Lumbar puncture

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 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, bone ridges, 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);

  • Autoimmune pathologies;

  • Regular increased strain on the spine;

  • Hypodynamics;

  • Hereditary predisposition.

Another attack of radiculitis can be caused by:

  • Physical overexertion;

  • Subcooling;

  • Colds, flu;

  • General intoxication;

  • 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

Symptoms of lumbar radiculitis

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 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

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, 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.

Surgical intervention

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;

  • Movement disorders;

  • Dysfunction of the pelvic organs.

Exercises with radiculitis

Physiotherapy is an important part 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 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:

  • On stretching;

  • On relaxation;

  • Respiratory;

  • 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 the pain has completely ceased.

A small training complex can be viewed on the following video:

Author of the article: Andrei Sokov, neurologist, especially for the site ayzdorov.ru

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Lumbar radiculitis and methods of its treatment

Radiculitis - inflammation of the roots of the spinal nerves( lat.radix - root, it - inflammation).Theoretically, radiculitis can develop in any of the departments of the spine - in the cervical, thoracic or lumbar. In practice, lumbar radiculitis is most common. This frequency is due to the peculiarities of the anatomical structure of the spine and the functions performed by it. These features are that the lumbar region is under maximum load, and therefore more susceptible to various pathological changes.

Causes of

The leading cause of lumbar sciatica is osteochondrosis. As a result of this degenerative process, the height of the intervertebral discs, and, respectively, of the spaces between the vertebrae, decreases. This leads to the fact that the roots of the spinal nerves are impaired in the holes between the adjacent vertebrae. In later stages, osteochondrosis is complicated by disc hernias, spondylolisthesis( displacement of vertebrae) or spondylosis( the appearance of pathological bone growths - osteophytes).All these negative processes aggravate the course of lumbar radiculitis.

In addition to osteochondrosis, sciatica can develop due to scoliosis( lateral curvature of the spine), which is congenital or acquired. Another reason for sciatica is injuries of the spine( bruises, fractures of the spine).Injuries of the lower extremities, flat feet, increase the burden on the spine, and therefore can also lead to radiculitis. The risk of lumbar radiculitis increases in people with various metabolic disorders, including obesity, diabetes, osteoporosis( pathological dilution of the bone tissue of the vertebrae).

Symptoms of

As is known, nerve roots are represented by the front( motor) and back( sensitive) nerve fibers. Accordingly, the main signs of radiculitis are sensory and motor disorders. The combination and severity of these disorders can vary in each clinical case.

back pain

The leading symptom of radiculitis is back pain - lumbulgia. In most cases, the pain appears abruptly, even suddenly, like a chamber( lumbago).The provoking factors of lumbago are physical stress, nervous stress, hypothermia, alcohol abuse. Sometimes, in order for radiculitis to manifest itself, one sharp or awkward movement is enough. And in some cases, the aggravation of this disease occurs for no apparent reason.

Pain from the waist gives to the buttocks and lower extremities. This is especially evident in sciatica( sciatica nerve root inflammation), which is one of the manifestations of lumbar radiculitis. In addition to pain, patients often notice other symptoms - a burning sensation, tingling sensations, crawling crawling.

Radiculitis in the lower back is necessarily accompanied by motor impairment. These disorders are caused by pain syndrome, as well as inflammation of the motor fibers of the roots of the spinal nerves. The degree of their different - ranging from light lameness, and up to the total inability to move. In this case, the restriction of movement is noted not only in the lower limbs, but also in the lumbar spine. The slightest attempt of flexion-extension of the back causes a sharp pain.

In some cases, even the inclination of the head leads to an increase in pain.symptoms of tension. In addition to motor limitations and pain, sciatica is accompanied by a tension in the muscles of the back. This tension at first has a reflex character. In the future, because of a constant spasm in the muscle, lactic acid accumulates. This leads to a disruption in metabolic processes in the muscles and to a further increase in muscle spasm.

Types of treatment

We advise you to read:
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Treatment of radiculitis at home

Treatment of lumbar radiculitis is carried out in 3 main directions:

  • Effect on the cause( on osteochondrosis) by improving metabolic processes in the cartilaginous tissue of intervertebral discs;
  • Elimination of inflammation in nerve fibers;
  • Elimination of negative manifestations - sensory and motor disorders.

To this end, they apply:

  • Medication;
  • Physiotherapy;
  • Massage and physiotherapy procedures;
  • Special orthopedic appliances.

