Radiculitis, acute pain. Acute and chronic sciatica: what are the differences between symptoms and treatment? When the bath is a lifesaver

The spine and spinal cord are susceptible to many diseases, but most often people suffer from commonplace sciatica. Doctors-neurologists call radiculitis chronic or acute inflammation of the miniature processes of the bone marrow.

Destructive inflammation can occur in the neck, sternum, lower back, and even the sacrum. It often happens that an attack of sciatica is confused with such a serious disease as prostatitis.

In 70% of cases, sciatica develops in the lumbar region. In addition, inflammatory processes in the back are often aggravated by physical damage or excessive exertion.

According to research statistics, radiculitis occurs at the age of 40 and affects people around the world. Recently, there has been a tendency towards a decrease in the average age of the disease. The influencing factor is the modern lifestyle.

What causes sciatica? Serious problems with the spine or is it trite to blow?

Many people who are sick believe that a sharp back pain can arise from a draft, but this is not the case.

The founder of the disease is often serious hernias in the spine, cracks and even pinched nerves. All this is very serious and requires a complete examination and competent, comprehensive treatment.

Less often, the cause of sciatica can be nervous diseases and the notorious stress, in which a person arrives for a long time. Also, an exacerbation can be caused by metabolic disorders or poor nutrition. Playing sports (for example, bodybuilding or weightlifting) is a direct path to a sore back.

Among other things, sciatica can provoke chronic spinal injuries, tumors and inflammatory diseases of the tissues around the spine.

Factors by which the disease is diagnosed

The main symptoms of sciatica are:

Pain syndrome... Pain sensations can be of a different nature. It can be aching, pulling pain, as well as sharp and so strong that it will be impossible to get up. As a rule, pain is not localized in one place, but radiates to other parts of the spine.
Rapid muscle fatigue... Muscle weakness is caused by intermittent nerve impulses. For this reason, the muscles do not work normally. There is a possibility of muscle atrophy.

Increased temperature and exacerbation of sciatica. Is there a relationship?

The facts of an increase in body temperature with radiculitis most patients do not have... Only a slight increase in temperature is possible with extremely severe inflammation of the nerve endings in the lower back.

Therefore, if the temperature rises and at the same time you feel severe pain in the lower back, which interferes with movement, then most likely both pain and fever are caused by sciatica.

You should not bring down such a temperature.... This is a normal reaction of the body to severe inflammation. But drinking a course of general antibiotics is definitely worth it. Tsiprolet or amoxiclav eliminate this temperature after a day of admission.

However, this will not cure sciatica, but only relieve some of its symptoms. The treatment of this disease is complex and this will be discussed below in the article.

But do not forget that an increased temperature with back pain may not indicate the presence of sciatica, but other diseases:

Sudden viral illness.
Diseases of the throat (tonsillitis), ailments of the sinuses (sinusitis).
Vascular problems.
Inflammation of the liver.
Stomach problems.
"Irritated" intestines.

Exacerbation of the disease is characterized by acute shooting pain, which constrains movement and does not allow movement. In this case, it is impossible to turn the neck or simply straighten out.

Is there a relationship between an increase in temperature and an exacerbation of sciatica? Definitely yes. With a radical exacerbation, the nerve endings of the bone marrow become inflamed, which is the reason for the uncomfortable temperature and general weakness.

Official medicine and folk remedies

Most diseases of the spine and bone marrow are severe and require treatment by a certified specialist. Do not self-medicate, since in this case the acute form of the disease will turn into a chronic one, which is much more difficult to treat.

When contacting the clinic, the patient is prescribed analgesics (usually diclofenac), warming up and a special hard orthopedic mattress. Homemade alcoholic tincture made from adam apple or horseradish can be used as an additional remedy. Acupuncture and Chinese medicine are often used. A belt made of dog hair will not be superfluous, which gives extremely good results.

If the pain persists for 3-5 months, then the patient is prescribed neurosurgical surgery on the vertebrae and bone marrow, followed by rehabilitation.

