An acute attack of sciatica causes excruciating pain, but the pain in sciatica is not inflammation, but direct pressure on the roots of the spinal nerves, causing their irritation. An acute attack of sciatica in extreme cases may end with surgery.
The acute attack of sciaticaand the accompanying unbearable painpainis caused by pressure on the nerve roots. These nerves, which come out of the spinal canal at the height of the L4, L5, and S1 vertebrae, merge into a large peripheral nerve called the sciatic nerve. It runs along the entire leg and at knee level splits into several branches. That is why not only the cross, but also the leg hurts.
Sciatica: troublesome disc or intervertebral disc
The intervertebral disc, or disc, consists of a multilayer fibrous ring and nucleus pulposus. Partial damage to the ring is a protrusion, a complete disruption of its continuity and the pouring out of the nucleus pulposus is called a hernia, and the separation of a part of the nucleus pulposus and wedging in the spinal canal is a sequestration. The second and third types of disc damage occur in sciatica.
Sciatica: pain depends on how the disc ruptures
The cause of the pressure is a complete rupture of the fibrous ring of the intervertebral disc (called the disc) and the discharge of the nucleus in the form of a gel from inside it. The related ailments depend mainly on the degree and direction of the displacement of the nucleus pulposus:
- if it flows to one side, we feel a piercing pain radiating to the left or right leg
- as it travels backward, the pain may vary in intensity, but it rarely radiates to the legs because the so-called nerve fibers. the cauda equina (the last nerves departing from the spinal cord) are protected here against pressure by a strong ligament.
Sciatica: horse tail syndrome
However, it happens that such protection is not enough. Then there is a "ponytail" syndrome, that is, bilateral pain, leg paresis, dysfunction of the urinary bladder and anus sphincters, and perineal sensation. Then an immediate operation is needed.
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