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 exacerbation 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 believed that the cause of the development of radiculitis is an 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, bony projections, called osteophytes, grow on the vertebrae edges.
As a result, bulging or dropping disks, coupled with soft tissues that are injured by osteophytes, put pressure on the 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 general symptoms of lumbosacral radiculitis include:
Pain syndrome of varying intensity and localization, which is aggravated by abrupt movements of the lower part of the trunk, with falls, lifting of weights and other physical exertions on the lower back;
Strengthening pain when coughing, sneezing, tension of abdominal muscles;
Restriction 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 can 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 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. For its diagnosis, the following set of specific symptoms is also used:
Bechterev's symptom - a reflex leg flexion is observed on the side of the lesion when passing from a supine position to a sitting position;
Symptom Lasega - pain in the lumbar, gluteal region and the back surface of the leg is dramatically increased during lifting of the straightened leg in the supine position;
Dejerine symptom - 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 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);
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.
Medication for lumbar sciatica
The most effective drugs to date remain 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 are 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 drug therapy, ultraviolet irradiation of the waist and legs along the affected nerve is performed.
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, ultrasonic 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).
In lumbar sciatica caused by osteochondrosis, traction on the 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, not amenable to conservative treatment for 3-4 months;
Severe neurological symptoms;Symptoms of degenerative-dystrophic changes in 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 you start, you need to assess the condition of the spine, check the gait, reveal the tolerability of stretching 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.
During the opening 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 is extinguished, it is possible to include in the exercises strength exercises( with objects or when the role of burdening is carried out by the weight of one's own body).
Corrective exercises for correcting posture can be done only after complete cessation of the pain syndrome.
A small training complex can be viewed on the following video:
Author of the article: Andrei Sokov, neurologist, especially for the site ayzdorov.ru
Lumbosacral sciatica and its treatment
If a person develops lumbosacral radiculitis, treatment of the disease should begin as early as possible - adherence to this rule helps to prevent the development of severe pain syndrome, spasm of the muscles of the back and waist of the lower limb, impairment of the function of the pelvic organs.
Timeliness of treatment is important, and because the spinal column is closely related to the work of virtually all organs and systems of the human body, because spinal cord segments spiral out spinal nerve roots that provide innervation of organs located in the abdominal cavity and small pelvis.
In the case where the doctor, based on the patient's complaints and the results of the examination, puts this diagnosis, it is important not only the appointment of symptomatic treatment, which is aimed at eliminating the symptoms of the disease, but also the selection of the examination program conducted simultaneously. If the disease that caused the symptoms of lumbosacral radiculitis is not detected, and its treatment is prescribed, there is a high probability of relapse of the radicular syndrome in the patient.
Causes of the syndrome
It is very important not only to prescribe the treatment of sciatica, but also to identify the cause of its appearance
The cause of development of the radicular syndrome is the pathological processes occurring in the spinal column. Most often, the symptoms of lumbosacral radiculitis occur in patients suffering from diseases of the spine - they include:
- traumatic injuries of the vertebral bodies, intervertebral discs, ligaments and muscles surrounding the spine;
- degenerative-dystrophic processes in the discs connecting vertebrae - osteochondrosis, herniated intervertebral discs in the lumbar region;
- malformations of the musculoskeletal system, which are accompanied by a change in muscle tone;
- disorders of posture - scoliosis, and the treatment of lumbosacral radiculitis in this case may be required for patients of relatively young age, and persistent pain syndrome becomes one of the indications for the surgical treatment of scoliosis.
The direct cause of an attack of radiculitis can be an unsuccessful movement, a prolonged stay of the body in a motionless, physiologically unfavorable position, a sharp rise in gravity - almost any condition in which there is a sharp stretching of the muscles in the lumbar spine or local impairment of blood circulation in the structures of the spinal column or surrounding tissues.
Many patients who suffer from sciatica for a long time often do not pay attention to the advice of a neurologist who recommends abandoning addictive habits. Nevertheless, conducted studies have proved that smoking, alcohol abuse, consumption of large amounts of foods rich in caffeine, the abuse of diets worsens the condition of the blood supply to the spine and burdens the course of sciatica.
How to treat this disease correctly?
Often patients ask their doctor how to treat lumbosacral sciatica correctly and whether it is necessary to prescribe a complex therapy for this disease, or it can be limited only to medical treatment or sets of physical exercises, manual therapy, massage or physiotherapy. A long-term study of this disease has proved that only complex treatment of this disease will be effective, in which all these methods will be used.
Belt for prevention and treatment of sciatica
If there is an exacerbation of lumbar radiculitis, it is impossible to cure the patient without the prescription of drug therapy, and the combined use of systemic and local treatment, with which a survey should be conducted to determine the root cause of the development of radicular syndrome, is almost never necessary.
