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What is sciatic neuralgia?
Inflammation of the sciatic nerve is a protective reaction to the action of an irritant, manifested in severe pain in the lumbar region, buttocks and legs.
The sciatic nerve is one of the largest in the human body. It is he who has increased sensitivity and inflames more often than others. Its function is to be responsible for the movement of the lower limbs.
A nerve is a bundle of nerve fibers that are covered with a sheath called endoneurium. Endoneurium, in turn, is penetrated by the smallest blood vessels – capillaries. Below it is the second layer, which is called the perinervium. It also has vessels, but they are larger. Each vessel is covered with a layer of connective tissue, which protects the sciatic nerve from various kinds of damage, acting as a kind of shock absorber.
The nerve itself is located in the neural tube, which is very dense, as it is also covered with a connective tissue called the epinervium.
In medicine, you can also find the term – sciatica, neuritis, sciatic nerve neuropathy or sciatica, which characterizes the same condition. It should be understood that inflammation of the sciatic nerve is not a separate disease, but a symptomatology that signals problems in the lumbar and sacral region.
Where is the sciatic nerve located?
This largest nerve originates in the pelvic region, in the lumbar spine. Its length is great, so it covers most of the lower body. From the sacral region, a branch of the nerve enters the pelvis through a special hole called the piriformis. Further, the nerve stretches under the gluteal muscle and branches into smaller processes that penetrate all the gluteal and femoral muscles. In addition, it affects all the joints in this area.
Going down to the popliteal fossa, the nerve branches into a pair of large processes. They are called the tibial branch and the fibular branch. Thanks to these branches, the sensitivity of the skin of the lower leg and foot, as well as all the joints and muscles in the lower extremities, is ensured.
The sciatic nerve stretches along the entire length of the leg, thereby causing pain throughout the lower limb during inflammation and any other damage to it.
Symptoms of inflammation of the sciatic nerve
Symptoms of inflammation of the sciatic nerve cannot go unnoticed by a person.
You can suspect this condition by the following signs:
Pain in the gluteal muscle and back of the lower limb. Pain is most often bilateral, but they are somewhat different. It will be more intense on the side where the inflammatory process occurs.
The movement of pain is from top to bottom. It captures the buttocks, thighs, lower leg, lower back.
It is difficult for a person to straighten up, especially if he leaned forward. When you bend over, the pain becomes less intense.
When you try to turn around, the discomfort becomes more pronounced.
Reliance on the limb in which the sciatic nerve has become inflamed becomes impossible. When you try to step on it, a person experiences acute pain.
Sometimes inflammation is accompanied by defecation or urination, which occurs involuntarily.
Body temperature most often rises, but does not exceed 38 ° C. This symptom occurs against the background of spasms and muscle pain. Moreover, both the body temperature in general and at the site of inflammation in particular rise.
Physical activity becomes impossible.
The skin along the inflamed nerve becomes red and swollen.
Sometimes a person complains of muscle atrophy or slow weakening.
Since the clinical picture is pronounced, doctors are able to suspect inflammation of the sciatic nerve only according to the complaints of the patient who came to the appointment.
Pain with inflammation of the sciatic nerve
The pains can be of a different nature, sometimes they are burning and shooting, sometimes stabbing and pulling, sometimes aching. However, in most cases – paroxysmal. That is, a period of severe, almost unbearable pain is replaced by a period of relative rest, when it is weakened for a while.
Another distinguishing feature of pain in the defeat of the sciatic nerve is the direction of occurrence of unpleasant sensations. Pain originates in the lumbar region and gradually descends lower, penetrating the entire limb up to the very toes.
If severe pain occurs in both legs, then doctors talk about bilateral neuralgia. This process is the most painful for a person, however, it occurs infrequently. In most cases, sensations appear in the second leg, such as: a slight tingling and numbness, a feeling of goosebumps.
In especially severe cases, the pain simply paralyzes the person. He becomes unable to move. Any attempt to move the body causes an excruciating spasm. The patient is unable to sleep, turn around, bend over, or even stand. This is due to the very structure of the sciatic nerve, because it is permeated with a huge number of sensitive receptors.
The acute form of sciatica is characterized by severe painful sensations that exhaust a person, preventing him from leading a normal life. With the transition of inflammation of the sciatic nerve into a chronic form, the pain becomes aching, in parallel there is a feeling of tingling and numbness in the legs.
Causes of inflammation of the sciatic nerve
There are several reasons that lead to inflammation of the sciatic nerve:
Prolonged exposure to a cold wind, leading to hypothermia of the lumbar region and inflammation of the sciatic nerve. And often this happens in the warm season, when the lower back remains open.
