Causes, symptoms and treatment of sciatica
What is lumbar radiculitis?
Lumbosacral sciatica is a disease affecting the peripheral nervous system. With this pathology, compression and inflammation of the roots of the spinal nerves in the lumbosacral spine.
This disease occurs quite often. According to statistical data, about 10% of the adult population is affected to varying degrees. The risk group includes people of working age from 35 to 50 years. The main cause of the disease are degenerative-dystrophic changes in the spine( osteochondrosis).
For lumbosacral radiculitis usually characterized by a chronic course, with periodic exacerbations of varying duration. The development of the disease is provoked by finding and working in bad climatic conditions and considerable physical stress on the spine.
Causes of lumbosacral radiculitis
Lumbosacral sciatica is a complex of symptoms arising from irritation or compression of the roots of the spinal cord. This is not an independent disease, but a pathological process that has a secondary character.
Earlier it was thought that the cause of the development of radiculitis is infection. Currently, most experts are of the opinion that it is one of the consequences of the development of osteochondrosis( degenerative changes occurring in intervertebral discs).
When the intervertebral discs of the spine receive insufficient nutrition, qualitative and structural changes of non-inflammatory nature begin to occur in their tissues. The fibrous ring surrounding the pulpous nucleus of the disk, dries and compacts, cracks are formed in it. As the degenerative process develops, the nucleus of the disc together with the fibrous ring protrudes into the intervertebral canal( protrusion of the disc), or the fibrous ring breaks and the nucleus exits( hernia of the intervertebral disc).
The height of intervertebral discs is reduced, the ligamentous apparatus is weakened. To compensate for excessive mobility and prevent possible displacement of the vertebrae, bone ridges, called osteophytes, grow on the vertebrae edges.
As a result, bulging or dropping disks, coupled with soft tissues that are traumatized by osteophytes, exert pressure on closely spaced nerve endings of the spinal cord, against which a characteristic pain syndrome arises. Progression of osteochondrosis can lead to such a complication as stenosis( narrowing) of the spinal canal. This process can capture and foraminar channels. Bunches of nerve fibers leave the spinal canal through the foraminous openings between the vertebrae and are sent to the lower extremities and internal organs. Their squeezing causes characteristic symptoms of pinching of the sciatic nerve.
In addition, the development of lumbosacral radiculitis can be triggered:
Injuries of the spine;
Tumors of the peripheral nervous system;
Other diseases, such as arthritis or spondylolisthesis;
Inflammatory process in the near-vertebral soft tissues;
Metabolic disorders( deposits of calcareous salts that cause the formation of osteophytes);
Regular increased strain on the spine;
Another attack of radiculitis can be caused by:
Sharp or awkward movements of the lumbar region of the back.
Thus, the causes of lumbosacral radiculitis are of a polyethological nature.
Symptoms of lumbar sciatica
The following are common symptoms of lumbosacral radiculitis:
Pain syndrome of varying intensity and localization, which is aggravated by sudden movements of the lower part of the trunk, with falls, lifting of weights and other physical exertions on the lower back;
Strengthening of pain during coughing, sneezing, tension of abdominal muscles;
Restrictions of movements with torso tilting to the sides, forward and back;
Such impellent violations as the inability to stand on your fingers or bend your toes.
Depending on the severity of the lesion, the pain may be localized in different parts of the body: in the lumbar and gluteal regions, the hind and frontal surface of the thigh, the calf muscles and the calves. Also, the pain syndrome can affect both one and both sides of the body. Explain this by the nature of the protrusion of intervertebral discs( median or lateral).
When lesions of nerve endings that are under I-II lumbar discs, lumbar and buttock lumbago, pain sensations passing along the posterior and lateral surfaces of the thigh are observed. With the defeat of the nerves of IV-V lumbar discs, the pain drops to the anterior part of the shin, the calf muscle, the outer ankle and the heel;there are violations of flexion of the foot and the big toe.
The acute period of sciatica continues for an average of 2-3 weeks. To diagnose it, the following set of specific symptoms is also used:
Bekhterev's symptom - a reflex flexion of the leg on the side of the lesion is observed in the transition from the supine position to the sitting position;
Symptom Lasega - pain in the lumbar, gluteal region and back of the foot sharply increases during lifting of the straightened leg in the supine position;
Symptom of Dejerine - pain increases during coughing and sneezing;
Symptom Bonnet - on the side of the defeat the fold under the buttocks is smoothed;
Symptom Neri - pain in the lower part of the body increases with a sharp tilt of the head forward.
