1.What is the sciatic nerve?
The sciatic nerve is the thickest peripheral nerve in the body. It consists of part of the lumbar 4 and 5 and sacral 1-3 nerves converging in the pelvic cavity to form the sciatic nerve, which penetrates the pelvis through the lower edge of the sciatic foramen pyriformis and travels down the back of the thigh to the toes.
2.Typical performance.
The typical manifestation is the affected pain from the buttock along the lateral back of the thigh to the lateral side of the calf and ankle, which may be accompanied by weakness and numbness of the calf and foot. The pain can be triggered and aggravated by the strain and stimulation of the sciatic nerve, such as bending, lifting heavy objects, coughing, etc.
3. Etiology.
Any injury or disease near the sciatic nerve itself or along the line of walking can occur sciatica.
It can be summarized into the following major categories.
(1) trauma, such as lumbar fractures, nerve contusions, etc.
(2) Inflammatory diseases, such as neuritis, lumbosacral tuberculosis, epidural abscess, etc;
(3) Tumors, such as neurofibroma, primary or metastatic tumors of the lumbosacral vertebrae
(4) nerve entrapment due to lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, etc.
(5) pear-shaped muscle syndrome: compression of the sciatic nerve due to spasm of the pear-shaped muscle caused by posterior sacral buckling.
Among the many causes mentioned above, the most common causes of sciatica are disc herniation and pear-shaped muscle syndrome, especially in young adults.
4.Treatment.
(1) Drug treatment: anti-inflammatory and analgesic, nerve nutrition, muscle relaxation, etc.
(2) Local injection analgesic treatment: compound betamethasone, methylcobalamin (neurotolepin) and lidocaine are injected into the sacral canal or local injection after proportioning, once a week for 2-3 times. It has obvious effect on reducing edema of nerve root and eliminating pain.
(3) In the acute stage of lumbar disc herniation, lumbar spine traction or traction plus massage reset method also has better effect.
(4) correct Chinese medicine massage, to find experienced doctors to carry out, to prevent the “charlatan doctors” brutal techniques caused by side injuries.
(5) The correct use of protective lumbar girth can help limit lumbar activities and prevent recurrence of sciatica symptoms, but long-term use may aggravate lumbar muscle atrophy, and the use of lumbar girth must be combined with strengthening lumbar back muscle exercises to help prevent recurrence.
(6) Surgery: For those with long duration, recurrent attacks, ineffective conservative treatment, urinary and fecal dysfunction or obvious weakness of calf muscles, and no contraindications to surgery, surgery should be performed, and the majority of surgical results are better.