- (lat.radicula - root) - lesions of the roots of the spinal cord, causing motor, autonomic and pain disorders. Radiculitis is manifested by intense pain syndrome, decreased muscle strength, reflexes and sensitivity in the area innervated by the affected spinal nerve. Diagnosis of sciatica is carried out using radiography, CT and MRI of the spine, according to indications, it is possible to carry out myelography and lumbar puncture. In the treatment, pain relievers and anti-inflammatory drugs, blockades, physiotherapy procedures, manual techniques, spinal traction, physiotherapy exercises and massage are used.

General information

- (lat.radicula - root) - lesions of the roots of the spinal cord, causing motor, autonomic and pain disorders. The etiological factors of radiculitis are degenerative-dystrophic changes in the spine, such as osteochondrosis, deforming spondylosis, as well as various anomalies in the development of the spine (sacralization, spondylolisthesis, accessory ribs, aplasia of the vertebrae). Hypothermia, trauma, infections (influenza, tuberculosis, syphilis, cerebrospinal meningitis), as well as radicular forms of neuroviral diseases (tick-borne encephalitis, etc.) can also provoke inflammatory processes in the spine.

Pain syndrome with sciatica can manifest itself as a result of weight lifting, awkward movement, infection or a cold, when the fibrous ring of the disc is stretched or ruptured, the gelatinous disc extends beyond its borders, and an intervertebral hernia forms in its place. Often, an extended disc or osteophytes squeeze not only the spinal root, but also nearby membranes and tissues, which in turn serve as an additional source of pain. In addition, two more factors play a role in its pathogenesis: dyscalgia and muscle-tonic pain.

Classification of radiculitis

Depending on the topography of the inflammatory process, radiculitis is divided into a number of forms: lumbosacral, thoracic, cervical, which in turn can be chronic or acute.

In addition, there are primary radiculitis (toxic, infectious origin) and secondary, caused by anomalies of the spine and spinal cord. With meningoradiculitis, the inflammatory process develops simultaneously in the roots with the spinal nerve. and the membranes of the spinal cord.

Symptoms of sciatica

The main symptoms of sciatica are pain, decreased reflexes, partial sensitivity disorder, autonomic disturbances. The first attacks of pain associated with a rupture of the fibrous ring of the intervertebral disc are diffuse in nature (reminiscent of "myositis" or "lumbago"). And only with the formation of a disc herniation, which compresses the root, a radicular syndrome is formed, when there are sensations of tingling and numbness. In the area of the affected root, innervation develops and, as a result, a decrease or complete absence of sensitivity (temperature, tactile and pain). Over time, the weakness of the muscles located in the area of the affected root increases, up to their complete atrophy.

Symptoms of primary radiculitis (infectious and toxic etiology) are manifestations corresponding to the disease that caused sciatica (in the case of ARVI - fever, chills, etc.). With lumbosacral radiculitis, localization of pain that increases with walking and coughing is possible in the lumbar region, lower leg, thigh or foot. At the initial stage, the disease proceeds according to the type of lumbago, lumbodynia and lumbar ischialgia.

To partially relieve pain in radiculitis, patients take a "protective" position: they sit with their legs bent under them and resting their hands on the bed, or lie with a pillow under their stomach. The gait changes: in movement, patients try to rely mainly on a healthy leg. Quite often, there is an increased tone of the lumbar muscles, antalgic scoliosis, less often kyphosis. On palpation, the paravertebral points in the lumbar region, the posterior surface of the thigh, the popliteal fossa, the heel (Gara point) and the middle of the foot (medioplanatary ankylosing spondylitis) become painful, and this is almost the defining symptom complex of lumbosacral sciatica.

Radiculitis treatment

Forecast

A favorable prognosis is possible in the case of timely diagnosis and extensive treatment, including all possible directions. Only with this approach can you expect recovery without fear of relapse. In the case of ischemia and, as a consequence, spinal cord infarction, it is impossible to predict complete recovery, since the consequence of such complications is often a violation of the motor and sensory functions of the body.

Prevention of sciatica

Prevention of radiculitis includes measures aimed at maintaining correct posture, strengthening the back muscles. It is recommended to avoid excessive stress on the spine. Correct posture during sleep and wakefulness minimizes the stress on the spinal column. You should not sleep on too hard mattresses. Contrary to popular belief, they are capable of distorting the position of the spine and disrupting its function. To avoid this and maintain the natural curve of the spine, it is recommended to pin small pillows under the neck and lower back, or to use a semi-rigid mattress that is able to support the natural position of the spine.

