Inflammation of the sciatic nerve or sciatica is a pathological condition, accompanied by severe pain. The sciatic nerves are the longest and largest, they begin in the lumbosacral spine, run along the surface of the buttocks, thighs, and in the lower leg region they branch into small processes extending to the tips of the fingers.
The sciatic nerve is very sensitive – pinching and squeezing of the nerve roots is manifested by pains of different intensity. Pain syndrome may be weak or pronounced, unbearable, preventing a person from moving and leading a normal life. The disease requires long-term complex treatment based on the use of medicines, physiotherapy and physical therapy methods.
Inflammation of the sciatic nerve – the main causes
The most common cause of inflammation of the sciatic nerve, are pathological processes in the sacrum and lower back. The following states are accompanied by pinching of the nerve:
- intervertebral disc displacement;
- intervertebral hernia;
- osteophytes (bone growths);
- tunnel neuropathy (piriformis syndrome);
- the effects of infectious diseases;
- excessive exercise;
- spinal or pelvic trauma;
- post-injection abscesses;
- spinal curvature (scoliosis, flat feet);
- tumor processes.
With the hernial protrusion of the intervertebral disk, the roots of the spinal cord are infringed, against this background inflammation of the sciatic nerve develops. Arthrosis and chondrosis contribute to the development of sciatica, which are accompanied by the appearance of bone growths in the region of the vertebral junction. They squeeze the nerve fibers and cause inflammation of the nerve fibers. A common cause of sciatica is osteochondrosis, spinal spondylosis and injuries of its departments.
A certain role in the development of the disease is played by intoxication of the body with alcohol, salts of heavy metals and other toxic compounds. Often, the sciatic nerve is caused by toxins secreted by pathogenic bacteria. In this case, sciatica occurs against the background of influenza, ARVI, scarlet fever, tuberculosis, malaria, syphilis or chronic systemic diseases (gout, diabetes).
Often the cause of sciatica are spinal cord tumors, both benign and malignant, as well as metastasis of cancerous tumors of other organs that grow into the vertebrae and intervertebral discs.
The main symptom of sciatica – pain syndrome, the intensity of which depends on the cause of inflammation. The pain is usually localized along the nerve, that is, it is felt in the area of the buttock, popliteal fossa, posterior surface of the thigh and lower leg. The nature of pain in inflammation of the sciatic nerve is mainly intense, shooting through – according to patients, reminds stabbing or electric shock.
Pain syndrome may be present constantly or occur sporadically. In this case, the attack usually begins with pain of weak intensity, which soon become very strong. They exhaust a person, deprive him of peace and sleep. Any physical effort, movement, even coughing or sneezing – contribute to increased pain.
In addition to pain, the patient’s condition is aggravated by such manifestations as difficulties with flexion of the extremities, reduced sensitivity and muscle tone, a violation of thermoregulation (cold legs), a feeling of crawling on the skin.
During the examination, the doctor must pay attention to the nature of the pain. It helps to make the correct diagnosis and determine the area of inflammation. Experts identify a number of specific manifestations that indicate the development of sciatica.
- Symptom of landing (the patient can not sit on their own).
- Symptom Lasega (inability to raise a straight leg).
- Symptom Sicard (pain increases while trying to bend the foot).
- Paresthesia (deterioration of limb sensitivity). At the initial stage, this syndrome is manifested by numbness and a tingling sensation of the skin of the buttocks and the posterior surface of the extremities from the side of the inflamed nerve. As the disease progresses further, the sensitivity disappears completely.
- Impaired motor function. As a result of prolonged infringement of the motor fibers of the nerve, muscle weakness increases in the limbs. Over time, the person’s gait is disturbed, he begins to limp on a sore leg.
- Dysfunction of the pelvic organs. Develop due to dysfunction of the autonomic nervous system, arising against the background of infringement of fibers passing through the sciatic nerve. In severe cases, symptoms such as burning during urination, urinary and fecal incontinence, or the development of chronic constipation occur.
An attack of inflammation usually begins suddenly, most often at night. It can be provoked not only by chronic diseases, but also by banal hypothermia or severe stress factor and nervous breakdown.