For radiculitis caused by osteochondrosis, external changes in the body are also characteristic: straightening of the lumbar lordosis, an increase in kyphosis, scoliosis with bulging in the direction of the lesion. In the pathology of the disc between the V lumbar and I sacral vertebrae, it is possible to develop a scoliosis with a concavity to the healthy side.
The cause of infectious infection of the nerve roots of the lumbosacral can be acute( influenza, malaria) or chronic( brucellosis) infections. The pain increases with the body tilted forward and does not increase during the load on the spine. Vegetative disorders are possible. In this case, with the extinction of the inflammatory process, the pain stops relatively quickly. There are no deviations on X-rays.
Treatment of lumbosacral radiculitis
Treatment of the disease is carried out depending on the causative factors( infectious-inflammatory or disco-conditioned) and its stages( acute or chronic).
Conservative treatment is complex and includes:
Bed rest( in acute period);
Wearing a corset for immobilizing the spine;
Use of drugs that remove inflammation( in the form of injections, tablets, topical products);
The use of muscle relaxants, eliminating muscle spasm in the lumbar region;
Physiotherapeutic procedures that provide analgesic and preventive action;
Extension of the spinal column;
Exercises exercise therapy, aimed at strengthening the muscles and forming a muscular corset supporting the spine.
Drug treatment of lumbar radiculitis
The most effective to this day remain drugs from the group of non-steroidal anti-inflammatory drugs. They stop the inflammation and remove the swelling. However, NSAIDs have a number of contraindications, have a negative effect on the gastrointestinal tract and are not recommended for long-term use.
With a sharp exacerbation, Diclofenac, Ibuprofen, Orthofen tablets are taken, afterwards, after easing the pain, it is better to use ointments and creams that are applied to the sites of pain localization. These include Finalgon, Apizarthron, Diclofenac, Naise, Indomethacin. Well-proven ointment based on snake venom Viprosal. Provoking local irritating effect, it improves blood circulation in the affected area.
Injections and blockades are prescribed for very severe pain. But they do not cure the disease, but only relieve the symptoms. As anesthetics, Novocain, Lidocaine, Trimecaine are used. Depending on the nature of the course of the disease, chondroprotectors or milgamma are put.
Of muscle relaxants used Midokalm, Baksolan, Sirdalud. However, they also have many side effects and should be applied only once.
Physiotherapy with lumbar radiculitis
In the subacute stage, together with medical therapy, ultraviolet irradiation of the waist and legs along the affected nerve is carried out.
It is often used electrophoresis with various medications: novocain solution, a mixture of phenol, dicaine and adrenaline solutions, with virapin ointment. Also electrophoresis with an extract of medical mud is done. With infectious radiculitis - with salicylates, a solution of copper, lithium.
In the acute stage with discogenic radiculitis, ultrasound therapy in pulsed mode is prescribed, in which a mixture of analgesics can be used as a contact substance. With the weakening of symptoms, ultrasound is used in both pulsed and continuous mode. In the infectious nature of radiculitis, an effective combination of ultrasound with hydrogen sulphide and sodium chloride baths is effective.
Diadynamic currents showed good results, in which small electrodes are installed on the nerve root exit zones and along the affected nerve.
In severe infectious lesions, physiotherapy is supplemented by injections of antibiotics or urotropine( intravenous).
With lumbar sciatica caused by osteochondrosis, traction on an inclined plane is very important. It can be carried out on a simple bed, the head of which is raised by 10-15 cm. The body of the patient is fixed at the head level. Stretching may be short-term( 2-3 times a day for 10 minutes) and long( up to 2 weeks), depending on individual tolerability.
Indications for surgical intervention are( in complex):
Pain syndrome, which is not amenable to conservative treatment for 3-4 months;
Severe neurological symptoms;
Signs of degenerative-dystrophic changes in the discs on the roentgenogram;
Changes in the composition of cerebrospinal fluid;
Dysfunction of the pelvic organs.
Exercises for radiculitis
Physiotherapy is an important component of therapy. It must be done under the supervision of a doctor in the chronic stage of the disease and in subacute periods, for the prevention of relapses.