Maintaining the correct posture is also very important in your daily work. When lifting objects from the floor, it is recommended to bend your knees without bending your torso. Thus, the load will shift from the back to the legs. It is recommended to avoid uncomfortable postures (prolonged sitting at a table with your head down, sitting in front of the TV, dropping your chin on your chest, etc.). In addition, gymnastics, which helps to strengthen the muscles of the back, as well as sports and hardening, which increase the body's resistance to physical exertion and hypothermia, play an important role in the prevention of sciatica.

Acute sciatica is an inflammatory lesion of the roots of the spinal cord, due to the destruction of the cartilaginous structures of the spinal column. Depending on the location of the damaged nerve processes, radiculitis can be cervical, thoracic, lumbar or lumbago and sacral. Lumbago is the most common type, since it is the lumbosacral spine that experiences the greatest stress. The dominance in society of a sedentary, sedentary lifestyle leads to the fact that sciatica is getting younger.

The most common age at which the disease now manifests itself is 30 - 40 years. In the vast majority, after the first acute attack, radiculitis becomes chronic, when periods of remission are replaced by periods of acute manifestation. Signs of sciatica lumbar are acute pain both during movement and at rest, which can be aggravated by coughing and sneezing. The pain is radiating (radiating to the leg or groin), encircling in nature.

Treatment of sciatica should be carried out by a neurologist and consists of a whole range of measures. Before contacting a health care institution or the arrival of a doctor, it is necessary to provide first aid to a person with an attack of acute sciatica. First aid for radiculitis of the lumbar spine begins with immobilization of the lower back. It is necessary to reduce the mobility of the lower back as much as possible; for this, you can wear a special corset or bandage. If there are none, it is necessary to tightly wrap the lower back with a diaper or other available means.

It is interesting to read:

Then you need to lie on your back and raise your legs a little (this position helps to relax the muscles of the back and more quickly relieve the condition). At the same time, the back should not bend, therefore, the surface on which a person with acute sciatica lies should not be soft, ideally of medium hardness. For this purpose, sheets of plywood, thick cardboard are often placed under the back, or they lie on the floor, provided that it is warm.

It is interesting to read:

Limitation of mobility in the lumbar spine and physical activity is the main recommendation throughout the entire treatment period.

Medication assistance

The next step is to take pain relievers. If possible, it is better to give an injection than to take pills. This is due to the fact that the action of the drug after injection occurs faster. For effective pain relief with radiculitis, the following are suitable:

Ketorolac-based preparations - Ketarolac, Ketanov, Dolak, Ketolong;
Tramadola - Tramal, Tramalgin, Tramadol, Stud, Protradol.

Antispasmodics can be taken to increase the effectiveness of pain relievers and to help relax the muscles. To do this, you can use pills or injections based on drotaverine (Nosh-pa, Drotaverin, Spazmol), as well as suppositories or injections of Papaverine. The vasodilating ointments Finalgon and Kapsikam also have an antispasmodic effect.

Be sure to take note:

Together with anesthetics, it is necessary to use non-steroidal anti-inflammatory drugs for the lumbar region in the form of ointments (Valusal, Ketoprfen, Fastum, Aertal, Nise). The action of local anti-inflammatory drugs is reinforced with tablets or injections (Diclofenac, Indomethacin, Nimesulide, Ketoprofen).

To maintain the therapeutic effect, it is necessary to take painkillers and anti-inflammatory drugs at regular intervals (indicated in the instructions) throughout the entire acute period of the disease. If it is not possible to regularly take pills or injections, you can use:

The innovative plaster Nanoplast has a good and fast analgesic and at the same time anti-inflammatory effect;
Anti-inflammatory patches based on diclofenac Valtoren, Diclofenac-ratiopharm or lidocaine Versatis, Emla, Parapran.

Do not forget that the use of patches is used in addition to pills or injections, and not instead of them.