At the same time, accompanying vegetative manifestations appear – puffiness, excessive sweating of the feet, redness of the skin. With the infectious nature of the lesion, fever, chills, weakness and other symptoms of intoxication of the body join the pain syndrome. Sometimes, with too sharp and severe pain, a person may lose consciousness.
In severe cases, nerve function is completely impaired, there is a decrease in the volume of the gluteus, femoral or gastrocnemius muscle, temporary immobilization occurs, the patient cannot turn the foot, bend and unbend his toes. With an extensive inflammatory process, the pain syndrome can become chronic and constantly remind of a relapse.
Symptoms and treatment of sciatic nerve inflammation are closely interrelated. Given the manifestations of the disease, the doctor can suggest what causes the development of the pathological process and make a preliminary diagnosis. To confirm it, you will have to undergo a series of additional surveys.
Diagnostic method: MRI
To understand how to remove inflammation of the sciatic nerve, it is necessary to establish the cause of this condition. Diagnosis of sciatica is conducted by a neurologist, prescribing a series of laboratory and instrumental examinations of the patient. To establish the degree of damage to the sciatic nerve, a specialist performs a series of special motor tests, by tapping the mallet he checks the reflexes on the legs.
Under polyclinic conditions, the most accessible method of diagnosis is conventional radiography, which makes it possible to detect the presence of bone growths and other degenerative changes in the lumbosacral spine. To do this, make x-rays of the spine in two projections, which allows to find out whether the inflammation of the sciatic nerve is associated with pathology of the intervertebral discs.
If this method is not sufficient for a diagnosis, the patient is referred to a CT (computed tomography) or MRI (magnetic resonance imaging) procedure. These are the most informative methods to determine the cause of inflammation, if it is associated with pathological changes in the spinal cord or in the nerve plexus vessels.
If tumor processes are suspected, a radioisotope spinal scan is used. To determine the degree of disturbance of nerve conduction and contractility of the affected muscles resort to the method of electroneuromyography.
If necessary, the patient is sent for additional examination and consultation with narrow specialists – a vertebrologist, a rheumatologist, a vascular surgeon.
How to treat sciatic nerve inflammation?
Comprehensive treatment of sciatica is aimed at relieving pain, restoring sensitivity and motor functions of the extremities and consists in the use of drugs, manual therapy, massage, physiotherapy methods, physical therapy.
The methods of alternative medicine are widely used – acupuncture, hirudo-patience (treatment with leeches), traditional medicine and sanatorium-resort treatment (during periods of remission of the disease).
Drug treatment of sciatic nerve inflammation
In the acute period of sciatica, a course of anti-inflammatory and analgesics is prescribed to relieve a strong pain syndrome. For this purpose, they use drugs from the group of NSAIDs (Diclofenac, Ortofen, Indomethacin, Meloxicam, Ketoprofen), as well as strong non-narcotic analgesics (Sedalgin, Sedalgin Neo, Baralgin, Pentalgin).
In severe cases, when the patient is suffering severe pain that can not be treated with the above means, the doctor may prescribe opioid analgesics (Tramadol, Tramal, Tramalin). They should be taken under the supervision of a doctor in short courses, as these drugs can quickly cause addiction and drug dependence, they have many contraindications and side effects. In addition, novocainic or ultracainic blockades are prescribed for the relief of pain.
Corticosteroid hormones (Prednisone, Hydrocortisone), prescribed in the acute period, help to quickly suppress the development of the inflammatory process, relieve puffiness and improve the mobility of the extremities. However, it is not possible to use hormonal drugs in all cases, they are prescribed only for severe edema in the lumbosacral spine.
As a maintenance therapy, they use muscle relaxants, antioxidants, vitamin complexes and other drugs that help restore the blood supply and nutrition of the affected nerves and normalize their functions.
Muscle relaxants (Sirdalud, Tizanidine, Mydocalm, Tolperisone) relax well tense muscles, which eliminates pinching of nerve fibers, helps reduce pain, restore sensitivity and range of motion of the affected limb.