The more severe the exacerbation and the greater the changes in the structures of the spinal column, the more medications and larger doses may be required by .That is why it is important to start treatment with the first symptoms of lumbosacral radiculitis - the appearance of pain in the lumbar spine, difficulty in movement or the emergence of a forced position of the trunk, development of paresthesia or muscle weakness, impaired function of pelvic organs.
Drug therapy involves the use of drugs for systemic therapy and topical treatment - in this case it is possible to reduce the total dose of the drug substance and prevent the development of numerous side effects. Drugs for systemic therapy are prescribed orally or parenterally( in the form of subcutaneous, intramuscular injections or adhesion).With local treatment of radiculitis drugs are applied directly to the innervation zone of the inflamed nerve root - in this capacity, substances of irritant effect can be used.
Systemic treatment of
These drugs allow you to quickly stop pain and muscle spasm, but you need to remember that such treatment is only the elimination of symptoms, and it can not be a solution to the problem. After improving the patient's condition, it is important to prescribe active treatment of the underlying disease, which triggered the development of radicular syndrome. If this rule is fulfilled, the patient will be able to forget about the existence of problems with the spine for many years. The complex of medicines for systemic treatment of radiculitis usually includes:
- muscle relaxants, which contribute to the rapid arrest of spasm of skeletal muscles - their appointment helps to eliminate the compression of nerve fibers, but these substances have quite a lot of side effects when applied;
- non-steroidal anti-inflammatory drugs that provide analgesic, anti-inflammatory and decongesting action - they help to quickly eliminate pain( the main symptom of radiculitis).Despite the fact that most of these medicines can be purchased in the pharmacy network even without the appointment of a doctor, it is worth remembering the possibility of side effects from the digestive tract, hemopoiesis, urinary system, hemostasis system;
- narcotic analgesics are currently not used for the treatment of lumbosacral radiculitis - despite the rapid relief of pain, these drugs quickly become addictive;
- antidepressants, hypnotics and sedatives can be prescribed only as part of a comprehensive treatment - their use improves the general condition and well-being of the patient.
Nodules prescribed for the treatment of radiculitis
- non-steroidal anti-inflammatory drugs can be prescribed for rapid relief of an exacerbation of sciatica in the form of injections;
- vitamin complexes, normalizing the metabolism in the inflamed nerve fiber;
- biologically active substances, restoring the processes of blood circulation and tissue metabolism in the inflammation zone;
- adhesion - the introduction of a complex solution, which includes corticosteroid hormones, preparations for local anesthesia, several B vitamins in the epidural space of the spine.
More similar about nyxes with radiculitis read in this article.
Non-pharmacological treatment of
To eliminate the symptoms of inflammation, the appointment of bed rest is indicated, and the patient's bed should be as tight as possible - in this case, optimal conditions are created for unloading the lumbar spine. At the same time, the use of physiotherapeutic treatment is shown:
- Khivamat( relieves pain in 2 sessions)
- Laser therapy MLS
- Ozokerite application
- Electrophoresis( but only by Ionoson device)
The prescribed procedures help to stop pain syndrome, eliminate muscle spasm, and reduce hernia size.
Often, patients ask a question - when exercises for lumbosacral radiculitis can be prescribed and whether the manifestations of the disease can be suppressed by additional physical activity. In the presence of signs of lumbar radiculitis, excessive physical stress can lead to deterioration of the patient's condition - the patient has a spasm of overstretched muscle fibers, and the intensity of pain and muscle spasm will only aggravate the symptoms of the disease.
Complexes LFK should be selected for each patient individually, and appointed only when the condition improves - this treatment helps restore the condition of the muscular skeleton of the spine and normalize muscle tone.
Symptoms and effective treatment with folk remedies for lumbar radiculitisMost people mistakenly believe that radiculitis is an independent disease. In fact, radiculitis is a radicular pain syndrome. Most often, the lumbar region suffers. Treatment of lumbar radiculitis is very similar to the scheme of standard treatment of diseases of the spine. It differs only in a few nuances. This is due to the peculiarities of the lumbar region.
As you know, the lumbar region accounts for the largest part of the load, which is due to the body located near the center of gravity. In this case, the waist should have sufficient mobility, since this depends on the freedom of movement of a person. The spine is capable of coping with a multitude of tasks assigned to it. Various diseases often lead to a very rapid disruption of the spine.
What is the cause of the emergence of lumbar radiculitis
The real cause that provoked lumbar radiculitis can not be recognized in all cases. The causes of sciatica in the lumbar region can be quite controversial. Many experts believe that the pain syndrome occurs in connection with the causelessly inflamed nerve root, others suggest that the fault is the disc herniation. There is an opinion that the occurrence of lumbar radiculitis is associated with spinal cord injury caused by some disease.