Frequent infections. First of all, these include neuritis, which is caused by inflammation of the soft tissues that surround the sciatic nerve.
Herpes infection leading to the development of shingles and inflammation of the sciatic nerve.
Weight lifting, excessive physical activity, which affect the condition of the spine in general and the deformation of the muscular frame in particular. All this becomes a prerequisite for the occurrence of sciatica.
Sharp and awkward movements.
Osteochondrosis, causing degenerative changes in the entire bone apparatus and leading to clamping of the largest nerve.
Gout.
Injury to muscles or organs located in the pelvic area.
A herniated disc that leads to a pinched nerve.
Spondylosis, as a stage of osteochondrosis, leading to the development of growths along the edges of the spine.
Spinal stenosis. This condition is especially common in older people.
Growths on the spinal column.
Tumors, both benign and malignant.
Spinal injury.
Piriformis Syndrome. Its reflex tension causes compression of the sciatic nerve and its inflammation. Often this happens due to unsuccessful injections, as well as against the background of lumbar sciatica.
Diabetes.
Gynecological and urological diseases.
Birth trauma.
Pregnancy can cause inflammation of the sciatic nerve. This is due to the fact that the enlarged uterus presses on it, causing pain in the lower back and legs. Especially often, sciatica develops in the third trimester and intensifies when the baby moves inside the womb. Moreover, the symptoms of inflammation of the sciatic nerve may be present after childbirth, for 3 months.
Lyme disease, fibromyalgia, Reiter’s syndrome.
Arterial and venous thromboses.
Poisoning the body with toxic substances, such as mercury and arsenic.
Diagnosis of inflammation of the sciatic nerve
Although the symptoms of sciatica in most cases clearly indicate the occurrence of this condition, in some cases they masquerade as signs of another disease. Therefore, doctors perform a clinical and neurological examination of the patient. It boils down to determining a person’s hypersensitivity to pain. For this, the patient is asked to lie down and lift the leg up without bending it.
If pain occurs along the course of the nerve, which subsides when the person lowers the limb, then this makes it possible to suspect sciatica. This diagnostic technique is called the Lasegue test. Do not assume that this is the only way to determine inflammation of the sciatic nerve. Doctors have a whole set of similar techniques, for example, the definition of the symptoms of Lerrey, Firestein, Bekhterev, etc.
The Valsalva maneuver is indicative. The person is covered with a nose and mouth and offered to create forced breathing. The result will be an increase in pressure not only in the chest, but also in the abdominal cavity. Pain in the lower extremities disappears, but other neurological symptoms appear, indicating compression of one or another root. For example, a violation of sensitivity from the side of the calf, a weakening of the knee jerk, a violation of the motor function of the foot or fingers, etc.
Doctors also come to the aid of such modern research methods as computed tomography, MRI, x-rays. An additional diagnostic method is electroneuromyography, which allows you to evaluate the speed of nerve impulses during nerve stimulation.
However, it is not only important to determine that a person is suffering from nerve inflammation. It is necessary to establish the cause that led to this state. This is what will make it possible to conduct effective treatment and save the patient from the problem.
Treatment of inflammation of the sciatic nerve
Therapy primarily consists in eliminating the pain symptom and relieving inflammation. For this, a person is prescribed anti-inflammatory and analgesic drugs. After the pain is stopped, you can begin to eliminate the cause that caused sciatica.
Physiotherapeutic procedures are often used, in particular electrophoresis, magnetotherapy, UHF, etc. Also, modern conservative methods include the use of fixing belts, muscle stimulation with electrical impulses, acupuncture, and manual therapy.
If the inflammation was caused by infectious pathogens, then the person is shown antibacterial and antiviral treatment of inflammation of the sciatic nerve. When the cause lies in diseases of the pelvic organs, the underlying disease should be eliminated.
When the cause of sciatica is a herniated disc or a neoplasm, it will not be possible to avoid surgical intervention. So, microdiscectomy is an effective and modern way to get rid of many pathologies of the intervertebral disc that cause sciatica.
A doctor who deals with the treatment of inflammation of the sciatic nerve is a neurologist or neuropathologist. If necessary, a person is sent to other specialists – to a gynecologist, urologist, oncologist, etc.
Whatever the cause leading to inflammation of the sciatic nerve, a person needs complete rest. Bed rest is indicated until the acute period has passed.
The prognosis for recovery directly depends on the cause of the inflammation and the timely visit to the doctor.