Complex preparations containing vitamins of group B (Kombilipen, Milgamma, Binavit) reduce the severity of neuralgic symptoms and restore the permeability of the nerve impulse along the fibers, which returns the former sensitivity to the extremities, relieves numbness and other unpleasant symptoms.
To restore impaired blood supply and tissue nutrition, angioprotectors and microcirculation correctors are used (Actovegin, Curantil, Trental). Such drugs fight atrophic changes in muscles and restore damaged structures of the sciatic nerve. With the same purpose, vitamin complexes with the content of vitamins C, E, microelements – copper, selenium and other useful substances are prescribed as antioxidants.
Metabolic drugs such as Mildronate, Inosine, Riboflavin, Elkar help to improve the nutrition of the nerve roots of the spinal cord and sacral plexus, thereby restoring the function of the strangulated sciatic nerve and returning the sensitivity and motor activity of the limbs.
Ointments for the treatment of sciatica
Photo: Voltaren Emulgel
Local external agents are prescribed as an adjunct to the main course of treatment, since their main purpose is to relieve pain. When treating sciatica, external agents with an irritant and warming effect are shown, which improve blood circulation in the affected area and reduce the intensity of pain. In inflammation of the sciatic nerve, the following drugs are prescribed:
- snake and bee venom based ointment (Nayatox, Apifor);
- camphor or turpentine ointment;
- outdoor products with extract of hot peppers (Espol);
- gels, creams and ointments from the group of NSAIDs (Voltaren gel, Diclofenac, Nurofen, Indomethacin);
- preparations for external use with warming or irritating components (Finalgon, Viprosal, Kapsikam).
External means for sciatica is applied to the affected area 2 to 3 times a day. After treatment, the painful area is covered with a warm bandage to enhance the warming effect of local preparations.
Physiotherapy methods, exercise therapy
Physiotherapy treatment for sciatica is used during periods of remission of the disease, when pain is absent, but signs associated with malnutrition and blood supply to tissues and loss of sensitivity persist. The doctor may prescribe the following procedures:
- dynamic currents;
- magnetic therapy;
- laser treatment;
Physiotherapy treatment relaxes the muscles, removes the clips of the nerve roots, restores the mobility and sensitivity of the limbs and allows you to prevent and prevent recurrent relapses of the disease.
With regard to massage, to restore muscle tone and blood circulation in the affected area massaged the lumbar area, the area of the buttocks, thighs, legs and feet. To achieve a stable therapeutic effect, it is necessary to conduct 10 sessions of therapeutic massage, lasting up to 30 minutes. Strengthen the effect of massage procedures helps therapeutic exercises. You can perform simple exercises at home or in a hospital under the guidance of an experienced instructor.
Surgery for inflammation of the sciatic nerve is recommended only if the methods of medical and physiotherapy treatment do not give results.
In order to eliminate the pinching of the nerve, it is necessary to resort to such types of surgery as microdiscectomy and diskectomy, the essence of which consists in the complete or partial removal of the intervertebral disc, which provokes the incarceration of the sciatic nerve.
Treatment of sciatic nerve inflammation at home
Folk healers can offer a lot of tools for the treatment of sciatica. But before using any of them, you should consult with your doctor to avoid unwanted complications.
- Beeswax. Compress with beeswax is an excellent warming agent that allows to reduce the manifestations of sciatica pain. Before the procedure, the wax should be melted in a water bath and molded from it a cake according to the size of the affected area. In a warm form, apply a cake of wax to the sore area, cover with a plastic wrap, warm with a towel or rug and leave the compress for the night. The procedure can be done daily during the week.
- Tincture of pine buds. Grinding on the basis of tincture helps eliminate pain and reduce inflammation. Instead of pine buds, you can use spruce needles or dandelion inflorescences. Vegetable raw materials are placed in a half-liter jar, stuffing it over the hangers, pour 500 ml of vodka and leave in a dark place for a week. The finished tincture is used for daily rubbing of the affected area.
- Can massage. At home, you can do the procedure yourself with a massage jar. First, the affected area should be smeared with warming cream or horse chestnut-based ointment, and then put the jar and move it in a circular motion in a clockwise direction. The duration of the procedure is 10 minutes, it should be performed every other day.