient takes a bath for 10 minutes. This method is very effective in treating sciatica.
9.
Rubbing hot chili peppers.
Pour 2 chili peppers with 300.0 ml of ammonia and leave for 2 weeks. This infusion will effectively relieve pain.
10.
Bathrooms with pine.
Pour young pine shoots (1 kg) with water, bring to a boil and boil for 10 minutes, let it brew for several hours. 1 liter of this infusion is counted on 13 kg of warm water. Such a bath is taken within 10 minutes, after the bath, effectively lubricate the back with any essential oil.
Bath, hot bath, physical activity, swimming, sleeping on a shield with sciatica, what is possible and what is contraindicated?
With sciatica, it is necessary to warm the sore back area. And warmth is one of the factors in the treatment of back pain. Therefore, all thermal treatments will be very useful. Bath, sauna, hot bath with acute radiculitis and exacerbation of chronic radiculitis, they will very effectively affect recovery. You can achieve results even faster if you warm up with a broom and apply essential oils. With sciatica, the bathhouse can be visited daily, and after recovery, to prevent exacerbations, you need to steam once a week.
But the baths and saunas should be treated with vigilance by people suffering from diseases of the heart and blood vessels (hypertension, coronary heart disease, cardiac arrhythmia, heart defects, heart attack, stroke and other pathologies), they are not advisable to bathe at all.
As for physical activity, during the period of acute pain, bed rest and complete restriction of movement in the damaged spine are necessary. But after removing the pain syndrome, physical activity is simply necessary. If you lie down after acute sciatica, then the development of chronic radiculitis is very close and the next attack will not be long in coming. Of course, you can't immediately run a marathon and lift barbells after an attack. Physical exercises begin with minimal loads, gradually increase. Therapeutic exercises should be aimed at strengthening the muscles of the back and stretching them. 
Swimming Is one of the best sports for patients with spinal diseases. But swimming is possible only after an attack of sciatica, as a prophylaxis for subsequent exacerbations. And people with chronic sciatica naturally cannot swim in cold water (below 19 0 C). Yoga also gives a good result in the prevention of sciatica and its exacerbations. 
Sleep on a shield or sleep on a hard, level surface- a desirable condition in the treatment of sciatica and many diseases of the spine. Of course, those who are pampered on comfortable soft beds at first feel specific discomfort on such a surface, but over time they get used to it and get enough sleep even better. It is desirable for everyone to sleep on a firm and level one, and even more so for people who have had an attack of sciatica at least once.
Sleeping on a shield can be arranged without the extra cost of purchasing a new orthopedic bed. To do this, a wooden shield is placed under a low, but not too thin mattress, it can be a specially made wide board, a wooden door. Also, if the house is warm and there is no acute attack of sciatica, you can sleep on the floor with a thin mattress.
But don't overdo it! A bed that is too hard is also not recommended and can lead to spinal problems.
- (lat. radicula - root) - lesions of the roots of the spinal cord, causing motor, autonomic and pain disorders. Radiculitis is manifested by an intense pain syndrome, a decrease in muscle strength, reflexes and sensitivity in the area innervated by the affected spinal nerve. Diagnosis of sciatica is carried out using X-ray, CT and MRI of the spine, according to indications, it is possible to carry out myelography and lumbar puncture. In the treatment, pain relievers and anti-inflammatory drugs, blockades, physiotherapy procedures, manual techniques, spinal traction, physiotherapy exercises and massage are used.
General information
- (lat. radicula - root) - lesions of the roots of the spinal cord, causing motor, autonomic and pain disorders. The etiological factors of radiculitis are degenerative-dystrophic changes in the spine, such as osteochondrosis, deforming spondylosis, as well as various anomalies in the development of the spine (sacralization, spondylolisthesis, accessory ribs, aplasia of the vertebrae). Hypothermia, trauma, infections (influenza, tuberculosis, syphilis, cerebrospinal meningitis), as well as radicular forms of neuroviral diseases (tick-borne encephalitis, etc.) can also provoke inflammatory processes in the spine.
Pain syndrome with sciatica can manifest itself as a result of weight lifting, awkward movement, infection or a cold, when the fibrous ring of the disc is stretched or ruptured, the gelatinous disc extends beyond its borders, and an intervertebral hernia forms in its place. Often, an extended disc or osteophytes squeeze not only the spinal root, but also nearby membranes and tissues, which in turn serve as an additional source of pain. In addition, two more factors play a role in its pathogenesis: dyscalgia and muscle-tonic pain.
Classification of radiculitis
Depending on the topography of the inflammatory process, radiculitis is divided into a number of forms: lumbosacral, thoracic, cervical, which in turn can be chronic or acute.
In addition, there are primary radiculitis (toxic, infectious origin) and secondary, caused by anomalies of the spine and spinal cord. With meningoradiculitis, the inflammatory process develops simultaneously in the roots with the spinal nerve. and the membranes of the spinal cord.
Symptoms of sciatica
The main symptoms of sciatica are pain, decreased reflexes, partial sensitivity disorder, autonomic disturbances. The first attacks of pain associated with a rupture of the fibrous ring of the intervertebral disc are diffuse in nature (reminiscent of "myositis" or "lumbago"). And only with the formation of a disc herniation, which compresses the root, a radicular syndrome is formed, when there are sensations of tingling and numbness. In the area of the affected root, innervation develops and, as a result, a decrease or complete absence of sensitivity (temperature, tactile and pain). Over time, the weakness of the muscles located in the area of the affected root increases, up to their complete atrophy.
Symptoms of primary radiculitis (infectious and toxic etiology) are manifestations corresponding to the disease that caused sciatica (in the case of ARVI - fever, chills, etc.). With lumbosacral radiculitis, localization of pain that increases with walking and coughing is possible in the lumbar region, lower leg, thigh or foot. At the initial stage, the disease proceeds according to the type of lumbago, lumbodynia and lumbar ischialgia.
To partially relieve pain in sciatica, patients take a "protective" position: they sit with their legs bent under them and resting their hands on the bed, or lie with a pillow under their stomach. The gait changes: in movement, patients try to rely mainly on a healthy leg. Quite often, there is an increased tone of the lumbar muscles, antalgic scoliosis, less often kyphosis. On palpation, the paravertebral points in the lumbar region, the posterior surface of the thigh, the popliteal fossa, the heel (Gara point) and the middle of the foot (medioplanatary ankylosing spondylitis) become painful, and this is almost the defining symptom complex of lumbosacral sciatica.
Radiculitis treatment
Forecast
A favorable prognosis is possible in the case of timely diagnosis and extensive treatment, including all possible directions. Only with this approach can recovery be expected without fear of relapse. In the case of ischemia and, as a consequence, spinal cord infarction, it is impossible to predict complete recovery, since the consequence of such complications is often a violation of the motor and sensory functions of the body.
Prevention of sciatica
Prevention of radiculitis includes measures aimed at maintaining correct posture, strengthening the back muscles. It is recommended to avoid excessive stress on the spine. Correct posture during sleep and wakefulness minimizes the stress on the spinal column. You should not sleep on too hard mattresses. Contrary to popular belief, they are capable of distorting the position of the spine and disrupting its function. To avoid this and preserve the natural curvature of the spine, it is recommended to pin small pillows under the neck and lower back, or to use a semi-rigid mattress that is able to support the natural position of the spine.
