sciatica

The concept of sciatica sciatica: refers to the sciatic nerve, along the nerve pathways that occur outside the foot and waist, hip, thigh, l

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The concept of sciatica sciatica: refers to the sciatic nerve, along the nerve pathways that occur outside the foot and waist, hip, thigh, leg pain after after symptoms. Etiology and pathology of sciatic nerve of Sciatica by lumbar 5 ~ 3 sacral nerve roots. According to the site of lesion root and trunk sciatica two, the former more common root sciatica lesions in the spinal canal, the most common cause of lumbar disc herniation, followed by spinal tumors, spinal tuberculosis, lumbosacral nerve root inflammation. Sciatica lesions are mainly in spinal sciatic nerve stroke, etiology of sacroiliac arthritis, pelvic tumor, uterine compression, hip trauma, piriformis syndrome, gluteal muscle injection of inappropriate and diabetes. Sciatica symptoms of this disease are young men see more, more unilateral. The degree of pain and often associated with the etiology and the onset. First, with the onset of sciatica etiology varies. The most common protrusion of the lumbar intervertebral disc, often in the force, bending or strenuous activities, such as incentives, acute or subacute onset. A small number of chronic onset. The pain is often from the waist to the side of the buttocks, thigh, calf and foot lateral popliteal fossa, radiation, or burning a knife like pain, cough and exertion can exacerbate the pain, even at night. In order to avoid the nerve stretch, compression, often take a pain reduction posture special, such as sleep lying to the contralateral hip and knee flexion, while standing, focus on the healthy side, a cause of scoliosis, bending the contralateral seat into the hip to the contralateral tilt, to relieve pressure on the nerve root. Pull the sciatic nerve can induce pain, or pain, such as Kernig syndrome (positive patient supine, first hip flexion knee at right angles, then lift the leg. Due to the extension of knee flexor spasticity, and thus less than 130 degrees and there is pain and resistance); SLRT (Lasegue syndrome) (positive patient supine, lower limbs, limb elevation into less than 70 degrees caused by leg pain). The sciatic nerve pathway may have tenderness, such as the point of the waist, hip, country, ankle and plantar. Numbness and decreased sensation in the lateral and dorsal leg. Gluteal muscle tension relaxation, extensor hallucis and flexor pollicis muscle weakness. Achilles tendon reflex diminished or disappeared. Two, sciatica onset with different etiology. Such as inducing cold or acute onset of multiple trauma. The pain is often from the hip to the thigh, the posterolateral and lateral foot. The pain of walking, moving and pulling sciatic nerve. Tenderness points below the hip, Lasegue positive and Kernig negative, multi curvature of the scoliosis to the affected side in order to reduce the tension of the sciatic nerve. According to the diagnosis and differential diagnosis of sciatica pain and radiation direction, factors that exacerbate pain, reduce pain posture, traction pain and tenderness point diagnosis is not difficult but very important to determine the cause. A lumbar disc herniation patients often have a long history of recurrent low back pain, or heavy physical labor history, often in a waist injury or acute onset of labor after bending. In addition to the typical symptoms and signs of sciatica, and lumbar muscle spasm, lumbar mobility and amount of flexion disappeared, intervertebral disc herniation parts have obvious tenderness and pain. X ray film can be involved in intervertebral space narrowing, CT examination can be confirmed. Two, cauda equina tumor slow onset, gradually increased. At the beginning of the disease often unilateral radicular sciatica, the gradual development of bilateral. At night, the pain was significantly increased and the course of disease was aggravated. Sphincter dysfunction and saddle area depression. There was a significant increase in the amount of cerebrospinal fluid (CSF) and cerebrospinal fluid (Froin) in cerebrospinal fluid (MRI) and cerebrospinal fluid (CSF) in the lumbar puncture. Three, lumbar spinal stenosis is more common in middle-aged men, often early "intermittent claudication, lower limb pain aggravated after walking, but to walk or rest after the symptoms were relieved or disappeared. When the nerve root or cauda equina is serious, also can appear on one side or both sides of sciatica symptoms and signs, the course of progressive, bed rest or traction therapy. X-ray or CT diagnosis of lumbosacral spine. Four, lumbosacral nerve root inflammation due to infection, poisoning, nutritional and metabolic disorders or pathogenic factors such as strain, cold. The onset of the disease is more acute, and the damage is often beyond the control area of the sciatic nerve, which is characterized by the weakness of the lower limb, pain, mild muscle atrophy, and Achilles tendon reflex. In addition, the need to consider lumbar tuberculosis, vertebral metastasis cancer. Sciatica, should pay attention to whether cold or infection, and the lesions of the sacroiliac joint, hip joint, pelvic and hip, except when necessary for lumbosacral spine radiography, also feasible sacroiliac joint X-ray, anal finger, gynecological examination and pelvic ultrasound examination to clear the cause. It happened in the treatment of this disease should be on the hospital to identify the etiology, active treatment makes nerve compression or irritation of the primary disease (such as lumbar disc herniation). Symptomatic treatment can be used antipyretic analgesics, such as Bloven, diclofenac etc.. Adjuvant treatment of sciatica pain episodes, available ice affected 30-60 minutes, several times a day, for two to three days, and then in the same interval with hot water bag apply to the affected area, can also take taking non prescription painkillers. A day before going to bed with a hot towel or cloth hot salt hot compress the waist and hips, the temperature is not too high, to comfort is appropriate. Sciatica note hard bed, the bed can insist on doing gymnastics. To rest, the law of life, to participate in various sports activities as appropriate. Pay attention to the protection of the waist and limbs to exercise, to timely change of underwear wet, damp clothes on the body is warm dry sweating, not immediately after a bath, to be sweating after washing, to prevent a cold, wind. In the period of acute pain, don't pick up more than 10 pounds (1 pounds per =0.9072 weight) and do not use the arms and legs and back on the lifting force, but don't push pull a heavy load. In order to avoid pulling the sciatic nerve, to relieve pain, patients often have some special pain relief posture, such as sleep to sleep like a healthy side, leg hip knee slightly bent. Sit down with the hips on the healthy side. When standing, the body center of gravity in the health side, bent down to pick things, limb knee flexion, a long time will cause scoliosis, mostly bent to the lesion side. Any test of sciatic nerve can induce or aggravate pain. Along the nerve pathways points: such as the equivalent of lumbar paravertebral, Huantiao point, lateral ankle and foot fibular head below the central government may have obvious tenderness. In addition to pain, acupuncture, and feeling numb with the lateral aspect of the lower leg and foot dorsum, rear thigh and leg muscle weakness, lack of soft mild muscle atrophy.

 

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