Why does numbness in the foot and sciatica not go away? Severe pain in the leg due to pinching of the sciatic nerve. Signs of inflammation of the sciatic nerve

Nervus ischiadicus (sciatic nerve) provides muscle movement and sensation to the back of the legs. With its paralysis, there is a lack of movement in the knee joint and below. Paralysis is quite rare, but pinched nerves are common and painful. Let's figure out how to treat if a nerve is pinched, what are the symptoms and consequences of this pathology.

In our body, the sciatic nerve is a pair and begins in the sacral region of the spine. Therefore, the etiology of pinched sciatic nerve can be various pathologies and injuries of the spine. For example, compression of the nerve roots between the vertebrae or damage to the pelvic bones. Also one of the common causes is piriformis syndrome (piriformis syndrome). With this pathology, the nerve fibers are pinched by the piriformis muscle or ligaments in the space located under the muscle. The reason for this may be excessive tension as a result of increased physical activity or incorrect injections into the muscle.

Symptoms

Symptoms of compression of the nervus ischiadicus are almost always accompanied by severe pain, but in some cases they can only manifest themselves in autonomic disorders, for example, chilliness and tingling of the leg. Most often, symptoms of pinched nervus ischiadicus appear only in one of the lower extremities and are accompanied by the following factors:

dull pain in the pelvic area, increasing with physical activity;
spread of pain throughout the leg;
impaired general sensitivity of the leg, numbness and tingling of the posterolateral surface of the leg;
decreased reflex when hitting the heel tendon;
intermittent claudication and pallor of the limb;
weakness and heaviness in the muscles of the thigh and lower leg;
decrease in thigh muscle volume;
pain in the lumbar or sacral spine;
decreased mobility of the knee, foot and fingers.

If any of these symptoms are present, a thorough diagnosis of nerve compression is necessary before treatment begins. To exclude problems such as intervertebral hernia, osteochondrosis or spinal canal stenosis, it is recommended to perform radiography, MRI or CT of the spine.

If problems with the spine have not been identified, but the symptoms indicate pinching, then compression of the nerve is caused by piriformis syndrome. Before you begin to treat a pinched nerve, you need to conduct additional diagnostics with the following manipulations:

palpation of the area of attachment and projection of the piriformis muscle;
examination of the condition of the pelvic ligaments;
novocaine blockade of the piriformis muscle in order to monitor the dynamics of pain (in the presence of piriformis muscle syndrome, the pain will decrease).

In addition, the sciatic nerve may be pinched by a tumor, which must be identified and treated. For this purpose, radiological studies are used. For example, radioisotope scanning of the spine.

Treatment should always be based on the cause of the pinching and not on the symptoms that accompany it. You can get rid of pain in the sciatic nerve through surgery and therapy. Surgical intervention is necessary for serious pathologies of the spine, when compression of the nerve is caused by compression of its roots.

It should be treated comprehensively using methods such as medication, manual therapy, and physiotherapy.

Drug therapy

Treatment is carried out only under the supervision of a neurologist. To relieve neurogenic inflammation, drip infusions of Actovegin 200 mg are prescribed for five days, after which the patient is transferred to oral use of Actovegin.

Vasoactive drugs will help reduce vegetative symptoms and improve blood circulation. It is recommended to administer Instenon by drip (2 ml per 200 ml of physiological solution) - 10 procedures per course of treatment. Oral administration of the drug "Trental" 400 mg 3 times a day is also effective.

Pain symptoms decrease after the introduction of non-steroidal anti-inflammatory drugs into treatment. One of the effective and safe analgesics today is Xefocam (lornoxicam). Treatment according to the following regimen: on the first day – 16 and 8 mg; second to fourth days – 8 mg twice a day; fifth day – 8 mg. In addition to lornoxicam, the following may be recommended:

"Ketoprofen" ("Ketonal", "Ketanov") in the form of injections;
“Ketorol” (ketorolac) – injection;
"Diclofenac" - injection;
“Nimesulide”, “Meloxicam”, “Celecoxib” - in the form of tablets, after a course of injectable NSAIDs (points 1-3) on the fifth or sixth day. The total duration of taking these drugs can be two to four weeks.

In addition to vasoactive drugs, NSAIDs, centrally acting muscle relaxants (Mydocalm, Sirdalud), B vitamins (B1, B6, Milgamma), and novocaine may be prescribed.

Manual treatment

It is recommended to treat a pinched nerve not only with medications, but also with your hands. The main goal is to relax the piriformis muscle, reducing pain and discomfort of the spine. Cupping, acupressure, therapeutic massage or acupuncture are effective treatments when performed by a qualified professional.

To treat pinching due to piriformis syndrome, a special massage technique, post-isometric relaxation, is used:

The affected leg is bent at the hip joint at a right angle and thrown over the healthy leg, which is fully straightened;
The massage therapist clasps the outer surface of the bent knee with one hand and immobilizes the pelvic bones with the other;
Passive stretching of the muscle is performed by light pressure on the knee with a delay of up to five seconds;
The patient holds his breath and exerts slight resistance by abducting the hip for ten seconds;
The patient relaxes, the doctor increases the pressure on the knee for ten seconds;
The piriformis muscle begins to relax, it stretches, discomfort decreases;
The actions of points 1-6 are repeated five times, the massage therapist does not reduce the initial pressure on the muscle, carefully keeping it stretched.

Thanks to this massage technique, tension in the piriformis muscle and nerve compression are reduced.

Physiotherapy

Various procedures, such as electrophoresis, ultraviolet irradiation, UHF therapy or laser therapy, will help treat pinching and relieve symptoms. The required course of physiotherapy is selected by the attending physician in order to improve blood circulation and relieve pain. It is possible to use compresses, since heat helps to relax muscles, and therefore reduces the symptoms of compression of nerve fibers.

If the sciatic nerve is pinched, you should immediately contact a specialist and begin treating the disease to avoid worsening the condition. Thus, competent treatment after a thorough diagnosis will ensure a faster recovery, and is also a kind of prevention of chronic pain syndrome.

Sources:

Xefocam: possibilities of use for the treatment of pain syndromes. Danilov A.B. Russian Medical Journal;
Myofascial syndrome (piriformis syndrome) – approaches to diagnosis and treatment. Shostak N.A. Russian Medical Journal;
Putilina M.V. Sciatic nerve neuropathy. Syndrome piriformis muscle // Attending physician. 2006. No. 2.
Srbely J.Z. New trends in the treatment and management of myofascial pain syndrome // Curr Pain Headache Rep. 2010. Vol. 14 (5). R. 346–352.

As you know, the sciatic nerve begins from the lumbosacral plexus and, going down the leg, branches into two directions - the tibial and peroneal nerves. Its pinching is accompanied by acute pain, which affects both limbs and limits the patient’s movement.

Only complex treatment, which includes physiotherapeutic treatment and a set of special exercises, can relieve the symptoms of inflammation of the sciatic nerve and correct the situation with pinching. However, in the acute period, drug therapy is inevitable.

In this article we will look at the basic principles of treatment for inflammation and pinched sciatic nerve in adults, and also talk about the first symptoms and causes of this disease. If you have any questions, leave them in the comments.

What it is?

A pinched sciatic nerve is an inflammation of one of the longest nerves in the body, which manifests itself in the lumbosacral spine with severe pain. In medicine, this phenomenon is called sciatica.

Inflammation of the sciatic nerve is a syndrome or manifestation of symptoms of other ailments. In this regard, inflammation can be caused by problems in the functioning of other organs and systems of the body, but in most cases the occurrence of pathology is associated with problems in the spine.