Maintaining the correct posture is also very important in your daily work. When lifting objects from the floor, it is recommended to bend your knees without bending your torso. Thus, the load will shift from the back to the legs. It is recommended to avoid uncomfortable postures (prolonged sitting at a table with your head bowed, sitting in front of the TV, dropping your chin on your chest, etc.). In addition, gymnastics, which helps to strengthen the muscles of the back, as well as sports and hardening, which increase the body's resistance to physical exertion and hypothermia, play an important role in the prevention of sciatica.
Radiculitis, or radiculopathy, is a neurological pathology associated with compression or inflammation of the spinal nerves. This happens most often due to degenerative-dystrophic changes in the spine or inadequate loads. With the modern sedentary lifestyle, the lumbar region suffers the most from these factors. It is on him, as well as on the place of his junction with the sacrum, that the greatest loads fall when walking, standing and even sitting. Therefore, lumbosacral radiculitis most often occurs, causing severe pain and disrupting the patient's normal life.
general characteristics
Lumbosacral sciatica most often causes back pain. According to statistics, it occurs in 10% of adults. Usually this disease is secondary and develops in the presence of other pathologies of the spine. Therefore, some experts consider radiculitis a symptom complex, a consequence of degenerative-dystrophic diseases, most often osteochondrosis. But changes in joints, discs or musculo-ligamentous apparatus can provoke pain. Sometimes the inflammation of the nerve roots develops on its own, for example, when exposed to infection, alcohol intoxication or severe hypothermia.
Radiculopathy of the lumbosacral spine, better known as sciatica, is common mainly in people 35-50 years old. Moreover, pathology is more common in men. This is due to the fact that it appears due to increased loads on the lower back or hypothermia. People who spend a long time in a sitting position, doing work on their legs, forced to lift weights are susceptible to sciatica. In some professions, the risk of sciatica is especially high. These are movers, builders, drivers, agricultural workers, as well as athletes.
Usually, after the first attack of sciatica, which occurs after an injury, when performing a sharp movement or lifting a heavy object, the disease does not cure at all, but acquires a chronic course. With the correct behavior of the patient, relapses can be rare - once every 2-3 years. But most often the pathology is exacerbated several times a year.
Depending on the type of nerves affected, the reasons for their compression, as well as the symptoms manifested, there are several types of lumbosacral radiculopathy:
- lumbago is characterized by acute shooting pain in the lower back, which makes a person freeze in a bent position;
- lumbodynia is a painful condition that lasts for several months;
- sciatica is a type of sciatica associated with damage to the sciatic nerve, while pain occurs not in the back, but in the buttock, thigh, lower leg;
- lumboischialgia - a pathology that combines the manifestations of lumbago and sciatica;
- with a herniated disc, leading to compression of the nerve roots, a condition called discogenic radiculopathy of the lumbosacral region develops.
Backache can occur when leaning forward sharply
Reasons for the appearance
The main reason for the appearance of radiculopathy is compression or inflammation of the nerve roots extending from the spinal cord. Most often this happens with the development of degenerative-dystrophic processes in the spine. It is believed that in 80% of cases, radiculitis occurs with osteochondrosis, spondyloarthrosis or herniated discs. Due to degenerative processes, the cartilaginous tissue of the discs begins to collapse, the distance between the vertebrae decreases. Muscle spasm occurs, which disrupts the blood supply to the spine. This leads to an inflammatory process.
Nerve roots can be compressed by overgrown osteophytes, which appear to reduce the load on the vertebrae, displaced vertebrae or hernias. All of these conditions develop due to the destruction of cartilage tissue. The reason for such degenerative processes can be a lack of movement, leading to a slowdown in blood circulation, metabolic disorders, obesity, trauma, bad habits, curvature of the spine or increased stress.
But backache occurs in certain situations. The factors provoking the development of radiculopathy of the lumbosacral spine include:
- severe hypothermia;
- a sharp turn of the body or tilt forward;
- lifting weights;
- long stay in a sitting position;
- increased loads;
- infectious diseases;
- general intoxication;
- inflammatory processes in the surrounding tissues.
Symptoms
When exposed to provoking factors, an attack of radiculitis occurs. This is a severe, sharp pain in the lower back known as a lumbago. In this case, the patient can take a forced position, most often - bending forward a little. Any movement hurts, especially turning or bending, it also hurts to walk.
In addition, in the acute period there are such characteristic symptoms of lumbosacral sciatica:
- back muscle spasm;
- severe pain when pressing on the spinous processes of the vertebrae;
- increased pain when sneezing, coughing, shaking the body;
- sweating, weakness;
- along the damaged nerve, there is a decrease in the sensitivity of the skin, its pallor and cold snap;
- a sharp increase in pain when raising a straight leg from a prone position;
- stiffness in movement.
Sharp pain can occur during physical work or lifting weights
Pain with radiculitis lumbar is special. It is sharp, shooting, spreading along the affected nerve. Most often, pain sensations appear, in addition to the lower back, in the buttock, thigh, lower leg and foot. They intensify with movement or increased loads. When the sciatic nerve is affected, there is pain and numbness along the back of the leg. The patient cannot sit, it hurts him to walk. If the nerves are severely damaged, the pain may worsen when the head is tilted forward.
Discogenic lumbosacral radiculitis, in addition to pain, is characterized by other symptoms. Basically - this is a violation of sensitivity. You may feel tingling, running creeps, numbness or chilliness. When the motor fibers of the nerves are damaged, motor disorders develop. This is mainly reflected in the movements of the foot. A condition such as a drooping or paralytic foot develops. In this case, the patient cannot stand on his toes. Due to the limitation of motor activity, muscles gradually atrophy. Weakness, instability of movements develop, tendon reflexes often disappear.
Usually, an exacerbation of sciatica lasts 2-3 weeks. At this time, the patient also exhibits external signs. The lumbar lordosis straightens and the spine bends to the side due to muscle spasm on the side of the nerve injury. The gluteal fold is smoothed, spasmodic muscles can be noticeable on the lower back. The patient's gait changes, and in general he tries to walk less.
Usually, the doctor makes a diagnosis already during an external examination of the patient.
Diagnostics
The symptoms of sciatica are so characteristic that the diagnosis of the disease does not cause problems. The preliminary diagnosis is made after examination and special tests. With their help, the reflex reactions of the body are checked. For example, when lifting a straight leg from the side of a nerve lesion, the pain increases - this is a symptom of Lasegue, and an increase in pain when the head is tilted forward is a symptom of Neri. Ankylosing spondylitis is characteristic: when the patient sits down from a supine position, the sore leg reflexively bends.
X-rays and blood tests may be done to confirm the diagnosis and determine the cause of radiculopathy. CT and MRI help to identify the degree of damage to the nerve roots, to determine the condition of the discs and the musculo-ligamentous apparatus. Sometimes electroneuromyography is also performed to assess the state of the nerves themselves. Such an examination is necessary in order to recognize in time the presence of a tumor, intervertebral hernia, osteophytes, circulatory disorders, stenosis of the spinal canal.
