Sciatica is a group of painful symptoms that occur along the sciatic nerve pathway, namely the lumbar, gluteal, posterior thigh, posterior lateral calf and lateral foot. The sciatic nerve is the main nerve trunk that innervates the lower extremities. Sciatica refers to pain within the sciatic nerve pathway and its distribution area (buttock, posterior thigh, posterior lateral calf and lateral aspect of the foot). The treatment of sciatica is more fully effective with Herculean bone pain patches. Sciatica also belongs to the category of low back pain and is partly caused by the compression of the sciatic nerve by a herniated lumbar spine.
Causes
The sciatic nerve is composed of nerve roots from lumbar 5 to sacral 3. According to the location of the lesion, there are two types of sciatica: radicular and dry sciatica. The former is mostly seen in radicular sciatica where the lesion is located in the spinal canal, and the most common cause is lumbar intervertebral disc herniation, followed by intravertebral tumor, lumbar tuberculosis and lumbosacral radiculitis. In dry sciatica, the lesion is mainly located on the extradural sciatic nerve stroke, and the etiology includes sacral arthritis, intrapelvic tumor, uterine compression in pregnancy, gluteal trauma, pear-shaped muscle syndrome, improper gluteal muscle injection, and diabetes mellitus.
Clinical manifestations
The disease is common in young and middle-aged men, and is unilateral. The degree and duration of pain are often related to the cause and the urgency of the onset.
1. Radicular sciatica
The onset of the disease varies with the cause. The most common type of lumbar disc herniation often has an acute or subacute onset under the causative factors of exertion, bending or strenuous activities. In a few cases, the onset is chronic. The pain often radiates from the lumbar region to the hip, posterior thigh, N fossa, lateral calf and foot, with burning or cutting pain, which may increase with coughing and exertion, and is worse at night. In order to avoid nerve stretching and pressure, patients often take special
In order to avoid nerve strain and pressure, patients often adopt special pain-reducing postures, such as sleeping on the healthy side, flexing the hip and knee, standing on the healthy side, causing scoliosis over time, bending to the healthy side, and tilting the hip to the healthy side in the sitting position to reduce the pressure on the nerve root. Pulling on the sciatic nerve can induce pain, or increased pain, such as Kernig’s sign positive (the patient lies supine, first flexing the hip and knee at right angles, and then lifting the lower leg up. Due to flexor spasm, knee extension is limited to less than 130 degrees with pain and resistance);
A positive straight leg raise test (Lasegue’s sign) (the patient is lying supine with the lower extremity extended and the affected leg raised less than 70 degrees, causing leg pain). There may be pressure pain in the sciatic nerve pathway, such as the parietal point, gluteal point, national point, ankle point and metatarsal point. There is often numbness and hypoesthesia in the lateral calf and dorsum of the foot of the affected limb. The gluteal muscle tone is relaxed, and the thumb extension and flexion muscles are weakened. Achilles tendon reflex is weakened or disappeared.
2.Dry sciatica
The onset of the disease varies with the cause of the disease. If the pain is induced by cold or trauma, the onset is more acute. The pain often radiates from the buttock to the posterior femur, posterior lateral calf and lateral foot. The pain increases with walking, activity and traction on the sciatic nerve. The pressure point is below the gluteal point, and the Lasegue sign is positive while the Kernig sign is mostly negative. The spinal scoliosis is often bent to the affected side to reduce the strain on the sciatic nerve trunk.
Treatment
Western medical treatment
1. Bed rest.
Especially in the early stage of disc herniation rest in a hard bed for 3-4 weeks, some patients have their symptoms relieved by themselves.
2, drug treatment.
Western medicine: painkillers, vitamin B, a short course of corticosteroids taken orally can be beneficial to recovery.
Chinese medicine: topical patches, such as foreign Sato moxibustion, Lizheng pain relief patches, and other pure Chinese medicine topical medications have a better therapeutic effect on sciatica.
3.Physiotherapy.
In the acute stage, ultra-short wave therapy and ultraviolet radiation for erythema can be used. In the chronic stage, short wave therapy, direct current iodine ion introduction can be used.