Before starting to practice, it is necessary to evaluate the condition of the spine, check the gait, reveal the tolerability of traction and movement, which increase pain. With discogenic radiculitis, stretching the back is an obligatory part of medical gymnastics and is performed at the beginning and at the end of the complex.
Basic exercises of the complex:
Passive and active leg exercises in the supine position.
In the introductory period, the focus is on relaxation skills: the muscles of the arms, legs, and trunk relax at rest and during the execution of elementary movements.
In the basic period, stretching exercises are added. Each exercise should end with relaxation of the muscles of the whole body. Useful vises on the hands on the bar or the gym wall for 30-60 seconds.
As the pain dies away, you can include in the exercises strength exercises( with objects or when the role of burden fulfills the weight of your own body).
Corrective exercises for correcting posture can be done only after the pain has completely ceased.
A small training complex can be viewed on the following video:
Author of article: Andrey V. Sokov, neurologist, especially for the site ayzdorov.ru
Treatment of radiculitis with injections. Analgesics, anti-inflammatory drugs
preparations Repeated seizures of radiculitis always need not only anesthesia, but also in treatment.
Chronic radiculitis never passes by itself , the frequency and intensity of seizures is only aggravated. You need to analyze in consequence of what you suffer from radiculitis, the reasons for its appearance depends on the method of treatment and the choice of medications.
There are three types of radiculitis. Discogenic radiculitis occurs due to pressure or pinching of the spinal roots. Infectious radiculitis appears as a result of neuronal damage( nerve cells) of the spine by neurotropic viruses.
Symptoms of radiculitis can occur as a result of inflammation of the spinal root.
Depending on the cause of the damage and the nature of the disease, treatment is prescribed.The fastest and most effective treatment for radiculitis is with the help of injections.
What shots are stuck with radiculitis?
Complex treatment of radiculitis is carried out with the help of drugs that practice various mechanisms of action. Sometimes, it is advisable to use several tools at once, which are introduced in different ways.
|Anti-inflammatory drugs are used to eliminate painful syndromes or eliminate feelings of discomfort.|
They are grouped according to the principle of their ability to arrest pain under different etiologies, intensity and nature of application.
Nonsteroidal agentsNon-steroidal drugs are used in inflammatory processes in the tissues of the spine.
They relieve pain and cramps in the muscles.
In addition to the elimination of enzymes that secrete the body, reacting to inflammatory processes in tissues, nonsteroidal preparations have the anti-inflammatory effect of .Acting on the foci of inflammation, reduce the intensity of inflammatory processes, remove edema.
Possess antipyretic properties.
The name non-steroid preparations received from the word "steroid", in the translation of the hormone. The particle "not" means , the absence of hormones in their composition.
The drug acts for a certain time. In fact, it blocks the production in the body of its own chemical pro-inflammatory enzymes of prostaglandins, due to which the inflammatory processes begin to subside, and the painful sensations cease.Nonsteroid drugs have significant contraindications to .
Due to the relief of prostaglandin enzymes, the drug not only reduces pain, but also relieves inflammation.
Prostaglandin regulates the level of acidity in the stomach and takes an important part in the process of blood clotting, having the property of inhibiting platelet aggregation. When the enzyme prostaglandin ceases to be produced and stopped for a long time, there is a risk of ulcer disease( stomach ulcer).
The long absence of an enzyme in the body provokes a deterioration in blood coagulability.
People who decide to take non-steroid medicines on a regular basis need to include foods( salts and fats) in the diet that do not allow the appearance of stomach ulcers.Pregnant women should not use non-steroid drugs, as there is a( increased) risk of miscarriage.
To avoid the risk of suffering from contraindications, you can use selective nonsteroid drugs .They have less effect on the stomach, but a significant help is provided only when taking large doses.
Narcotic analgesicsNarcotic analgesics are agonists of opioid receptors.
They are used only for very severe pains of , which do not stray to nonsteroidal drugs.
Differ tremendously pain relievers. As a result of the action on the central brain, in addition to pain relief, self-control in a person is leveled, often causes inexplicable joy and euphoria of , which is replaced by with a severe dysphoric syndrome - the unexplained deep sadness of .
Most drugs of this kind depress respiration. Even with a short course of use, drug dependence is caused.