Severe pain can often only be relieved with injections
Treatment
The effectiveness of treatment depends on its timeliness, the cause of the lesion and the state of health of the spine. If vertebrogenic pain symptoms are ignored or with improper treatment, pathology may progress. The nerve can gradually die off, leading to problems with walking. Violations of urination and defecation may develop. But if the patient turns to the doctor on time and follows all his recommendations, the attack can be stopped in 5-7 days, and subsequently to prevent the occurrence of exacerbations.
The objectives of the treatment of sciatica should be not only pain relief. It is necessary to eliminate the factors that led to the compression of the nerve, remove the inflammatory process, and restore the patient's mobility.
For this, the following methods are used:
- pain relievers or non-steroidal anti-inflammatory drugs in the form of pills and injections;
- topical ointments and compresses;
- orthopedic devices to reduce the load on the affected area;
- physiotherapy procedures;
- massage and manual therapy;
- traction traction of the spine;
- physiotherapy.
What to do in case of an attack
In case of an acute attack of sciatica, it is very important to see a doctor as soon as possible. But before that, it is important to relieve severe pain. To do this, you need to drink 2 tablets of anesthetic. Effective, for example, Diclofenac, Ketanov, Ortofen, Nimesulide, Indomethacin.
After that, you need to lie down on a flat, hard surface, you can on the floor. Raise your legs on pillows or rolled up blankets. Moreover, they should be bent at the knee and hip joints at right angles. It is very important to keep your back warm. But hot compresses are unacceptable, it is better to wrap the lower back in a scarf or wear a warming belt.
Rest and warmth is what the patient needs for several days after the attack. If you consult your doctor in time, pain symptoms can be removed in 5-7 days. But for this, complex therapy is necessarily applied.
Medications
To remove the compression of the nerve roots, you first need to relieve pain, muscle spasm and inflammation. Most often, drug therapy is used for this. The most common drugs for radiculopathy are NSAIDs. These are Ibuprofen, Diclofenac, Indomethacin, Ketoprofen, Nimesulide. They can be taken for no more than 5 days, so other drugs are used to speed up recovery.
The pain is aggravated by muscle spasm, so muscle relaxants are effective. Sirdalud, Midocalm, Baksolan are used. Sedatives are often prescribed, which, due to inhibition of consciousness, provide a decrease in pain. B vitamins are helpful and can help relieve pain. They can be used alone or as part of complex preparations, for example, Milgamma or Neurodiclovitis. To restore cartilage tissue, chondroprotectors are used - Chondroitin, Teraflex, Artra. They help reduce the frequency of exacerbations of sciatica.
Additionally, pain relieving patches can be used to relieve pain.
External remedies
At the initial stage of treatment of sacral sciatica, ointments are used to relieve pain. They have a warming and irritating effect, stimulate blood circulation and reduce pain. It makes no sense to use such funds on your own, but they are effective in complex treatment.
The most commonly used ointments are Viprosal, Nikoflex, Finalgon, Nise, Apizartron. Compresses with Dimexide are also effective. At the recovery stage, it is good to rub pepper tincture, camphor alcohol, Novocaine into the lower back. Recently, plasters have become popular for relieving pain in sciatica. In addition to the well-known pepper for a long time, now used funds based on NSAIDs, anesthetics or herbal extracts. For example, Nanoplast, Voltaren, Versatis are effective.
Injections
With severe pain, sciatica can be treated with blockades. This is an injection of drugs directly into the area of the affected nerve. Only a doctor should do them. Injections are injected into the epidural space, trigger points, the joint cavity, or where the nerve is pinched.
Anesthetics are used for this, for example, Lidocaine or Novocaine. In some cases, corticosteroids are used. It can be Hydrocortisone, Diprospan, Kenalog. In addition, B vitamins or biologically active substances can be introduced to accelerate the recovery of the affected tissues.
Physiotherapy
After the removal of acute symptoms during the recovery phase, additional methods are used to treat lumbosacral sciatica. It can be ultraviolet irradiation, electrophoresis with Novocaine, pulsed ultrasound therapy. Effective diadynamic currents, magnetotherapy, laser irradiation, hydrogen sulfide baths.
Hirudotherapy has proven itself well. After all, leeches secrete special substances that relieve pain and inflammation. Acupuncture is effective for radiculitis. This method improves blood circulation and metabolic processes, increases the body's defenses, relieves swelling.
Physiotherapy treatments can help speed up recovery
Physiotherapy
Bed rest for radiculopathy is recommended for no more than 3 days. Then you need to start moving and perform special exercises. They will help activate blood circulation and metabolic processes, prevent muscle atrophy. At first, they can be performed in the supine position, then, after pain relief, physical activity increases.
All exercises are performed slowly, without jerking or sudden movements. Muscle relaxation and stretching exercises are mandatory. It is contraindicated in radiculopathy, even during remission, to perform forward bends and torso rotation. If you practice regularly, you can prevent frequent exacerbations of the pathology.
Lumbosacral sciatica is a pathology that arises once and can periodically worsen. Therefore, patients need to change their lifestyle, monitor weight, avoid hypothermia and increased stress. If you follow all the doctor's recommendations, you can prevent the complications that often lead to radiculopathy.
On the other hand, many people with this ailment have a moderately high temperature. Is this phenomenon dangerous and what can it talk about? Let's try to figure it out.
In this article, we will find out whether the temperature occurs with osteochondrosis and to what numbers it can rise. We will also analyze the causes of a short fever that occurs against the background of diseases of the spine.
Can the temperature rise with osteochondrosis
The term osteochondrosis is a combination of dystrophic changes in the intervertebral discs (IVD) that occur under the influence of traumatic factors or as a result of natural aging of the body. The disease is non-inflammatory and therefore cannot by itself cause fever.
However, over time, osteochondrosis is complicated by spondylosis, spondyloarthrosis, intervertebral hernias, etc. All this leads to a change in the distance between the vertebrae, narrowing of the spinal canal and the formation of osteophytes. Pinching of the spinal roots or trauma to soft tissues is often accompanied by the development of an inflammatory process and a slight increase in temperature.
Fact! Can there be a temperature with osteochondrosis? Yes, but it does not arise because of the disease itself, but as a result of complications that have arisen. The cause may be nonspecific or specific diseases of the spine.
Before talking about the temperature rise, let's find out its normal values. Many of you are sure that a thermometer reading of 36.6 is the norm. In fact, everything is a little different. Normal body temperature can be in the range of 36.5-37.2 degrees Celsius. By the way, its fluctuations throughout the day are absolutely physiological. For example, if you measure the temperature in the evening, you can get higher numbers.
Output! Osteochondrosis and a temperature of 37 degrees is considered quite normal for many people. If you do not have other alarming symptoms, there is no point in being scared and worried.
Reasons for a slight increase in body temperature
Some people have situations when, with osteochondrosis, the temperature rises sharply in degrees. Along with this, there are difficulties in bending and unbending the spine, a feeling of stiffness and severe back pain, radiating to different parts of the body. Such symptoms usually indicate the development of nonspecific complications of osteochondrosis. Let's see what they are.