Medications

What should I do first with exacerbation of sciatica? Of course, relieve the pain. Although the elimination of the pain syndrome does not affect the course of the radiculitis itself, it will relieve the patient of suffering and return it to the habitual life course. One of the most effective ways to eliminate pain are injections of local anesthetics( Novocain, Lidocaine, Trimekain) into the paravertebral( near-vertebral) region. The effect is good, but short-term - after a while the pain reasserts itself. In addition, during the introduction of these drugs should be monitored so that they do not enter the vascular bed, otherwise collapse is possible - a sharp drop in blood pressure.

Apizarthron The most popular drugs for the treatment of radiculitis are non-steroidal anti-inflammatory drugs( NSAIDs).These drugs have a direct analgesic effect, and also eliminate inflammation and swelling of the outer myelin sheath of the nerve roots. This eliminates the infringement of these roots in the intervertebral foramen. NSAIDs with radiculitis are mainly used externally in the form of gels and ointments with Indomethacin, Ibuprofen, Voltaren, Orthophene. Also locally-irritating ointments are effective - Apizarthron, Finalgon. When applied to the skin, they cause a rush of blood to the pathological focus. This promotes local improvement of blood circulation and resorption of the inflammatory focus.

Another group of drugs with radiculitis are muscle relaxants, which relax the spasmodic muscles, and thus reduce pain and increase the amount of movement. The muscle relaxants include tablets Midokalm, Baklosan, Sirdalud. Chondroprotectors( agents that enhance cartilage tissue regeneration) do not directly affect radiculitis. But they to some extent eliminate its cause - osteochondrosis. Although it is impossible to completely get rid of osteochondrosis, but improvement of metabolic processes in intervertebral discs will prevent further development of radiculitis. But in order to come to this, all these drugs( chondroxide, chondroitin complex) should be used constantly for a long time.

Therapeutic physical training

Healthy gymnastics with radiculitis is shown only at the stage of recovery, when the aggravation has already passed. The purpose of the exercises is to restore the initial volume of movements and finally eliminate muscle spasm. All exercises are performed at a slow pace, without jerks, jumps and other sudden movements. If in the course of training there is pain in the lower back, they are immediately stopped.

Exercises begin with a minimum of force loads, complicating them over time. In the beginning, it is recommended to practice lying down with lifting, retraction and rotation of legs bent at the knee and hip joints. Then you can turn over on your side, and in this position to do the maximum retreat of the legs back and bringing them to the front.

In the sitting position on the chair, it is necessary to extend the legs forward, and in this position to swing the trunk back and forth. After that, you can lower your legs and try to reach out with your hands to the feet. And in the standing position, leaning on some kind of vertical surface, for example, on the wall, alternately raise and for a few seconds fix the legs bent in the knee and hip joint. It is also recommended walking on all fours with a curved back. In this position, the load on the spine decreases, and the gaps between the discs increase. All exercise complexes of exercise therapy are developed by the appropriate specialist individually for each patient.

Other

methods

The action of medications and exercise therapy is supported by massage and physiotherapy procedures, including electrophoresis, phonophoresis, amplipulse. Thanks to the new devices, some physiotherapy can be done at home. One such device is the medical belt. On the one hand - this is an orthopedic device, a corset, which immobilizes the lower back. And on the other hand - it's a thermal massager. Warming and various modes of massage effects in it are provided by means of small batteries.

And still popular are the belts of dog hair, recently widely advertised. Although for the warming of the waist with radiculitis, any natural wool - sheep, goat, camel will do. You can warm your back with dry, heated sand, or simply lying in the sun. It does not recommend hot baths, saunas. The sick back does not like not only the damp cold, but also the damp heat. And only after there has come a persistent improvement, on the recommendation of a doctor, you can improve your spine on mud or climatic health resorts.

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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 that 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, since 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.

Causes of

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 spinal column) 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 that lead to the infringement of the spinal roots in the lumbar spine:

  • spine injury in the lumbar spine:
  • sprains of the vertebrae in the lumbar spine;
  • displacement and vertebral fractures in the lumbar spine.
  • chronic diseases of the spinal column:
  • scoliosis;
  • lumbar lordosis.

Lumbar radiculitis may also occur in people with a perfectly healthy spine, but if there are risk factors to 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).

