Sciatica: what it is, causes, manifestations and treatment methods

Causes

Painful intensity makes sciatica an extremely painful and unpleasant process. Patients want to get rid of this disease as quickly as possible, not disdaining either “grandmother’s” methods or medications. But what underlies this pathology?

The sciatic nerve is the thickest and longest in the human body. It belongs to the lumbosacral plexus and is formed by the roots of 5 paired spinal nerves. Branches go to the thighs and buttocks.

Sciatica is not an independent disease, but a syndrome associated with a whole complex of other pathologies. This syndrome develops under the following conditions:

rachiocampsis;
osteochondrosis, accompanied by disc herniation and protrusion of the intervertebral disc;
Bekhterev's disease;
spinal tumors;
spinal injuries;
pregnancy;
spinal tuberculosis.

In all of these pathologies, the sacral and lumbar roots of the spinal nerves are involved in the process. Before writing about how to treat sciatica, let's try to understand its symptoms.

Treatment of sciatica of the sciatic nerve

Sciatica has its own causes, symptoms, diagnosis and treatment methods.

Sciatica, due to its manifested pain, can be extremely painful. The patient cannot wait to get rid of this unpleasant process. Therefore, many resort to any, including non-traditional methods of treatment.

Causes of the disease

What is the basis of sciatica? The sciatic nerve is considered the longest and thickest nerve in the human body, the treatment of diseases of which is often difficult. This nerve is part of the lumbosacral plexus area. It is formed by 5 pairs of nerve roots of the spinal cord, branches from which extend into the buttocks and thighs.

Sciatica is mistakenly considered an independent disease, but in reality it is just a syndrome that occurs due to many pathologies. The syndrome has the ability to occur in the following cases:

rachiocampsis;
Bekhterev's disease;
spinal tuberculosis;
pregnancy status;
various vertebral tumors and injuries;
osteochondrosis with hernias.

Symptoms

The main symptom of the disease is pain affecting the lower back and buttocks. Next, this pain descends to the thighs, moves to the lower leg and after that to the dorsum of the foot. If lumbar lumbago is observed the day before, then this is lumbago. This pathology is called lumboischialgia. There are cases when pain affects the joint in the knees.

Secondary signs of the disease:

movement disorders (from lameness to immobility);
urinary and fecal incontinence;
low sensitivity of the affected area;
constant muscle tension in the lower back, pelvis and lower extremities;
tingling and burning sensation.

How to diagnose sciatica?

If you experience the symptoms described above, contact a neurologist. You should not treat yourself. In general, the diagnosis can be made based on:

patient complaints;
neurological symptoms;
blood and urine tests;
results of computed tomography or magnetic resonance imaging;
X-ray results;
the patient's appearance.

Treatment methods

Treatment methods include traditional treatment, both with and without the use of medications, as well as treatment with traditional medicine.

With traditional treatment, it is important to follow the following scheme:

impact on inflammation;
relieving the patient of pain;
restoration of muscle tone;
increase in range of motion.

In this case, the doctor can use medications, physiotherapy procedures, massage procedures, and gymnastics in treatment. In addition to tablets and injections, the use of ointments is appropriate.

Among the non-drug methods, therapeutic physical education, physiotherapy and massage are widespread and effective. These methods lead to strengthening muscles, improving blood flow and metabolic processes in the body. Special attention from physiotherapy should be paid to the following:

phonophoresis;
amplipulse therapy;
diadynamic therapy;
UHF.

Regarding exercise therapy, it is worth noting that it should be done in a lying position. Only this position is as positive and gentle as possible. You need to start with minimal load, gradually increasing the volume.

The massage can be either acupressure or segmental, up to 30 minutes every day.

Treatment with medications is not allowed in patients with tuberculosis, pregnant women, children, as well as people suffering from tumors and skin diseases.

You can choose endlessly from traditional methods of treatment. But three of the most effective recipes that save patients with sciatica have been noted.