Causes

What is it and why does it develop? The disease occurs more often in people over 30 years of age, although recently younger people have also been affected by the pathology, which is associated with the early formation of degenerative changes in the soft tissues around the spinal column.

The most common factor in the development of inflammation of the sciatic nerve is a pathological process localized in the lumbar and sacral segment of the spine.

Therefore, the most common cause of pinching is:

Complete or partial displacement of the intervertebral disc, accompanied by pinching of the sciatic nerve, narrowing of the spinal canal, growths on the spine;
Piriformis syndrome;
Damage to organs or the muscular system of the pelvis due to injury or heavy physical exertion;
Hypothermia, infectious processes;
Presence of neoplasms.

Inflammation of the sciatic nerve may have the nature of a primary lesion, the causes of which are most often hypothermia, an infectious process, or trauma. Secondary pinching occurs when the nerve roots that form the sciatic nerve are pinched as a result of protrusion, herniated disc, bone growths around the spine, muscle spasm due to physical overload, etc.

Symptoms of inflammation of the sciatic nerve

If pinching of the sciatic nerve progresses, the symptoms of the pathology are expressed in an acute form, significantly disrupting the patient’s usual quality of life. The main symptom of the disease is pain, the intensity of which depends on the cause of inflammation:

pinching of the sciatic nerve by a hernia;
influenza, malaria and other infections that lead to inflammation;
stenosis;
spondylolisthesis.

The nature of the pain must be taken into account. This helps doctors make an accurate diagnosis and then begin treating the inflammation. Therefore, pinching in the lower part of the spine is divided into three groups:

sitting symptom - the patient cannot sit down;
Lasegue's symptom – the patient cannot raise his straight leg;
Sicard's symptom - pain increases with flexion of the foot.

In addition to pain, there are also characteristic symptoms of inflammation of the sciatic nerve associated with disruption of the conduction of nerve impulses along motor and sensory fibers:

Decreased sensation (paresthesia)– in the initial stage it manifests itself as a feeling of numbness, tingling of the skin of the buttocks and legs along the back surface. As symptoms progress, other types of sensitivity also decrease, until they disappear completely.
Dysfunction of the pelvic organs– occurs due to compression of the fibers of the autonomic (sympathetic and parasympathetic) nervous system passing in the sciatic nerve. There are disturbances in urination (urinary incontinence) and defecation in the form of constipation. This symptomatology develops in severe cases of sciatica with significant infringement of the spinal roots.
Disturbances in motor function- the result of infringement of the motor fibers of the nerve. A person experiences weakness in the gluteal, thigh and calf muscles. It is expressed in a change in gait with a unilateral process (limping on the affected leg).

If the above symptoms occur, treatment should begin immediately, because pinching of the sciatic nerve can lead to complete loss of sensation in the legs.

Diagnostics

To determine how to treat a pinched sciatic nerve, you should definitely find out its etiology and, if possible, eliminate all factors that may provoke the development of the disease.

To clarify the diagnosis, it is necessary to conduct a comprehensive examination of the patient - it should include:

methods of clinical and biochemical laboratory diagnostics;
examination by a neurologist, and, if necessary, a vertebrologist, rheumatologist and vascular surgeon;
taking x-rays of the spine in several projections (necessarily in a lying and standing position);
tomographic studies.

Urgent consultation with a doctor required if:

against the background of pain, body temperature rises to 38 ° C;
swelling appears on the back or the skin turns red;
pain gradually spreads to new areas of the body;
there is severe numbness in the pelvic area, hips, legs, making it difficult to walk;
there is a burning sensation when urinating, problems with holding urine and feces arise.

These studies help to find out what to do in order to relieve pain as soon as possible and eliminate inflammation in the sciatic nerve.

How to treat a pinched sciatic nerve

If symptoms of a pinched sciatic nerve occur, treatment should begin as early as possible; based on the results of the diagnosis, the specialist will prescribe appropriate therapy:

First of all, determine what caused the pinched sciatic nerve. Treatment may vary depending on the cause. For example, tumors may require surgery.
Drug treatment. The first stage of this treatment is aimed at pain relief and relieving the inflammatory process. For this purpose, muscle relaxants and NSAIDs are used.
B vitamins(combilipen, milgamma) help normalize metabolism in nerve cells. In the acute period, they are prescribed intramuscularly for a period of 10 days, then switch to oral administration.
Physiotherapeutic treatment. Such treatment includes electrophoresis, the use of electromagnetic fields or ultraviolet radiation, massage (impact on certain points, cupping, vacuum types of massage), therapy through paraffin procedures, hydrotherapy.
Unconventional treatment, which currently includes many different methods. This includes acupuncture, the use of Kuznetsov’s applicators, stone therapy, hirudotherapy, herbal medicine, and moxibustion.
Treatment with traditional recipes. So, when pinched, horse chestnut, bay leaf tincture, cakes made from flour and honey, potato compresses, beeswax, spruce and pine buds, dandelion tincture and many other methods are used.
Diuretics used to reduce swelling in the area of nerve roots (furosemide).
Physiotherapy. Helps improve blood flow in the affected area and strengthen muscles. The doctor decides which exercises to perform in a particular case, based on the degree of neglect of the disease, the severity of the pain syndrome, the presence of an inflammatory process and other factors.
Surgery. If medications and physiotherapeutic procedures are ineffective, the only option for eliminating pinching is surgical intervention: discectomy and microdiscectomy.

It is worth noting that treating inflammation or pinching of the sciatic nerve at home is a complex, lengthy undertaking that does not always give an immediate effect, so you have to take care of your health over a long period of time.

If the pain does not subside within several months, the patient is prescribed steroid injections administered epidurally into the affected area. This procedure reduces the symptoms of inflammation at the local level, giving an immediate but very noticeable effect.

Mode

One of the main components of treatment is the creation of a therapeutic and protective regime for the patient.

The patient should lie on a hard bed, the possibility of movement is recommended to be limited until the obvious signs of inflammation subside. Bed rest is indicated until the condition improves and pain is eliminated.

Nonsteroidal anti-inflammatory drugs

The most effective painkillers are. This pharmaceutical group of drugs is represented by drugs that stop the action of the COX enzyme and have an anti-inflammatory effect, these include:

"Meloxicam" ("Movalis", "Amelotex")– Available in tablet and injection forms, it is one of the safest drugs in the NSAID group.
“Piroxicam” is available in the form of a solution (ampoules of 1-2 ml), tablets, suppositories, gel, cream; it can be used both locally and by injection - 1-2 ml once a day to relieve an acute pain attack.
"Nimesulide" ("Nise", "Nimesil")– Available in the form of powders, tablets, capsules. The usual dosage is 100 mg per day, in the first days it is possible to increase to 200 mg.
"Celebrex" - capsules, the recommended daily dose is up to 200 mg, but for severe pain it can be increased to 400-600 mg at the first dose, followed by a subsequent reduction in the dose to 200 mg.
"Ketonal", "Ketanov" ("Ketoprofen")– is available both in ampoules and capsules, tablets, suppositories and in the form of an ointment; for sciatica, it is most often used intramuscularly (up to three times a day, 2 ml), but the symptoms are also well relieved by local application (ointments).

When pain and inflammation increase, hormonal steroids are sometimes prescribed in short courses; they relieve pain, but do not eliminate the cause of inflammation, and their use has a lot of side effects and contraindications.

See also how to choose effective ones for treating joints.

Muscle relaxants and vitamins

Muscle relaxants prescribed to reduce reflex local muscle tension caused by pain syndrome. This:

Tizalud;
Baclofen;

They also produce an anti-inflammatory effect multivitamin complexes based on B vitamins:

Neurobion;
Milgamma;
Combilipen;
Trigamma;
Neurovitan.

