Sciatica is manifested by a sharp, stabbing pain in the lumbar region. For sciatica to appear, one sudden movement is enough: lifting, bending, stumbling, or breaking off the bed. How to deal with an attack of sciatica?

Sciaticaoccurs in the most unexpected situations. There is a sharp, stabbing pain in the lumbar spine (also known as tingling or burning pain) that travels along the buttocks and hip. Further behind the thigh, it goes through the calf to the foot. It magnifies with the slightest movement. But it can be felt most at night.

What causes sciatica?

The sciatic nerve arises from the connection of several roots that come out of the spine and join into one large nerve that runs along the leg, so we also feel ailments in the leg, although they are caused by changes in the spine.

The cause of the pain is the compression of the sciatic nerve root in the place where it leaves the spinal canal.The causes of pressure on the sciatic nerve may be different. The most common are degenerative changes in the spine and prolapse of the intervertebral disc (disc). Another reason may be edema of the nerve root caused by constant compression by the deformed vertebra, as well as degenerative changes in the intervertebral joints.

The tear can also occur as a result of curvature of the spine or abnormal structure of the pelvis.It also happens to women in advanced pregnancy, because they shift the center of gravity and the spine is improperly loaded Sciatica is accompanied by spasm of the paraspinal muscles, which further aggravates the pain. In this way, they try to immobilize the spine to protect it from damage. And this leads to the non-physiological alignment of the spine.Characteristic for tears is that when lying on your back, you have difficulty lifting your straight leg up at the knee.

Important

Sciatica can be dangerous!

If, apart from severe pain, you have sensory disturbances, leg weakness or urinary retention (sometimes urinary incontinence may occur), you must see a doctor immediately. These symptoms could indicate changes that lead to permanent damage to the nerve. To rule this out, you need to get an MRI immediately.

How to deal with an attack of sciatica?

The best way to reduce pain is to find a position that will take the pressure off the pinched root.Contrary to popular belief, this is not always a lying position. Many people prefer to stand, saving their sore leg, or sit in a position that is most comfortable for them.

  • If you can, lie on your back on a stable, firm mattress with your legs bent at right angles at the hips and knees(you need to put pillows under your legs, for example). The chair position will relax the muscles and relieve the pinched root.
  • Save yourself with non-steroidal anti-inflammatory and analgesic drugs.
  • Relief may be provided by applying an analgesic and anti-inflammatory ointmentto the sore area and massaging it. This warming massage will relax tense muscles.
  • Some people find relief in cooling the sore spot.Under the influence of low temperature, endorphins are released, which have an anesthetic effect. Where it hurts you the most, you can apply a cold compress or an ice pack. But a pain-relieving treatment can also be heating the painful area.
  • If the pain does not decrease within 24 hours, see a doctor.Renal colic can cause similar symptoms - you need to find out the source of the pain and take appropriate treatment.
  • Pain warns that something is wrong in the body.Therefore, each attack of acute back pain should prompt us to check the condition of the spine.

How is sciatica diagnosed?

The doctor will ask about the type of ailment, whether it occurred for the first time, how often and under what circumstances, whether there was a spine injury. He will check where and when it hurts the most.

In case of any doubts, he or she will recommend x-rays of the lumbosacral spine.For the X-ray to be reliable, it is better to perform it when acute symptoms subside. On the basis of the photo taken immediately, one can only exclude fractures or suspect discopathy. It is impossible to define other lesions, because the spine is in a non-physiological position. In addition, for an accurate photo, you must have an empty gastrointestinal tract.

If the pain is radiating to both legs, or if the patient has no feeling below the pressure on the nerve, an MRI should be performed to find out what is actually causing the problem.

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How do medications work for muscle relaxation during an attack of sciatica?

In the first period of the disease when acutethe pain makes it impossible to move,the most important thing is to stay calm and lie on a relatively hard bed , in a position that is comfortable for you.

The doctor selects drugs depending on the intensity of pain. They usually start with high doses of non-steroidal anti-inflammatory and analgesic drugs (by mouth or injection) and muscle relaxants.

In case of sleep problems, she also recommends sedative and hypnotic preparations.Peace of mind and sleep promote muscle relaxation, which reduces pain.

May prescribe B vitamins by injection in some cases. When the pain persists, an opioid drug is given.

The treatment usually lasts 7-10 days , but it can take up to several weeks. Then the drugs are changed to stronger and stronger ones. In the case of chronic pains, sometimes antidepressants are added to additionally relieve pain.

What to do to prevent the sciatica from coming back?

  • Avoid jerky movements , sudden bends, turns, and jogs.
  • When picking anything up off the floor, crouch instead of bending over with straight legs.Hold the object close to you in both hands. Kneel down on one knee while washing the bathtub or vacuuming under furniture.
  • Replace the one-shoulder bag with a backpack , spread the shopping to two nets to evenly load both sides of the body.
  • Shift your weight from leg to leg during long standing.
  • Regularly perform the exercises recommended by the physiotherapistto strengthen the muscles of the spine and abdomen.
  • Swim, especially in the backstroke , which strengthens the muscles of the spine, arms and legs.

What is the role of physical therapy in the treatment of sciatica?

The pain relief does not mean the end of the treatment. Now rehabilitation and physical therapy are indispensable. Exercises under the supervision of a physiotherapist and therapeutic spine massage. Heating, electric current, magnetic field or biostimulating laser light or iontophoresis give good results.

The therapy is complemented by sanatorium treatment. Rest, the use of sulfur baths or mud compresses, all this prevents the recurrence of the disease.

If there is no improvement after conservative therapy or the pain frequently recurs, surgeryis required to remove the degenerated intervertebral disc.

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Spine, bones, joints