These recipes:

Mix one egg white with turpentine (15 ml). Soak gauze with this mixture and apply it as a compress to the lumbar region, covering it with paper. Wrap it all in a woolen scarf and walk until pain occurs. Remove the compress, removing everything from the skin. Repeat every 6 hours.
Grind horseradish with radish, taking 200 grams of each. Mix with 15 ml table vinegar, 1 tbsp. a spoonful of table salt and 10 ml of kerosene. Leave for 10 days. Apply as a compress for 60 minutes. Repeat 2 times a day.
Grind 30 grams of laundry soap and mix with 1 tbsp. a spoonful of honey and one egg white. Also use as compresses for 2 hours, 1 time every day.

It is worth remembering that using traditional methods of treatment will not get rid of the cause of the disease. You need the help of a qualified doctor.
Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

Symptoms

The key symptom of the disease is pain. It affects the gluteal and lumbar regions, then moves down to the thighs, lower legs and dorsum of the feet. If the process is preceded by a lumbago in the lower back, we talk about lumbago. This type of pathology is called lumboischialgia. Sometimes the pain symptom affects the knee joint; only a qualified doctor can diagnose such a pathology.

Additional signs of sciatica:

burning and tingling;
pathological muscle tension (pelvis, lower back, lower limbs);
low sensitivity (applies only to the affected area);
pelvic organ dysfunction (manifests itself in the form of fecal and urinary incontinence, but is quite rare);
movement disorders (from mild lameness to complete immobility).

Drug therapy

Treatment of the sciatic nerve with medications is the first stage of therapy when a patient consults a doctor. There are several pharmaceutical groups of drugs to treat this disease.

Nonsteroidal anti-inflammatory and painkillers

These medications quickly help with pain and inflammation. They also have antipyretic properties.

There are several forms of release of painkillers.

Pills

When taking tablets, you must follow your doctor's recommendations and not exceed the permissible dosage, as they have a negative effect on the gastric mucosa.

Examples of painkillers:

Diclofenac;
Ibuklin;
Movalis;
Ketorol;
Indomethacin.

Patients with a history of bleeding problems should be aware that these drugs may reduce blood clotting.

Capsules

They have a special shell that the patient does not have to remove. It is recommended to take the capsules with boiled water.

Examples of painkillers in capsule form:

Celebrex;
Ketonal;
Nurofen.

If the patient has stomach diseases, the doctor may prescribe medications that protect the gastrointestinal tract (for example, Omeprazole, Nexium).

Diagnostics

If the above symptoms occur, you should urgently go to a neurologist - he will make the correct diagnosis. It is better not to do treatment at home, but to leave it to professionals.

The diagnosis is made based on:

patient complaints;
neurological symptoms;
the patient's appearance;
radiography;
magnetic resonance and computed tomography;
blood test (detects the severity).

Sciatica must be differentiated from kidney disease - for this, the patient’s urine is examined. In order to make an accurate and timely diagnosis, you should not delay your visit to the clinic.

Treatment

All treatment methods used in the case of sciatic nerve sciatica are reduced to the following goals:

relieve pain
strengthen the body
relieve inflammation of the sciatic nerve.

The approach to therapy in each case must be individual. Age group, gender, medical history are taken into account. The procedures are formed into a set of measures, scheduled hourly. It lasts about a month. A day hospital option is available. The pain symptom goes away already in the first week of treatment, followed by gradual recovery and consolidation of the result.

Drug therapy

Drug therapy for sciatica is in first place, as it allows you to quickly and effectively relieve pain and eliminate other symptoms, reduce inflammation, and also helps restore nervous and muscle tissue, and overall strengthen the body. The following groups of drugs are most often prescribed for the treatment of sciatica:

