Sciatica - warn it is too late

August 19, 2013

  • Sciatica - warn it is too late
  • Signs
  • Causes
  • Prevention
  • Treatment
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 The sciatic nerve - the longest nerve in the human body. It takes place on the back of the pelvis, buttocks, legs, and comes to feet. Inflammation of the sciatic nerve, which is also called sciatica, caused by compression or irritation of it, resulting in back pain occurs, which is usually given in the legs - that is felt along the nerve. The range of pain sciatica wide - from mild to very intense.

Offset vertebral discs - the most common known cause of sciatica. Less sciatica is caused by spinal canal stenosis (abnormal process in which gradually reduces the diameter of the spinal canal), trauma, infections or growths on the spine.

The most common cause of sciatica Pain in mastitis  Pain in mastitis
   They are:

  • The displacement of the spinal disc
  • Piriformis syndrome
  • Damage to organs or muscles in the pelvic area
  • Tumors



The pain of sciatica can range from mild to severe and persist for a period of a couple of days to several months. If pain persists for six weeks or more, talk about chronic sciatica.

In many cases, the pain gets worse with time. It can also become stronger when a person sneezes or coughs laughing (pulse pain) leans back, it stands or sits for a long time.

Also, the symptoms of sciatica can be numbness, tingling in the legs, muscle weakness and loss of reflexes tendons.

Urgently seek medical attention if the following symptoms:

  • Numbness waist, buttocks and legs;
  • Urinary incontinence and / or stool;
  • Sudden weakness in the legs.

These symptoms may be from a rare disorder, known as the cauda equina syndrome, in which treatment should begin as soon as possible.

Usually, pain appears only on one side of the body. Some patients experience severe pain in one leg or thigh, and the other - the numbness. Pain or numbness can be felt only in the calf or foot only. It is usually accompanied by a feeling of weakness in the leg.

The pain occurs gradually intensified when a person stands or sits, sneezes, coughs, or laughs when tilted back. Often the pain is particularly severe at night.


When to see a doctor

In most people, the pain caused by sciatica, extends itself for several days or weeks later. However, one should see a doctor if:

  • However, pain in the back and the leg there are other symptoms such as weight loss, incontinence of urine or faeces;
  • Eventually, the pain and discomfort are amplified;
  • The pain is so strong that it can not remove the OTC analgesics.



Typically, patients suffering from sciatica, go to the doctor only when symptoms of the disorder does not disappear within a few weeks, or if they cause very severe discomfort. In such cases, you must consult your doctor to identify or exclude serious violations that could lead to the development of sciatica.

First of all, the doctor needs to find out whether the pain is caused by inflammation of the sciatic nerve; for this there is a simple test. The patient lies on his back and stretches out her legs, and then the doctor asks him to lift one leg. If this causes pain, or pain from this action is enhanced, it indicates a high probability that the problem is indeed in the sciatic nerve.

Primarily for suspected diseases associated with inflammation of the sciatic nerve, the doctor conducting a survey that may show:

  • The deterioration of the mobility of the knee joint or a foot (in particular, a patient can be difficult to twist his foot inwards and pulling it forward)
  • Abnormal reflexes or weak
  • Pain when the patient picks up a straightened leg
  • To confirm the diagnosis may be necessary:
  • Blood test
  • X-ray examination
  • Magnetic resonance imaging or other methods of medical imaging
  • If the pain is slight or moderate and of short duration, additional tests are usually not required.

During the diagnosis is necessary to exclude serious diseases that could cause sciatica, for example, cauda equina syndrome, spinal infection or cancer.

Factors that increase the likelihood that the patient cauda equina syndrome is the presence of symptoms such as incontinence of urine, and the weakness of the leg muscles. Factors associated with a significant probability of detection of cancer and infections of the spine include:

  • Age older than 50 years and no back pain history;
  • Cancer in history;
  • Fever, chills, or wanton weight reduction;
  • Recently transferred bacterial infection, such as urinary tract infection;
  • The patient is receiving or taking illicit drugs earlier, such as heroin or cocaine (a major risk factor for the development of the vertebrate infections);
  • Have a disease that weakens the immune system;
  • Structural deformity of the spine.

