The reasons of occurrence and methods of detection of the symptom of tension Wasserman-Mackiewicz
Symptom Wasserman (Matskevich) occurs, when lifting up the legs of a man lying on his back, there pain in the front of the thigh. Condition caused by irritation of the femoral nerve, which runs along the upper-outer thigh. When you run the test at the same time there are sharp pain in the groin and lower leg.
for the First time the above symptoms studied German physician S. Wassermann, on behalf of which this manifestation of the infringement of the femoral nerve was called. Simultaneously with the German specialist the symptoms in patients with intervertebral hernia studied Russian doctor Matskevich, but his discovery was not patented.
Causes of symptoms
Symptom Wasserman (Matskevich) occurs for the following reasons:
- lumbosacral radiculopathy is a set of lesion of spinal roots by pinching or stretching of the femoral nerve;
- Persistent and severe pain is observed on the background of a large herniation of the lumbar disc of the spine. Against the background of a radicular syndrome (Dejerine) are manifestations of compression of the tension of paravertebral muscles (Lasegue, Neri);
- the Syndrome occurs Wasserman also against muscle-tonic symptoms arising from spastic contractions of skeletal muscle in myositis on the background of hypothermia lumbar.
When properly applied, this diagnostic test can be diagnosed entrapment of the nerve roots in 72.5% of cases. This percentage is determined by the specific features of the nervous system some patients with low or high pain threshold, which complicates the application of the test.
To improve the reliability of the results of the symptoms of tension paravertebral muscles should be properly combined with each other. There is a special diagnostic algorithm.
the diagnosis Algorithm
The Symptoms of tension in assessing the condition and type strangulated nerves doctors neurologists use the following algorithm:
- the symptoms of the pathology should be divided into four groups: compression, muscle-tonic, liquorodynamic, compression-irritative. This rating eliminates the need to use the symptoms of tension in patients without signs of infringement of the nerve;
- In the presence of compression and compression-irritative signs should apply the following scheme: when severe pain with the lack of protrusion and hernia (assessed by the results of magnetic resonance imaging) are used the symptoms and Polyflame Mandela. In the presence of the protrusion can apply a syndrome Wasserman and Lasegue. When the hernia is more diagnostically reliable symptoms of Motor Maarten and Minor-1
- To assess the amount of pathological lesions of the lumbar spine it is necessary to use the syndromes tension according to the following scheme: multiple protrusions or hernias – Motor-Martin, Hoover, Mandela. When expressed pain in the lower back – Wechsler and Seletsky. In the amplification of pain when bending the torso – Matskevich and Lasegue.
The Above approaches are applied in neurology, but his readers do not recommend to use them at home. Even experts stop running any tests when the patient has a pain syndrome, as the procedure can cause a painful shock.
causing the disease
Any doctor, from a therapist and to the surgeon, should check the syndrome Wasserman outpatient examination of patients.
Intervertebral hernia and protrusion are common in elderly patients, but there are also young men. If they come to the doctor with complaints of pain in the buttocks, posterior thigh and calf, weakness, disturbance of skin sensation – it is necessary to perform the test. It will allow us to detect inflammation of the femoral nerve and prescribe an adequate treatment.
In the basis of this test lie many years of scientific study and research work of doctors around the world. Despite the fact that the discoverer of this diagnostic test is considered to Wasserman, many of the professors made changes to the initial version of the study, because there was a necessity of usage of tension symptoms in various diseases of the waist and lower limbs.
what diseases symptom occurs:
- degenerative disc disease of the lumbar spine in the segment L5-S1. Clinically the pathology is manifested by pain in the gluteal region and lower extremities;
- Sciatica of the lumbosacral spine is manifested by inflammatory changes in the femoral and sciatic nerves. In the background there is a symptom of Lasegue, Wasserman and Neri. In severe pathology observed violation of skin sensitivity on the front of the thighs;
- Myeloradiculopathy – damage to the nerve roots on the background of compression of the spinal cord. Diseaseis quite dangerous in terms of disability. When it falls out of the tendon reflexes (not unbent knee joint, limited mobility of the foot).
Simultaneously with the above mentioned diseases during the inspection of patient with pathology of the lumbar spine, the physician must pay attention to additional signs of nervous system:
- Involuntary contraction of the muscles of buttocks, belly, lower back;
- Pain in back when coughing
- Loss of tendon reflexes.
Upon detection of syndromes of tension, the therapist refers the patient to a neurologist to assess the condition of the nervous system and determine the tactics of treatment.
In conclusion, recall that in their own home should not be the Wasserman test, as you will not be able to stop in time. Approach is uninformative, but can cause a painful shock.