When physical therapy and medications do not help, they resort to surgical methods - microdiscectomy, discotomy, in which part of the disc pressing on the sciatic nerve is removed.

Unconventional treatment

In specialized clinics and medical centers, various non-traditional methods are used to treat pinched sciatic nerve:

phytotherapy;
acupuncture;
acupressure;
warming up with wormwood cigars;
stone therapy or stone massage;
vacuum or cupping massage;
hirudotherapy - treatment with leeches and others.

Spa treatment

Only without exacerbation, sanatorium-resort treatment of inflammation of the sciatic nerve is recommended; mud therapy, hydrotherapy using radon, hydrogen sulfide, pearl baths, and underwater traction courses are especially effective.

Climate therapy always helps strengthen the immune system, reduces the frequency of colds, rest improves mood and creates a positive attitude, which is so important for recovery.

Massage

Massage procedures are allowed after the acute inflammatory process has subsided.

Thanks to this technique, the conductivity of the damaged sciatic nerve increases, local blood circulation and lymph flow are normalized, pain is reduced, and already developed muscle wasting is reduced.

Exercises

After recovery, beneficial physical exercises are especially necessary, but only those in which the load is evenly distributed on both sides of the body (light jogging, race walking, swimming, leisurely skiing).

In addition, there are special exercises that are ideal for all patients in remission. Here is an example of exercises that can be easily performed at home while lying on the floor.

All exercises are performed 10 times, with a subsequent increase in load:

Bring your legs towards your body, hug them under your knees. Using your hands, press your legs towards you as much as possible, maintain this position for 30 seconds, then return to the starting position.
Legs are straight, toes pointing up, arms along the body. Stretch your heels and the back of your head in different directions for 15 seconds, then relax.
Turn to your side, pull your legs towards you. Pull up your socks. Then return to the starting position and turn to the other side.
Roll over onto your stomach, lift your torso on your arms, and do push-ups. Do not strain your legs while doing this.

However, you need to know that if a pinched sciatic nerve is caused by a herniated intervertebral disc, you need to select a complex of physical therapy together with your doctor.

Treatment with folk remedies

Traditional medicine is of particular importance to cure pinched sciatic nerve. After all, its remedies become practically the only method of treatment, for example, if a nerve is pinched in a pregnant woman or there are any contraindications to the medications or physical procedures being taken.

The following treatments can be done at home:

Bay leaf tincture. You need to take 18 medium-sized bay leaves, pour 200 ml of good vodka into them, leave for 3 days in a cool, dark place. After this period, the resulting infusion must be rubbed into the sacrum area with massaging movements. After the fourth procedure, a positive effect is observed.
At night, you can attach a honey cake to the sore spot.. To do this, you need to heat a tablespoon of honey in a water bath, mix it with a glass of flour, form a cake and place it on the sore spot. Cover with cellophane and wrap everything with a warm scarf. This compress will relieve pain.
Potato sprout infusion is prepared from sprouted potatoes, or rather their sprouts. To do this, you need to take a glass of sprouts and pour half a liter of vodka. In this form, the mixture is infused for two weeks in the dark. After it is ready, you need to rub it into the affected area twice a day and wrap it in a warm cloth for a while.
Dissolve 10 analgin tablets in 200 ml of alcohol solution (at least 70%) and add a bottle of 5% iodine. The resulting mixture should be stored in a dark place for 3 days. Rub the prepared tincture into the problem area before bed, then wrap a scarf around your lower back and sleep until the morning.

Remember that home treatments cannot replace complex drug therapy; they are intended only to reduce the manifestations of the disease.

Prevention

When a pinched sciatic nerve is diagnosed, medications relieve pain and general discomfort; but it is also recommended to explore preventative measures to prevent relapse:

you only need to sleep on a hard surface,
avoid lifting heavy objects
hypothermia of the extremities,
do not make sudden movements.

Which doctor should I contact?

If symptoms of sciatica appear, you should consult a neurologist. The treatment involves a physiotherapist, massage therapist, and chiropractor. If necessary, the patient is examined by a neurosurgeon.

Among the numerous problems associated with the lower extremities, one should highlight the situation when the legs go numb. A general practitioner hears such complaints almost every day, not to mention more specialized specialists. And this brings nothing to patients except inconvenience and anxiety about their health. To get rid of such sensations, you should first find out their cause and do everything exactly as the doctor recommends.

Causes

The most common numbness in the legs is below the knees. This is due to the fact that the legs and feet, firstly, are subject to significant load, bearing the weight of the entire body, and secondly, they are as far as possible from the central organs of the vascular and nervous systems. Such conditions create the prerequisites for the development of conditions that are characterized not only by local disturbances, but also by damage at a distance. These include:

Polyneuropathy.
Vascular diseases.
Spinal diseases.
Tunnel syndromes.
Pathology of the spinal cord and brain.
Traumatic injuries.
Tumors.
Frostbite.

Thus, the problem may lie not only in the peripheral parts of the limbs, but also much higher - in the spine and even the head. You can find out why your legs go numb from the hip to the foot through a careful differential diagnosis, taking into account all conditions with a similar clinical picture.

The causes of numbness in the legs are quite diverse; the same symptom can indicate a completely different pathology.

Symptoms

To determine the symptoms of the disease, the doctor conducts a clinical examination. It includes subjective information received from the patient (complaints), as well as objective data revealed during examination. All symptoms are subjected to maximum detail and subsequent analysis in order to form a holistic picture of the disease.

Unpleasant symptoms can be felt in various parts of the limb: thigh, lower leg or foot. Their localization will often tell a lot about the location of the main pathological focus. However, numbness in the legs is unlikely to be the only sign of pathology - most often there are other manifestations, sometimes more significant.

Polyneuropathy

A common cause of numbness in the legs below the knee is polyneuropathy. In most cases, it occurs due to metabolic disorders in the body (diabetes, thyroid diseases, kidney failure, various intoxications). Disorders are not limited to numbness, but include the following symptoms:

Moderate to intense pain in the legs and feet.
A crawling sensation, a burning sensation.
Reduced superficial sensitivity.
Changes in reflexes.

In addition to the lower extremities, nerves in other parts of the body may be affected, since the process is multiple. Polyneuropathy necessarily occurs against the background of an underlying disease, which has its own characteristic features.

If your legs below the knees are numb, then first of all it is necessary to consider the issue of multiple nerve damage - polyneuropathy.

Vascular diseases

Numbness in the legs from the hip to the foot can be the result of vascular problems. For sensory disturbances to develop, a long course of the disease is required, so acute conditions should not be taken into account. As a rule, such a symptom is considered as a sign of endarteritis, atherosclerosis or varicose veins of the lower extremities. Along with it, the following complaints can be noted:

Feeling tired in the legs in the evening.
Pain in the calf muscles when walking is a symptom of “intermittent” claudication.
Pale or bluish skin, dilated saphenous veins.
Reduced pulsation in various areas of the main arteries: on the foot and above - under the knee, in the thigh area.
Trophic disorders: hair loss, formation of ulcers.

In most cases, there is bilateral damage to the arteries or veins. If you do not pay attention to the signs of the disease in time, especially with endarteritis and atherosclerosis, you will have to expect a significant increase in ischemia, which in the future can cause gangrene.

When symptoms of vascular pathology of the lower extremities appear, in order to avoid complications, you should consult a doctor in time.