Antioxidants. Remove toxins from the body and prevent their spread during illness. Powerful antioxidants - vitamins C, A and E in capsules. You can use the Complivit Selenium supplement complex for these purposes. Lipin is an immunomodulatory drug with antioxidant properties. Essentiale contains vitamins and belongs to the same group of drugs. Supports the natural immune status of the body, removes poisons, restores metabolic processes. Lipoic and succinic acids are able to protect the body from the effects of internal and external negative influences, have a detoxification effect, and participate in cell regeneration.
Metabolites. Designed to enable the natural process of resisting the body to adverse influences from the outside. Restorative functions are activated, new cells begin to be built, the nervous system relaxes, and the brain works in an improved mode. Preparations: Glycine, Limontar, Biotredin.
Angioprotectors. These are drugs that normalize blood circulation and microcirculation. They improve capillary permeability, activate metabolic processes in the walls of blood vessels, restore their elasticity, and prevent fragility. Curantil, Persantine, Trental, Flexital, Vazonit, Radomin, Pentoxifylline, Doxy-Chem.
Muscle relaxants. Endowed with the ability to relieve spasms in muscle tissue, relax and eliminate pressure on the sciatic nerve. The pain goes away and the motor function of the legs returns. Sirdalud, Baklosan, Mydocalm, Pancuronium, Tubocurarine, Ditilin.
Non-steroidal anti-inflammatory drugs ( NSAIDs ). Relieves pain, heat, inflammation, fever. Among them, Diclofenac, Ibuprofen, Meloxicam, Lornoxicam, Ketorolac, Ketoprofen are common.
Hormonal (corticosteroid) drugs. In cases of exacerbation of sciatica, the course of eliminating inflammation is supplemented with hormonal drugs from the group of glucocorticoids. They are used only for severe swelling in the sacral region. Modern forms include Hydrocortisone, Dexamethasone, and Prednisolone.
Blockades. Novocaine or hydrocortisone blockades are used for urgent pain relief in a hospital setting. They relax muscles and relieve pain.

Physiotherapy

For sciatica, in combination with treatment with conservative methods, hardware methods are also used:

Darsonvalization is the effect of a low-power electrical impulse on the human body for medicinal purposes. As a result, we obtain a weak analgesic effect and activate metabolic processes in those areas of tissue where the action is directed.
Laser therapy. It can also have a positive effect on restoring blood circulation in swollen and insensitive areas affected by sciatica. Red and infrared laser radiation is applied topically, observing changes in the nature of pain and inflammation.
Magnetotherapy. This type of physiotherapy is based on the ability of a magnetic field to penetrate deeply into human tissues and organs. Thanks to this, an analgesic and anti-inflammatory effect is achieved, as well as improved blood circulation;
UHF. The electromagnetic field creates a certain heat, which is used for therapeutic purposes, directing it to relieve swelling, inflammation, and improve blood supply.
Electrophoresis. Currents of a given frequency help medications influence the deep layers under the skin, creating a beneficial therapeutic effect.
Massage

This procedure for repeated attacks of sciatica shows good statistics for pain relief, as it relaxes muscle tone and eliminates lymphatic congestion. The areas selected are not only those that are affected in each specific case, but also those that are potentially risky. This is the lower back, hips, back of the lower leg up to the end of the foot. Conduct from 10 to 15 sessions, with a frequency of 2-3 days, lasting about half an hour.

Exercise therapy

Therapeutic exercise and gymnastics are among the most effective methods of conservative treatment of sciatica. Their use is aimed at relieving increased tension from muscles, improving blood circulation and generally strengthening the body. Performing exercises helps to significantly reduce pain after the first sessions.

An approximate set of exercises for sciatica of the sciatic nerve:

Lie on your back, arms along your body. Bend your legs at the knees and bring them to your chest. Without straightening your legs completely, repeat 8-10 times.
Lying on your back, raise your straight legs 90 degrees up, hold for 3-5 seconds and lower to the starting position. Repeat 5 times. The back should not be stressed.
Lie on your stomach and lift your upper body with your hands. The palms are under the shoulder. Perform 5 times with short intervals.
Sit on a chair, legs at right angles, back strictly vertical. We turn the body as far as possible in both directions. Repeat 5 times.
Tilts. Sit on your knees, raise your arms vertically above your head, alternately bend to the side. Repeat 5 times.
Starting position: standing, feet shoulder-width apart. We tilt the body to the sides 5 times.

Attention: gymnastics should be smooth, all movements should be careful and without sudden lunges.

Treatment at home

Sciatica is treated at home with medications prescribed by a doctor. Traditional methods are also popular, the advantage of which is the natural origin of the components used.

Warming ointments with pepper and heparin are often used. They provide only a supportive effect and temporarily relieve pain.
You can prepare a compress from dandelion flowers. To do this, you need to tightly place fresh inflorescences in a vessel and fill them with alcohol. Leave in a dark place for at least 3 days. Apply as a compress or rubbing morning, afternoon and evening.
A chicory bath helps relax muscles. To do this, at the moment of flowering, the entire plant is torn off and dried without access to direct sunlight. Then prepare a decoction in a water bath, taking plant mass and water in a 1:2 ratio. Fill the bath with warm water and pour in 3 to 5 liters of broth. The duration of the procedure is 20-30 minutes. No more than 3 times a week.