To date, among the most common causes that can cause radiculitis, there are the following diseases:
- intervertebral hernia;
- deforming spondylarthrosis;
- of various degenerative-dystrophic processes.
In some cases, radiculitis is the result of influenza, rheumatism, cerebrospinal meningitis, brucellosis, and tuberculosis. When choosing a method of treatment for radiculitis, the individual characteristics of the patient must be taken into account. Often, ailment is treated by applying folk methods.
The causes of radiculitis can be many. However, as practice shows, it is not always possible to determine them, which often affects the effective treatment of the disease and the removal of the pain symptom.
Symptoms of radiculitis
As a rule, the method of treatment of radiculitis is determined depending on the accompanying symptoms. The main sign of pathology is the presence of strong pain in the lower back. Severe pain often affects the mobility of the lumbar spine. In most cases, the signs of radiculitis depend on the degree of complication of the disease.
Symptoms of the disease can be divided into several main groups.
- Pain syndrome. The nature of the pain is pulling, aching, cutting, stitching. Duration can be different. Pain sensations are an indication of what the cause is in squeezing the nerve fibers.
Acute pain occurs due to compression of nerve endings.
Sensitivity disturbed. Various symptoms of a neurological nature become a consequence of compression of nerve endings. This is explained by the impaired passage of nerve impulses. In most cases, this leads to a feeling of slight tingling, crawling, burning, and perhaps numbness in the legs. The reason for the compression of the nerve channels: the nerve impulses are interrupted, affecting the performance of the muscles.
- Often sciatica is accompanied by lumbago. Characterized by this symptom as acute pain, which can provoke any physical activity. Sometimes the prostate in the lower back arises due to hypothermia of the body. Continue lumbago can as a few minutes, and the whole day. It can be caused by intervertebral hernia, displacement of vertebrae, normal muscle spasm.
- When sciatica is often observed sciatica. This pain syndrome differs in the localization in the lower lumbar region( for example, in the buttock).Painful sensations in this case have the property of shifting to the whole leg. The patient may complain of muscle weakness. The character of pain is shooting.
- The disease can be manifested by lumboschialgia. As a rule, it combines the two above described symptoms. Painful sensations can be localized in the lumbar region, giving way to the upper part of the leg. The pain is aching or burning.
- The disease can be cervico-brachial. It is characterized by such symptoms as pain in the occipital region of the head, in the neck, shoulder and shoulder blade.
To cope with radiculitis, applying folk methods of treatment, it is possible in the event that the symptoms are not too pronounced.
The use of folk remedies against radiculitisMethods of treating radiculitis are different. In addition to taking medications, folk remedies can be used at the initial stage of the disease. Treatment of radiculitis in the home can give quite good results. Some methods can not only eliminate pain, but also provide a therapeutic effect for a long time. If you decide to treat sciatica at home, do not forget about the therapeutic gymnastics, which can significantly speed up the healing process.
Before you can treat your radiculitis yourself at home, it's still worthwhile to visit a specialist. A qualified physician is able to determine the cause of the pain syndrome, which is very important for the effective treatment of radiculitis. The full treatment of radiculitis is not only to relieve the pain syndrome, but also to eliminate the cause that it provoked. Easy forms of the disease can be cured alone. But the treatment of radiculitis, which is in acute form, requires serious measures, which the specialist must determine.
Treatment of radiculitis with folk remedies is quite capable of coping even with severe pain.
Lumbar radiculitis: folk methods of treatment
Many ask the question, how to treat sciatica in the home. And this is the answer. In order to treat radiculitis with folk remedies, special conditions are not required.
- Very effective treatment of a disease with the use of black radish. This root is able to have an anti-inflammatory effect and improve blood supply. Grind the product, spread it on a gauze pad and attach it to the area that bothers you. Over the compress, tie a warm woolen shawl, but first cover it with a plastic wrap( you can use parchment paper).
- If you decide to cure sciatica with folk remedies, you can apply the method with the comfrey root. This method is very effective even in the case of fairly neglected causes that caused pain. Finely chopped comfrey is applied as a compress.
- Treatment with folk remedies can improve nutrition of nerve fibers. Remove inflammation and favorably affect nerve fibers rye cakes. In order to cook them, you will need a chopped horse chestnut( 3 pcs.), Rye flour( 1 tbsp.) And camphor oil( 0.5 tbsp.).A cake is applied to the inflamed patch on the back and left for 2 hours.
- If you are interested in how to treat sciatica with massage, you can apply the method with natural honey. It is very important to remember that this procedure does not work with a pronounced pain syndrome. Rub honey( 2 tsp) smoothly, without applying any special efforts.