Spinal diseases

The cause of numbness in the lower extremities often lies in diseases of the lumbar region - osteochondrosis or disc herniation. In this case, compression of the spinal roots that give rise to the sciatic nerve occurs, which is manifested by the following symptoms:

Pain in the lower back, radiating to the leg - buttock, back of the thigh, lower leg and foot.
Other sensory disorders.
Feeling of weakness on the affected side.
Limitation of lumbar mobility.

Compression of the root most often occurs on one side, but damage to both nerves is possible. Upon examination, tension in the back muscles and pain in the paravertebral points are revealed. Therefore, when your leg goes numb, you must definitely pay attention to the condition of the spine.

Tunnel syndromes

If numbness in the legs occurs in a specific area, then we can assume compression of the corresponding nerve in the canal formed by bones, tendons and muscles. This is observed at various levels, starting from the inguinal fold and is provoked by injuries, hematomas, and tumors.

When the right leg goes numb along the outer surface of the thigh, above its middle, Roth's disease can be assumed. In other words, it is neuropathy of the external cutaneous nerve, which is located very superficially and can be compressed by a belt or objects located in pockets. Only local sensory disorders are characteristic. Numbness on the inside of the leg indicates damage to the femoral nerve. At the same time, movement disorders are also observed:

Weakening of the knee reflex.
Weakness and wasting of the quadriceps and iliopsoas muscles.
Impaired hip and knee flexion.

And if, for example, the left leg goes numb on the outside of the shin and along the dorsum of the foot, then you need to think about compression of the peroneal nerve. Patients complain of pain in the legs below the knee, crawling “goosebumps”. The extension of the foot and fingers is impaired, causing walking to suffer.

Any numbness in the lower extremities should be considered a sign of pathology, the nature of which must be determined by the doctor.

Treatment

Once it becomes known why the patient’s legs are numb, treatment should be started immediately. First of all, it is necessary to eliminate the cause of this condition, be it compression of a nerve, occlusion of a vessel, or a violation of metabolic processes in the body. Only after the elimination of the main pathological process can we talk about the restoration of sensitivity in certain parts of the lower limb.

Drug therapy

In most cases, the disease that causes numbness in the legs is treated with medication. The doctor selects the optimal drugs that are indicated for the identified pathology, and the patient only needs to follow his recommendations. Depending on the clinical situation, the following medications may be used:

Anti-inflammatory (Ortofen, Larfix).
Muscle relaxants (Mydocalm).
Vitamins (Milgamma).
Antiplatelet agents (Aspecard).
Venotonics (Detralex).
Antioxidants (Cytoflavin, Berlition).
Vascular (Actovegin, Latren).

Treatment will be more effective if it is carried out in stages - first using injectable forms of drugs, and then tablets.

Physiotherapy

Physiotherapy methods help improve nerve conduction and blood circulation. Such treatment includes local and general procedures, which are carried out under the supervision of a specialist. For numbness in the extremities above or below the knees, the following methods may be indicated:

Electrophoresis.
Magnetotherapy.
Wave treatment.
Barotherapy.
Reflexology.
Spa treatment.

The physiotherapist will create an optimal program consisting of the most effective procedures. In combination with other methods, this will be a good impetus for recovery.

Physiotherapy

When the left leg goes numb after an injury or similar symptoms appear due to osteochondrosis, certain therapeutic exercises are required that will not only restore the motor function of the limb, but also help normalize sensitivity. You need to do gymnastics regularly, starting in a hospital setting and under the supervision of a doctor, and continuing at home. But such exercises are justified only after the pain syndrome has been eliminated.

Operation

In some cases, adequate treatment is only possible through surgery. This happens with serious injuries, severe vascular pathology, tumors, and intervertebral hernias. The main goal of surgery is to eliminate pathological formations that cause compression of nerve fibers or disruption of blood flow through the vessels. Recently, endoscopic and microsurgical techniques have been used, which are less traumatic compared to open operations and do not require long recovery.

If there is numbness in the lower extremities, you should first find out why this symptom appears. A correct diagnosis allows you to effectively treat the disease, which gives hope for a speedy recovery.

Pain in the legs from the knee to the foot: why do the legs hurt below the knees?

Severe pain in the legs bothers almost every second person. The discomfort most often affects the lower extremities.

The causes of the problem may lie in simple fatigue after prolonged walking, physical activity or uncomfortable shoes.

However, sometimes the legs below the knees and bones hurt due to the development of articular pathology, for which timely treatment cannot be ignored.

Features of the structure of the legs and causes of pain

If a person suffers from pain in the legs below the knees, then usually we are talking about the area from the lower leg to the foot. The lower leg consists of the fibula and tibia, nerve, venous, arterial fibers, and a large number of muscles.

If there is discomfort of an organic or functional nature, the pain syndrome will radiate to the lower leg. In some cases, pain is not critical and may not be a threat to health. There are pathological conditions when pain below the knee becomes life-threatening for the patient. For example, this is relevant for deep vein thrombosis.

In such situations, you cannot delay treatment, because if a blood clot has formed in the legs, then in the absence of diagnosis and when treatment is not started, the clot may break off. This provokes blockage of the pulmonary artery and instant death.

Only a doctor who can prescribe adequate treatment can answer the question of why the legs hurt below the knees. Often the causes of pain in the muscles and bones of the limbs lie in:

muscle tone, spasms caused by prolonged stress on the leg (physical strain);
injuries (sprains, torn ligaments, muscles, bone fractures);
inflammatory process in the lower leg (myositis);
varicose veins of the legs;
atherosclerosis (plaques in the arteries);
arthrosis, arthritis;
osteoporosis;
thrombosis of deep veins, vessels and arteries below the level of the knees;
osteomyelitis (infection of the inside of the legs);
diseases of rheumatic nature;
polyneuropathy (pathology of nerve fibers) in patients with diabetes, chronic smokers and alcoholics;
lymphostasis of the vessels of the leg;
diseases of the leg arteries (vasculitis, periarthritis nodosa);
compression of the soft tissues of the extremities;
benign and malignant tumors of bones, muscles, tissues below the knees;
lack of microelements in the blood (magnesium, potassium, calcium);
prolonged use of medications (diuretics, glucocorticosteroids);
compression of nerve endings, for example, with osteochondrosis.

Varicose veins and vascular thrombosis

Pain below the knee can be caused by varicose veins. The disease manifests itself as enlarged veins in the legs, and in the initial stages this symptom is not visible. Other signs of varicose veins will be swelling of the legs at the end of the day, a burning sensation and heaviness, rare cramps, a dull aching pain that goes away after resting in a horizontal position.

This pathology can develop in a fairly short period of time, is acute and is usually accompanied by vivid external manifestations. Varicose veins in some cases occur with blockage of arteries or veins.

With venous thrombosis, symptoms appear gradually over a couple of days. In this case, the patient suffers from heaviness in the legs and excruciating arching pain.

Soreness is localized both on the outside of the limb and on the inside:

legs swell (left and right at once);
the skin on them becomes very red.

At the site of the inflammatory process, the temperature rises and the leg becomes hot. After some time, the redness gives way to a bluish color. The pain syndrome in a person is so severe that he is unable to step on the affected limb. Already on days 3-4, tissue death and gangrene occur. If there is no treatment or it is not timely, the patient risks losing the affected leg or dying.

With arterial thrombosis, the affected leg becomes numb and cold within a few hours. Due to the fact that the lower leg is left without blood supply, its covering becomes white.

In addition, sudden, quite acute pain below the knee may appear. Without medical intervention, tissues die within 2-4 hours due to necrosis.

Mineral deficiency, polyneuropathy, polyarthritis obliterans

If there is a lack of any microelements in the body, pain in the legs may develop. There are many reasons for this, for example, bones do not receive the required amount of calcium. In this case, cramps in the calf muscles may develop, especially at night. Because of this, the patient is unable to fully rest.