Classification

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, this is achieved by lying on the back or on the side, standing on "all fours" with a high pillow under the belly;
  • cutting, stitching pains in the gluteal region;
  • aching pain in the 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, and also to suggest a segment of the lumbar spine where inflammation or infringement occurred;
  • 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));
  • a general urine test, to exclude kidney disease, in which such symptoms can 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), with the help of this method it is possible to 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 sciatica

Treatment provides for a combination of taking medicines with physiotherapy and treatment with 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 subsequent relapse of the disease.

Conservative methods of treatment

The group of methods includes medicamentous and physiotherapeutic treatment, as well as diet.

Medical treatment

The treatment regimen that is most effective in the development of lumbar sciatica:

  • Diclobert or Dolobene intramuscularly 3.0 ml once a day for 5-7 days, then transition to 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 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-forte-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.

Physiotherapeutic treatment

Treatment is performed in physiotherapy units, the most suitable procedures for sciatica of the 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 alleviates the disease

Recommendations on nutrition during the disease:

  • considering the intake 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, a large amount of sweet.

Surgical treatment

In case of ineffectiveness of conservative treatment, decompression of the damaged spinal root is performed, this type of treatment is used only when the nerve is contracted.

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.

Folk treatment

Here are 2 examples of folk recipes for the treatment of lumbar radiculitis:

  • Treatment using 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.

Complications of

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.

Prevention

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.
loading. ..

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Lumbar pelvic pain: symptoms and treatment

If the sciatica affects the lumbosacral spine, then it is considered a polyethological disease. Any sudden movements, physical overstrain in the lumbar region, hypothermia, intoxication or colds can trigger an aggravation of radiculitis.

Symptoms of

The main symptom that indicates that the lumbosacral region is affected by sciatica is severe back pain, which radiates to the thigh, or rather to its posterior part. In 80% of the pain occurs initially in the back of the , only then it gives back to the foot.

Simultaneous pain, both in the leg and lower back, occurs rarely at the initial stage, as well as only pain in the leg. Depending on the degree of damage depends on the nature of pain.

In case of inflammation or infringement of the fifth root of the lumbar region, the patient may complain of acute shooting pain in the buttock area, the front surface of the shin, the outer-lateral surface of the thigh, the inner side of the foot sometimes up to the thumb. Often the manifestation of paresthesia occurs - a violation of the sensitivity of the skin.

If the first sacral spine is affected, then the pain passes along the buttock, the outer and the back of the thigh, then along the shin and the foot from the external and plantar side to the little finger. It is possible to observe the disappearance or simply lowering of the Achilles tendon reflex.

When diagnosing a disease, it can be seen that the muscles are tense - this is their protective state. Also, when examined, it is possible to identify a number of other symptoms - vegetative-trophic disorders: increased sweating, pallor and coldness of the skin, weakening of pulsation in the arterial foot and others.

When examining a patient with suspected lumbosacral sciatica, the symptoms have the following expression:

  • Bechterew's symptom: the patient should sit down from a supine position on the back, with the patient's leg bending at the reflex level;
  • symptom of Lasega: the patient lies on his back, and his leg on the side of the lesion is raised in a straightened position.with the pain syndrome sharply increased in the lumbar region, back of the thigh and gluteal region;
  • Dejerine symptom: when sneezing, coughing, or straining, the patient feels an increase in pain in the lower back;
  • Neri symptom: if the patient sharply tilts his head forward, then it occurs in the lower back, and also in the leg pain intensification;
  • Bonnet symptom: the gluteal fold on the side of the disease is flattened.

Diagnosis of the disease

To ensure that the diagnosis and, as a result, the treatment of sciatica is successful, you should consult a qualified, competent doctor who will perform a differential analysis of with similar diseases in its symptoms.

In addition, an experienced specialist will take into account all diseases that a patient may have. Anamnesis is the first stage in the diagnosis of lumbosacral radiculitis. Even at the very beginning of the survey, one can already assume that it led to the development of sciatica in the lumbosacral spine. Only after a thorough examination, the doctor prescribes additional methods of diagnosing the disease. Among them may be:

  • laboratory( urinalysis and general blood test);
  • methods with which you can visualize the disease( X-ray pictures, CT, MRI);
  • tools.
With the help of all the above survey methods, you can easily put an accurate diagnosis, through which an effective treatment is assigned.

Treatment of

Treatment should take place in such conditions that the patient has been maximally protected. First of all, the patient should be given rest.