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Help with folk remedies

From folk remedies in first aid for radiculitis of the lumbar spine, you can use ointments with the addition of bee and snake venom (Viprosal, Cobratoxan, Apizartron, Mellivenon).

From improvised means in the fight against sciatica are used:

Garlic compresses (throw large heads of garlic in boiling water for a couple of minutes, then crush and make a compress) and radish (grated radish is applied to the pain site in the form of a compress), horse chestnut (chestnuts are ground into flour, mixed with camphor oil and a compress );
Rubbing with alcoholic tinctures of burdock and valerian;
Bodyagi ointment (bodyagi powder, which can be bought at a pharmacy, is mixed with vegetable oil to the state of gruel and lubricated the lumbar region);
Baths (with a water temperature not higher than 36 - 37 degrees Celsius) with a decoction of yarrow or mustard powder. Brew 2 tablespoons of yarrow in a glass of water or dissolve 2 glasses of mustard powder in the same volume of water and add to the bath;
Rubbing with essential oils of rosemary, pine, arnica, St. John's wort;
Draw a grid on the lower back with an alcohol solution of iodine.

When first aid is provided for radiculitis, especially folk remedies, it must be remembered that any warming procedures are strictly contraindicated.

It is interesting to read:

Sciatica by its nature is an inflammatory process, which increases under the influence of heat, which complicates further treatment, and contributes to the transition of radiculitis into a chronic form. If you have symptoms of sciatica of the lumbar spine, consult a doctor in a timely manner and do not self-medicate. This will help avoid complications and the transition of the disease into a chronic form.

Chiropractor, orthopedic traumatologist, ozone therapist. Treatment methods: osteopathy, post-isometric relaxation, intra-articular injections, soft manual technique, deep tissue massage, pain relief technique, craniotherapy, acupuncture, intra-articular drug administration.

Pain symptoms of sciatica are always aggressive, regardless of the area of locality. This pain is difficult to confuse with any other later. It has its own character and its accompanying features. Often people define sciatica as an independent disease. However, you need to know that this is not a separate disease and cannot be independent. Almost always this is only a set of signs that indicate the activity of osteochondrosis.

Radiculitis is always secondary, its peculiarity is that the attack lasts for a long time. And the main question is not how to relieve pain in sciatica, but how to prevent its appearance. To do this, you need to know a little about the "enemy", since understanding the etiology of the syndrome will help to get rid of the next acute phase more effectively.

Like other pain syndromes in spinal lesions with osteochondrosis, radiculitis becomes a consequence of pinched nerve endings. From the fact that such a pinching occurs, the nerve root becomes inflamed and gives impulses to pain. As the duration progresses, the area of inflammation will increase, and swelling of the internal tissues begins.

Radiculitis is distinguished by the place of locality:

lumbar;
lumbosacral;
cervical;
chest;
combined, mixed.

The area of soreness allows you to determine the locality. So, with thoracic variation, intercostal neuralgia occurs. When pinched in the cervical region, the patient will complain of pain in the cheekbone, jaw, neck. The patient feels pain along the entire length of the nerve fiber. It is important that even if the release of the root occurs relatively soon, the consequences of pinching will need to be eliminated with therapy.

Radicular syndrome of this type is one of the most aggressive, capable of completely changing the patient's quality of life. The peculiarity is that in the overwhelming majority of cases, when it hurts for a long time, we are talking about a chronic form. And most often because the first signs of the root cause are simply ignored by a person. Only a negligible percentage of patients seek help when they first grab their back and spine.

That is why the appearance of radiculitis is immediately diagnosed as an exacerbation of osteochondrosis in a chronic form. In this moment, the question is not raised about healing, which is impossible. But it is quite possible to try to minimize seizures and the frequency of exacerbations.

The first symptom that manifests itself sharply and unequivocally in acute radiculitis is pain syndrome. The nature of such a syndrome can be different, depending on the location. Some patients characterize it with acute pains, others dull and cutting. It is often unlikely to independently determine the source, since acute pain may be signs of other diseases.

So, an acute attack of heart failure can perfectly disguise itself as an attack of sciatica. The patient will complain of chest pain, chills, weakness. Many diseases have such symptoms, it is important to diagnose the correct one in time.