Table 1. Nonspecific diseases of the spine, accompanied by a temporary increase in body temperature.
Curious! Is there a temperature with uncomplicated cervical or lumbar osteochondrosis? Yes, this happens with a long course of the disease, accompanied by pronounced destructive processes in the spinal column. There are cases when people with ostechondrosis had a temperature of 37.5 degrees for many months.
Herniated intervertebral discs
A herniated IVD is a rupture of the annulus fibrosus with subsequent displacement of the nucleus pulposus. Lifting weights, sudden awkward movements, or strenuous physical work may be the cause. The formation of a hernia is usually accompanied by the development of an inflammatory process. In some cases, a person's spinal root is pinched, which also leads to the appearance of neurological symptoms.
Signs of a hernia of the lumbosacral region:
- sharp sudden pain in the lower back, often radiating to the lower limb;
- Difficulty flexing and extending the spine
- weakness in the legs;
- inability to perform daily work and lead a normal life.
Typical signs of a hernia of the IVD of the cervical spine:
- neck pain extending to the back of the head and upper limb;
- feeling of stiffness and numbness in the cervical region;
- dizziness and headache;
- a slight rise in blood pressure;
- numbness of the fingers, weakness in the upper limbs.
Even "neglected" OSTEOCHONDROSIS can be cured at home! Just remember to brush it on once a day.
Hernias of the thoracic region are manifested by painful sensations and limited mobility of the spine. Because of this, it becomes difficult for the patient to sit in the same position for a long time. Typically, such hernias appear in people with scoliosis, kyphosis, or kyphoscoliosis. The reason for their formation is the excessive load on the IVD due to the curvature of the spine.
Advice! A sudden increase in temperature with osteochondrosis of the cervical and lumbar spine often indicates the presence of complications. If you get this symptom, you should see your doctor and get tested.
Spinal stenosis
It develops mainly in the lumbosacral spine. The reason may be not only osteochondrosis, but also congenital malformations, ankylosing spondylitis, and previous surgery on the spinal column. Stenosis of the spinal canal can lead to trauma to the nerve roots and the development of an inflammatory process in them.
- the formation of intervertebral hernias;
- displacement of the vertebrae relative to each other;
- ossification of the yellow ligament;
- proliferation of marginal osteophytes;
- deformation of the intervertebral joints due to spondyloarthrosis.
Important! High temperature with osteochondrosis of the thoracic spine is an extremely alarming symptom. Note that protrusions, hernias and pinching of the nerve roots in this section are very rare. Therefore, fever and chest pains may indicate tuberculosis or a spinal tumor.
Nerve root damage
As we have already found out, radiculitis can develop due to pinching of the spinal roots by IVD hernias. It can also be caused by hypothermia, acute intoxication, compression of the nerves by spasmodic muscles of the back or neck.
Note that with radiculitis, the temperature can rise to no more than 37-37.2 degrees. If it has risen above these figures, a more serious pathology should be suspected. Under the mask of radiculitis, urolithiasis, pyelonephritis, glomerulonephritis, tumors or tuberculosis of the spine, rheumatic diseases, etc. can be hidden.
Advice! Do not confuse fever with cervical osteochondrosis with occipital neuralgia caused by hypothermia. The latter is manifested by severe pain in the back of the head and is often accompanied by a headache, runny nose, cough and other colds.
Inflammation of muscles and ligaments
The inflammatory process can develop in the ligaments or muscles against the background of long-term osteochondrosis, complicated by spondyloarthrosis or myofascial pain syndrome. The inflammation can spread from the affected intervertebral joints or develop in the muscles due to their persistent spasm. Pathology is accompanied by aching pain and stiffness in the back.
High temperature with osteochondrosis
In 1-2% of cases, pain in the back and the appearance of fever are the result of specific diseases of the spine. These include tuberculous spondylitis, ankylosing spondylitis, malignant and benign neoplasms. In this case, the person's temperature rises above 37.8 degrees and other alarming symptoms appear.
You can suspect the presence of specific diseases in such cases:
- the appearance of the first back pain at the age of less than 20 or more than 50 years;
- a history of serious spinal injuries;
- past oncological diseases;
- unreasonable loss of body weight;
- cough, hemoptysis;
- chronic pain that gets worse over time and is not associated with physical activity;
- pathological changes in blood tests;
- the presence of destruction of the vertebrae on x-ray examination of the spine;
- lack of response to treatment for 1 month or more.
Advice! With a prolonged increase in temperature above the permissible norm and the appearance of alarming symptoms, immediately go to the hospital. A timely visit to a doctor will help you identify life-threatening diseases in time and start treatment as early as possible.
What to do when the temperature rises
If you have a fever and back pain, you should go to the doctor anyway. He will examine you and appoint the necessary research. This will help determine the cause of the fever and make sure there are no serious illnesses.
The diagnostic program should include general clinical research. With their help, you can detect kidney diseases, tuberculosis, rheumatological diseases, inflammatory processes in the body, etc.
For the treatment and prevention of OSTEOCHONDROSIS, our readers use the method of fast and non-surgical treatment recommended by the leading rheumatologists of Russia, who decided to oppose the pharmaceutical lawlessness and presented a medicine that REALLY CURES! We got acquainted with this technique and decided to bring it to your attention. Read more.
To identify pathological changes in the spine, you can use X-ray or magnetic resonance imaging. The first method is more accessible and cheaper, but not very informative. With its help, it is possible to identify only distant osteochondrosis, complicated by spondylosis. Diagnosis of the disease in the early stages is possible only thanks to MRI. This technique allows you to see almost any changes in the IVD and intervertebral joints.
Important! With a slight increase in body temperature, it makes no sense to take antipyretic drugs. Drugs from the NSAID group can be used to relieve vertebral pain caused by complications of osteochondrosis. It is better to use them after consulting a doctor.
How to forget about joint pain and osteochondrosis?
- Joint pains limit your movements and a fulfilling life ...
- You are worried about discomfort, crunching and systematic pain ...
- Perhaps you have tried a bunch of medicines, creams and ointments ...
- But judging by the fact that you are reading these lines, they did not help you much ...
Do you want to receive the same treatment, ask us how?
How to treat sciatica during pregnancy
Sciatica is a common disease of the peripheral nervous system. It occurs as a result of damage to the roots of the spinal nerves. The term "radiculitis" itself comes from the Latin word "radicula", meaning "root".
Symptoms of the disease
Strange, but it is customary to call any back pain radiculitis, especially if this pain is sharp and severe. This is the so-called "lumbago". In fact, the signs of sciatica can be much more serious than just acute back pain.
It is worth starting with the fact that diclofenac is generally used to relieve inflammation and pain. These two concepts are almost always related to each other, therefore, a decrease in inflammation is directly related to the disappearance of pain. One of the undoubted advantages of this drug is the richness of dosage forms in which it is presented. These are tablets, and solutions for injections, and suppositories, and ointments, etc. This drug is most often prescribed to relieve swelling, inflammation and pain with various joint pains, lumbago, radiculitis, osteoarthritis, after various sprains and bruises, with rheumatism. There are even eye drops based on this drug that are used after cataract surgery.
