Drug treatment of sciatica

The Disorders is always annoying, and doubly annoying if this is accompanied by excruciating pain. Sciatica refers precisely to such pathologies. To relieve the symptoms of inflammation and can improve the situation only the complex therapy, which includes physiotherapy and a set of special exercises. However, in the acute phase medication is inevitable. Consider its basic principles.

Little anatomy

The Sciatic nerve is the largest nerve in the human body. Taking its origin from the sacral plexus, he descends from the buttocks and down the back of the legs to approximately the level of the tibia, where it splits into two smaller branches. Inflammation of the sciatic nerve, which in medicine called sciatica, characterized by pain along the nerve. The sciatic nerve sciatica is not a separate disease. This is a symptom that accompanies many diseases of the spine.

the Causes and factors of development of sciatica

Inflammation of the sciatic nerve can cause various pathologies of the spine and diseases of the internal organs, particularly of the pelvic organs. Most often, sciatica is the result of the following diseases:

• degenerative disc disease, osteoarthritis of the intervertebral joints – in these diseases the vertebrae are formed bony outgrowths (osteophytes), which compress the nerve, causing an inflammatory process;
• herniated discs – pinched nerve roots that form the nerve, is due to the hernia;
• piriformis syndrome, other neuropathy tunnel;
• infectious processes – the nerve becomes inflamed due to damage by toxins in diseases such as tuberculosis, syphilis, typhoid, malaria, generalized sepsis;
• intoxication – sciatica can be caused by both external influences (alcohol, poisoning poisons), and lesions of the substances produced in the body (gout, diabetes).

Often the factor that triggered the inflammation of the sciatic nerve, is hypothermia. Under the action of low temperatures of the protective reactions of the organism are weakened, the symptoms of inflammation are gaining momentum.

Symptoms

The Main symptom of a pinched sciatic nerve will be pain along the nerve fibers. Symptoms are low back pain, which runs down to the buttock and then on the back of the thigh and lower leg to the foot. Neuralgia is often unilateral, but can capture and both limbs. The pain symptoms are sharp, shooting character, worse by movement or exertion. The characteristic symptom of sciatica is a symptoms of tension: pain is sharply aggravated by flexion of the affected limb in the pelvic joint, the forward tilt of the head or torso.

There are other neurological signs:

• burning, numbness or "tingling" on the skin of posterior surface of leg;
• decreased sensitivity
• is unsteadiness of gait.

All these features make it quite easy to identify the problem. Despite this, to diagnose and to prescribe treatment should neurologist. After all, depending on the reasons that caused the inflammation of the sciatic nerve regimen may differ significantly from each other.

Treatment

Sciatica today is a well-studied pathology, its treatment has been streamlined. It includes not only medical, but also manual therapy, osteopathy, physiotherapy, special complexes of physical therapy and other treatments. The main aim of therapeutic measures is the relief of pain and reduction of inflammation.

As a rule, it is mainly used in preparations for intramuscular or intravenous administration. Tablets with the pinched sciatic nerve almost not used, because the symptoms are too intense. In some cases it is necessary to treat by injecting drugs into the spinal canal.

Drug therapy

Treatment for pinched sciatic nerve involves the use of several groups of drugs.

NSAID

In order to treat sciatica, most commonly used nonsteroidal anti-inflammatory drugs. Advantage of drugs in this pharmacological group is the ability to block the prostaglandins as primary mediators of the inflammatory process. In addition, they do not cause persistent addiction that givesthe ability to treat with them for quite a long time without fear of addiction. Currently, nonsteroidal anti-inflammatory drugs are widely represented in the pharmacy networks. There you can find both prescription drugs and commercially available. The most commonly used medications are:

• "Ketonal", "Ketanov" ("Ketoprofen") – available as in ampoules or in capsules, tablets, suppositories and in the form of ointment, sciatica is most often used intramuscularly (up to three times daily 2 ml), but symptoms and relieves topical application (ointment)
• "Piroxicam" is available in the form of a solution (ampoules of 1-2 ml), tablets, suppositories, gel, cream, can be used both topically and injected 1-2 ml once a day to relieve the acute pain attack;
• "Meloxicam (Movalis", "Amelotex")- available in pill and injectable forms, is one of the safest drugs of the NSAIDs group;
• "Nimesulide" ("Nise", "Nimesil") – issued in the form of powders, tablets, capsules. Usual dosage is 100 mg per day, in the early days may increase to 200 mg;
• "celebrex" capsules, the recommended daily dose to 200 mg, but severe pain can be increased to 400-600 mg at first admission, with subsequent dose reduction to 200 mg.

Drugs NSAIDs are many, but, despite the availability, assign them and to treat a pinched sciatic nerve need under the guidance of a doctor.