It is also necessary to pay attention to the bed of the patient with radiculitis - it should be rigid, it is best to sleep on a special orthopedic mattress. It is desirable not only to limit the load on the lumbar spine, but also to minimize the movement of the damaged part of the .

It is possible to wear corsets, but not more than 3 hours a day. In addition, the treatment of radiculitis is almost always medically necessary.

Medication

The amount and timing of drug use is determined by the stage of the disease. Medication is used for local and systemic therapy.

The local treatment of is the use of ointments on the affected area, and systemic therapy means taking medications inside or injections. The primary goal of taking medicines is to remove the pain syndrome.

Systemic treatment of includes the following remedies for radiculitis:

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Lumbar sciatica - treatment, symptoms and folk remedies

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness orweakness that arise in the lower back and pass through the buttock and down the large sciatic nerve along the back surface of the leg.

Radiculitis is one of the symptoms of the underlying disease - this is not a medical diagnosis in itself.

Treatment of radiculitis

In severe or recurrent radiculitis, treatment of this condition should be carried out, possibly in such a way that it does not deteriorate over time.

  • For the most part, easily accessible non-surgical products and regular exercise for a long time can relieve pain.
  • For others, when pain is expressed or not, a more structured approach to treatment and possibly surgical treatment can offer a better approach to finding relief of pain and preventing or minimizing future recurrence of lumbosacral radiculitis.

Nonsurgical treatment of radiculitis

Types of non-surgical treatment of lumbosacral radiculitis cover a wide range of possible options, with the aim of alleviating the pain caused by the jamming of the nerve roots. One or some combination of the treatments listed below is generally recommended in conjunction with a special exercise program.

Heat / ice

With acute radiculitis, ice packs or warmers are readily available and can help alleviate leg pain, especially in the initial phase. Usually, ice or heat is held for about 20 minutes, and repeated every two hours. Most people use ice at first, but some people get more relief from the warmer. They can be alternated.

Medications for radiculitis

Drugs prescribed without a prescription or prescription can also be helpful in relieving pain with radiculitis. Non-steroidal anti-inflammatory drugs( eg, ibuprofen, naproxen, or COX-2 inhibitors), or oral steroids may be useful in reducing inflammation, which is usually a factor that causes radiculitis.

What is important to know in the treatment of radiculitis

For the treatment of joint pain, many are self-prescribed such drugs and ointments based on diclofenac, without first consulting a doctor. These drugs are really powerful and effective, but cause a large number of side effects up to the stomach ulcer. It is because of side effects that NSAIDs can not be used for a long time, and ideally they should be alternated with warming ointments-harmless, but not less effective. For example, it perfectly warms and relieves pain Capsicum ointment, which is suitable for long-term use, and as a means of alternating with NSAID preparations.

Treatment plasters for radiculitis

It is important to remember that tingling, itching, burning, numbness, slight or severe pain are signs that may indicate localized neuropathic pain with radiculitis. In certain cases, it is characterized by persistent and persistent painful sensations, which are not removed by usual analgesics. In the treatment of localized neuropathic pain, local action is considered preferable for pain relief, for which drugs are developed that can cope with it by direct contact with the skin. Doctors often prescribe a modern drug Versasitis - an anesthetic plaster with lidocaine, which when applied to the painful area of ​​the skin, protects and nicely cools it, relieving painful sensations of any intensity.

Epidural injections of steroids

If pain in the lumbosacral radiculitis is intense, an epidural injection can be made to reduce inflammation. Epidural injection is different from oral medications, since steroids are injected directly into the painful area around the sciatic nerve to help reduce inflammation, which can be the cause of the pain. While the effect is usually temporary( pain relief can persist for from one week to one year), and it does not work for everyone, epidural steroids injection can be effective in assisting against an acute attack of radiculitis. It is important that it can provide sufficient relief to allow the patient to improve their health through a special exercise program and physical exertion.

Alternative treatment for radiculitis

In addition to standard treatment, several alternative treatment procedures have also been shown to provide effective pain relief in radiculitis for many patients. Three of the most common forms of alternative treatment for lumbosacral radiculitis include manipulative chiropractic, acupuncture and massage therapy.