Only narcotic analgesics can be prescribed by physician. In this case, he will issue a prescription form. Without it, drugs are not issued in pharmacies.
NovaQainic blockade ofNovokainovye blockades are performed by slow entry of a low-concentration solution of drug Novocain .
When squeezing or jamming the nerve root, which causes an attack of radiculitis, it is necessary to accurately inject the remedy into the muscle and nerve tissues for which the inflamed root is an axon, that is, it conducts nerve impulses. Since it is inflamed, pain sensitivity is also possible in the tissues that it innervates.
It is necessary to inject the drug into the muscles, joints and nerves that are in the innervation zone of the sore root. By injecting the remedy, it is not permissible to touch or damage the spinal root itself.
Novokainovye blockades neutralize local pain even better than narcotic analgesics, while they have much less contraindications.Unfortunately, the duration of the drug is very limited.
The pain will resume within half an hour. This blockade is ideal if you can quickly eliminate the cause of pain.
There are two main groups of anti-inflammatory drugs used in radiculitis.
Non-steroidal anti-inflammatory drugsNSAIDs are accepted by a large number of people.
They have an extensive scope, are used as analgesic, antipyretic and anti-inflammatory drugs .
NSAIDs act by inhibiting( i.e., delaying the production) of the cyclooxygenase enzyme.
There are NSAIDs that do not have serious contraindications( selective inhibitors - coxibs).They do not affect the change in acidity in the intestine, but the intensity of their action is noticeably lower than in the classical representatives of nonsteroidal drugs( nonselective inhibitors).
Local administration of glucocorticoids
After passing into the cell membrane and performing a number of transformations, synthesizes regulatory proteins.
One of them - lipocortin inhibits( stops the production) of the enzyme that regulates the appearance of inflammatory reactions - phospholipase-A2.
Glucocorticoids boost blood microcirculation in an inflamed area and effectively reduce or relieve inflammation.
Glucocorticoid drugs are recommended to be administered topically( in trigger zones), for quick action on the cause of pain in the affected object. Glucocorticoids are usually prescribed as a single , for rapid relief of severe pain. After removal of the inflammation, it is necessary to continue treatment by other means.
Drugs for improving impulse conduction to nipped rootlets
- Galantamine .The dose of 2.5-25 mg / day. Take 3-4 times a day, for 4-5 weeks;
- Nivalin .A dose of 2.5-25 mg / day. Take 3 times a day, the course is 50 days;
- Dibazole .Dose 2-3 ml 2-3 times a day;
- Proserin .The dose of 1 ml of 0,05% 1-2 times a day;
- Vitamin B1 .A dose of 25-50 mg / ml, a course of 10-30 injections;
- Vitamin B12 .The dose of 1 mg / day. Take within 1-2 weeks.
Medications to reduce the edema of clamped roots
- Trichopol .The dose of 0.75-1.5 g / day.3 times a day. The course is about a week;
- Pipolphen .The dose of 75-100 mg / day.3-4 reception.
- Sirdalud .A dose of 6 mg / day.3 times a day.
- Xsefokam .A dose of 8-16 mg / day.3 times a day.
Drugs for the treatment of reflex muscle spasm that occurs to level the pain
- Tubokurarin causes relaxation of skeletal muscles( relaxation).Dose 0,4-0,5 mg / kg;
- Pipecuronium promotes muscle relaxation. Dose 0,04-0,08 mg / kg;
- Atra-curium rapidly causes an easily reversible muscle relaxant effect. At a dose of 0.3-0.6 mg / kg, the muscle relaxes for 15-35 minutes. Extras.a dose of 0.1 to 0.2 mg / kg prolongs the effect by 15-35 minutes. Can be used as an infusion, injected into the bloodstream at a rate of 0.005-0.01 mg / kg per minute;
- Pancuronium provides a longer duration of muscle relaxation. Dose 40-60 mcg / kg;
- Vecuronium guarantees a mild-relaxing effect of medium duration. It is used for surgical intervention. The initial dose is 0.08-0.12 mg / kg;
- The rocuronium relaxes the skeletal muscles. Weaker than other muscle relaxants. The initial dose is 0.45-0.6 mg / kg;After 20-40 minutes, a maintenance dose is introduced: if struino, then 0.15 mg / kg, if infusion, then 5-12 mcg / kg per minute;
- Mivakuriy creates a myoparalytic effect. The dose is 0.15-0.2 mg / kg. The exact dose of infusion depends on pseudocholinesterase in plasma.
