Sciatica (sciatica) is inflammation of the sciatic nerve. Occurs when the nerve is compressed, mainly by a hernia, protrusion or spasmodic piriformis muscle, acute pain occurs in the lumbosacral region, which radiates to the leg, often to the toe or heel. The pain intensifies during movements such as: walking, bending over, sitting for a long time. Sometimes it is accompanied by a feeling of numbness in the leg, a feeling of "creeping ants".
Causes of inflammation of the sciatic nerve
The main reason is a complication of osteochondrosis, such as protrusions, hernias, osteophytes, and the nerve can be pinched by the piriformis muscle, which is in spasm.
A neuro-orthopedic examination is performed to accurately determine the location of the pinched sciatic nerve. Imaging methods such as MRI and, if necessary, neuromyography.
Affected spinal segments (L1, L2, L3, L4, L5) and reflected pain in innervated areas for each segment
And after that, appropriate therapy is prescribed. As a rule, these are NSAIDs and muscle relaxants for acute pain and anticoagulants for chronic pain (more than 3 months). Physiotherapy also plays an important role in treatment. During pregnancy, the therapy differs from the usual one (many types of therapy are excluded).
Treatment
1. It is necessary to remove the pain syndrome (drugs from the group of nonsteroidal anti-inflammatory drugs, muscle relaxants, B vitamins, anticoagulants)
2. Unloading poses.
The patient should most often be in a position that "unloads" the lumbar spine, thus reducing the pressure on the nerve roots.
3. For the first 5-7 days from the onset of pain, the patient should not sit or stand. It is recommended to be in the unloading position. When the pain syndrome decreases and when the patient can move, it is desirable to walk up to 2 kilometers.
Unloading pose
4. In our clinic, there are innovative methods of treating pinched sciatic nerve, which will help the patient relieve pain immediately and further affect the cause of the disease itself.
Procedures at the "Vertebra" clinic for the pathology of ischialgia (sciatica):
High intensity laser (12 W / 20 W). Removes pain, swelling, inflammation, dilates blood vessels, restores damaged tissues at the cellular level.
High intensity laser therapy in the treatment of sciatica
Super inductive system (high intensity magnet 2.5 T). It has anti-inflammatory, analgesic and muscle relaxant effects. Gives a long-lasting result. Restores nerve function, improves nerve conduction.
Treatment of inflammation of the sciatic nerve with a super inductive system
PIRM - postisometric muscle relaxation - are soft, careful manual techniques in which a specialist, acting on various muscle groups, removes pinched nerves.
PIRM - soft manual techniques
Shock wave therapy is the best way to remove muscle clamps and trigger (painful, stagnant) muscle points that are inaccessible to the hands of the massage therapist.
Trigger points and their reflected pain, which is shown in red
Electrotherapy along the course of the "clamped" nerve - relaxes muscles, improves local blood circulation and nerve conduction.
Electrotherapy along the course of the nerve
TR therapy is local heat therapy for better muscle relaxation and deep warming of affected areas
Exercise for sciatica at home, if its cause is a spasmed piriformis muscle
If nerve compression occurs due to a spasmodic piriformis muscle, effective exercises at home are shown in the picture below.
Exercise for spasmed piriformis muscle
(In this case, the girl stretches the right piriformis muscle)
This exercise should be performed until you feel slight pain and tension and alternate with the phase of stretching and relaxation. The stretching phase should be performed on exhalation. Gradually, the piriformis muscle will be stretched and the amount of movement in the exercise will increase. If sharp pain occurs, immediately stop the exercise and do not repeat it.
Prevention of sciatica
For the prevention of sciatica, it is recommended physical therapy, kinesiotherapy, to exclude prolonged incorrect sitting, lifting heavy objects (especially in incorrect positions).
Lifting heavy objects
Sitting on a chair
Stressful factors are also often the provocateurs of sciatica, as during stress, adrenaline and cortisol are released, which leads to muscle spasms, so any relaxation methods are also effective.
What shall I do?
Come for a consultation with a neurologist-vertebrologist in order to determine in which area the nerve is "clamped". The doctor will conduct all the necessary tests, palpation, neurological examination, which will make it possible to make a correct diagnosis and prescribe high-quality treatment. If you have the above-mentioned complaints, you should immediately contact a vertebroneurologist.
Video review of the vertebrology and neuroorthopedic clinic Vertebra
Last review: Tanya Platina 06/21/2020 / Patient: Shyam Kumar
My guest, who flew in from India, had severe lower back pain. It happened in November 2019. He is a professional athlete, he underwent several operations and after lifting weights, he developed pain in his lower back. I accidentally found out about this clinic on the Internet