Chiropractic / Manual Therapy

Spine correction and manual therapy performed by specially trained medical personnel( for example, chiropractors, osteopathic physicians, physiotherapists) are aimed at providing a better alignment of the spine, which in turn should help resolve a number of underlying conditions that can cause radiculitis. Manual manipulations performed in order to address the correct indications of health care workers who have received appropriate training can create an environment for better healing and should not be painful.

Acupuncture

Practice focuses on the philosophy of achieving or maintaining well-being through an open flow of energy through specific ways in the body. Needles, thin as hair( which, as a rule, is not felt) are introduced into the skin, near the area of ​​pain. Acupuncture was approved in the US by the FDA for the treatment of back pain, and the National Institute of Health recognized acupuncture effective in alleviating back pain, including lumbosacral radiculitis.

Treatment of radiculitis with massage

Certain forms of massage have been shown to have a number of advantages for back pain, including improved circulation, muscle relaxation and release of endorphins( natural pain relievers in the body).

For most people, the good news is that lumbosacral sciatica usually heals itself, and the recovery process for most will only take a few days or weeks. In general, the vast majority of seizures of lumbosacral radiculitis occur within a period of six to twelve weeks. After the primary relief of pain, you should start a program of physiotherapy and exercises, shown with radiculitis, in order to alleviate the pain and prevent or minimize any current radiculitis.

There are several types of non-surgical professionals who specialize in treating symptoms of lumbosacral sciatica, including chiropractors, physiotherapy and rehabilitation specialists, pain specialists, physiotherapists, all of whom have been trained to provide relief of pain and help preventfuture relapses of radiculitis. It is always advisable to be under the supervision of a qualified medical professional when passing any method of treating lumbosacral radiculitis.

Physiotherapy and Exercise

Exercises of physiotherapy, including strengthening, stretching and the program of aerobic physical activities - are the main component of almost any plan for the treatment of lumbosacral radiculitis.

When patients are involved in a regular program of gentle strengthening, stretching and aerobic exercise, they can recover faster from sciatica and are less likely to have recurrence of lumbosacral radiculitis in the future.

Exercises for radiculitis usually focus on three key areas:

Strengthening exercises from radiculitis

Many exercises can help strengthen the spine and supporting muscles, ligaments and tendons. Most of these exercises for the back are oriented not only on the lower back, but also the ventral, buttock( buttocks) and thigh muscles. Together, these strong "basic" muscles can provide relief of pain, since they support the spine, keeping it in a natural physiological position, and promote movements that expand or twist the spine with less likelihood of injury or damage.

Stretching exercises

Stretching is usually recommended to relieve sciatic pain. Stretching for the sciatic nerve with radiculitis, is designed for muscles that cause pain when they are stiff and inflexible. Stretching the muscles of the back of the thigh is almost always an important part of the exercise program for radiculitis.

A small influence of aerobic exercises

Some forms of small cardiovascular exercises, such as walking, swimming or swimming-therapy, are usually components of recovery, as aerobic activity encourages the exchange of fluids and nutrients to help in creating an environment of better healing. Aerobic exercise has the unique advantage of releasing endorphins, natural body analgesics, which help reduce pain with radiculitis.

The special exercises shown in lumbosacral radiculitis will depend on the underlying medical condition that causes radiculitis, as well as a number of other factors such as the patient's pain threshold and the ability to generally withstand physical exertion.

In severe radiculitis, patients may find the pain unbearable, and they may need rest for a day or two. However, rest more than one or two days is usually not recommended, as long rest or inaction can aggravate the pain and lead to a deterioration in physical condition. Regular movements are also important for delivering healing nutrients to affected structures that cause pain.

There are several types of health professionals who specialize in providing appropriate physical therapy services, exercise programs and instructions, including physical therapists, chiropractors, physiotherapy and rehabilitation specialists, and qualified certified sports trainers.

Surgical treatment of radiculitis

If pain in lumbosacral radiculitis is severe and there is no improvement for six to twelve weeks, it is usually advisable to consider the option of a lower back surgery. Depending on the cause and duration of pain of radiculitis, one of two surgical procedures is usually considered:

  • Microdiscectomy( open small surgery);
  • Open decompression( lumbar laminectomy).

Microdiscectomy( microdecompression)

In cases where pain associated with radiculitis is associated with disc herniation, one can consider a microdiscectomy option or an open small surgery with an increase. This operation removes part of the protruding intervertebral disc, which pinches the nerve.

This operation is usually considered in a period of 4 to 6 weeks if there is no relief of severe pain from conservative agents. If the patient's pain and disability are severe, the operation can be considered even earlier than 4 to 6 weeks.