Some patients with such a phenomenon as chronic sciatica may present more extensive complaints:

fatigue;
change of mood for no reason;
rush of blood to the head;
shooting pain in the lower back;
numbness in the legs or arms;
pain radiating to the shoulder;
limited movement.

When there is a history of acute sciatica, all symptoms are expressed aggressively, literally folding the patient. One must be able to provide first aid, and then turn to the treatment of the original source.

It is important to understand that until the acute phase goes away, treatment cannot be carried out. The patient is provided with rest for several days. It is necessary to find a position in which it is possible to lie down and try not to move, so as not to increase the pain. Be sure to start using ointments and creams with non-steroidal anti-inflammatory substances.

Well suited for this:

Diclofenac;
Fastum gel;
Voltaren.

At the initial stage, it is better not to use warming ointments or creams. If there is no accurate diagnosis, warming up can only worsen the situation. It is allowed to do a light massage at the time of rubbing the affected area. But massage should be relaxing, relaxing. It is forbidden to use force, since the muscle layer is already in a state of severe spasm at the moment of exacerbation.

If possible, you can purchase Midocalm in injections and give an injection. Mydocalm refers to muscle relaxants that reduce muscle spasms, thereby relieving pain. The back should be warm, without tension. In the first days, you should only lie down. Already as the pain subsides, movements are allowed and exercises for muscle activity are introduced, but so far in the supine position.

Since the spine does not always respond to medication therapy, great importance is attached to other techniques. However, you can switch to them after relieving pain.

Treatment includes taking various medications:

chondroprotectors;
non-steroidal drugs;
muscle relaxants;
vitamins of different groups;
drugs to improve blood circulation;
drugs to strengthen the walls of blood vessels.

The final scheme depends on the degree of damage and the development of the underlying disease. The concept of osteochondrosis and how long the acute phase lasts are very relative. So, osteochondrosis can be paired with one of its complications. Therefore, the treatment is tailored to the specific situation.

The most important thing is to control the pain, for which blockade can be used. The blockade is placed directly at the source of the lesion, the drug is injected deep into the tissue area. This remedy is used in situations where all therapy has proved powerless and the pain retains its aggression for a long time. The blockade can be from one component or from several. The type is selected individually.

Novocaine blockade is more often used for osteochondrosis of the lumbosacral region. Local (skin) anesthesia is preliminarily performed by injecting the affected area. Drugs are then administered while the pain relief is in effect. The advantage of blockages is that the medicine is directly transported to the desired area and does not lose its strength. However, this effect is temporary, after 1-2 months the substances leave the body and there is a need for a secondary procedure.

Various ointments are used for relief. Good effect of ointment based on snake or bee venom. If the use is planned without a prescription, then it is better to choose Viprosal or Ketonav. They do not have a pronounced warming effect, but they relieve pain and reduce inflammation in the tissues.

The use of medicinal patches of the nano generation is extremely effective. The choice is significant, it is possible to use it every day. If warming is permitted, a red pepper patch is best. On all such patches, where such a bright component is based, there is a microimage of red capsicum. The effect of such treatment is noticeable, usually in three days it is possible to significantly reduce swelling and reduce pain.

Patches can be with belladonna, have a calming and relaxing effect. In fact, the plasters are applied without restrictions, on the principle of “when it becomes easier”. It is important that local allergic reactions do not occur. You cannot tolerate if there is discomfort or a burning sensation. Remove immediately, otherwise skin may be damaged, causing burns. The only limitation on the use of pepper patches is radicular syndromes in the cervical spine.

The cervical region has extremely thin and delicate skin. Additionally, there are many vessels in the zone, so it is better not to use such aggressive methods of treatment. But the patch can be replaced with sage oil and a warm wool shawl.

The preparation of sage oil is simple: grind the sage herb itself, make about 8 tablespoons in powder form. Separately, let the vegetable oil boil - 0.5 liters. Mix everything and immediately remove from the heat, then thoroughly stir the powder to one mass and put in a bath. Hold for about half an hour, remove in cool. After 3 hours, drain and apply.