The attacks last several minutes and go away on their own. You can make your well-being easier by massaging the affected area of your leg.

With polyneuropathy of the lower extremities, the causes of pain in the left leg usually lie in diabetes mellitus. The disease affects not only vital organs, but also bones and nerve endings. Sometimes diabetes makes itself felt by severe pain in the muscles and bones around the foot. This is especially true for type 2 pathology.

Signs of polyneuropathy:

burning pain in front of leg;
numbness and the so-called cold extremity syndrome.

It hurts constantly, and the intensity of the discomfort does not depend on physical activity and type of activity.

When the leg muscles hurt due to obliterating polyarthritis, the patient suffers from a disruption of the main blood flow in the legs, caused by a narrowing of the lumen of the blood vessels. The causes of the pathology are the development of atherosclerotic plaques.

The person feels pain from the knee to the foot and is forced to limp. Often, discomfort in the front of the legs occurs when walking for a long time, especially over long distances. If you rest for at least a few minutes, the pain syndrome subsides.

In cases where medical assistance is not provided, the disease actively progresses, the pain intensifies and reduces the muscles of the left and right legs even at rest. Trophic ulcers form on the skin of the legs, the integument peels off and becomes too dry. In addition, the nail plates on the left and right legs are connected to the pathological process.

This disease can cause the affected limb to die due to gangrene. If your legs hurt from the knee to the foot, then it is necessary to undergo a comprehensive examination and begin appropriate treatment.

Prevention measures and pneumopressotherapy of the legs

To prevent the development of leg pathologies and pain syndrome, you should consult a doctor. They will tell you how to protect yourself and what you absolutely should not do. So, to prevent restless legs syndrome, you should follow these simple recommendations:

Avoid wearing uncomfortable, tight clothing, especially trousers. This will help prevent venous and lymphatic congestion in the legs, especially in the front;
correct flat feet;
when sitting for a long time, avoid a position where the left leg is crossed over the right, as this compresses the blood vessels;
control water-salt balance;
during rest, it is better to lie on your back, while raising your legs up for at least half an hour to improve blood supply to the muscles;
bring your weight to normal;
take walks as often as possible;
walk barefoot on uneven surfaces;
dilute a sedentary lifestyle with regular exercise and sports;
carry out exercises for the foot, lifting small objects from the floor with your left and right feet. The exercise develops the muscles in the front of the limb well.

Pneumopressotherapy is an excellent way to stop or prevent leg problems. This physiotherapeutic treatment has a beneficial effect on the body and tissues of the legs by displacing venous blood from muscle pockets, where lymph often stagnates.

Using a special medical device, a foot massage is performed, during which the effect on the tissue is dosed. One pneumopressotherapy procedure can replace about 30 sessions of standard manual massage.

In addition, such preventive treatment has a positive effect on the appearance of the legs, especially if the procedure is done systematically.

What is sciatica and why is this disease dangerous?

Sciatica is a complex disease, the characteristic symptoms of which are pain, periodic tingling, weakness and numbness that occurs along the sciatic nerve from the lower back and buttocks to the legs and thighs. Today we will tell you what this disease is and how it can be cured.

Sciatica: what is this disease?
Why does sciatica appear?
Symptoms of sciatica
Types of diagnostics for sciatica
- Features of magnetic resonance imaging (MRI)
How to treat sciatica?
- Features of massage for sciatica
- Effect of acupuncture for sciatica
- The use of osteopathy for sciatica
- Therapeutic exercises during sciatica
- Treatment of sciatica with traditional methods
Preventive measures against sciatica

Sciatica: what is this disease?

The sciatic nerves are the longest in our body. Each spinal root begins on a five-level segment of the lumbosacral region. Each descends down the legs and branches along the way, supplying small nerve processes with such parts of the body as:

shins;
hips;
knees;
fingers;
feet.

Since the sacral spine bears the key load, then for all lesions that can cause pinching, compression or irritation of the trunk of the sciatic nerve or its roots. Pain can spread to all areas of the body along the path of the main trunk.

Why does sciatica appear?

The causes of this disease are as follows:

Symptoms of sciatica

The only symptom of this disease is often pain. It has the following features:

dagger, shooting and burning character;
spread to the buttocks, back of the thighs, back of the lower legs and popliteal fossa. They can spread throughout the leg and reach the tips of the fingers, sometimes it appears in the lower back;
With this disease, pain is most often chronic. They may be constant or intermittent;
they can vary in strength, be either too intense and cause severe suffering, or not very intense and do not cause discomfort;
Most often, with sciatica, the pain is unilateral - appearing on only one side, in rare cases - on both sides at once.

With a disease such as sciatica, the following neurological disorders appear:

Types of diagnostics for sciatica

Sciatica is a disease that requires diagnosis, which can be different and has its own advantages and contraindications.

X-ray. Radiography during sciatica allows you to diagnose this disease, which is a consequence of vertebral pathologies and intervertebral discs. It's a quick and easy way to diagnose sciatica, and it's affordable.

X-rays should not be taken in the following cases:

during pregnancy;
with severe anxiety, when it is impossible to record a person’s movements;
with severe obesity, when the vertebrae cannot be seen in the image.

Computed tomography as a method for diagnosing sciatica can reveal the true causes of pain in the sciatic nerve. Unlike radiography, tomography is more informative and accurate; it also helps to construct layer-by-layer sections of the lumbar spine or its 3-D model.

Like x-rays, tomography cannot be prescribed during pregnancy and in a number of other cases, provided individually. This research method does not allow us to examine in detail only soft tissues:

muscles;
nervous tissue and others.

Features of magnetic resonance imaging (MRI)

This type of tomography has the same capabilities as computer tomography, and not only:

layer-by-layer images of the body are obtained;
a clear 3-D image of the spinal column, intervertebral disc and spinal cord is constructed;
the ability to obtain a clearer image of soft tissues.

MRI is a very effective method for diagnosing the causes of sciatica; it is used to examine:

spinal cord;
membranes of the spinal cord;
roots;
vessels;
adjacent tissues.

Indications for this type of diagnosis are:

the presence of a pacemaker is a device that is sewn into the heart muscle during arrhythmia;
the presence of a metal implant in the middle ear that can be magnetized;
the presence of any metal implants capable of magnetization, metal fragments remaining after wounds and injuries;
artificial mechanical ventilation of the patient's lungs;
the presence of the Ilizarov apparatus is a metal device for connecting and holding bones in place after fractures.
Thanks to MRI, it is possible to identify the causes of sciatica located in the following places:
nerves;
muscles;
other soft tissues that are not visible on images of other types of diagnostics.

Sciatica is also diagnosed through electroneuromyography, which is performed on some sciatica sufferers to evaluate nerve conduction if sensation and motor ability are impaired. Special electrodes are placed on the muscles to record the passage of nerve impulses.

How to treat sciatica?

There are different areas of treatment for a disease such as sciatica:

We will describe in detail below some methods of treating this disease.

Features of massage for sciatica

With this disease, both in the acute stage and during remission, massage is used. The rules for its implementation in the presence of sciatica are as follows:

in the presence of lumbosacral radiculitis, which affects the sciatic nerve, they practice massage of the lower back, buttocks, back of the thigh, feet and legs;
in the acute phase of this disease, rubbing and stroking are used, but vibration and kneading only intensify the pain;
when pain and other symptoms subside, the massage will be more intense; you can practice acupressure, cupping and reflex-segmental massage;
essential oils during massage improve its effect;
for sciatica, massage is best combined with rubbing with ointments and special gymnastics;
one massage session lasts about half an hour;
total number of sessions – 10.