Medicines that relieve pain
There are several areas of drug therapy:
NSAIDs. For the treatment of inflammation of the sciatic nerve, non-steroidal anti-inflammatory drugs are primarily used. Do not exceed the dose recommended by the doctor, as this increases the risk of complications. A person may experience indigestion, increased blood pressure, headache, drowsiness, and other symptoms. In addition, taking NSAIDs alone will not affect the cause of inflammation, and their long-term use increases the risk of developing stomach ulcers.
Steroid anti-inflammatory drugs. They are prescribed by a doctor strictly according to indications. In some cases, epidural injections are used, they are injected into the epidural space, which contributes to the immediate relief of pain.
Vitamins. It is mandatory to take vitamin complexes that can accelerate the recovery of damaged nerve fibers and normalize the functioning of the nervous system as a whole.
Local anesthetics. Various ointments are used as local anesthetics.
If it is not possible to deliver a person with sciatica to the hospital, then it is worth giving him first aid on the spot. First of all, it must be laid on the stomach on any hard surface. Place a low pillow under your chest. You can warm the patient with a blanket. But at the same time, it is strictly forbidden to apply any warm compresses or heating pads to the site of inflammation, as this can increase swelling and increase the intensity of pain. After that, you need to call a doctor or take the person to a medical facility on their own. Do not knead the sore spot or apply ointments to it. All therapeutic measures are permissible only after consultation with the doctor.
Exercises for inflammation of the sciatic nerve
Therapeutic gymnastics is another effective way to treat and prevent inflammation of the sciatic nerve. It is important to perform them daily, which will allow you to train various muscle groups and avoid pain in the future. The load should be gradual, as you train, it must be increased. However, you can not overexert yourself, gymnastics should not cause discomfort, let alone pain. Its goal is to maintain muscle tone, normalize their blood supply, and relieve inflammation. Any set of exercises can be supplemented with other feasible loads, for example, swimming, cycling, hiking.
However, do not assume that gymnastics does not allow you to achieve an effect. This is one of the ways to treat inflammation of the sciatic nerve, so you should approach it responsibly. It is important to work out the muscle groups that caused the compression of the sciatic nerve. Need exercises for the legs, buttocks, outer and inner thighs. It is worth starting to do them carefully. If pain occurs, you need to take a break and rest. In the event that the pain does not go away or even intensifies, it is worth completely stopping the implementation of the complex and consulting a doctor. When choosing the most effective exercises, it is necessary to take into account the presence of other diseases so as not to provoke their exacerbation.
It is desirable that the complex be compiled by a doctor or exercise therapy instructor. He will tell you how to move and breathe correctly. After that, you can begin to implement exercises at home.
The following exercises are most often recommended for implementation:
Lying on your back, always on a hard surface, you need to raise your legs and pull them to your chest, while holding your buttocks with your hands. In this position, you should hold out for at least 30 seconds, then straighten your legs. You need to repeat at least 10 times.
Staying on the floor, you need to roll over to one side. Bend your legs and press them to your chest, while stretching your socks. Then the legs return to their original position. The number of repetitions, as in the first exercise. If you perform it at a fast pace, then this will warm up the muscles and prepare for further classes.
Without getting up from the floor, you need to roll over on your stomach and raise your upper body as high as possible. The legs do not bend. Since the exercise is difficult to use for beginners, 5 repetitions will initially be enough. Then they can be gradually increased.
Get up off the floor and sit on a chair. The leg must be placed crosswise. The back should be straight and the arms should be behind the head. From this position, you need to make turns with the body in different directions, you should generally make 10 turns.
Then from the chair you need to move to the floor, while kneeling. Hands are located above the head, fingers are clasped in the castle. From this position, a forward bend is made with the maximum extension of the arms. After the palms touched the floor, you can go back.
After a little rest, you need to sit on the floor. Raise your arms to shoulder level and spread them apart, and stretch your legs. Then the hands with light springy movements are retracted as far back as possible and come back. Repeat at least 5 times.
Remaining sitting on the floor, you need to spread your legs wide apart, then lie on your back, and raise your limbs. In this case, put your hands behind your head. Press the shoulder blades to the floor. Stretching your legs to the ceiling, you need to reach the maximum height and fix, then return to the original position, repeat at least 5 times.
After a short rest, you need to rise from the floor and spread your legs shoulder-width apart. Lower one hand, and stretch the other up and lean in her direction. Then change hands and tilt in the opposite direction. In this case, you need to bend as low as possible. In general, the number of slopes is 10.
How to relieve inflammation of the sciatic nerve in 2 minutes:
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