Diagnosis and treatment of pinched sciatic nerve

Nervus ischiadicus (sciatic nerve) provides the movement of muscles and the sensitivity of the rear surface of the legs. When paralysis there is absence of movement in the knee joint and below. Paralysis is quite rare, but a pinched nerve is common and painful. Let's find out how to treat, if caught in the nerve what are the symptoms and consequences of this disease.

In our body the sciatic nerve – a pair of starts in the sacral region of the spine. Therefore, the etiology of the pinched sciatic nerve can be of various pathologies and spinal injury. For example, compression of the nerve roots between the vertebrae or damage to the pelvic bones. Also one of the common causes is piriformis syndrome (piriformis syndrome). In this disease nerve fibers are pinched piriformis muscle or ligaments in the space located under the muscle. The reason for this may be to excessive tension as a result of increased physical exertion or incorrect injection into the muscle.

Symptoms

The Symptoms of compression of the nervus ischiadicus almost always accompanies severe pain, but in some cases they may appear only in a vegetative disturbances, for instance, coldness and tingling of the feet. Most often the symptoms of a pinched nervus ischiadicus appear only in one of the lower limbs and accompanied by the following factors:

• dull pain in the pelvic area, increased by exertion;
• spread pain throughout the leg
• the violation of the General sensitivity of the feet, numbness and tingling of the rear-side surface of the foot;
• reduction of reflex when you hit the Achilles tendon;
• intermittent claudication and pallor of the extremities
• the weakness and heaviness in the muscles of the thigh and lower leg;
• reducing the volume of the thigh muscles;
• pain in the lumbar or sacral spine;
• decreased mobility of the knee, foot and toes.

Diagnosis of compression

If there is one of these symptoms, it is necessary to conduct a thorough diagnosis of the nerve compression prior to begin to heal. To avoid such problems as herniated discs, degenerative disc disease or spinal stenosis, it is recommended that the x-rays, MRI or CT of the spine.

If back problems have been identified, but the symptoms point to a pinched, mean, and nerve compression caused by piriformis syndrome. Before you start to treat a pinched nerve, need to run diagnostics with the following manipulations:

• palpation dock areas and the projection of the piriformis;
• study of the state of the pelvic ligaments;
• novocaine blockade of the piriformis with the aim of monitoring the dynamics of pain (in the presence of piriformis syndrome is the pain will decrease).

In Addition, the sciatic nerve can be pinched by a tumor that needs to identify and begin to heal. This is used for radiological studies. For example, radioisotope scanning of the spine.

Effective treatments for

Treatment should always be based on the cause of the pinching, not the symptoms accompanying it. To get rid of pain in the sciatic nerve can be surgical and therapeutic way. Surgical intervention is required in case of serious pathology of the spine, when the compression of the nerve caused by compression of the spinal root.

should be Treated comprehensively by methods such as medication and manual therapy, physiotherapy.

Drug therapy

The Treatment is carried out only under the supervision of a neurologist. To relieve neurogenic inflammation administered drip infusion of Actovegin 200 mg for five days, after which the patient is transferred to oral administration "Actovegin".

To Reduce vegetative symptoms and to improve blood supply will help vasoactive drugs. It is recommended that drip of drug "Istene" (2 ml per 200 ml of physiological solution) – 10 treatments per course of treatment. Oral administration of the drug "Trental" 400 mg 3 times a day also is effective.

Pain symptoms reduced after treatment with nonsteroidal anti-inflammatory drugs. One of effective and safe analgesics for today is "Xefocam" (lornoxicam). Treatment according to the following scheme: in the first day or 16 and 8 mg; second-fourth day, 8 mg twice a day; the fifth day of 8 mg. In Addition, lornoxicam can be recommended:

1. "Ketoprofen" ("Ketonal", "Ketanov") in the form of injections;
2. "Ketorol" (Ketorolac) injection;
3. "Diclofenac" is an injection;
4. "Nimesulide, Meloxicam, Celecoxib" – in the form of tablets, after a course of injectable NSAIDs (items 1-3) in the fifth-sixth day. The total duration of intake of these drugs can be two to four weeks.

In Addition to vasoactivedrugs, NSAIDs can be prescribed muscle relaxants Central action ("Mydocalm", "Sirdalud"), b vitamins (B1, 6, "Milgamma"), novocaine blockade.

Chiropractic treatment

To Treat a pinched nerve is recommended not only medicines, but also hands. The main goal is the relaxation of the piriformis, reducing pain and discomfort of the spine. Cupping, acupressure, therapeutic massage or acupuncture is an effective treatment if it is performed by a qualified technician.

To treat a pinched because of piriformis syndrome, massage technique, post isometric relaxation:

1. leg bend at the hip at a right angle and put her over your good leg, which is fully rectified;
2. the Therapist wraps around the outer surface of the bent knee with one hand while the other immobilizes pelvic bone;
3. Is the passive stretching of a muscle with a light pressure on the knee with a delay up to five seconds;
4. the Patient holds his breath and has little opposition, reserving the thigh for ten seconds;
5. the Patient relaxes, the physician increases the pressure on the knee for ten seconds;
6. Begins the relaxation of the piriformis, it is stretched, the discomfort is reduced;
7. Steps 1-6 are repeated five times, the therapist does not reduce the initial pressure to the muscle, and gently holding it stretched.

Thanks to this massage technique reduces tension piriformis and compressing the nerve.

physical Therapy

To Treat a pinched to relieve the symptoms to help different procedures, such as electrophoresis, UFO, UHF-therapy, or laser therapy. Need a course of physiotherapy selects the attending physician for the purpose of improving blood circulation and relieving pain. Perhaps the use of compresses, as heat helps to relax muscles and therefore reduces the symptoms of compression of nerve fibers.

If pinched sciatic nerve, you should immediately consult a specialist and begin to treat the disease to avoid deterioration. Thus, proper treatment after thorough diagnosis will lead to more rapid recovery, but also prevention of the chronic pain.

Sources:

1. Xefocam: possible application for treatment of pain syndromes. Danilov A. B. Russian medical journal;
2. Myofascial pain syndrome (piriformis syndrome) – approaches to diagnosis, treatment. Shostak N. And. Russian medical journal;
3. Putilina M. V. Neuropathy of the sciatic nerve. Syndrome Piriformis // Attending physician. 2006. No. 2.
4. Srbely, J. Z. New trends in the treatment and management of myofascial pain syndrome // Curr Pain Headache Rep. 2010. Vol. 14 (5). R. 346-352.