- To achieve a great effect can help the bath with a fir decoction. Drink a glass jar of needles in 3 liters of water. The filtered broth is added to the pre-cooked bath. After the procedure, it is recommended to rub the fir oil into the loins and wrap in a warm blanket.
Before treating radiculitis with folk remedies, it is recommended to consult a doctor. Making sure that the cause of the disease is not serious( hypothermia, causeless inflammation of the nerve root, etc.), you can safely apply folk methods of treating radiculitis.
Lumbar sciatica - how to cure
Contrary to popular belief, radiculitis is not an independent disease. By and large, this is nothing more than a radicular pain syndrome. In this case, the most common sciatica is lumbar, its treatment differs little from the standard for all diseases of the spine, but there are a number of nuances associated with the specificity of the lumbar spine.
And the specificity is that - this particular section of the spine experiences maximum loads, because the center of gravity of the body is next to it. At the same time, this department should be sufficiently mobile to provide the person with the necessary degree of freedom of movement. It is worth noting that the human backbone perfectly copes with the tasks assigned to it, but the emergence of various diseases can quickly disrupt the "habitual way" of the work of the lumbar department.
Symptoms that help diagnose sciatica are:
A symptom of Lasega, when the patient, lying on her back, feels a sharp pain on the back of the thigh and in the buttocks and lower back if she lifts her straightened leg( from the affected side).
Bechterev's symptom, when the patient flexes his legs in a reflexive way from a recumbent to a sitting position.
A symptom of Neri, when the pain in the leg and lower back increases significantly if the patient sharply tilts his head forward.
Symptom of Dejerine, when the lumbar pain intensifies, if the patient strains, sneezes or coughs.
Bonnet symptom when the patient has a gluteal fold on the affected side.
Spondylosis treatment of the thoracic department http: //pozprof.ru/bn/spn/ spondilez-grudnogo-otdela.html # t2.
About 95% of all cases of radiculitis are caused by osteochondrosis, which is manifested in the formation of intervertebral hernias, and in the formation of osteophytes. The causes of the remaining 5% of cases of development of radiculitis are old spinal injuries, inflammatory diseases of the near-vertebral tissues, tumors.
One of the most common causes of radiculopathy or radiculitis is a herniated intervertebral disc. Such a hernia is formed between the vertebrae, due to degenerative - dystrophic processes in the intervertebral discs. As a result of such a change in the disc appears profusia, the so-called protrusion, which leads to the formation of intervertebral hernia. This hernia begins to squeeze and irritate the nerve roots that drain from the spinal cord.
Also, the spinal cord roots can be irritated by osteophytes, stenosis of the spine, which is a narrowing of the spinal canal or holes, which are called the foraminal canals, of which spinal nerves leave.
The cause of radiculitis can also be stressful conditions in which a person stays for a long time. Promotes development of radiculopathy and metabolic disorders, lifting of heavy objects, hypothermia and transferred infections.
Treatment provides for a combination of medication with physiotherapeutic treatment and treatment of traditional medicine.
All methods of treatment are aimed at relaxing the muscles of the lumbar spine, eliminating the pain syndrome, restoring the integrity and normalization of metabolism in the damaged spinal nerve, strengthening the body and preventing the subsequent occurrence of relapses of the disease. Conservative methods of treatment
The group of methods includes medication and physiotherapy treatment, as well as diet.
The treatment regimen that is most effective for lumbar sciatica:
Dicloberte or Dolobene intramuscularly 3.0 ml once a day for 5 to 7 days, then switch to the treatment with tableted forms: Dicloberl, Diclac 100 mg 1times a day. The course of treatment is 10 to 12 days.
Mydocalm or Tolperil intramuscularly 1.0 ml 2 times a day, the duration of injection 10 days, after which the drug is taken in the form of tablets of 100 mg 1 tablet 2 times a day. The course of treatment is 30 days.
Neurobion 2.0 intramuscularly once a day. The course of treatment is 10 days.
Neurorubin-fort-lactab orally 1 tablet once a day after injections of neurobion. The course of treatment is 30 days.
Mucosate 2.0ml intramuscularly every other day. The course of treatment - 20 injections. After injections, it is necessary to take chondroetin sulfate in tablets or powder 2 to 3 times a day for 3 to 6 months.
Plaster with diclofenac or gel with ketoprofen on the lumbar region, overnight. The course of treatment is 5 - 7 days.
Treatment is performed in physiotherapy units, the most suitable procedures for sciatica lumbar spine are:
Lumbar massage, 10 - 20 sessions. Acupuncture 15 - 20 sessions. Therapeutic gymnastics for the waist, duration of employment 2 - 3 months. Electrophoresis on the lumbar spine according to the scheme: the first five days cause hydrocortisone, the next five days cause lidocaine. Magnets on the lumbar region. The course of treatment 10 - 12 sessions.