Orthopedics

If there is a history of spinal disease, the help of an orthopedist is needed. With exacerbations of radicular syndrome, you can choose a medical belt or corset. The task of such devices is to fix the position of the body and reduce the tension of the muscle layer. Corsets are different, differ in material and degree of fixation. It is unacceptable to choose it yourself, since in some diseases the corset is not allowed.

Also, the device can be supportive or curative, depending on the tasks to be achieved. However, wearing a corset of the correct pattern and size can restore muscle health and help relieve radiculitis exacerbations.

Radicular syndrome is always aggressive towards the body. Nerve fibers are sensitive to even minor damage. It is important to maintain the general tone of the spine, give moderate stress, and then the risk of exacerbations is reduced.

Radiculitis, or radiculopathy, is a neurological pathology associated with compression or inflammation of the spinal nerves. This happens most often due to degenerative-dystrophic changes in the spine or inadequate loads. With the modern sedentary lifestyle, the lumbar region suffers the most from these factors. It is on him, as well as on the place of his junction with the sacrum, that the greatest loads fall when walking, standing and even sitting. Therefore, lumbosacral radiculitis most often occurs, causing severe pain and disrupting the patient's normal life.

general characteristics

Lumbosacral sciatica most often causes back pain. According to statistics, it occurs in 10% of adults. Usually this disease is secondary and develops in the presence of other pathologies of the spine. Therefore, some experts consider radiculitis a symptom complex, a consequence of degenerative-dystrophic diseases, most often osteochondrosis. But changes in joints, discs or musculo-ligamentous apparatus can provoke pain. Sometimes the inflammation of the nerve roots develops on its own, for example, when an infection, alcohol intoxication or severe hypothermia occurs.

Radiculopathy of the lumbosacral spine, better known as sciatica, is common mainly in people 35-50 years old. Moreover, pathology is more common in men. This is due to the fact that it appears due to increased loads on the lower back or hypothermia. People who spend a long time in a sitting position, doing work on their legs, forced to lift weights are susceptible to sciatica. Representatives of some professions are especially at risk of developing sciatica. These are movers, builders, drivers, agricultural workers, as well as athletes.

Usually, after the first attack of sciatica, which occurs after an injury, when performing a sharp movement or lifting a heavy object, the disease does not cure at all, but acquires a chronic course. With the correct behavior of the patient, relapses can be rare - once every 2-3 years. But most often the pathology is exacerbated several times a year.

Depending on the type of nerves affected, the reasons for their compression, as well as the symptoms manifested, there are several types of lumbosacral radiculopathy:

lumbago is characterized by acute shooting pain in the lower back, which makes a person freeze in a bent position;
lumbodynia is a painful condition that lasts for several months;
sciatica is a type of sciatica associated with damage to the sciatic nerve, while pain occurs not in the back, but in the buttock, thigh, lower leg;
lumboischialgia - a pathology that combines the manifestations of lumbago and sciatica;
with a herniated disc, leading to compression of the nerve roots, a condition develops called discogenic radiculopathy of the lumbosacral region.

Backache can occur with a sharp bend forward

Reasons for the appearance

The main reason for the appearance of radiculopathy is compression or inflammation of the nerve roots extending from the spinal cord. Most often this happens with the development of degenerative-dystrophic processes in the spine. It is believed that in 80% of cases, radiculitis occurs with osteochondrosis, spondyloarthrosis or herniated intervertebral discs. Due to degenerative processes, the cartilaginous tissue of the discs begins to collapse, the distance between the vertebrae decreases. Muscle spasm occurs, which disrupts the blood supply to the spine. This leads to an inflammatory process.

Nerve roots can be compressed by overgrown osteophytes, which appear to reduce the load on the vertebrae, displaced vertebrae or hernias. All of these conditions develop due to the destruction of cartilage tissue. The reason for such degenerative processes can be a lack of movement, leading to a slowdown in blood circulation, metabolic disorders, obesity, injuries, bad habits, curvature of the spine or increased stress.

But backache occurs in certain situations. The factors provoking the development of radiculopathy of the lumbosacral spine include:

severe hypothermia;
a sharp turn of the body or tilt forward;
lifting weights;
long stay in a sitting position;
increased loads;
infectious diseases;
general intoxication;
inflammatory processes in the surrounding tissues.