If you suspect that one or another serious disease, for further diagnosis may be used: a blood test, x-ray, computed tomography or magnetic resonance imaging.



To get rid of the symptoms, you should treat the underlying disease. In some cases, treatment is required and the patient's condition improves soon itself.

To relieve pain and reduce inflammation, it is recommended during the first 48-72 hours after the onset of symptoms to use cold compresses (best pieces of ice wrapped in a soft cloth.

Pain can also be removed with the help of non-prescription drugs, like ibuprofen and acetaminophen.

Bed rest is not recommended. In the first 2-3 days can reduce physical activity, and then gradually return to normal life. Within six weeks after the onset of symptoms of sciatica Symptoms of sciatica when the pain intensifies  Symptoms of sciatica when the pain intensifies
   We need to avoid heavy lifting. It is desirable to return to full training after 2-3 weeks, after consultation with the doctor. Consideration should be given special attention exercises for abdominal muscles and improve flexibility of the spine.

If home remedies do not help relieve the pain, your doctor may prescribe strong painkillers and anti-inflammatories.

  • Physiotherapy. For patients with sciatica, and displacement of the vertebrae, physiotherapy is a very important step therapy. Once the acute pain persists, your doctor will develop a special rehabilitation program of exercises to help prevent re-injury. Typically, such a program includes exercises to correct posture, strengthen back muscles and improve flexibility of the total. Physiotherapy is recommended to start as early as possible - then it will give the best results. In no case do not ignore it - it's the cornerstone of your treatment plan, as recommended by the doctor exercises should be part of your regular workouts.
  • Prescription drugs. In some cases, sciatica your doctor may prescribe anti-inflammatory drug intake, along with muscle relaxants. For ease severe pain for a short time may be prescribed opioid painkillers. Tricyclic antidepressants and anticonvulsants may be used to relieve chronic pain. They block pain signals to the brain, or stimulate the production of endorphins, which are natural painkillers.

As soon as possible, contact your doctor if sciatica you accompanied by the following symptoms:

  • Fervescence
  • Redness and / or swelling on the back
  • The pain, which began in the upper leg, moves below
  • Weakness and numbness in the legs, hips and pelvis
  • The burning sensation during urination and / or blood in the urine
  • The pain gets stronger when you lie down or makes you wake up at night
  • Loss of control over urination and / or defecation (incontinence)
  • Severe pain that does not pass for a long time

If conservative measures do not help relieve the pain for a few months, it can be used more aggressive treatments, such as:

  • Epidural injection of steroids. Some patients suffering from sciatica, a doctor may recommend corticosteroid injections. Corticosteroids suppress the inflammatory processes in the area of ​​the affected nerve, thus helping to relieve the pain.
  • The use of corticosteroids in the treatment of sciatica Treating inflammation of the sciatic nerve: possible methods  Treating inflammation of the sciatic nerve: possible methods
   controversial. Some researchers have found that corticosteroids may provide short-term relief of symptoms, but in the long term, they are virtually useless. In addition, these drugs have serious side effects, and the number of injections that can be done to the patient is limited. If the doctor decides to resort to this method of treatment, it must determine the safest course of injections to a patient.
  • Surgery is usually given in cases where the compression of the nerve causes weakness, incontinence of urine or faeces, and / or causes pain, which progresses only and is not treatable by other methods.

The main types of surgical procedures, which are used for sciatica are discectomy and mikrodisketomiya.

When diskoektomii surgeon removes part of the displaced disc that presses on the sciatic nerve The sciatic nerve: how to avoid the excruciating pain?  The sciatic nerve: how to avoid the excruciating pain?
 . Ideally, most of the disc remains intact: the surgeon's task is not only to cure the disease, but also as far as possible, preserve the normal anatomy. In some cases, surgery is performed through a small incision, using special optical tools. This operation is called a microdiscectomy.

The success of these two kinds of operations is approximately the same, but microdiscectomy associated with less discomfort for the patient after surgery, and in addition, after the recovery is faster.