Diet , facilitating the disease
Recommendations on nutrition during the disease:
taking into account the reception of many groups of medicines shows fractional meals, in small portions;
to exclude from the diet completely: smoked, salted, fried, spicy, fatty, alcohol, carbonated water, coffee, strong tea, a large amount of sweet.
In case of ineffectiveness of conservative treatment, decompression of the damaged spinal root is performed, this type of treatment is used only for nerve entrapment.
In the operating room, under general anesthesia, an incision is made of soft tissues in the lumbar region of the spine, find the cause of compression of the nerve and eliminate it mechanically.
Radish black. Peel and grate the black radish. Put a thin layer of radish on a cotton or linen cloth and cover it with another piece of cloth. Put the bandage on a sore spot, wrap it on top with a tracing paper or parchment and tie it with a warm kerchief. Keep the compress for as long as possible. You will feel how slowly the waist is warming up. Sometimes 2-3 procedures are enough to let the pain go.
Anchor( kidney).2 teaspoons of dry shredded buds of the sedge are filled with 1-1.5 cups of boiling water, aged for 15 minutes and filtered. Drink 1/3 cup 3 times a day. You can use this recipe: 1-2 teaspoons of kidneys pour 1/2 cup of 40% alcohol, insist 7 days and filter. Take 20 drops 3 times a day. Furacilin, honey, mustard. Pour 50 ml of water and dissolve in it 1/4 pills furatsilina, boil well, until the drug dissolves. Then add 1 tablespoon of honey to the resulting solution and mix thoroughly. Take ordinary mustard plasters, dip them into a honey solution of furacilin and apply on the lower back. After 5-6 minutes, remove the mustard plasters, and cover the remainder of the solution on the skin with a plastic wrap, secure and wrap with a woolen shawl. In this bandage, sleep all night and remove it in the morning.
Potatoes. A very effective way is to apply raw potatoes to a sore spot.
Aloe. Take 300 g of leaves of 3-5-year-old aloe, and do not water the plant for 5 days before cutting. Pass the leaves through the meat grinder, add to the resulting mass of 500 grams of natural May honey, 520 ml of any fortified red wine( preferably "Cahors"), mix everything thoroughly and put it on a dark cool place for 5 days to infuse. Dosage: the first 5 days - 1 teaspoonful 3 times a day for an hour before meals, and all the following days - 1 tablespoon 3 times a day for an hour before meals. Term of treatment: from 2-3 weeks to 1.5 months.
Burdock. Dampen the burdock leaf with cold water and place the underside on the sore spot. Tie it up. This is a wonderful anesthetic. In summer, you can grab the burdock leaves and dry it. Then in winter it will be enough to moisten the prepared dry leaves with warm water and use it for the compress in the same way as above.
The medicines for the treatment of lumbar radiculitis include injections of a steroid drug( cortisone) into the painful area surrounding the sciatic nerve. These injections speed up the treatment process.
The area where the pain is concentrated by tomography( computer or magnetic resonance) is first established. A fluoroscope, the doctor accurately determines the area of injection and injects a steroid connected to an anesthetic local remedy or saline solution.
Some experts consider such injections unsafe. Therefore, a method with point injections is more often used. Such injections include:
dextrose glycerin water
Injections are placed in the muscles and ligaments located next to the spine. According to the research, this form of drug therapy promotes the growth of connective tissue and activates the circulatory process. As a result, recovery is much faster.
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NSAIDs are often used in the form of ointments and gels in lumbar radiculitis. They are manufactured with indomethacin, orthophene, ibuprofen. Effective ointments such as Finalgon and Apizarthron. Absorbed, they provide a rush of blood to the focus of inflammation, which helps improve blood circulation. Ointments with radiculitis are applied with the addition of an extract of hot red pepper, snake and bee venom. Complex application of ointments, oral medications and nyxes will have the greatest effect and will help to overcome such an ailment as radiculitis. Among the ointments, the Finalgon, Capsicum, Viprosal, Nyz, Diclofenac, Indomethacin have proved themselves very well.
Exercises 1-3 are suitable for most people with chronic diseases of the lumbar and sacral spine. Purpose: training the muscles of the trunk, strengthening the spine and developing its functionality.
Exercise 1. Starting position: lying on the back, arms along the trunk, legs slightly bent.
Strain the abdominal muscles, without holding your breath and without straining, so that they become firm, to put your hand on your stomach for control. Repeat the exercise 10-15 times. When performing this exercise, the lumbar spine is bent slightly upward. In addition, the tension of the abdominal muscles allows you to "find" them, which is important for further studies.
A lightweight option. If there are painful sensations, the exercise can be modified: put your feet on the floor to the right or to the left. After.how this exercise is fully mastered, you can proceed to the next.