Surgery

If the cause of sciatica is a pathology of bone tissue or is a consequence of mixing of the vertebrae, surgical intervention is resorted to.

Surgical treatment is indicated only for those patients for whom conservative treatment has not helped . To do this, in a hospital setting, the dynamics of disease progression are monitored against the background of prescribed procedures.

Traditional treatment

Traditional treatment has the following objectives:

inhibition of inflammation;
pain relief;
normalization of muscle tone;
expansion of motor volume.

To do this, doctors use a whole range of methods:

drug treatment;
physiotherapeutic procedures;
therapeutic exercises;
massage;
folk remedies.

Drug therapy can be local and general (tablets, injections). Tablet forms of drugs include renalgan and analgin. Ointments containing NSAIDs in their structure - indomethacin, diclofenac, ibuprofen - are extremely effective.

Local anesthetics are used in paravertebral blockades. They do not eliminate the cause of the disease, but they promote pain relief, improve the emotional background, and expand motor activity.

Symptoms of nerve inflammation

Regardless of the cause of the ailment, external signs have much in common. What symptoms indicate sciatica. This is usually pain in the area of the sciatic nerve.

Characteristics of pain

Localization. Most often, only one leg or lower half of the body hurts, and on the other side there is a slight numbness and tingling. Rarely both legs hurt, this happens in case of severe pinching. The pain is very severe, it is necessary to see a doctor.

Usually the pain is localized in the hip on one side of the body
Intensity. They can have different intensities, it all depends on the degree of compression of the fibers and their inflammation. At the initial stage of the disease, pain symptoms are mild and easily tolerated and can be relieved with ordinary analgesics.

Analgesics are used to relieve pain
If measures to eliminate the cause are not taken, the inflammatory process intensifies, increases in area and affects new areas of nerve fibers. With any load the pain increases. Such a clinic is observed not only with heavy lifting, but also with ordinary sneezing, coughing or laughing. Subsequently, the unpleasant sensations increase, intensify during sleep, and prevent you from falling asleep. At night you have to wake up and change your position to reduce the syndromes. In the most severe cases, the pain blocks any movement, only subside a little at rest.

Symptoms worsen at night, during sleep

Non-drug treatment

This may include:

massage;
physiotherapeutic procedures;
physical therapy.

These methods lead to strengthening muscles, improving metabolic processes and increasing blood flow. Among the physical procedures we will highlight:

UHF;
diadynamic therapy;
amplipulse therapy;
phonophoresis.

As for physical therapy, it is best to carry it out in a supine position, since it is optimally gentle. At first the load is minimal, then the volume increases. Massage is divided into segment and acupressure. Duration: 30 minutes daily.

Drug treatment is contraindicated:

children;
pregnant women;
for tuberculosis;
for skin diseases and tumors.

Ointments and gels

In addition to tablets and injections prescribed by a neurologist, patients often use local treatment in the form of ointments and gels at home. As mentioned earlier, in the acute stage of the disease you cannot use ointments with a warming effect, but as the inflammatory process subsides, some of them can be used in moderation.

Local remedies can be used in addition to injections and tablets to enhance the analgesic and anti-inflammatory effect. Ointments should be applied 2-3 times a day. There are painkillers and warming ointments.

It is important to understand that warming ointments cannot be used in the presence of an inflammatory process.

Effective pain relieving ointments:

Voltaren emulgel (contains NSAIDs - diclofenac) - from 250 rubles;
Diclofenac - from 30 rubles;
Nise - from 200 rubles;

Nise gel provides good pain relief for sciatica
Ketoprofen - from 50 rubles;
Traumeel S is a homeopathic ointment. It contains herbal extract, improves metabolism in affected tissues, reduces pain. Costs from 500 rubles;
Teraflex M, Chondroitin, Chondroxide. The funds cost from 100 rubles. Such ointments and gels restore the structure of the ligamentous apparatus of the spine. They contain several components that are part of the natural “composition” of our cartilage, discs and ligaments.
Sofia - from 150 rub.