Side effects and contraindications NSAIDs

Nonsteroidal anti-inflammatory drugs in case of prolonged or uncontrolled use can give a range of side effects. Primarily affected the gastrointestinal tract. Increases the risk of gastric ulcer and gastric bleeding. Taking medications with food reduces the possibility of such complications, but also reduces the effectiveness of medications. Also, the following complications:

• increased pressure
• abnormalities in the kidneys (swelling)
• haemorrhage
• headaches.

It is Impossible to use drugs NSAIDs concurrently with medications, thin the blood, it increases the risk of bleeding.

Vitamins

According to research, the appointment of b vitamins together with NSAIDs significantly reduces the duration of painful period. When inflammation of the sciatic nerve, however, as in any other neuritis, the important role played by vitamins B1, B6. Usually assigned intramuscular injection of 1-2 ml (dosage to be determined by the doctor).

Steroid drugs

As a rule, start to apply them, if non-steroidal drugs are unable to relieve the symptoms of inflammation. Most often, in order to treat a pinched nerve, used the following drugs:

• "Dex"
• Prednisone
• "Metilprednizon".

Medicines relieve pain, but quickly relieve inflammation and decrease tissue swelling, which lowers pain and. Often there is a necessity of introduction of medicinal substance in the tissue located around the pinched nerve or epidural. This procedure is called a blockade and is conducted only by experienced doctors.

Side effects of

The Need for long-term treatment with steroid medications may also have side effects. Usually it is as follows:

• increasing body mass
• the risk of developing stomach ulcers;
• osteoporosis
• swelling
• increased blood coagulability.

Painkillers

In case of unbearable pain can be prescribed painkillers. These include "Vicodin", "Morphine", "Peridon", "Katadolon", "Tramadol". They do not reduce inflammation but facilitate the patient's condition by reducing pain. These substances are narcotic and are subject to strict accounting, to purchase them without a prescription is impossible.

Muscle relaxants Central actions

This group of drugs aimed at relief of muscle spasm in the area of the inflammation, and also has a Central analgesic effect. Muscle relaxants are prescribed in conjunction with NSAIDs and preference is given to the following medications:

1. "Mydocalm";
2. "Sirdalud";
3. "Baclofen".

physical Therapy

To treat the inflammation of the sciatic nerve, one medical intervention is not enough. Physiotherapy methods and begin to apply when the acute stage has passed. Their operating principle is based on the fact that, by acting on inflammation, they relieve swelling and improve circulation of the affected area, thereby reducing the intensity of the pain. Sciatica can prescribe the following procedures:

• electrophoresis or phonophoresis with various medicinal substances;
• DDT
• magneto therapy
• UHF
• paraffin baths.

Effective in pinched sciatic nerve massage and remedial gymnastics.

leech therapy

Treatment for pinched sciatic nerve is not only to drug therapy and fiziolechenie. Excellent results can be achieved by applying a method such as treatment with leeches. Their saliva, which contains a largethe amount of biologically active substances has a positive effect on the inflamed nerve. Secret, which by leeches, in addition to hirudin, blood thinning and preventing blood-clot formation, there are substances that breakdown products produced during tissue inflammation. In addition, the leech saliva has the ability to dilate the blood vessels.

It promotes increased blood flow to the area where the nerve is inflamed, providing tissues nutrition. Leeches help to relieve pain, reduce inflammation. In addition, the secret of the leech has not only local but also the overall impact on the body. Under its influence blood vessels are purified from the cholesterol, strengthens the immune system. The leech saliva also has anti-edema effect that can also help reduce pain.

To influence the affected sciatic nerve, you will need six leeches. On the foot of the leeches are installed in the following sequence: on the back side, the first 3 cm below the popliteal fossa in the midline of the foot, the second and third sets underneath with an interval of 3 cm For the second leg of the leeches are installed the same way.

Criteria of efficiency of treatment and prophylaxis of acute exacerbation

Criteria showing the effectiveness of treatment, reduced intensity, and then a disappearance of pain syndrome, reduction of neurological symptoms.

To neuralgia of the sciatic nerve does not recur and the treatment will not repeat again, you need to follow a few simple rules. The first is to pay attention to your bed. The mattress should not be too soft or hard. Should not place undue overwork, but also to forget feasible exercise cannot. When you work with a long stay in a sitting position, it is important to allocate time for outdoor activities, and also use quality office furniture, if necessary – orthopedic corsets.

Sources:

1. Celecoxib, etoricoxib, meloxicam and nimesulide: advantages and disadvantages. M. D. A. E. karateev. "EF. Rheumatology. Traumatology. Orthopedics." "" 1/2011

2. Neuropathy of the sciatic nerve. Piriformis syndrome. M. V. Putilina. The magazine doctor, 02/06;
3. Diclofenac in the treatment of pain. A. B. Danilov, Journal of the Attending physician, 05/09.