Exercise 2. Starting position: lying on the back, arms along the trunk, legs stretched.
Raise the upper part of the trunk, keeping the feet on the floor all the time. Keep this position 10s, then slowly return to the starting position. To have a rest 5-10 with. Repeat 10-15 times.
Exercise is easier to perform with arms outstretched forward, putting them on the back of the head, you can complicate it. Purpose: this exercise
well develops the abdominal muscles. The number of repetitions is determined by the state of the person: the performance should not cause painful sensations in the muscles of the abdomen or back.
Exercise 3. Starting position: lying on the back, legs slightly bent.
Right hand to pull forward, while putting the brush on the left knee. Bend the left leg, while leaning against the knee with his right hand and not letting it come close to his head. Do the exercise with effort for 10s. To have a rest 10-15 with. Repeat 5-10 times. Then change the position in the starting position so that the left hand rests on the right knee. Repeat 5-10 times. In pauses between exercises, you should lie on your back to relax the muscles of the arms, trunk and legs. This condition is easier to achieve if you first strain your muscles.
Purpose: trains the torso muscles of the trunk and back. The pain in the muscles, which appeared after the first training, passes in a few days.
Massage has many properties that help the patient cope with the pain syndrome and contribute to the early achievement of a positive effect of drug therapy.
When performing various massage techniques in the body, the following phenomena occur:
activation of the receptors of the zone of action of the segment of the spinal cord, which indirectly acts on the damaged spine, having a reflex effect;increased blood flow to the heart;
in the subcutaneous tissue contains a large number of mast cells that possess the properties of the endocrine glands, as their stimulation leads to the release of biologically active substances. They, in turn, affect the activation of neurohumoral processes;
single muscle contractions decrease;
improves the overall strength and time of muscle group contractions. As a result, a strong frame is formed for the vertebral column from its own muscles, which makes it possible to reduce pain and make the spine more mobile.
Lumbar radiculitis: treatment, symptoms, causes, prevention, diagnosis |spinomed.ru
Lumbar radiculitis is an inflammatory disease of the spinal roots emerging from the spinal cord in the lumbar region of the spine, characterized by intense pain in the corresponding area, which can spread to the buttocks, lower abdomen, lower extremities.
The lumbar spine consists of 5 vertebrae, between which the top and bottom of the intervertebral disc are separated by 2 spinal nerves - a total of 8 pairs. The nerve roots of the department innervate the muscles of the waist and the front surface of the abdomen, buttock muscles and muscles of the lower extremities. Also, part of the nerve fibers innervates the pelvic organs, in women - the uterus, ovaries, fallopian tubes, bladder, kidneys;in men it is the prostate gland, the bladder, the kidneys.
People living in developed countries( USA, European countries, Japan) are more likely to suffer from the disease, because mainly the disease is associated with a sedentary lifestyle.
Radiculitis of the lumbar spine is more likely to affect women. The age group of individuals characteristic of this disease is 50 years and older.
Lumbar sciatica occurs with inflammation or infringement of the spinal root.
Diseases leading to inflammation of the spinal roots in the lumbar spine:
- spondylitis( inflammation of the spine) in the lumbar spine. Most common syphilitic, tuberculosis and gonorrhea spondylitis;
- is a viral infection of the body that, with blood flow, can enter the lumbar spine and cause inflammation of the spinal nerve;
- myositis - inflammation of the muscles of the lumbar spine.
Diseases resulting in infringement of spinal roots in the lumbar spine:
- spinal cord injuries in the lumbar spine:
- vertebra dislocations in the lumbar spine;
- displacement and vertebral fractures in the lumbar spine.
- chronic diseases of the spinal column:
- lumbar lordosis.
Lumbar radiculitis may also occur in people with a perfectly healthy spine, but in the presence of risk factors, which include:
- female age after 50 years;
- endocrinological diseases: hypothyroidism, hyperthyroidism, diabetes mellitus;
- obesity or the presence of excess body weight;
- is engaged in sports, which is associated with lifting of gravity( bodybuilding, weightlifting);
- work associated with constant slopes, turns and lifting of gravity( for example: loader, cleaner, work in factory shops).
For reasons of lumbar radiculitis:
- Primary, the result of which is the inflammation of the spinal root.
- Secondary, which results in infringement of the spinal root.