Symptoms

When exposed to provoking factors, an attack of sciatica occurs. This is a severe, sharp pain in the lower back known as a lumbago. In this case, the patient can take a forced position, most often - bending forward a little. Any movement hurts, especially turning or bending, it also hurts to walk.

In addition, in the acute period there are such characteristic symptoms of lumbosacral sciatica:

back muscle spasm;
severe pain when pressing on the spinous processes of the vertebrae;
increased pain when sneezing, coughing, shaking the body;
sweating, weakness;
along the damaged nerve, there is a decrease in the sensitivity of the skin, its pallor and cold snap;
a sharp increase in pain when raising a straight leg from a prone position;
stiffness in movement.

Sharp pain can occur during physical work or lifting weights

Pain with lumbosacral radiculitis is special. It is sharp, shooting, spreading along the affected nerve. Most often, pain sensations appear, in addition to the lower back, in the buttock, thigh, lower leg and foot. They intensify with movement or increased loads. When the sciatic nerve is damaged, there is pain and numbness along the back of the leg. The patient cannot sit, it hurts him to walk. If the nerves are severely damaged, the pain may worsen when the head is tilted forward.

Discogenic lumbosacral radiculitis, in addition to pain, is characterized by other symptoms. Basically - this is a violation of sensitivity. You may feel tingling, running creeps, numbness or chilliness. When the motor fibers of the nerves are damaged, motor disorders develop. This is mainly reflected in the movements of the foot. A condition such as a drooping or paralytic foot develops. In this case, the patient cannot stand on his toes. Due to the limitation of motor activity, muscles gradually atrophy. Weakness, instability of movements develop, tendon reflexes often disappear.

Usually, an exacerbation of sciatica lasts 2-3 weeks. At this time, the patient also exhibits external signs. The lumbar lordosis straightens and the spine bends to the side due to muscle spasm on the side of the nerve injury. The gluteal fold is smoothed, spasmodic muscles can be noticeable on the lower back. The patient's gait changes, and in general he tries to walk less.

Usually, the doctor makes a diagnosis already during an external examination of the patient.

Diagnostics

The symptoms of sciatica are so characteristic that the diagnosis of the disease does not cause problems. The preliminary diagnosis is made after examination and special tests. With their help, the reflex reactions of the body are checked. For example, when lifting a straight leg from the side of a nerve injury, the pain increases - this is a Lasegue symptom, and an increase in pain when the head is tilted forward is a Neri symptom. Ankylosing spondylitis is characteristic: when the patient sits down from a supine position, the sore leg reflexively bends.

X-rays and blood tests may be done to confirm the diagnosis and determine the cause of radiculopathy. CT and MRI help to identify the degree of damage to the nerve roots, to determine the condition of the discs and the musculo-ligamentous apparatus. Sometimes electroneuromyography is also performed to assess the condition of the nerves themselves. Such an examination is necessary in order to recognize in time the presence of a tumor, intervertebral hernia, osteophytes, circulatory disorders, stenosis of the spinal canal.

Severe pain can often only be relieved with injections

Treatment

The effectiveness of treatment depends on its timeliness, the cause of the lesion and the state of health of the spine. If vertebrogenic pain symptoms are ignored or with improper treatment, pathology may progress. The nerve can gradually die off, leading to problems with walking. Violations of urination and defecation may develop. But if the patient turns to the doctor on time and follows all his recommendations, the attack can be stopped in 5-7 days, and subsequently to prevent the occurrence of exacerbations.

The objectives of the treatment of lumbosacral radiculitis should be not only pain relief. It is necessary to eliminate the factors that led to the compression of the nerve, remove the inflammatory process, and restore the patient's mobility.

For this, the following methods are used:

pain relievers or non-steroidal anti-inflammatory drugs in the form of pills and injections;
topical ointments and compresses;
orthopedic devices to reduce the load on the affected area;
physiotherapy procedures;
massage and manual therapy;
traction traction of the spine;
physiotherapy.

