Pregnancy and the sciatic nerve

During pregnancy, there are often problems with the sciatic nerve, as a growing uterus compresses the surrounding soft tissue, including can crush and sciatic nerve before it exits the pelvis. This causes pain along the sciatic nerve, sometimes quite strong.

Why during pregnancy injured sciatic nerve

Often during pregnancy the woman has back pain Back pain: Do not start the process Extending to the buttock and the back of the thigh. This is a sign that irritated the sciatic nerve, which runs behind the uterus, and then comes out of the pelvic Subpiriforme through a hole in the pelvis, and is on the hamstring muscles in the back to the popliteal fossa, where the forks and supplies the lower leg and foot.

Sciatic nerve irritation may occur due to the fact that its length located in the pelvis, presses growing uterus. Furthermore, during gestation the displacement of the pelvis and sprains, whereby the sciatic nerve can be diminished in the exit site of the pelvic Subpiriforme hole, and with the junction of the pelvis to the spine. The latter is restrained not the nerve, and spinal nerve roots, branches which then form the sciatic nerve.

All these phenomena are amplified by the fact that during pregnancy there is a shift of the center of gravity and the main burden is on the lumbosacral spine. Therefore, great importance is the condition of the back muscles that support the spine in the correct position.

Symptoms of irritation of the sciatic nerve in pregnant women

The main symptom is irritation of the sciatic nerve pain. If the reason is the growing pressure on the nerves of the uterus, the pain usually occur episodic and often depend on what position the moment the woman. When you change the position of pain are usually held. As for the irritation of the sciatic nerve is characterized by one-sided defeat in the attacks of back pain Low back pain: the spine signals Extending to the buttock and back of the thigh, it is recommended to go to the opposite (healthy) side. As a rule, then the pain go away.

If the infringement took place, the pain can be constant, aggravated by sharp movements, laughing, sneezing or coughing. Change the situation can reduce this pain, but very likely, will not remove.

Besides pain may come and sensory disturbances on the affected side. They are manifested by numbness or pins and needles sensation in the body, sometimes the sensitivity of the skin in this location intensifies.

Sometimes acute illness associated with hypothermia. This suggests the inflammatory process that begins with the shell of the nerve (sciatica), but may eventually go on very nerve (sciatica) that is already apparent loss of function of muscles innervated by the nerve of the data.

Diagnosis and treatment

In order to find out why sciatic nerve pain, usually Send the Prince diagnostic studies mainly radiology. But pregnant women to carry out such research is not desirable, so she just needs to see a neurologist, who diagnosed based on her questioning and inspection. A full diagnostic examination will have to wait and hold it after birth, if the pain persist.

A way out could be a special gymnastics for pregnant women, which helps to strengthen the back muscles and partially removes the burden from the spinal column.

It is impossible for pain in the spine to gain weight, so it is particularly necessary to monitor the food intake: exclude from fatty, fried, sweet, sweet food, sugary soft drinks - all of this will not benefit the child, and only add the weight of the mother, which, of course , will have an impact on the state of the back.

It should also give up the high heels - they are the center of gravity in the spine moves further while increasing the load on the lumbosacral. It is not recommended as a long standing - it can lead to stretching of ligaments and further compression of the sciatic nerve.

Exercise special exercises to help reduce back pain and leg woman always show in the antenatal clinic, for this there is a doctor or nurse for physical therapy. If necessary, the specialist can always consult a gynecologist aksherom about the state of a pregnant woman and her possible appointment of certain exercises.

If a pregnant woman is regularly seen in the antenatal clinic, she will always help reduce the pain caused when the sciatic nerve irritation.

Galina Romanenko

Surgical treatment of sciatica

In cases where the conservative treatment sciatic neuralgia not eliminate pain and inflammation persists for six to twelve weeks to resort to surgery. The choice of operation depends directly on the cause of sciatic neuralgia.

In many diseases of the spine, such as a herniated disc, spinal stenosis, or low back pain Osteochondrosis - learn how to properly distribute the weight Conducting the following operations:

• microdiscectomy;
• laminectomy;
• vertebroplasty;
• intradiscal electrothermal therapy;
• Radiofrequency thermal annuloplasty;
• puncture laser discectomy;
• automated percutaneous discectomy;
• facetectomy.