- Doxapuria causes muscle relaxation. The dose is 30-50 μg / kg. The effect is maintained every 30-45 minutes at a rate of 5-10 μg / kg.
Vitamins of group B
Group B vitamins are necessary for normal life and functioning of body cells, including the nervous system.
For the health of the nervous system, the correct regulation of its activity, the structure of the cells and their membranes, it is necessary to take medications containing various types of vitamin B12.
Each type of vitamins differs in properties and provides the correct system of its work. When there is a shortage of any vitamin B, there are special, peculiar to the absence in the body of a particular type of vitamin.To take B vitamins is best in the form of complex injections. In their composition, there are those vitamins that you lack in the body.
In relation to the nervous system, the representatives of B vitamins perform such functions:
- B1( thiamine) controls the activity of the nervous system;
- B3( PP nicotinic acid) regulates the normal functioning of the nervous system;
- B4( choline) prevents the breakdown of the nervous system;
- B5( pantothenic acid) is involved in the synthesis of lipids, including the nervous system;
- B6( pyridoxine) takes part in the regulation of the nervous system;
- B12( cyanocobalamin) serves as a reinforcing agent in the formation of the myelinated neural membrane.
Vitamin B12 is sometimes used in complex injections of radiculitis blockades, combining in solution with the main substance and hydrocortisone acetate.
Names and characteristics of
The most popular, universal drugs used to eliminate the symptoms of sciatica and treat associated diseases.
KetonalProduces a rapid analgesic and antipyretic effect.
Application: 0.1 g( 1 ampoule) 1 - 3 times a day.
KetolongAn anti-inflammatory agent with pronounced analgesic properties.
Application: 10mg once. The maximum dose is 90 mg. Therapy up to 2 days.
DiclofenacThe drug has a rapid anti-inflammatory and antipyretic effect. Reduces stiffness and swelling of tissues.
Application: 75 mg 1 - 2 times a day. The course lasts 4-5 days.
HydrocortisoneDesensitizing, anti-allergic and anti-inflammatory. It has antishock and antitoxic properties.
Application: a dose of 100 mg( 30 seconds) to 500 mg( 10 minutes each).Repeat in 2-4-6 hours.
DENEBOLIt blocks cyclooxygenase II, thereby eliminating inflammatory processes.
Application: the solution is administered only intramuscularly. A dose of 50 mg per day every 24 hours.
Kenalog 40Provides anti-shock, antitoxic action, prevents inflammatory processes.
Application: 40-80 mg once. If necessary, you can repeat after 4 weeks.
Usage: 8 mg of dry powder are diluted in 2 ml of water for injection.
MovalisBlocks the work of an enzyme involved in the formation of inflammatory processes. Antipyretic and analgesic effect.
Application: 15 mg / 1.5 ml per day.
MilgammaStabilizes the nervous system, improves microcirculation, activates the process of hematopoiesis.
Application: 2 ml once a day. Course 1 month.
NeurorubinRegulates the exchange of proteins. Improves the performance of impulses in nerve cells.
Application: 3 ml 1 time in 2 days. The course is 7 days.
Radiculitis, in any of its manifestations, almost always occurs suddenly. A person simply captures a strong burning pain in this or that part of the spine, as statistics show, more often in the lower back. And the pain is so strong that it is almost impossible to bend or unbend the back.
What kind of animal is this for "radiculitis" and what does it appear from?
In medical terminology this disease is called "radiculopathy" or "radicular syndrome" is a collective term from the field of neurology, it means inflammation, pinching of the radicular nerve of the spine. Speaking in a simple language, the nerve endings from the spinal cord leave the holes between the vertebrae, it is their inflammation that causes the appearance of the disease. Depending on the localization of inflammation, radiculopathy can be:
- cervical - the roots of the cervical spine( C1-C8), respectively, become inflamed.
- thoracic - the site of inflammation localization of 12 vertebrae of the thoracic spine;
- lumbar ( second name - lumbosacral) - inflammation of the roots of the nerves of the lower back, to be precise, one of the 5 most mobile vertebrae of the lumbar spine.