For sciatica, massage has the following effect:

distracting and annoying;
blood flow to the affected roots and nerves is better;
increased muscle tone, which is caused by pain, is relieved;
inflammatory swelling is relieved, lymph outflow is improved;
The skin releases biologically active substances that reduce inflammation and pain.

Effect of acupuncture for sciatica

Acupuncture is effectively practiced for sciatica and various forms of radiculitis, but not much research has been conducted in this regard.

The procedure looks like this: at some points, thin needles based on stainless steel or precious materials are inserted into the skin. It should only be performed by a qualified specialist.

The effects of this treatment method are as follows:

pain relief occurs due to the release of endorphins - these are natural substances that act in a similar way to analgesics;
the protective forces and regenerative abilities of tissues increase;
small vessels dilate and blood flow improves, the condition of pinched roots improves;
general inflammation and edema goes away.

Contraindications to the use of this technique are:

presence of cancer;
acute infections;
skin damage at the affected areas.

A course of acupuncture treatment for sciatica lasts about three months. At first it lasts 3-4 sessions per week, and then it is from 1 to 4 courses per month.

The use of osteopathy for sciatica

Osteopathy is a modern direction in the treatment of sciatica and a number of other diseases. It is a small application of pressure and movement that helps eliminate inflammation and pain.

This method has virtually no contraindications. And the positive effect is achieved after the first session. This method does not deal with the cause of the disease, but only relieves the symptoms of sciatica.

Therapeutic exercises during sciatica

In the acute stage of sciatica, the patient is prescribed bed rest and any physical activity is prohibited. He is placed on his back, his legs are raised on a platform, and pillows are placed under his lower back.

When the pain subsides, the following exercises are prescribed:

lying on your back, pull your legs bent at the knees to your chest. Repeat the exercise 10 times;
lying on your stomach, lift your body as if doing a push-up and repeat 5 times;
lying on your back, raise your legs straight up and hold for 5 minutes;
sitting on your knees, lean forward, raising your arms up, and clasp your hands;
in a standing position, place your feet shoulder-width apart, bend alternately to the right and left.

All exercises should be done gently and carefully, since sciatica can appear at any time.

Treatment of sciatica with traditional methods

Below we present recipes for some folk remedies for sciatica.

So, to prepare a special infusion for pain, prepare the following ingredients:

a tablespoon of viburnum;
the same number of calendula flowers;
the same amount of thyme herb;
two large spoons of horsetail grass;
0.5 liters of water.

Grind everything prepared and take 2 large spoons of the resulting mixture. Bring to a boil and simmer for 5 minutes, then cool. You need to take half a glass three times a day before meals.

It is also recommended to practice rubbing with homemade agave. Cut off the stem of agave - this is a potted plant that can be purchased at a specialty store. The stem should not be too young or old, otherwise there will be no effect and the skin will burn. It needs to be cleared of thorns and cut lengthwise. Rub the cut into the area of pain 2-3 times a day.

Even with sciatica, you can rub the sore spot with homemade ointment. To prepare it you will need:

5 glasses of squeezed black radish juice;
1 glass of honey;
1 tablespoon table salt;
a glass of vodka.

Mix all ingredients and shake the mixture well before each rub. Rub it on your lower back and back of your thighs twice a day.

And to make an effective compress for sciatica, grate a black radish, place a piece of cloth on your lower back, place the radish on top, and put another piece of cloth on top, then cover it with wax paper and wrap it in something warm. The compress is applied twice a day for 15 minutes.

Sciatica is also treated with methods such as:

In some cases, sciatica can be treated through surgery, but this is very rare.

Preventive measures against sciatica

The following methods of prevention are practiced against this disease:

exercise fully, but not too intense. Brisk walking, yoga and swimming are best;
maintaining hygiene at work;
comfortable sleep - the bed should not be very soft, not very hard;
lift heavy things correctly.

Sciatica can be cured if everything is diagnosed correctly and the right treatment method is chosen. Prevention of this disease is also very important.

Content

Neuritis and neuralgia cause a lot of trouble: numbness, stabbing, cutting pain, lumbago. Inflammation of the sciatic nerve, symptoms and treatment of which were previously noted in people 40–60 years old, is rapidly becoming younger. A sedentary lifestyle, lack of physical activity, and poor nutrition become prerequisites for the development of sciatica. Treatment of inflammation of the sciatic nerve is a long process, which largely depends on the correct diagnosis and determination of the causes of the pain attack.

Causes of the disease

Inflammation of the sciatic nerve, otherwise sciatica, is a pain syndrome that occurs in the lumbar region and radiates throughout the leg. The well-known sciatica is one of the manifestations of sciatica. The sciatic nerve is the largest in the human body, very sensitive due to the presence of special fibers. It begins in the lumbosacral region, passes along the surface of the buttock, thigh, and in the lower leg it diverges into smaller processes to the fingertips.

Pinching or inflammation of the sciatic nerve is caused by compression of the nerve roots. Becomes a consequence of a number of reasons:

Intervertebral hernia. As a result of rupture of the fibrous ring, which protects the nucleus pulposus - the shock absorber of the spine during movement - the latter ceases to function normally and displacement occurs. When a vertebra protrudes, as in the photo above, the nerve endings of the sciatic nerve are compressed, causing inflammation. The danger is that the pain factor associated with a hernia is a signal of advanced disease, which in some cases may require surgical intervention.
Osteophytes of bones - arthrosis and chondrosis. These are growths that form at the junction of bones (vertebrae). They pinch the roots of the sciatic nerve, causing inflammation.

Displacement of the vertebrae relative to each other (spondylolisthesis). Often a consequence of spinal injuries or birth defects.
Past infectious diseases, often uncured.
Poisoning, intoxication. There are two types:
- internal – under the influence of diabetes mellitus;
- external – when chemical agents enter the body with food and drinks.

Tumors.
Hypothermia.
Inflammation of the piriformis muscle.
Pregnancy. A shift in the center of gravity when carrying a child often causes pain in the lumbosacral region.
Stress, nervous feelings, depression.

Main symptoms

The variety of causes of inflammation of the sciatic nerve determines the difference in the symptoms of the disease. The main common symptom is pain, and symptoms such as fever and weakness give clues about an infectious or viral cause of exacerbation of sciatica. In case of chronic osteoarthritis, destruction of the joint capsule, displacement of discs, intervertebral hernia, acute relapses with pronounced shooting pain are characteristic, which gradually descends along the leg to the knee, and then to the foot.

Constant aching, periodically burning pain in a resting position at the initial stage of the disease subsides. If treatment is not started in a timely manner, the inflammatory process will not disappear: the symptoms may weaken slightly, moving down the leg. Numbness of the limbs, tingling, but no pain in the lower back are symptoms of advanced sciatica, untimely treatment of which sometimes leads to the need for surgical intervention.

What to do and how to treat inflammation of the sciatic nerve

Pronounced symptoms or the first harbingers of the disease are a reason to consult a specialist. It is necessary to make an accurate diagnosis, because the specifics of treatment will depend on the identified causes of inflammation of the sciatic nerve. An X-ray or CT scan, MRI or electroneuromyography will help determine exactly what is causing sciatica.

At the same time, the neurologist examines the degree of damage to the sciatic nerve, conducting special tests for motor reflexes:

Achilles tendon,
knee joint,
checks for the presence of Lassen symptoms (pain on the back of the thigh and lower leg when lifting a straight leg up and forward independently), Bonnet (the same procedure, only the doctor lifts the leg).