Diclofenac during pregnancy
- the pregnant woman suffers from osteochondrosis or herniated disc;
- the disease manifests itself as acute pain in the lumbar region and sacrum, radiating to the buttock along the back of the thigh;
Radiculitis is a disease of the human nervous system caused by compression of the roots of the spinal cord or nerve trunks at any level. The main reason for the appearance of sciatica is untreated osteochondrosis, therefore, these diagnoses are often synonymous.
The main manifestation of radiculitis is radicular syndrome: sharp, burning pains in the neck, upper and lower extremities, chest, lower back, groin and abdomen.
- Microdiscectomy (open small operation);
- Open decompression (lumbar laminectomy).
In cases where sciatica pain is associated with a herniated disc, microdiscectomy or open small surgery with magnification may be considered. This operation removes part of the protruding intervertebral disc, which pinches the nerve.
This surgery is usually considered 4 to 6 weeks if there is no conservative relief of severe pain. If the patient's pain and disability are severe, surgery may be considered even earlier than a week.
Typically, about 90% to 95% of patients experience relief from sciatica after this type of surgery.
Lumbar laminectomy for sciatica
In cases where sciatica pain is associated with lumbar spinal stenosis, lumbar laminectomy may be recommended. In this operation, a small piece of bone and / or disc material is removed, which is pinching the nerve root.
Laminectomy may be an option if spinal stenosis reduces the patient's ability to tolerate physical activity to an unacceptable level. The patient's general health may also raise doubts about whether surgery should be performed or whether conservative treatment should continue.
After lumbar laminectomy (also called open decompression), approximately 70% to 80% of patients usually experience relief from sciatica.
In most cases, surgery to treat sciatica is elective, which means that it is the patient's decision to do or not to do the surgery. This applies to both microdiscectomy and laminectomy operations.
A patient's decision to have surgery is based primarily on the severity of the pain and dysfunction they are experiencing and the length of time the pain persists. The general health of the patient is also taken into account.
As a result - chronic
Some people resort to strong and even narcotic drugs to relieve pain (this pain is so unbearable). But it is important, if possible, to eliminate the cause of intercostal neuralgia, and not to suppress the pain with pills and injections.
Treatment of intercostal neuralgia is carried out according to the same schemes as other types of radiculitis are treated. As a first aid to reduce pain, a nerve blockade with novocaine or lidocaine is performed. This manipulation should not be carried out often, it can eventually lead to a chronic course of intercostal neuralgia and aggravate the inflammatory process in the nerve fiber.
It is important not to be mistaken in the diagnosis, because the help for neuralgia and diseases of internal organs is fundamentally different. It is advisable to immediately consult a doctor so as not to miss a heart attack or colic, because these diseases can lead to irreversible consequences.
Can the body temperature rise with radiculitis?
For most cases of sciatica
the body is not typical and can be observed in a small number of patients, and the temperature is usually low, subfebrile (from 37.1 to 37.5
C) and in most cases is a reaction to an inflammatory process in the body (namely, in the nerve).
For back pain, an increase in body temperature may also indicate
Therefore, an increase in body temperature in the presence of symptoms of sciatica should push a person to see a doctor in order to exclude the above diseases.
Radiculitis during pregnancy, how to identify and treat?
- this is a special period for any woman and a completely physiological state. But not all of them run smoothly and without problems. Radiculitis during pregnancy is a fairly common occurrence.
The reasons for the development of sciatica during pregnancy:
1. The weight of the fetus with amniotic fluid, placenta and enlarged uterus at the week of pregnancy (before childbirth) is more than 10 kg.
2. Possible swelling of soft tissues, often accompanying women (with toxicosis in the second half of pregnancy, their volume can be 5-10 liters).
5. Normally, any woman preparing for childbirth undergoes changes in the pelvic bones, and almost all pregnant women in the last trimester constantly experience pelvic pain. In this case, there is an expansion of the internal pelvis, a discrepancy in the joint between the sacral and lumbar spine. And all this puts a huge load on the spine, pelvis, lower limbs and their vessels.
6. The hormonal background of pregnant women helps to reduce the tone of muscles and ligaments, so the body prepares for childbirth and easier passage of the baby through the birth canal. Muscle tone also decreases and the ligamentous apparatus of the spine is weakened, which can lead to the development of scoliosis, intervertebral hernias, and so on, and as a result - sciatica.
7. Stress, decreased immunity, lack of calcium, and so on.
Heavy load and all these factors significantly increase the risk of developing acute sciatica in a woman, which can become chronic after childbirth. Indeed, with the birth of a baby, a woman continues to load her spine with weights (a child living in her arms, milk-filled mammary glands, strollers and household life).
So, almost all pregnant women experience back pain, but only a few of them suffer from sciatica.
Radiculitis during pregnancy can be confused with other causes of back pain:
- expansion of the pelvis;
- stretching the muscles of the back and pelvic ligaments (normal in the second half of pregnancy);
- increased tone of the uterus (its back) with the threat of premature birth and precursors of childbirth;
- kidney disease, such as chronic pyelonephritis;
- osteoporosis of the spine (due to calcium deficiency);
- compression of the nerve roots by an enlarged uterus during movements or changes in fetal posture;
- exacerbation of chronic pancreatitis; peptic ulcer of the stomach and duodenum;
- exacerbation of chronic inflammation of the ovaries and fallopian tubes.
As you can see, back pain in pregnant women has a large number of possible causes, some of them are normal physiological conditions, and others are severe pathologies that require compulsory treatment. Therefore, any back pain is a reason to see a doctor and conduct an additional examination.
- the woman suffered from chronic sciatica even before pregnancy - it is highly likely that back pain is associated with sciatica;
- pregnant women more often have sciatica of the lumbar spine, while lower back pain can radiate down the abdomen and legs, that is, sciatica occurs - damage to the sciatic nerve;
- pains are acute, often shooting, paroxysmal;
- the back muscles in the affected section are tense;
- more rapid cessation of seizures, which is associated with the peculiarity of the hormonal background of a pregnant woman;
- there is no data for other diseases (pancreatitis, pyelonephritis, stomach ulcer, uterine hypertonicity, and so on).
To help relieve back pain during pregnancy, you should master stretching exercises:
- In the supine position, raise your arms up along the body, the lower limbs are straight, with the heels we stretch down, with the fingertips up - for about 30 seconds, then we completely relax. Repeat 5 times. In this exercise, the lower back should be completely pressed against the surface. You can put a small pillow under it.
- In the supine position, the legs are bent at the knees and spaced shoulder-width apart. Slowly begin to lift the pelvis up, starting with the tailbone. Do the exercise slowly, lifting vertebra by vertebra. Then lower your pelvis as well.
- Lying on your back, press your lower back to the floor, raise one straight leg slightly above the floor (5-10 cm), and draw circles with it first clockwise and then counterclockwise (5-10 times).
Treatment for back pain during pregnancy:
In any case, if you are concerned about regular back pain, you should not self-medicate at home, contact your doctor. Be healthy!