- also possible damage to the roots of the nerves at once in all parts of the spine, the so-called polyradiculoneuritis.
Causes of inflammation
Several factors of can provoke inflammation of the radicular nerve. However, most often the development of the disease is osteochondrosis( 95%).Osteochondrosis is a degenerative lesion of intervertebral discs, articular surface and vertebral bodies.
Among the reasons also called:
- the formation of a hernia in the intervertebral disk of the lumbar, thoracic, cervical spine, it actually leads to pinching the nerve;
- trauma - damage to the vertebrae as a result of a severe bruise, can also lead to the progression of the disease. And the symptoms can appear not immediately after the injury, but after a while;
- degeneration of the discs, in other words their wear, which leads to the fact that the discs can not fully perform their functions and thereby create a favorable basis for the development of various inflammatory processes;
- stenosis of the spinal canal is the constriction of the canal, in which the nerve root of the spinal cord itself is located. The narrowing of this space leads to their decompression and inflammation. This category of causes can also include foraminous stenosis;
- presence of tumors - with the development of a tumor next to the spine or a tumor in the spinal cord develops a radiculosis syndrome and radiculoneuritis;
- diseases of internal organs, which entail inflammatory-dystrophic changes in the spine;
- is an infectious disease, a complication after which may be the development of radiculitis and radiculomeningitis;
- osteophytes - proliferation of bone tissue of the spine, which leads to infringement of the roots;
- large and prolonged load on the spine;
- sedentary work, especially if it keeps the wrong position of the spine( for example, when we sit all day sitting, hunched, at the desk).
Doctors excrete primary and secondary radicular syndrome. Primary - occurs as a result of exposure to a viral infection. Secondary is the result of pathological processes in the spinal column. In this case it is worth mentioning spondylolisthesis, deforming spondylosis, deforming spondyloarthrosis, as well as tumors, hypothermia, traumas, circulatory disorders.
How to recognize sciatica?
Despite the fact that depending on the location of the inflammation( neck, thorax or lower back), radiculitis has a different clinical picture, the general symptoms can still be distinguished.
To general symptoms of the radicative syndrome doctors refer:
- suddenness of an attack. The pain appears sharp and strong, thus the patient practically loses ability to move;
- pain syndrome. Pain occurs at the site of inflammation and is a signal for the development of pathological processes in the spine. It can be both paroxysmal and spread to other parts of the body, and permanent. At the same time, any movement, straining, coughing and even a simple sneezing can provoke its intensification. The patient also feels acute pain when pressing on the spinous processes of the vertebrae and the paravertebral points. In the case of lumbosacral radiculitis, it is worth mentioning such pain syndromes as: lumbago, lumbalgia, lumboschialgia;
- impaired sensitivity, which implies a failure in the passage of impulses between the brain center, sensitive receptors and muscles. Sensitivity disorders have their own specificity depending on the area of development of the disease. Numbness, as a rule, spreads along the line of motion of the clamped nerve. For example, from the waist to the buttock, thigh, leg and to the foot.
- weakness in the muscles, is also associated with malfunctions in the conduct of nerve impulses. The unevenness of the arrival of impulses from the clamped nerve leads to malfunctions in the work of muscles. In especially severe and neglected cases, muscle atrophy and slow paresis are diagnosed.
- limitation of the mobility of the spine itself, flexibility and maneuverability of movements;
- in some cases, you may experience dizziness, hearing loss, swaying while walking.
Stages of radiculitis
- Discalcic( neurological).Doctors note such characteristic symptoms: almost constant strong pain syndrome( pain is sharp, can be constant or paroxysmal), increased sensitivity, presence of protective muscle tension, pronounced tendon reflexes, the appearance of painful sensations when you press the paravertebral points;
- Neurotic( stage of symptoms of prolapse) - characterized by a decrease in the pain syndrome, a decrease in the sensitivity of the spine at the site of inflammation, the extinction of periosteal reflexes, the appearance of local hypotrophy( atrophy), the preservation of local muscle tension and pain in the paravertebral points.
Diagnostics of radiculitis
Modern medicine offers a comprehensive diagnosis of this disease, which includes both specialist manipulations and examinations on innovative equipment.