Microdiscectomy in inflammation of the sciatic nerve

In those cases where sciatica Sciatica - warn it is too late   caused by herniated vertebral discs recommended microdiscectomy - neurosurgical operation aimed at stopping the nerve root compression disc herniation. Microdiscectomy relates to minimally invasive operations. To do it, it uses an operating microscope and microsurgical instruments. The task microdiscectomy is the removal of disc herniation, located in the spinal canal through a tiny incision with little or no damage to the bone structures. After microdiscectomy recovery period it takes a few days, and pain after surgery minimally expressed.

Microdiscectomy is performed under general anesthesia .  In the area of ​​the damaged drive is performed longitudinal or transverse skin incision .  The muscles of the back are not damaged during the operation, and discharged to the side .  After the surgical approach of the nerve root, strangled hernia becomes available inspection .  Next, the surgeon moves towards the nerve root and conducts removal of nucleus pulposus fragments forming disc herniation .  In many cases, to accelerate the process of regeneration and reduce the risk of recurrence after excision of a hernia carried restorative laser irradiation of the disk .  At the end of the operation is carried out layer by layer closure of the surgical wound .  In most cases, patients may begin to nonphysical work 4-7 days after surgery, and physical - in 2-3 weeks .  Typically, approximately 90-95% of patients experiencing relief of pain caused by sciatica, after this operation .

Laminectomy at sciatica

In those cases, when sciatica is caused by a narrowing of the spinal canal due to degenerative or traumatic lesions of the spine of the lumbar laminectomy recommended. Laminectomy - an operation aimed at ending the compression of one or more of the nerve roots and spinal cord. As a result, laminectomy increases the lumen of the spinal canal, nerve compression ceases structures.

During surgery the patient is on the operating table in the prone position or on one side. In the middle line over the area of ​​compression of the nerve root or the spinal pulp makes a small incision. Subcutaneous adipose tissue and paravertebral muscles are moved using special tools - retractor. In many cases during the surgery performed by the surgeon to identify the proper fluoroscopy vertebra. Next, the surgeon performs the removal of the vertebral arch. Thus the spinal canal becomes available for inspection and manipulation. Decompression of nerve structures is to remove education (herniated disc, tumor, scar tissue, osteophyte), compressing the spinal cord or nerve root. At the end of the operation is carried out layer by layer suturing tissues (muscle and skin).

Performing lumbar laminectomy at the level may lead to spinal instability due to the damage of the joints between adjacent vertebrae Therefore, in many cases, after a laminectomy is performed at the level of stabilization of the lumbar spine. After a lumbar laminectomy (open decompression) approximately 70-80% of patients usually experience relief.

The decision of the patient

In most cases, the decision on surgical treatment of sciatica patient receives (this also applies to microdiscectomy and laminectomy). The decision on the patient's surgery is based primarily on the intensity of the pain he is experiencing, and the severity of the general condition.

Generally, surgical treatment for sciatica is considered in the following situations:

• in the presence of severe acute pain in the leg, continued for 4 to 6 weeks or more;
• if other conservative and alternative therapies, or a combination thereof (eg, oral steroids, non-steroidal anti-inflammatory drugs, chiropractic Chiropractic: the main thing - to choose the competent expert , Physical therapy and physiotherapy) were ineffective;
• in diseases that restrict the ability of the patient to lead a normal life.

Urgent surgery is usually necessary only in cases where the patient experiences progressive weakness in the legs, or losing control of her bowels and bladder.

Other factors of surgical treatment

When deciding on the surgical treatment, the patient is guided by many factors, including personal reasons.

• Some patients prefer to try all possible methods of non-surgical treatment, so as not to resort to surgery, and often they learn to successfully control their condition and the painful symptoms. For example, patients suffering from recurrent bouts of acute pain caused by sciatica, bed rest recommended combined epidural injections of steroids at the beginning of the disease, and further to perform stretching exercises therapeutic Stretching exercises - Be careful   and massage for prevention.
• Other patients choose (or are forced) to resort to methods of rapid pain relief, which is usually achieved by surgery. For example, people with a family and children, do not have time for long and complex treatment, so they recommended an operation, after which they will be able to quickly return to normal life and performance of domestic duties.

It is important to remember that the decision on surgery is always the patient and the physician's role is to help him make an informed decision and make the best choice.