Causes, diagnosis, treatment of paralysis of the legs when the herniation of the spine
One of the most frequent complaints in patients with herniated discs in the lumbar and sacral divisions is numbness of the lower limbs. According to statistics, approximately 2/3 of these patients have various abnormalities of sensation, usually in the distal parts. This phenomenon is explained by the fact that during compression (compression) of the spine primarily affects long nerve fibres.
Types of sensitivity disorders in the hernia of intervertebral disc
The Feeling of numbness of the lower limb arises from the syndrome of compression of spinal roots at the level of L5-S1, i.e. The fifth lumbar – first sacral. Numbness in the legs when the herniation of the spine frequently occurs together with pain in the lower back and sacrum radiating along the back and side of the thigh and lower leg to the foot. Numbness may be accompanied by a feeling of pins and needles, tingling in the same leg. Together, these sensations are called paresthesia.
The Feeling of numbness in the foot must be differentiated from true numbness, i.e., reducing the sensitivity of the lower extremities with pressure on her hand, injections of light – gipostezii. Gipostezii also expressed in decreased sensitivity to temperature, e.g. The temperature of a bath.
The Symptoms of a hernia of the lumbar spine also include hyperesthesia – enhances the sensitivity of the lower extremities. Hyperesthesia see much less than the decrease in the sensitivity. Their manifestation in a patient with intervertebral hernia is characterized by burning pain or a strong pressure sensation when touching up to her feet, her touch, trying to pull the skin fold.
How to differentiate paresthesia, and hyperesthesia gipostezii home
At home quite able to assess the degree and nature of sensory disturbance of the lower limbs, but will need an assistant. Sensitivity is necessary to define symmetrically on both legs, with the subject lying on his back. The feeling should be described as follows: the same – less (not feeling) is more (stronger, harder).
Less (not feel) is a characteristic of gipostezii, more (harder) – feature giperestezii. Paresthesia will remain only subjective sensations.
To Investigate the sensitivity can be achieved by:
- the Definition of a sense of pressure. The task of the test to distinguish between real touch and finger pressure.
- Evaluation of the articular and the muscular sense. Assistant are passive movements in the joints of the foot, ankle joint and knee joint. Studied must recognize the direction of movement of the joint in which the movement is performed.
- Vibration sensitivity is evaluated by tuning fork, which, unfortunately, do not always have in the Arsenal of household items. Wound up fork is applied to the symmetrical parts of the skin. The task of the test is to determine the vibration (usually 15 seconds) and the application of a tuning fork.
- Tactile sensations. Normal people can feel light touch with a brush or cotton swab. To explore the tactile feel is better on symmetric sites for comparison.
- Thermal sensitivity is determined with the help of small containers with hot and cold water (pipette, test tube, small bottle of penicillin). The problem investigated is to determine hot-cold, and the area of application to the feet.
Paragraphs 1 to 3 describe the so-called deep sensitivity, it suffers less when the hernia of the intervertebral disk.
Paragraphs 4-5 are superficial sensitivity, violations are most frequent.
The Treatment of these disorders is associated with treatment of the underlying disease – herniated discs.
depending on the clinic the underlying disease the patient may be recommended conservative and surgical tactics. Conservative treatment includes the following items:
- non-Steroidal anti-inflammatory drugs. In the acute phase may be injections of diclofenac, Ketonal for 5 days followed by transfer to selective drugs. The drugs of choice for long-term therapy of pain are "Movalis", "Celecoxib", "Nimesil".
- Muscle relaxants "Sirdalud", "Mydocalm". In addition to its relaxing action on muscles in the inflammation, they have analgesic effect.
- Improve blood circulation – "Pentoxifylline", "Actovegin", "Berlition".
- protective agents – "Dona", "controlon".
- physical therapy methods are well established in the treatment of hernias: electrophoresis with novocaine, aminophylline, magnetotherapy, mud cure, etc.
- physical therapy and massage are also effective treatment, but their purpose is in remission or fading exacerbation. Ordinary Generalmassage for intervertebral hernias are contraindicated.
- Modern aspects of diagnosis and treatment of herniated intervertebral disc of the lumbar spine. Batyshev T. T., Bahir L. V., Kuzmina, V. Z., Boiko N. In. Magazine "doctor", – № 6, 2006.
- degenerative disc disease of the lumbosacral spine: diagnosis, clinic and treatment. Tyurnikov M. V. – Russian medical journal.
- Pain in the lower back. Kachkov I. A., Filimonov B. A., Kedrov A.V. – Russian medical journal.