What to do in case of an attack

In case of an acute attack of sciatica, it is very important to see a doctor as soon as possible. But before that, it is important to relieve severe pain. To do this, you need to drink 2 tablets of anesthetic. Effective, for example, Diclofenac, Ketanov, Ortofen, Nimesulide, Indomethacin.

After that, you need to lie down on a flat hard surface, you can on the floor. Raise your legs on pillows or rolled up blankets. Moreover, they should be bent at the knee and hip joints at right angles. It is very important to keep your back warm. But hot compresses are unacceptable, it is better to wrap the lower back in a scarf or wear a warming belt.

Rest and warmth is what the patient needs for several days after the attack. If you consult your doctor in time, pain symptoms can be removed in 5-7 days. But for this, complex therapy is necessarily applied.

Medications

To remove the compression of the nerve roots, you first need to relieve pain, muscle spasm and inflammation. Most often, drug therapy is used for this. The most common drugs for radiculopathy are NSAIDs. These are Ibuprofen, Diclofenac, Indomethacin, Ketoprofen, Nimesulide. They can be taken for no more than 5 days, so other drugs are used to speed up recovery.

The pain is aggravated by muscle spasm, so muscle relaxants are effective. Sirdalud, Midocalm, Baksolan are used. Sedatives are often prescribed, which, due to inhibition of consciousness, provide a decrease in pain. B vitamins are helpful and can help relieve pain. They can be used alone or as part of complex preparations, for example, Milgamma or Neurodiclovitis. Chondroprotectors are used to restore cartilage tissue - Chondroitin, Teraflex, Artra. They help reduce the frequency of exacerbations of sciatica.

Additionally, pain relieving patches can be used to relieve pain.

External remedies

At the initial stage of treatment of sacral sciatica, ointments are used to relieve pain. They have a warming and irritating effect, stimulate blood circulation and reduce pain. It makes no sense to use such funds on your own, but they are effective in complex treatment.

The most commonly used ointments are Viprosal, Nikoflex, Finalgon, Nise, Apizartron. Compresses with Dimexide are also effective. At the recovery stage, it is good to rub pepper tincture, camphor alcohol, Novocaine into the lower back. Recently, plasters have become popular for relieving pain in sciatica. In addition to the well-known pepper for a long time, now used funds based on NSAIDs, anesthetics or herbal extracts. For example, Nanoplast, Voltaren, Versatis are effective.

Injections

With severe pain, sciatica can be treated with blockades. This is an injection of drugs directly into the area of the affected nerve. Only a doctor should do them. Injections are injected into the epidural space, trigger points, the joint cavity, or where the nerve is pinched.

Anesthetics are used for this, for example, Lidocaine or Novocaine. In some cases, corticosteroids are used. It can be Hydrocortisone, Diprospan, Kenalog. In addition, B vitamins or biologically active substances can be introduced to accelerate the recovery of the affected tissues.

Physiotherapy

After the removal of acute symptoms during the recovery phase, additional methods are used to treat lumbosacral sciatica. It can be ultraviolet irradiation, electrophoresis with Novocaine, pulsed ultrasound therapy. Diadynamic currents, magnetotherapy, laser irradiation, hydrogen sulfide baths are effective.

Hirudotherapy has proven itself well. After all, leeches secrete special substances that relieve pain and inflammation. Acupuncture is effective for radiculitis. This method improves blood circulation and metabolic processes, increases the body's defenses, relieves swelling.

Physiotherapy treatments will help speed up recovery

Physiotherapy

Bed rest for radiculopathy is recommended for no more than 3 days. Then you need to start moving and perform special exercises. They will help activate blood circulation and metabolic processes, prevent muscle atrophy. At first, they can be performed in the supine position, then, after pain relief, physical activity increases.

All exercises are performed slowly, without jerking or sudden movements. Muscle relaxation and stretching exercises are mandatory. It is contraindicated in radiculopathy, even during remission, to perform forward bends and torso rotation. If you practice regularly, you can prevent frequent exacerbations of pathology.

Lumbosacral sciatica is a pathology that has arisen once and can periodically worsen. Therefore, patients need to change their lifestyle, monitor weight, avoid hypothermia and increased stress. If you follow all the doctor's recommendations, you can prevent the complications that radiculopathy often leads to.