Having compared the symptoms, found out the cause of the disease, the degree of damage to the nerve endings and the severity of the inflammation, the specialist prescribes a comprehensive treatment, which includes:

Drug treatment.
Prescribing a set of physical exercises, massages and special therapy.
Physiotherapy and radiology (in rare cases).
Homeopathic treatment. Special homeopathic ointments and creams will help relieve pain symptoms and reduce inflammation of the sciatic nerve.
Folk remedy.

Drug treatment

How to treat inflammation of the sciatic nerve? The first aid for a sharp exacerbation of sciatica will be painkillers:

analgin;
derivatives with a pronounced direction of action:
- tempalgin - pain symptoms subside as a result of the action of tempidine - a mild tranquilizer;
- sedalgin - codeine and paracetamol have an invigorating effect on the nervous system, relieving inflammation of the nerve roots;
- baralgin - antispasmodics in the composition remove muscle inflammation, relieving spasm of the sciatic nerve;
- pentalgin.

Non-steroidal anti-inflammatory drugs (NSAIDs) – tablets, injections for severe pain, ointments will be mandatory in the treatment of sciatic nerve entrapment:

Diclofenac (tablets) – anesthetizes and relieves inflammation, pain, swelling. Injections for inflammation of the sciatic nerve of this drug are more effective, but the degree of influence of side effects on the liver and kidneys increases. Therefore, they are prescribed intramuscularly or intravenously by a doctor with a minimum interval of 12 hours.
Movalis is a very powerful drug that quickly relieves pain symptoms. Quickly reduces inflammation of the sciatic nerve. The presence of significant side effects requires taking the tablets under medical supervision for no more than 5 days.
Ibuprofen, Nise, Nurofen are NSAIDs with less pronounced effects. They are good because they affect the peripheral nervous system, relieving inflammation, and muscles, relaxing and removing spasms.
Corticosteroids are prescribed for long-term, persistent pain symptoms. These are hormonal agents that relieve swelling and inflammation of the sciatic nerve.

For pregnant women, the doctor will recommend a special treatment for inflammation of the sciatic nerve. Taking most medications during this period negatively affects the health of the expectant mother and child, so it is strictly prohibited to use medications without consulting a doctor. The most gentle medicine would be painkillers - suppositories. Homeopathy will also become one of the possible and safe treatment options.

Physical exercise

The acute period of inflammation of the sciatic nerve in most cases lasts from 5 to 10 days. During this time, it is necessary to ensure a reduction in physical activity and rest for the lumbosacral region, in other words, it is more in a horizontal position, preferably on a hard orthopedic surface. The subsidence of symptoms is not a reason to increase sports activity.

The neurologist determines the time when it is possible to begin treatment of chronic sciatica with therapeutic exercises and physical exercises. Based on the identified causes of inflammation of the sciatic nerve and symptoms, the physiotherapist develops a special program. For pregnant women, it is drawn up by a medical commission, which necessarily includes a gynecologist, therapist, and physiotherapist. Yoga, Pilates, and swimming will be useful.

Massage and reflexology

The use of massage as a treatment method for acute symptoms of inflammation of the sciatic nerve is very careful: stroking and light rubbing. When the pain subsides, you can use more intense techniques - kneading and patting. Essential oils and warming ointments will be a good help. The result will be improved blood flow to pinched nerve endings, relieving tightness and muscle spasms, stimulating the production of endorphins, and reducing swelling.

Reflexology methods - acupuncture, manual acupressure - relieve pain symptoms of inflammation of the sciatic nerve. Long-term treatment with needles (up to 3 months) can not only eliminate the manifestation of the disease, but also cope with the causes of its exacerbation for a long time. Oncology, skin lesions, pregnancy are contraindications to the use of this type of therapy.

Blockade

In some cases of symptoms of sciatica, when NSAIDs and analgesics do not work, the doctor prescribes novocaine blockades. This drug blocks nerve impulses to the sciatic nerve, relieving the symptoms of inflammation. Nervous behavior (excitement or apathy), inability to move, feeling of pain both standing and lying down are grounds for prescribing a blockade with anesthetics.

How to relieve inflammation with folk remedies

Warming ointments will help relieve inflammation of the sciatic nerve at home. Turpentine, camphor ointment, beeswax - will perfectly warm the inflamed area, improve blood flow to the nerve endings, and remove spasms. A tincture of red pepper and vodka, used as a compress, improves the conductivity of the sciatic nerve and promotes the production of hormones - endorphins. Herbal infusions of calendula, horsetail, thyme and viburnum (2 tablespoons each) per half liter of water must be boiled and, when cooled, taken daily 3 times a day, 100 ml before meals.

Preventing pinched or inflamed nerves

Strong back muscles are the key to the health of the sciatic nerve and the ability to avoid relapses of the disease. Therapeutic gymnastics and moderate physical activity, yoga and Pilates will be an effective means of preventing sciatica. A straight back and slender posture when moving and sitting during the day are the basis for a healthy spine and the absence of inflammation of the nerve processes.

At the first symptoms of a previous attack, women need to give up heels. Swimming on your back and water aerobics treatment will strengthen your back muscles. Hypothermia is another friend of radiculitis, arthrosis and inflammation of the sciatic nerve. Warm clothing appropriate for the weather, a closed lower back and warm legs are important conditions for the prevention of sciatica.

Which doctor should I contact to diagnose sciatica?

A neurologist or neurologist will help you identify the symptoms of inflammation of the sciatic nerve, carry out diagnostics and find out the cause of the disease. When prescribing treatment, you may need consultation:

gynecologist - if the patient is pregnant;
surgeon, orthopedist - when the question of surgical intervention arises;
physiotherapist – when prescribing physiotherapy.

Video

Special gymnastics will help relieve tension in the lumbar spine and reduce the load on the sciatic nerve. As a preventive measure for sciatica, individual yoga exercises will unblock pinched nerve endings and strengthen the muscles of the back, buttocks, and legs. To complete this you will need a gymnastics mat and a desire to get your health in order. Most elements of gymnastics are performed lying on your back or in the “cat” position. Watch our video and repeat the set of movements after the instructor. Within a week you will notice the absence of discomfort in the lumbar region.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Sciatica is a syndrome manifested by severe pain in the areas where the sciatic nerve passes. The syndrome is caused by compression of the spinal cord roots in the lumbar region or parts of the nerve itself. Since there can be many reasons for compression of the roots of the spinal cord and nerve, the manifestations of the syndrome, in addition to pain along the sciatic nerve, can also be very diverse and polymorphic.

Currently, the term "sciatica" is used only to designate the syndrome, and the disease manifested by its development is called lumbosacral radiculitis. Also, to designate variants of sciatica caused by different causes, the terms radiculopathy, radiculoischemia and radiculomyeloischemia can be used.

Sciatica (sciatic nerve sciatica)

Since the term “sciatica” itself is translated from Greek as “inflammation of the sciatic nerve,” the names “sciatic sciatica” and “sciatic nerve sciatica” are an example of excessive specification - that is, what is called “butter oil” in everyday speech. Therefore, such “common”, “expanded” terms are incorrect. After all, when they talk about sciatica, they always mean that the problem is in the sciatic nerve, since the very name of the pathology already contains an indication of this particular nerve.

Which nerve is affected in sciatica?

With sciatica, non-inflammatory damage (compression) occurs to the sciatic nerve, which is the largest and longest in the human body, since it starts from the sacral nerve plexus and passes through the soft tissues to the very feet.