In general, the package includes:
- Anamnesis history: features, intensity and duration of the pain syndrome, loss of sensitivity and malfunction in the patient's muscles;
- Medical examination;
- neurological examination - reflex testing of the sensitivity and activity of muscles;
- X-ray, which will give a complete picture of the presence or absence of degenerative changes in the spine, as well as the degree of its damage;
- Magnetic resonance and computed tomography( MRI, CT) - allow you to appreciate the level of decompression of the nerve roots;
- Electromyography( EMG) allows you to determine the degree of damage to nerve fibers.
Prophylaxis of radiculitis
There are many simple and at the same time effective ways that can help protect against the development of the disease or prevent relapse.
Moderate physical activity
Physical loads, in reasonable doses, stimulate the work of muscles, blood circulation, return flexibility to the spine. Systematic physical education strengthens the spine and muscle corset, which is the key to the fact that you will not hear about the radicular syndrome for a very long time. For patients with radiculitis, not in the acute phase, doctors recommend such sports as walking, dancing, swimming. They help to significantly reduce the pain in the site of inflammation. Well-proven exercises with a bar and on the Swedish wall. They stretch the spine and strengthen the muscles. In this case, patients should avoid jumping and running, exercises with weights and bars.
Comfortable place to sleep
One of the reasons for the appearance of radicular syndrome, doctors believe, is the bed: too hard or soft mattress, springs protruding on it, an inconvenient pillow and so on. It is best to buy an orthopedic mattress, but if you do not have money for a rather expensive purchase, you can put a board of 2 cm from your boards under your mattress. Note that the shield must cover the entire surface of the bed. You can even install it at an angle by raising the head of the bed by 10-12 cm.
A good measure of prevention of the sciatica syndrome is going to the sauna. Thermal action improves blood circulation and metabolism within the body, and also removes excess fluid, salt, reduces swelling. In addition, patients are advised to wear special woolen belts.
The mode of work and rest
In this case it is worth mentioning that people who lead most, lead a sedentary or standing way of life are exposed to radiculitis: office workers, salesmen, doctors. Try to move more, change the pose during work, take breaks, watch your posture. Watch your health and do not be ill!
Lumbosacral radiculitis: symptoms, causes and treatment. Folk remedies.
Lumbosacral radiculitis is a disease manifested by the pathology of the peripheral nervous system. At the same time, the roots of the spinal cord nerves are damaged in the lumbosacral segment of the spine. This pathological condition is widespread among people older than 40 years. According to statistical data, about 10% of the adult population suffers from certain manifestations of radiculitis.
Causes of lumbosacral radiculitis
Lumbosacral sciatica is not an independent disease.then a complex of symptoms that arise when the roots of the spinal cord are compressed or irritated. Such bundles of nerve fibers exit from the spinal cord and are sent to the extremities, internal organs. Narrow foraminic canals, through which nerve fibers pass, create prerequisites for infringement of roots.
The most common cause of development of lumbosacral radiculitis is osteochondrosis. Development of this disease is accompanied by a violation of the bone structure of the vertebra, resulting in the intervertebral disc forming protrusion or hernia. This formation puts pressure on closely located nerve roots. As a result, a characteristic clinical picture of lumbosacral radiculitis appears.
The development of osteochondrosis is promoted by degenerative-dystrophic processes occurring in bone tissue as the person ages. In this disease, in addition to hernias, characteristic marginal growths-osteophytes-may also appear. These bone protrusions also injure nerve roots and soft tissues, contributing to the emergence of clinical symptoms. Progression of osteochondrosis often leads to the development of such a complication as stenosis of the spinal canal. This pathological process can also be seized by the foraminous canals, from which the nerve roots leave. This is the most common cause of compression of the fibers forming the sciatic nerve in the lumbar spine.
In addition, as the causes of lumbosacral radiculitis may be the following pathological conditions:
- spine trauma;
- inflammatory diseases of the near-vertebral soft tissues;
- tumors of the peripheral nervous system;
- diseases of internal organs;
- regular static-dynamic load on the vertebral column;
- physical inactivity;
- hereditary predisposition;
- autoimmune processes.