Irradiation of lower back pain during pregnancy can occur with inflammation of the uterine appendages. In this case, a woman may be bothered by pain in the lower abdomen, fever, nausea, vaginal discharge, chills. An asymptomatic course of the disease is also possible. Treatment of adnexitis (inflammation of the uterine appendages) includes antibacterial and antiviral therapy strictly according to the indications and prescription of the doctor, since many medications are contraindicated for pregnant women, as well as the exclusion of hypothermia.
Can there be temperature with sciatica?
The Latin word "radiculitis" is an inflammation of the roots of the spinal nerves. A number of diseases similar to radiculitis have other names: funiculitis, lumboischialgia, sciatica, inflammation of the sciatic nerve, there is also such a name for the disease - "lumbago".
The many scientific terms used to denote similar, and sometimes the same diseases, often mislead the patient. It seems to him that at first there was one disease, and then another and a third joined. In reality, however, we are often talking about the same fairly common ailment. Every fourth patient comes to an appointment with a neuropathologist, "holding on to the lower back", spares her when walking, tries not to cough or stumble, so as not to aggravate the pain.
Lumbosacral sciatica is rare in children and adolescents. It is usually observed after the flight. Often sciatica confides a person to bed, making him incapacitated for a long time. It is estimated that for the year the number of days of temporary disability in patients with sciatica was 5.4 percent of the total number of days of temporary disability. This further increases the need to eliminate all the causes that, to one degree or another, may contribute to the onset of the disease.
Thanks to the nervous system, a person can adapt to significant temperature fluctuations. However, with all the perfection of adaptive reactions, it is difficult for the body to react immediately to the effect of sharply opposite temperatures. Exposure to contrasting temperatures carries a high risk of developing lumbosacral sciatica. It is no coincidence that in pre-revolutionary times, when they did not pay any attention to the improvement of working conditions, workers of locomotive depots, for example, often suffered from lumbosacral sciatica. They carried out hot washing of the locomotive with the gates open, in a cold through wind, in constant dampness, without the necessary overalls.
What else explains the high vulnerability of the lumbosacral region? This part of the spine is in special conditions: it can withstand the weight of the torso, which increases with lifting loads and other physical stresses. The spinal cord is located in the vertebral canal, the roots extending from it come out through narrow intervertebral spaces. In the lumbosacral region, the nerve roots travel the longest path. Therefore, it is here that they are more often squeezed from various reasons. And one more feature: the lumbar vertebrae are mobile. If a person suffers heaviness, assuming the wrong posture, the vertebrae can be displaced and he has pain.
Let me give you one example. A patient came to our clinic, who for several years coped well with the work of a loader. Usually, before they put a weight on his back, he took a certain position. Once a comrade, without warning, hastened to put a load on his back. The patient felt an acute pain in the lower back. What happened? His intervertebral cartilage was displaced and the roots of the spinal cord were infringed. He had to undergo treatment for a long time.
Sometimes lower back pain occurs when you make unsuccessful jumps and turns, or when you jump awkwardly. In such cases, the joints and ligaments of the spine or the intervertebral cartilage can be damaged. And they, in turn, put pressure on the nerve roots located in the neighborhood.
In people engaged in physical labor, the occurrence of radiculitis is facilitated by physical overstrain or a contusion of the spine. There is another relatively common cause of sciatica. In people, especially the elderly, who do not comply with the normal regime of work, rest and nutrition, leading a sedentary lifestyle, metabolism is disturbed, general obesity occurs more easily, and salt deposition occurs in the area of ligaments and joints. It is these salt deposits that squeeze the roots.
If we also take into account the predisposing, provoking role of cooling and the influence of rheumatism, flu and other infections, it will become clear why patients with sciatica are relatively common. Lumbosacral sciatica develops in different ways: in some people - gradually, with periodic pain in the lower back and leg, in others, the disease begins suddenly, like our patient-loader. The duration of the attacks varies. The earlier the diagnosis is made and treatment is started, the sooner the patient gets better.
Lower back pain occurs not only with sciatica (see also lumbago). That is why it is especially important to clarify their nature. And this can only be done by the attending physician, who has the opportunity to carefully examine the patient and get acquainted with the sometimes necessary analyzes and X-rays.
What can you advise during acute pain? Complete rest. A comfortable position in bed soothes pain. Most often, the patient lies on his back or on his side, slightly bending his legs. The course and outcome of this disease, like any other, depend on the general condition of the person.
Repeatedly had to observe the aggravation of pain after unpleasant experiences, for example, under the influence of severe grief or personal conflict. For others, lower back pain is exacerbated if the person has a new source of pain, such as a toothache. Readers may have a legitimate question: what is the connection between these seemingly completely different diseases?
Pain that occurs in any part of the body causes excitement in the central nervous system, in areas of the cerebral cortex. The more and longer the painful irritation, the stronger the focus of excitation is created in the cortex. Sometimes, with prolonged and severe pain, persistent, long-term congestive excitement occurs. Such a focus of excitement dominates over other centers. New, additional irritation of the cerebral cortex caused by various reasons (noise in the room, unpleasant news, etc.), as it were, is added to the constant focus of irritation, intensifies it. This is why it is important to create an environment of peace and quiet for the patient.
Can sciatica pain be eliminated? Pain relievers such as pyramidone, analgin, phenacetin, and aspirin bring some relief. Sometimes you have to resort to sleeping pills: bromine or barbamil. They put bags of heated sand on the lower back and leg, use not too hot heating pads, an iron, put mustard plasters. Sometimes various pain relieving ointments and liquids, such as anesthetic ointment, capsin, saliniment, help well. All of these available tools can be successfully applied at home.
I would like to warn patients: do not listen to the advice of various healers and home-grown "healers" - the ointments and liquids prepared by them have repeatedly caused severe burns in gullible people.
Warm baths, daily or every other day, can have a good analgesic effect. Their usual temperature is degrees. However, they are made only on the advice of the attending physician. A large arsenal of remedies for radiculitis is available in medical institutions: here and exposure to ultraviolet rays (quartz lamp), and massage, and electrotherapy; heated clay, paraffin wax, ozokerite are also used. When prescribing certain procedures, the doctor takes into account the patient's condition, his age, the reasons that caused sciatica, the age and severity of the process.
Guided by these data, the doctor can prescribe pollination of the skin with chloroethyl (a kind of freezing), the infusion of painkillers, in particular novocaine, vitamins B1 and B12, and other treatment.
Each disease has its own characteristics in a particular person, so only a doctor can decide: whether to send a patient to a hospital or he can be treated on an outpatient basis; whether he needs to go to a resort and where - to the sea, hydrogen sulfide, radon (radioactive) sources or to mud therapy.
But the readers, obviously, are most interested in the question of how to prevent sciatica, and if the first signs of the disease appear, how to delay its development.
We have already said that lumbosacral radiculitis often occurs as a result of damage to the spine. That is why it is important from childhood to strengthen the spine and, in particular, its lumbosacral region. From an early age, you need to systematically, daily, do gymnastics and develop the correct posture; this will help protect the nerve roots from harmful mechanical influences, which are more likely in people with various curvature of the spine.