Typically, about 90% to 95% of patients experience relief from radiculitis after this type of surgery.

Lumbar laminectomy with radiculitis

In cases where pain in lumbosacral radiculitis is associated with lumbar spinal stenosis, lumbar laminectomy may be recommended. In this operation, a small part of the bone and / or disc material is removed, which infringes the nerve root.

Laminectomy may be suggested as an option if spinal stenosis reduces a patient's ability to transfer physical activity to an unacceptable level. The general health condition of the patient can also be the cause of doubt, whether to perform surgery or continue to conduct conservative treatment.

After lumbar laminectomy( also called open decompression), approximately 70% to 80% of patients usually experience relief from sciatica.

This is the decision of the patient

In most cases, the operation for the treatment of lumbosacral radiculitis is elective, which means that it is the patient's decision to do or not to perform the operation. This applies to both operations of microdiscectomy and laminectomy.

The decision of a patient to perform an operation is based primarily on the severity of the pain and dysfunction that he is experiencing, and the length of time during which the pain persists. The general health of the patient is also taken into account.

As a rule, operations with lumbosacral radiculitis can be considered in the following situations:

  • Severe pain in the leg, which lasts 4 to 6 weeks or more.
  • Relief of pain that is not achieved after concerted attempts to treat with conservative methods, such as alone or a combination of oral steroids, non-steroidal anti-inflammatory drugs, manual therapy, injections, and / or physiotherapy.
  • The condition limits the patient's ability to participate in daily activities.

An urgent surgery is usually necessary only if the patient experiences progressive weakness in the legs, or a sudden loss of control of the intestine or bladder.

Additional considerations for operation with radiculitis

There are many personal considerations for the patient to consider when deciding whether to perform an operation.

  • Some patients may prefer to try as many different non-surgical treatments as possible and remain without surgery for as long as possible, and often they will figure out how to successfully cope with their condition and control the painful symptoms. For example, a patient who periodically experiences relapses of acute pain of sciatica can find that a combination of initial rest and epidural steroids, followed by a program of sparing stretches and exercises, is effective in relieving pain as needed.
  • Some patients may have personal preferences or life situations that benefit more from the immediate relief of pain that is usually achieved surgically. For example, a parent with young children may not have time to undergo conservative treatment, and he may need immediate relief of pain in order to be able to take care of children and perform household duties.

The important point is that it is almost always the patient's decision to do or not to have surgery, and the role of the surgeon is to help inform the patient about options that will help the patient make better choices.

Symptoms of

For some people, lumbosacral radiculitis can be severe and disabling. For others, the symptoms of lumbosacral radiculitis may be rare and irritating, but there is a potential for deterioration.

As a rule, lumbosacral radiculitis affects only one side of the lower body, and pain often radiates from the waist along the back of the thigh and down the leg.

Back pain may be present along with pain in the leg, but usually pain in the leg is more pronounced than back pain.

Common Symptoms

  • Back pain, if any, does not appear as pronounced as leg pain;
  • Persistent pain only on one side of the buttocks or legs, but rarely on the right and left sides;
  • Pain that occurs in the lower back or buttock and continues along the path of the sciatic nerve - along the posterior surface of the thigh in the shin and foot;
  • Pain that is relieved when patients go to bed or walk, but are aggravated in a standing or sitting position;
  • Neuralgia of the sciatic nerve, which is usually described as acute or stinging, but not blunt;
  • Some experience pain in the form of a sensation of "pricking with pins and needles," numbness or weakness or tingling down the leg;
  • Weakness or numbness when moving a leg or foot;
  • Strong or shooting pain in the leg, which can make it difficult to stand or walk;
  • Depending on where the sciatic nerve is affected, pain and other symptoms of lumbosacral radiculitis may also include pain in the foot or pain in the toes.

Symptoms of sciatica for an individual sciatic nerve root

There are two roots of the sciatic nerve that come out of the lumbar spine( L4 and L5) and three that come out of the sacrum( S1, S2 and S3).All five nerves join together and form a sciatic nerve, and then branch out again in the leg to deliver motor and sensory functions to specific places in the leg and foot.