Thus, the sciatica of the lumbosacral spine is a polyethological disease. Provoke another exacerbation of the pathological process in a sick person may be physical overstrain, sudden movements in the lumbar spine, intoxication, hypothermia, colds.to content ^
Symptoms of lumbosacral radiculitis
Manifestations of lumbosacral radiculitis are manifold. Depending on the features of the clinical picture, several variants of the pain syndrome are distinguished in this disease:
- lumbulgia or lumbago - in this case the sick person complains of the appearance of acute pain in the lower back. Pain sensations in the lower back appear during exercise or after it. Provoke another attack can both supercooling and overheating of the lumbar region. Painful sensations can torment the patient from several minutes to several days;
- sciatica or sciatica - in this case the pain in the main is localized in the buttock, hamstring and can extend to the shin and foot. This clinical picture is mainly due to irritation of the sciatic nerve. Painful sensations are shooting character, accompanied by a burning sensation. Patients often describe them as "electric shocks".In addition, the clinical picture adds such unpleasant symptoms as numbness, a feeling of creeping "goosebumps", tingling;
- lyusichialgia - with this type of pain syndrome, pain is mainly localized in the lumbar region. Unpleasant sensations can radiate into the buttock, the back surface of the foot. Most often this is a burning, aching pain. The disease is prone to chronic current. In this case, the slightest physical strain and even nervous overexertion can trigger a painful attack. Over time, the protective tension of the paravertebral muscles leads to further progression of pathological processes in the spine and clinical symptoms become more and more pronounced. In addition, there is a risk of developing dangerous complications. For example, a hernia of the intervertebral disc may fall in the region of the "horse tail", leading to paralysis of the lower extremities, loss of control of the function of the pelvic organs.
Treatment of lumbosacral radiculitis
A conservative approach can be used to treat lumbosacral radiculitis. In order to alleviate the pain and stabilize the patient's condition, the following methods are used:
- bed rest is indicated during a period of exacerbation of the disease. Immobilization of the spine can be achieved by wearing a rigid or elastic corset;
- anti-inflammatory therapy - most often for the management of pain syndrome used drugs belonging to the group of non-steroidal anti-inflammatory drugs. They can be used in the form of tablets, creams, ointments, injections;
- muscle relaxants - these drugs are designed to eliminate muscle spasm in the spine, thereby weakening the clinical manifestations of the disease;
- traction - this method of manual therapy helps to restore normal anatomical relationships of structures in the spinal column;
- therapeutic exercise - performing a complex of therapeutic exercises is aimed at creating a supporting muscular corset;
- psychological correction - working with a psychologist and taking antidepressants will help to cope with the psychological stress that arises in chronic pain syndrome.
To ease the condition of the patient with sciatica in the lumbosacral spine will help and folk recipes:
- one root of horseradish and medium-sized potatoes must be grated. The resulting mixture should be applied to the loin area, covered with a towel. Flush the compress after an hour;
- finely chop 2 pods of hot red pepper and mix with 300 ml of ammonia. With this solution, rub your waist several times a day;
- spread the loin with a thin layer of honey and cover with a tissue paper. On top, put a few mustard plasters and wrap them around the food film, and then with a woolen shawl. It is recommended to keep this compress for an hour.
In case of ineffectiveness of conservative therapy, the appearance of neurologic complications is indicated the performance of an operative intervention. It can be aimed at excising the intervertebral hernia, removing osteophytes, restoring the height of the vertebral bodies.
- Protrusion of the intervertebral disc Progenesis of the protrusion is accompanied by degenerative changes in the intervertebral discs, resulting in a rupture of the fibrous ring, as well as loss of parts of the pulpous nucleus into the vertebral canal. Becomes
- Spondylarthrosis of the lumbar spine Under spondylarthrosis of the lumbar spine( lumboarthrosis) is meant a chronic spinal column disease that is caused by dystrophic processes in the joints of the spine. It should be noted that in most cases( 90%)
- Lumbago( lumbulgia) Lumbago, or lumbalia - pains in the lumbar region, mostly shooting character. Previously, he was associated with muscle pathologies, but studies have shown a connection between lumbago and primary neuralgia(
- diseases. Herniated cervical spine.) Intervertebral hernias are a fairly widespread disease of the spine, they can appear in any of its parts. "Due to a number of circumstances, the hernia of the cervical spine has its own specificsHernia
- : 05.02.2016
Thanks for the info. also I live with this radiculitis, or rather I try. But sometimes the pain gets very, usually it shoots in the leg,that it is impossible to step on it(