Symptoms of lumbar sciatica
For lumbar radiculitis is characterized by:
- sharp, intense pain in the lumbar spine, increasing with little physical exertion;
- pain can decrease with a comfortable position of the body, where the waist muscles relax, it is achieved lying on the back or side, standing on "all fours" with a high pillow under the belly;
- cutting, stitching pains in the gluteal region;
- aching pain in lower limbs;
- violation of sensitivity and motor activity of the lower limbs;
- pain in the lower abdomen;
- pain during intercourse;
- urination disorder;
A preliminary diagnosis of lumbar radiculitis is established based on:
- patient complaints;
- duration of the disease( for lumbar radiculitis characteristically acute onset, with rapid development of all symptoms);
- external examination and feeling in the lumbar region, this allows to identify the exact place of the onset of pain, as well as to assume the segment of the lumbar spine where inflammation or infringement occurred;
- of a general blood test, in which there will be inflammatory changes( an increase in the number of leukocytes and lymphocytes, a shift of the leukocyte formula to the left, an increase in ESR( erythrocyte sedimentation rate));
- of a general urine test, to exclude kidney disease, in which such symptoms may also occur.
The final diagnosis is established based on:
- radiography, which will visualize the disease of the spinal column, which leads to infringement of the spinal root;
- CT( computed tomography), this method can reveal the nature of the disease, i.e. see inflammation or impaction;
- MRI( magnetic resonance imaging), with which you can identify the exact location of the lesion and the degree of compression of the rootlet;
- EMG( electromyography), with the help of this method it is possible to trace which spinal nerve suffered.
Treatment of lumbar radiculitis
Treatment provides for a combination of taking medicines with physiotherapy and treating traditional medicine.
All the methods of treatment are aimed at relaxing the muscles of the lumbar spine, eliminating the pain syndrome, restoring the integrity and normalization of metabolism in the damaged spinal nerve, strengthening the body and preventing subsequent relapse of the disease.
Conservative methods of treatment
The group of methods includes medicamentous and physiotherapeutic treatment, as well as diet.
The treatment regimen that is most effective for lumbar sciatica:
- Dicloberte or Dolobene intramuscularly 3.0 ml once a day for 5 to 7 days, then switch to the treatment with tableted forms: Dicloberl, Diclac 100 mg 1times a day. The course of treatment is 10 to 12 days.
- Mydocalm or Tollyl intramuscularly 1.0 ml 2 times a day, the duration of injections 10 days, after which the drug is taken in the form of tablets of 100 mg 1 tablet 2 times a day. The course of treatment is 30 days.
- Neurobion 2.0 intramuscularly once a day. The course of treatment is 10 days.
- Neurorubin-fort-lactab orally 1 tablet once a day after injections of neurobion. The course of treatment is 30 days.
- Mucosate 2.0ml intramuscularly every other day. The course of treatment - 20 injections. After injections, it is necessary to take chondroetin sulfate in tablets or powder 2 to 3 times a day for 3 to 6 months.
- Plaster with diclofenac or gel with ketoprofen on the lumbar region, at night. The course of treatment is 5 - 7 days.
Treatment is performed in physiotherapy units, the most suitable procedures for sciatica lumbar spine are:
- Lumbar massage, 10 - 20 sessions.
- Acupuncture 15 - 20 sessions.
- Therapeutic gymnastics for the waist, duration of employment 2 - 3 months.
- Electrophoresis on the lumbar spine according to the scheme: the first five days cause hydrocortisone, the next five days cause lidocaine.
- Magnets on the lumbar region. The course of treatment 10 - 12 sessions.
Diet that facilitates the disease
Recommendations on nutrition during the disease:
- taking into account the reception of many groups of medicines shows fractional meals, in small portions;
- be excluded from the diet completely: smoked, salted, fried, spicy, fatty, alcoholic, carbonated water, coffee, strong tea, plenty of sweet.
In case of ineffectiveness of conservative treatment, decompression of the damaged spinal root is performed, this type of treatment is used only in case of nerve entrapment.
In the operating room, under general anesthesia, an incision is made of soft tissues in the lumbar region of the spine, find the cause of compression of the nerve and eliminate it mechanically.
Here are 2 examples of folk recipes for the treatment of lumbar radiculitis:
- Treatment with black radish .Radish clean, grind in a blender. Apply in the form of applications on the lumbar spine for 2 to 3 hours. The course of treatment is 10 days.
- Treatment using potatoes .Cook 4 - 5 large potatoes until ready, crush. Apply to the lumbar region in the form of an applique overnight. The course of treatment is 10 days.
Lumbar sciatica can lead to the following complications:
- atrophy( lowering of muscle mass) of the lower limbs;
- partial or complete immobilization of the lower limbs.
For the prevention of lumbar radiculitis, several rules must be observed:
- active lifestyle;
- wearing corsets in the presence of chronic diseases of the spinal column;
- timely treatment of all viral diseases;
- hardening of the body;
- compliance with work and rest;
- sleep on hard mattresses.
Lumbar sciatica: symptoms
Lumbar radiculitis is a combination of symptoms indicative of lesions of the roots of the spinal nerves. By itself, radiculitis is not a disease, its appearance is always associated with any pathology of the spine. Most often, the cause of the disease is osteochondrosis, manifested by dystrophic disorders of the intervertebral discs.