Symptoms of radiculitis vary depending on where the pinch of the nerve root is located. For example:

  • Symptoms of radiculitis of the nerve root L4 usually affect the thigh. Patients may feel weakness in straightening their legs, and they may experience a weakened knee reflex.
  • Symptoms of radiculitis of the nerve root L5 can extend to the big toe and ankle( the so-called sagging of the foot).Patients may feel pain or numbness in the upper part of the foot, especially on the skin between the thumb and the second toe.
  • Symptoms of radiculitis of the S1 nerve root affect the outer part of the foot, can radiate into the little finger or toes of the foot. Patients may experience weakness when trying to tear the heel off the ground or stand on tiptoe. The reflex "ankle-knee" can also be weakened.

Since more nerve roots can be jammed than one, patients may experience combinations of the above listed symptoms.

Symptoms requiring immediate attention

Rarely, symptoms of lumbosacral radiculitis, which are rapidly aggravated, may require immediate surgical treatment. The following symptoms indicate the need for immediate medical attention:

  • Symptoms of radiculitis that continue to deteriorate rather than improve, which may indicate a possible nerve damage, especially if the progressive symptoms are of a neurological nature( for example, weakness).
  • Symptoms that occur in both legs( the so-called bilateral lumbosacral radiculitis) and causes either bladder and bowel incontinence or dysfunction, which may indicate "ponytail" syndrome."Ponytail" syndrome is an acute compression of one or more nerve roots, which occurs relatively rarely, for example, in 2% of cases of a herniated intervertebral disc of the lumbar spine.

Patients should immediately consult a doctor if they experience any of the above symptoms.

The 6 most common causes of sciatica

When discussing lumbosacral radiculitis, it is important to understand the underlying medical causes of radiculitis symptoms. There are 6 lower back problems that are the most common causes of sciatica:

Herniated disc herniation

A herniated disc occurs when the soft inner core of the disc( pulpous nucleus) emerges, or protrudes through the fibers of the outer core( fibrous ring) of the disc andirritates the adjacent nerve roots when exiting from the spine. In general, it is believed that sudden twisting motion or trauma can lead to bulging of the disc and radiculitis. However, most drives become weak over time due to repeated loads, eventually leading to a hernia. Herniated discs are sometimes called a slipped disc, ruptured disc, bulging disc, protruding disc, or pinching of the nerve;and lumbosacral radiculitis is the most common symptom of lumbar herniation of the intervertebral disc.

Lumbar spinal stenosis of the spinal canal

This condition usually causes sciatica inflammation due to narrowing of the spinal canal. Lumbar spinal stenosis is associated with natural aging in the spine and is relatively common in adults over 60 years of age. The condition usually occurs as a result of a combination of one or more of the following: enlargement of the joint surfaces, proliferation of soft tissues, and protrusion of the disc that presses the nerve roots in the place where they exit from the spine, causing radiculitis.

Degenerative disc disease

While degeneration of the disc is a natural process that occurs with aging, for some people, one or more degenerated discs in the loin can also cause irritation of the nerve roots and sciatic nerve neuralgia. Degenerative disc diseases are diagnosed when a weakened disc leads to excessive micro-movement at this level of the spine, and inflammatory proteins from within the disc become prominent and irritate the area( including nerve roots).It's really not a disease, despite its name, it's part of the natural aging process.

Isthmic spondylolisthesis

This condition occurs when a small stress fracture allows the vertebral body to slip forward to another vertebral body( for example, the vertebra L5 jumps out onto the vertebra S1).Due to the combination of the collapse of the disk space, a fracture, the vertebra that slipped forward, the nerve can be jammed in the place where it leaves the spine and cause sciatica.

Pear-shaped muscle syndrome

The sciatic nerve can also be irritated, as it passes under the pear-shaped muscle behind. If the pear-shaped muscle irritates or presses on the nerve root that constitutes the sciatic nerve, it can cause pain such as radiculitis. This is not the true radiculopathy ( clinical definition of lumbosacral radiculitis), but leg pain can be felt in the same way as radiculitis caused by nerve irritation.

sacroiliac joint dysfunction Irritation of the sacroiliac joint located at the bottom of the spine can also irritate the L5 nerve that lies on the top of the sacroiliac joint, causing pain such as sciatica. Pain in the leg can be felt in the same way as radiculitis caused by irritation of the nerve.