Be sure to read: EVERYTHING about the Lyapko applicator for the spine: instructions for use, how to use, how to choose, which one is better to take

Warming ointments should be used only after the acute process has subsided and prior consultation with a doctor. When used correctly, they warm tissues, relieve pain and provide oxygen flow to affected areas.

Good warming ointments and gels (apply only with an applicator):

Viprosal B - from 300 rubles;
Finalgon - from 300 rubles;
Kapsikam - from 300 rubles;

Capsicam - a strong warming ointment for sciatica
turpentine ointment - from 30 rub.

Good article to follow up:

TOP 20 best ointments for pinched sciatic nerve: warming, analgesic, anti-inflammatory

Folk remedies

In this section we will present three good folk recipes that help cope with pain due to sciatica.

Egg white and turpentine. Take 1 egg white and mix with 15 ml of turpentine (pure). Soak the gauze cloth with the resulting mixture. The compress is applied to the lower back, covered with paper, and wrapped in wool (for example, a scarf). Hold until pain appears. The remaining mixture after removal is removed with a clean towel. Repeat - after 6 hours.
Grated laundry soap. 30 grams of the product is mixed with honey (a tablespoon) and egg white. A compress is made according to the above description. Duration: a couple of hours, repeat daily.
Grated radish with horseradish. The ingredients are mixed in equal proportions (200 g each). Kerosene (10 ml), table vinegar (15 ml), and a tablespoon of salt (tablespoon) are also added here. The drug is infused for 10 days. It is used again as a compress. Duration - hour. It must be repeated twice a day.

We remind you that you will not get rid of the cause of the disease in this way. Therefore, it is better to go to the doctor and do traditional therapy.

Causes of sciatica

Sciatica syndrome can be caused by a number of diseases, injuries and pathologies. Possible causes of sciatica can be divided into two large groups: pathological processes in the spine and other causes.

The following negative processes in the spine can cause compression of the sciatic nerve:

Intervertebral herniation is the central part of the disc, which bulges towards the spinal canal, squeezing the nerve root. In addition, the hernia releases a large amount of hyaluronic acid, which causes severe inflammation.
Canal stenosis - with this pathology, sciatica appears mainly when walking. Compression of the nerve roots occurs as a result of bone atrophy and narrowing of the intervertebral canal.
Displacement of the vertebrae - a similar phenomenon often occurs in the lumbar spine; the displacement of the overlying vertebra compresses the nerve root, causing pain.

An unpleasant condition characterized by sciatica pain can also be caused by other reasons, which include:

Inflammation of the piriformis muscle - this muscle is located under the gluteus and is adjacent directly to the sciatic nerve. Prolonged tension of the piriformis muscle leads to compression of the nerve ending.
Pregnancy - sciatica in this case is caused by fetal pressure on the roots of the sciatic nerve in the sacral area.
Spinal injury - damage to organs, pelvic muscles, microfractures can lead to pinching of the sciatic nerve.
A tumor in the spine - in rare cases, a malignant or benign tumor can also cause sciatica.

To study Neuralgia of the back: symptoms and treatment of the spine in adults

Pain syndrome can occur with significant physical exertion; weak back muscles and poor physical fitness increase the risk of sciatica.

Massage and acupuncture

If you manage to find a good massage therapist or acupuncturist, use massage or acupuncture. Massage tones, restores sensitivity and movement of the limbs, and acupuncture improves nerve conduction and relieves spasms. Read more: TOP 6 types of massage for sciatica: acupressure, cupping, honey, self-massage, video, how to do it

Video: sciatica. What to do if the pain “shoots”

Sciatica is a condition in which drug treatment must be combined with a correct lifestyle, therapeutic exercises and procedures carried out at home or in a clinic. It is necessary to understand which spinal disease causes the symptoms of inflammation of the sciatic nerve, and only then prescribe appropriate therapy.

Non-steroidal anti-inflammatory drugs are available in pharmacies without a prescription, but you cannot use them alone when self-medicating. Pain and inflammation require only complex treatment, and it can only be prescribed by a qualified neurologist.

Which of the following treatment methods, in your opinion, is the most effective? Share in the comments!