The main symptoms of lumbar sciatica
All manifestations of lumbar radiculitis can be divided into three groups:
- Pain in the lumbar region. Feelings can be very different, both in intensity and duration( strep, sharp pain during movement, dull aching pain, etc.).Pain syndrome suggests that the nerve fibers are affected and it is necessary to take measures to eliminate them.
- Sensitivity disorder. Because the nerve fibers are squeezed when nerve impulses are broken, symptoms such as cold feet, burning, numbness, tingling, a feeling of "running goosebumps" may appear.
- Dysfunction of the muscles. Here, the cause is the same compression of nerve fibers, which causes a feeling of muscle weakness.
The structure of the spine as the basis of radiculitis
The human spine is a kind of skeleton for the body. Its main structural unit is the vertebra. Their number varies from 29 to 31. All vertebrae are combined into several departments:
- The cervical segment consists of 7 vertebrae. They are strong enough to withstand the weight of the skull.
- The thoracic department includes 12 vertebrae. Their bodies are more durable and have processes for fastening the ribs.
- The lumbar region consists of 5 most massive vertebrae. They are designed to withstand the load of the entire upper half of the body.
- The sacrum consists of five vertebrae, fused into a single bone mass. But unlike the lumbar region, the sacrum is less stressed. Sacrum. The only department with a different number of vertebrae is from 2 to 4.
Due to the fact that the lumbar spine has the greatest load, it is here that the most frequent disturbances that cause radiculitis occur.
Mechanism of origin of radiculitis and its causes
All the symptoms of radiculitis are associated with the compression of the nerve processes of the spinal cord. In Latin they are called "radix".Hence the name of this pathology.
This squeezing is possible for three reasons:
- Pressing the roots with intervertebral discs - plates consisting of connective tissue and performing the role of peculiar shock absorbers.
- Compression of roots by various growths of connective tissue. It occurs with certain inflammatory and non-inflammatory diseases. For example, osteochondrosis or spondylarthrosis.
- Compression of the roots by a part of the vertebrae, as occurs with Bechterew's disease and osteoporosis of the spine.
Clinical manifestations of lumbar sciatica
This pathology can be manifested by three groups of symptoms or a combination of them.
The first place among all the signs takes pain. Its origin is due to two mechanisms.
- The mechanical effect on the nerve root irritates the neurons of pain sensitivity in it. As a result, a nerve impulse is formed, which enters the brain via the nervous pathways of the spinal cord. The cerebral cortex receives the information of this impulse, as a result of which the person feels pain.
- Compression of the roots leads to a disruption of the blood supply in the nerve tissue. This condition is called ischemia. It is a signal for all neurons to generate momentum. Further everything happens with accuracy, as in the first case.
Compression of roots leads not only to the formation of a pain pulse. It disrupts the normal activity of neurons in the spinal cord. Due to the fact that there are three types of neurons, there are three groups of symptoms.
- Afferent or sensory neurons are represented by two species. These are neurons of pain sensitivity( they were told about the manifestations of their compression) and neurons from muscles, tendons, skin and internal organs. The last neurons( that is, the nerve cells from the muscles, tendons, skin, internal organs) provide a link between these organs and the brain, which makes it possible to "follow" their condition. Violation of the work of these neurons leads to a poor "knowledge" of the brain on the condition of internal organs.
- Motor or motor neurons provide the impulse to the muscles, controlling their work. Therefore, the disruption of the work of these neurons can manifest as a mismatch in the work of the muscles.
- Vegetative neurons. They are part of the autonomic or autonomic nervous system. This system is named so because of its ability to perform "work", almost completely freed from brain control. It ensures the maintenance of the tone of blood vessels, glands( including glands of the skin) and the work of those internal organs that are not controlled by the brain, namely consciousness. Violation of the work of neurons of this system is accompanied by various disorders from the glands, blood vessels and internal organs.
From all that said it is clear that radiculitis is manifested by pain in the spine of , a violation of all kinds of sensitivity and the work of internal organs. Moreover, the more pronounced the pathological process in the spine, the more pronounced the symptoms.
The first pain appears, which can have a different character, but most patients describe it as aching. The pain can be constant or arise when moving in the spine.
Another important sign of pain in lumbar radiculitis is its ability to irradiate. That is, pain is given to one or both legs of the .This condition is called lumboschialgia.
Vegetative disorders in lumbar radiculitis are observed less frequently. They manifest themselves in the form of a sensation of coldness in the limbs, the patient feels that his feet are always freezing .
The motor neurons lie deeper in all the roots. Therefore, violations of their functions are extremely rare. These include disorders of the pelvic organs. Man ceases to control the processes of urination and defecation.