Other causes of sciatica

  • Pregnancy. Changes through which the body passes during pregnancy, including weight gain, a shift in the center of gravity, hormonal changes, can cause sciatica inflammation during pregnancy.
  • Scar tissue. If scar tissue compresses the nerve roots, it can also cause radiculitis.
  • Muscle tension. In some cases, inflammation associated with muscle tension can put pressure on the nerve roots and cause radiculitis.
  • Spine tumor. In rare cases, a tumor of the spinal cord can press on the back of the nerve in the back and cause symptoms of sciatica.
  • Infections. Although rare, the infection that occurs in the lower back can affect the nerve roots and cause radiculitis.

It is important to know the underlying clinical diagnoses of the cause of lumbosacral radiculitis, as treatment methods will often differ depending on the cause. For example, special exercises for lumbosacral radiculitis, which are almost always part of the radiculitis treatment program, will be different depending on the underlying cause of symptoms of sciatica.

About the disease

Radiculitis is often characterized by one or more of the following symptoms:

  • Constant pains on only one side of the buttock or leg( rarely occur in both legs);
  • Pain is aggravated in sitting position;
  • Burning or tingling down the leg( as opposed to blunt pain);
  • Weakness, numbness, or difficulty in moving the legs or feet;
  • Constant pain on one side of the buttock;
  • Acute pain that can make it difficult to get up or walk.

Radiculitis can vary from rare and irritating to permanent and disabling. Specific symptoms of sciatica also differ in type, location and severity, depending on the condition causing sciatica inflammation. Although the symptoms can be very painful, it is rare that permanent damage to the sciatic nerve( tissue damage) occurs.

Sciatic nerve

Symptoms of radiculitis occur when a large sciatic nerve is irritated. The sciatic nerve is the largest nerve in the body, and consists of separate nerve roots that begin by branching from the spine in the lower back and collectively form the "sciatic nerve".

  • The sciatic nerve begins in the lower back with the lumbar segment 3( L3).
  • At each level of the lower part of the spine, the nerve root emerges from the inside of the spine, and then connects to another rootlet, forming a large sciatic nerve.
  • The sciatic nerve passes from the lower back, along the back of each leg.
  • Parts of the sciatic nerve branch into each leg to innervate certain parts of the leg - for example, buttocks, hips, calves, feet, toes.

Symptoms of radiculitis( eg, leg pain, numbness, tingling, weakness, perhaps pain in the feet) vary depending on where the nerve is trapped. For example, pinching the nerve of the lumbar segment 5( L5) can cause weakness in the extension of the big toe and, possibly, in the ankle( "sagging foot").

The course of ischial pain

The incidence of lumbosacral radiculitis increases in middle age. Rarely occurring at the age of up to 20 years, the likelihood of the occurrence of pain reaches a peak in the 50's, and then decreases.

Often, a particular incident or injury does not cause sciatica, but the pain tends to increase with time.

The vast majority of people who experience radiculitis get better within a few weeks or months, they relieve pain without surgical treatment. For others, however, pain from pinching the sciatic nerve can be severe and disabling.

There are several symptoms that may require immediate medical, and possibly surgical, interventions, such as progressive neurological symptoms( eg, leg weakness) and / or bowel or bladder dysfunction.

Since pain with radiculitis is caused by a major disease, the treatment is aimed at alleviating the underlying causes of the symptoms. Treatment, usually - is self-medication, and / or non-surgical treatment, but also for severe or insoluble cases, surgical treatment can be a choice.

Radiculitis refers to a set of symptoms caused by a problem in the lower back called by radiculopathy - a condition in which the nerve roots that approach the sciatic nerve are clamped, infringed or irritated.

© Authors and Reviewers: Editorial team of the health portal "On health!".All rights reserved.

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Lumbar sciatica: symptoms

Lumbar sciatica 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 spine of a human being is a kind of skeleton for the organism. Its main structural unit is the vertebra. Their number varies from 29 to 31. All vertebrae are combined into several departments:

  1. The cervical segment consists of 7 vertebrae. They are strong enough to withstand the weight of the skull.
  2. The thoracic department includes 12 vertebrae. Their bodies are more durable and have processes for fastening the ribs.
  3. The lumbar department consists of 5 most massive vertebrae. They are designed to withstand the load of the entire upper half of the body.
  4. 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 acting as a kind of 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.
  • Squeezing the roots with a part of the vertebrae, as happens 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 violation of the blood supply in the neural 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.

  1. 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.
  2. 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.
  3. 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 this it is clearly seen 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 very first pain appears, which can be of a different nature, 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, the 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.

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