Essence and brief characteristics of the disease

Sciatica is a non-inflammatory lesion of the sciatic nerve that occurs as a result of its compression in any area. Accordingly, the causes of sciatica can be any factors that lead to compression of the tissue areas through which the sciatic nerve passes, such as, for example, injuries to the legs, pelvis, lumbar or sacral spine, compression of the nerve during prolonged immobility, pinching by fibrous cords , tumors, hematomas, etc. Most often, sciatica develops in people aged 40–60 years, which is due to pathological changes accumulated in the body, which can cause compression of the sciatic nerve.

To clearly understand and imagine what causes the clinical manifestations of sciatica, you need to know how and where the sciatic nerve passes. This nerve originates in the sacral nerve plexus, which is located in the sacral region, next to the vertebrae. The nerve plexus is formed by the roots of the spinal cord, which are not located inside the spinal canal, formed by vertebrae standing on top of each other, but outside. That is, these roots are located on the sides of each vertebra and are very close to each other, as a result of which the area of their localization was called the sacral nerve plexus.

From this sacral nerve plexus arises the large sciatic nerve, which then exits the pelvic cavity onto the posterior surface of the buttock, from where it descends along the posterior surface of the thigh to the lower leg. At the top of the leg, the sciatic nerve divides into two large branches, the fibular and tibial, which run along the right and left edges of the back of the leg (see Figure 1). The sciatic nerve is a paired organ, that is, it is present on the right and left. Accordingly, two sciatic nerves depart from the sacral nerve plexus - for the right and left legs.

Picture 1– Schematic representation of the sciatic nerve on the right.

With sciatica, as a rule, only one of the two nerves is affected, as a result of which the symptoms affect only the right or left limb.

The main symptom of sciatica is a strong and sharp pain that occurs on any part of the leg or buttock along the nerve. In addition, along the course of the affected nerve, paresthesia (numbness and a “pins and needles” sensation) and weakness appear on the posterior surface of the corresponding limb and foot. Paresthesia, numbness and weakness can persist for years, gradually progressing.

Upon examination with sciatica, pain is detected on the back surface of the leg from the side of the affected nerve, as well as neurological symptoms, such as decreased reflexes of the knee, Achilles tendon, Lasegue symptoms, etc. In about a third of cases, a person has increased sensitivity of the outer edge of the foot, in half of the cases - weakness muscles of the leg and foot. When trying to internally rotate a leg bent at the hip and knee, a sharp pain is detected in the buttock.

For diagnostics sciatica, an X-ray examination and magnetic resonance imaging of the lumbar spine are performed to determine at what level the spinal cord roots are pinched, as well as what caused their compression (tumor, hematoma, herniated disc, etc.).

For treatment For sciatica, various medications are used from the groups of antioxidants, metabolites, minerals and vitamins, agents that improve blood circulation and microcirculation, muscle relaxants and NSAIDs. In addition, as part of complex therapy, in addition to drug treatment, massage, physiotherapy, post-isometric relaxation, novocaine or hydrocortisone blockades are used. All means and methods of treating sciatica are aimed at eliminating compression of the spinal cord roots, as well as at relieving the painful manifestations of the syndrome for humans, such as pain, numbness and weakness of the limbs.

Causes of the disease

The causes of sciatica can be any condition or disease that compresses the roots of the spinal cord at the level of the lumbar spine or certain areas of the sciatic nerve. Such possible causative factors of sciatica include the following diseases and conditions:

1. Herniated disc in the lumbar spine (the herniated protrusion compresses the roots of the spinal cord, where the sciatic nerve originates, and thereby causes sciatica).

2. Infectious diseases (the sciatic nerve is affected by toxins secreted by pathogens):

Sepsis (blood poisoning);
Typhoid or typhus;

3. Intoxication with various toxic substances, such as:

Alcohol (sciatica can occur due to chronic alcoholism or after one-time consumption of a large number of low-quality drinks);
Heavy metal poisoning (mercury, lead);
Arsenic poisoning.

4. Chronic systemic diseases in which unresolved toxic metabolic products are deposited in tissues:
5. Episodes of severe hypothermia of the body (as a rule, cooling contributes to the activation of a chronic infection, which, in fact, provokes sciatica).

Surgical treatment for sciatica, it is performed extremely rarely - only in cases where the syndrome is provoked by spinal tumors or herniated intervertebral disc, which impinges on the spinal cord or spinal cord roots. In this case, after pain relief, a planned operation is performed, after which the disease is completely cured, since its cause is eliminated. Also, surgical treatment of sciatica is performed in cases where, due to disruption of the sciatic nerve, a person suffers from severe urination and defecation disorders (for example, urinary or fecal incontinence).

Sciatica Treatments

For complex symptomatic, etiological and supportive therapy of sciatica, the following drugs are currently used:

Medications(used to relieve pain, normalize microcirculation, sensitivity and mobility of the limb).
Massage and manual therapy (used to relieve pain, relax and normalize muscle tone, as well as to restore the correct position of the vertebrae, as a result of which it is possible to achieve long-term remissions or even completely cure sciatica).
Physiotherapy(used to improve microcirculation, conduction of nerve impulses, restore sensitivity and strength of muscle contractions and, accordingly, limb mobility).
Acupuncture (acupuncture) is used to relieve pain, improve microcirculation and nourish both the tissues of the affected limb and the pinched roots of the spinal cord. By improving nutrition, the condition of the spinal cord roots and leg tissues improves, and as a result, the functions of the sciatic nerve are restored to normal.
Physiotherapy– used during periods of remission to relax the muscles in the spine and improve blood supply to the spinal cord, its roots and the sacral nerve plexus.
Apitherapy (treatment with bee stings) is used to relieve pain and relax muscles in order to eliminate pressure on the sciatic nerve.
Hirudotherapy (treatment with leeches) is used to relieve swelling in the area of a pinched nerve, as a result of which the volume of tissue decreases, the nerve is released from the clamp and begins to function normally.
Sanatorium treatment (use of therapeutic mud, baths, etc.).

Drug treatment of sciatica

The following groups of drugs are used in the treatment of sciatica:

Massage

It is used during periods of remission and allows to improve blood flow to tissues and nerves, eliminate swelling and stagnation of lymph, relieve high muscle tone and relieve pain. For sciatica, massage is used in the lumbar and gluteal areas, as well as the back surfaces of the thigh, lower leg and foot. To obtain a good and lasting effect, it is necessary to conduct approximately 10 massage sessions lasting 30 - 35 minutes. It is recommended to combine massage with the application of ointments and therapeutic exercises.

Exercises (gymnastics)

It is recommended to perform therapeutic gymnastic exercises during the period of remission in order to prevent attacks of sciatica in the future.

So, gymnastics for sciatica includes performing the following exercises:

1. From a lying position on your back, pull your legs bent at the knees to your chest. Do 10 repetitions.

2. From a lying position on your back, lift your straight legs up, fix them in this position for a few seconds, and then lower them to the floor. Do 5 repetitions.

3. From a lying position on your stomach, lift your body on your hands, placing your palms under your shoulder. Do 5 repetitions.

4. From a sitting position on a chair, turn your body alternately to the right and left. Perform 5 turns in each direction.

5. From a sitting position on your knees, bend over with your arms raised above your head. Do 5 repetitions.

6. From a standing position with your feet shoulder-width apart, tilt your body to the right and left. Perform 5 bends in each direction.

All exercises should be performed slowly and carefully, avoiding sudden movements.

Sciatica: gymnastics (recommendations from a specialist in physical therapy) - video

Sciatica: therapeutic exercises - video

Treatment of sciatica at home

At home, the only way to treat sciatica is to take medications. In principle, this, as a rule, is enough to relieve pain and achieve remission, but the lack of comprehensive treatment, including massage and physiotherapy, leads to the fact that attacks of sciatica recur sporadically.