All measures that strengthen and temper the body are useful - the correct mode of work and rest, rational nutrition, daily walks in the air. In the warm season, air baths are good, and if the general condition of the body allows, then solar ones; wet rubbing, dousing, bathing in the river or in the sea are recommended.
It is known that trained people can systematically engage in hard physical labor without harm to their health. When a beginner who does not have the necessary skill takes on such work, then at first he can easily develop pain in the lower back and in the muscles of the whole body.
Gradually, a person acquires the necessary skill, the muscles become stronger, the pain disappears. Feasible physical labor is useful. It strengthens and develops muscles well. Mechanization of labor-intensive work and automation of production, improvement of technology, elimination or reduction of vibration, rationalization of the workplace - all this creates favorable conditions for the prevention of a number of diseases and, in particular, lumbosacral radiculitis.
Lumberjacks engaged in hard physical labor in the open air in any weather, until recently, quite often suffered from sciatica. Mechanization of labor of workers in the forest industry, regular hot meals, special clothing, the fight against alcohol abuse, which deprives a person of self-control as a result of which he often catches a cold - all this reduces the possibility of lumbar-sacral radiculitis.
At one of the Krasnodar enterprises, workers had to bend over many times for metal parts delivered on trolleys. As the trolley unloaded, they had to bend lower and lower. These "bows" throughout the working day caused back pain. The workers came up with a simple device. A platform on springs was installed on the trolley. The platform sank down under the weight of metal parts. As the parts were freed, the platform rose. Thus, both with a full load of the trolley and with a weak platform, the level of the platform remained high enough. Simple rationalization. And how much, thanks to her, the complaints of lower back pain have decreased! Improving the production environment - combating dampness, drafts, overheating, hypothermia - is undoubtedly of great importance in the prevention of sciatica.
People engaged in mental work, leading a sedentary lifestyle, should systematically take walks and exercise regularly without interruption.
There are pains in the lower back or along the sciatic nerve, it is necessary to avoid cooling, and even more hypothermia and physical overstrain, not to lift weights, avoid jerking and jumping, insulate the lower back, especially in damp and cold weather. Many people feel relief when they use a special corset or a homemade bandage that tightly tightens the lower back.
A wide linen belt is useful for the prevention of sciatica for loaders, stokers, lumberjacks - it fixes the lumbar vertebrae, protects against possible displacements. The pain often subside if a person lies on an even bed, on a hair or cotton mattress, placed directly on the boards. This position creates the best conditions for the spine, and this is especially important when the root disease is associated with changes in the spine.
For prevention purposes, people who have had an attack of sciatica are also advised to sleep on an even, not too soft bed. In some cases, when the work does not correspond to the physical capabilities of the worker, it is necessary to change the working conditions, and sometimes the profession.
What else prevents the development of sciatica? Strict observance of the doctor's instructions for various diseases. And here is just one example. Having got sick with the flu, the patient gets a release from work. He is advised to rest in bed. But still often, despite the fever, people carry the flu on their feet and do not follow the doctor's advice. As a result, complications and, in particular, radiculitis.
Those who, out of fear of a cold and fear of sciatica, constantly wrap themselves up, pamper themselves, and excessively spare the lower back, act completely wrong. In such people, hypothermia or physical overstrain will undoubtedly cause illness more easily than in trained, hardened people. Reasonable training, gradual hardening in accordance with age-related capabilities and the general condition of the body are the most important means of preventing sciatica.
What is sciatica, its causes and symptoms
Our body feels and moves, our internal organs work in their own way, without requiring volitional control from us. Everything happens, as if by itself, if not for one small "but".
When this small "but" fails, the whole harmony of the organization of the human body falls apart and it becomes obvious that the body is, first of all, the thinnest network of intertwined nerve fibers with a single control center.
With sciatica, the spinal nerves become inflamed.
Each nerve supplying one or another part of the body originates from the spinal cord (individual nerves from the brain), and is responsible either for motor function, or for sensory function, or for ensuring the work of internal organs.
Causes of the disease
Before going beyond the vertebral column, which is the bony sheath of the spinal cord, nerves with different functional loads are combined into a bundle or root (radiculus). The root, before splitting into branches, passes through the intervertebral foramen.
The inflammatory process that accompanies any damage to the nerve root is called sciatica.
The spinal cord has 5 segments, respectively, the spinal nerves emerging from one segment or another regulate a strictly defined area of the body.
Having a general idea of the structure of the nerve root, now you can find out what causes sciatica. The widespread philistine opinion that sciatica occurs from a draft is only half true. In fact, hypothermia refers to the resolving factors, as well as physical overstrain of the back muscles. The immediate causes of sciatica, in most cases, are diseases of the spine.
For more information about what sciatica is, see the video:
The first in frequency of occurrence, as a causative factor, is osteochondrosis. Even by the definition of a causal relationship, it is clear what is the difference between sciatica and osteochondrosis.
Osteochondrosis is a disease characterized by degenerative changes in the intervertebral cartilaginous disc, as a result of which the height of the vertebrae one above the other decreases and, as a result, the intervertebral foramen narrows.
In the future, there is an infringement of the nerve root with impaired blood circulation and the development of aseptic inflammation. Thus, radiculitis is a complication of osteochondrosis.
Other causes of sciatica can be:
- Deforming spondyloarthrosis, which refers to vertebrogenic causes of damage to the nerve root, that is, depending on the state of the vertebrae;
- Trauma;
- Acute and chronic infectious processes. Especially often the infectious cause of inflammation of the nerve root is herpes zoster;
- Various neoplasms;
- Congenital malformations of the spinal column.
Acute or chronic process
An attack of acute sciatica occurs either for the first time, or characterizes a picture of exacerbation of chronic radiculitis. The very definition of "acute" speaks of a vivid clinical symptomatology that occurs suddenly, without precursors.
Chronic sciatica is characterized by an endless series of improvements with exacerbations.
If we talk about the time division of an acute and a chronic disease, then if the cure of the process is within a month, then we are talking about an acute course of the disease, if signs of suffering persist even after 4 weeks, then the pathological process takes on a chronic course.
How long an attack of radiculitis will last depends on the cause that caused the inflammation of the root, and on the concomitant pathology, and on the therapeutic measures taken. In most cases, with an uncomplicated course and the adequacy of the measures taken, it is possible to cope with the disease in 7-10 days.
But it is not possible to cope with the causes of radiculitis in such a period. For the most part, these are chronic diseases that require long and ambiguous treatment.
Clinic of the disease depending on the level of damage
Common symptoms of nerve root inflammation are divided into three groups:
- Painful;
- Neurological;
- Muscle-tonic or reflex.
Pain with radiculitis is acute, sharp in nature, like an electric shock, is localized on the side of the infringement and can spread along the nerve. The pain is often accompanied by paresthesias, i.e. tingling, burning, or numbness of the supplied area of the body and causes protective muscle tension.
Pain occurs due to inflammation of the nerve roots and causes muscle tension
Symptoms of cervical radiculitis, in addition to those described above, include vertebral artery syndrome, which occurs due to vascular infringement in the lumen of the transverse processes of the cervical vertebrae, which is the cause of vertebro-basilar insufficiency.
Vertebrobasilar insufficiency manifests itself with dizziness, headache, impaired vision, hearing, nausea until vomiting.
Considering the fact that the brachial plexus originates from the cervical segment of the spinal cord, with cervical radiculitis there is a weakening of muscle strength and muscle tone of the upper extremities, reflexes caused by the hands are reduced, and the symptom of "frozen shoulder" appears.
Autonomic disorders (dryness, pallor of the skin with an emphasized vascular pattern, a decrease in local body temperature) join motor and sensory disorders with the development of Horner's triad: constriction of the pupil, palpebral fissure and some retraction of the eyeball.
Symptoms of thoracic sciatica are manifested by pain between the shoulder blades, in the intercostal spaces and may be accompanied by a disorder of the work of internal organs, which has to be differentiated from true somatic pathology.
For thoracic radiculitis, as for any other, a forced posture of the patient is characteristic (bending over to the side of the infringement of the roots with minimal physical activity), which reduces pain.
Chest sciatica may be accompanied by a disorder of the work of internal organs
Symptoms of radiculitis of the thoracic region often become a manifestation of nerve damage by the herpes zoster virus. In this case, and with any other infectious lesions with radiculitis, the temperature rises. The height of the numbers depends on the pathogenic force of the microorganism and on the reactivity of the diseased organism.
Cervicothoracic radiculitis is accompanied by mixed symptoms of damage to both cervical and thoracic nerve roots.
And yet, the maximum percentage of clinical symptoms of sciatica falls on the lumbosacral spine.
This fact is due to high physical exertion in the lower back.
It is not difficult for a person who is familiar with the shooting pain in the lower back to explain what sciatica lumbar is, which among the people "walks" like sciatica.
Almost every fourth inhabitant of the planet is familiar with the clinic of sacral sciatica. Regardless of at what level, at the lumbar or sacral, the nerve roots were infringed, the clinical picture will generally be of the same type.
What pain will be with sciatica depends on the speed and intensity of the onset of circulatory disorders in the root. Lumbago characterizes an acute process with pronounced edema of the perineural tissues and a lack of blood supply to the nerve root.
Symptoms of sciatica of the sacral region are familiar to many
In a chronic process, when some adaptation of the suffering tissues to a lack of oxygen occurs, the pain is dull and, depending on the degree of damage to the nerve fibers, the neurological deficit will come to the fore, manifested in muscle atrophy, disorders of independent movement and the work of the pelvic organs.
If you do not heal, but just dull the pain
The consequences of vertebral lumbosacral radiculitis can be:
- Paresis or paralysis of the lower limbs;
- Trophic ulcers of the skin of the lower extremities;
- Incontinence of urine and feces;
- Sexual disorders.
The lower back is a place of reflected pain
Despite the fact that back pain is the main complaint with inflammation of the nerve roots, it should be remembered that the lumbar region is also a zone of pain projection in case of kidney damage.
Urolithiasis, pyelonephritis often signify back pain. But there is no answer to the question of how to distinguish nephroptosis from radiculitis. Because nephroptosis, by itself, does not hurt.
And only in the presence of an inflection of the ureter, leading to acute expansion and inflammation of the pelvis, there is a precedent for differential diagnosis with sciatica.
Positive symptoms of tension will speak in favor of sciatica. But even in this case, it is possible to exclude the parallel course of two pathologies only with a complete clinical and laboratory examination of the patient with the inclusion of instrumental diagnostic methods.
Men and women with sciatica, is there a difference
The question of signs of radiculitis of the lumbar spine in women can be attributed to provocative questions. In these cases, more often it is not about the symptoms of sciatica in women, but about whether the lower abdomen can hurt with sciatica. The lower abdomen is a sacral female area and, hypothetically, it can be assumed that the source of pain lies in the infringement of the sacral nerve roots.
As a rule, sciatica does not manifest itself as pain in the lower abdomen.
But in practice, pain in the lower abdomen is caused by inflammation, often chronic, of the internal female genital organs.
The occurrence of sciatica during pregnancy can be assumed, due to the increased load on the lower back, in late gestation.
But internal changes in a woman's body during pregnancy are multifaceted and their influence on the course of a particular disease is unpredictable.
In some cases, a pregnant woman receives an aggravation after an aggravation that endangers the bearing of a child, and in others, the lower back reminds of itself only during labor.
If there are any pathological conditions of the spine identified earlier in pregnancy, you should start attending aqua aerobics classes for pregnant women, sleep with special orthopedic devices, wear comfortable shoes, and avoid physical activity that requires back strain.
If we talk about the second half of humanity, then the signs of sciatica in men do not differ from those in women, with the only caveat that the symptoms of damage to the nerve roots of the lumbosacral region include the clinic of impotence and erectile dysfunction.
Muscle clamping as a result of negative emotions that have not been eliminated
Back (neck) pain is the main complaint with which people come for a diagnosis at an appointment with a neurologist. But, often manifestations of sciatica are directed by psychosomatics.
It has been noticed that stressful tension in persons prone to the accumulation of negative emotions is manifested by prolonged muscle spasms, of all muscles that can only be contracted.
Muscle clamps of the back can lead to infringement of the roots, although not with such severe manifestations and consequences, as if the cause was an organic pathology of the spine.
When the bath is a lifesaver
In matters of treatment of acute conditions and at the onset of the disease, one should resort to qualified assistance. But sciatica is a complication of an often chronic, long-term underlying disease.
And in this case, with an established diagnosis and mild manifestations (like a shot, somewhere sipping), it makes sense to try folk methods to alleviate your condition instead of absorbing suggestive amounts of painkillers.
Do not forget about the sauna with a birch or coniferous broom.
The bath will ease the pain of sciatica
And for those who have doubts about whether it is possible to take a steam bath with radiculitis, one can authoritatively say: "Not only is it possible, but also necessary." Again, remember the severity of the pathological process.
If the condition is acute, accompanied by a sharp pain syndrome, from which the eyes become numb, you should urgently consult a doctor.
Remember, heat dilates blood vessels, which can contribute to an increase in edema of perineural tissues and aggravate the deficiency of blood supply to the nerve roots.
Prophylaxis
The prevention of sciatica is the hygiene of physical labor and the avoidance of drafts. But everyday life is full of surprises and devoid of conventions, so sooner or later you can get either under a stream of cold air, or tear off a heavy object from the floor, which will provoke another attack of sciatica.
In terms of longer-term prophylaxis, it is important to compensate for the underlying disease leading to nerve root inflammation.
Hanging on the bar is a good prevention of sciatica
In case of osteochondrosis, to stretch the distance between the vertebrae and prevent compression of the roots, hanging on the bar can be performed as prevention of sciatica.
Conclusion
Sciatica has no clinical features depending on the sex of the patient, with the exception of sexual dysfunction. Its manifestations fit into a certain structure of symptoms.
Clinical manifestations depend on the level of compression of the nerve roots, but do not depend on the cause that caused them.
Treatment of radicular syndrome should be started only after examination and after listening to the recommendations of the attending physician.
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