Sciatic nerve pinched

Pinched sciatic nerve

Commonly referred to as low back pain, in the back of the leg or buttocks in general as sciatica, which are often caused by a trapped sciatic nerve. There are several ways in which a sciatic nerve can become trapped - the most common cause is a disc herniation in which jelly-like tissue emerges from the intervertebral discs, thereby creating pressure on the sciatic nerve. Due to similar symptoms sciatic pain caused by a trapped sciatic nerve is often confused with a lumbago - however, a doctor can quickly clarify this.

Contents:
definition
Causes pinched sciatic nerve
symptoms
Causes of trapped sciatic nerve
diagnosis
treatment options
Naturopathy pinched at sciatic nerve

definition

The sciatic nerve (sciatic nerve) is the largest nerve in the human body and passes stimuli from the leg over the spinal cord to the brain or passes the movement impulses from the brain via the spinal cord to the muscles of the leg - this is necessary for the legs can be moved at all. The sciatic nerve occurs in the buttocks to the surface and runs at the back of the thigh. In the popliteal fossa, it divides into the fibular nerve (common fibular nerve) and the tibial nerve (tibial nerve), both of which continue along the lower leg towards the foot. The symptom "sciatic nerve clamped" is hard to define in a consistent way because it basically includes everything related to (mostly unilateral) back pain, back pain, back pain and pain on the back of the leg or calf.

If the sciatic nerve is trapped, complaints can be detected in its area of ​​care. (Image: rob3000 / fotolia.com)

Causes pinched sciatic nerve

The sciatic nerve is the body's largest nerve and must run through bottlenecks to its terminal areas. The two most plausible reasons why the phrase "pinched sciatic nerve" has found such a massive input into everyday usage: first and foremost, of course, is the entrapment by an intervertebral disc at the exit from the spine. As a second possibility, there is the entrapment of the sciatic nerve as it exits the surface under the gluteal muscles. The problem is also known as piriformis syndrome because the muscle under which the sciatic nerve passes is the piriformis muscle. In current anatomy books such as the "Prometheus" series from the Thieme Verlag, above and below the piriformis muscle small, almond-core thickenings are drawn, which are referred to as hernias. Here are so small pieces of tissue between the muscles emerged.

Whether they cause themselves as a trapped mass or secondarily by pressure on the nerves that cause pain in the buttocks is hard to understand. What is certain is that even with a herniated disc, in the very rare cases, those affected point to the point where the disc would have to press on the nerves, but usually specify the pain below the piriformis muscle punctually or from there to the back of the thigh down sometimes to the calf. And even if the pain is indicated in the back of the spine, there are often similar thickenings in the tissue - which are also listed as "inferior lumbar hernia" in the "Prometheus" mentioned at the beginning.

It is conceivable that due to an abnormally increased tension before the onset of the discomfort, a tissue part can more easily pass through the muscles. Basically, observations in practice do not support the assumption that people with softer connective tissue tend to have these symptoms in the buttocks. Theories that favor herniated discs as the cause of buttocks pain or back pain are based in part on the fact that so often the lower spinal column sections are affected by herniated discs, because overlying and underlying sections are very firm. This means that the triggers are seen not only locally but in relation to neighboring regions. The orthopedic diagnoses are usually based on structural causes, such as reduced intervertebral discs (osteochondrosis), degenerative changes in the vertebrae (spondylosis) or spondylolisthesis themselves.

symptoms

In the case of an allegedly trapped sciatic nerve, sufferers often complain of pulling pain on the back of the thigh, which worsens after prolonged lying (especially in the morning after getting up) or sitting and usually drains off a little by movement. However, as soon as more physical stress occurs (for example, by standing for long periods or longer walks), the pain returns. In addition to the drawing pain, there is often a pointy pain on the buttocks in connection with a trapped sciatic nerve. It is a place next to the sacrum, on which often a painful thickening can be felt. Since the pain usually "shoots" suddenly due to a trapped sciatic nerve, it is often confused with a lumbago. The main difference between the two symptoms, however, lies in the pain radiation - because with the lumbago, the pain does not radiate into the legs, but concentrate on the area of ​​the lower back. However, there is also a combination of lumbago and sciatic pain, which is referred to in technical terms as "lumbosia".

In general, the intensity of the pain due to a trapped sciatic nerve is perceived very differently by those affected - therefore, in each case an accurate diagnosis is necessary in order to fathom appropriate treatment options. For prolonged as well as severe or repeated pain should necessarily be consulted a doctor.

Causes of trapped sciatic nerve

The causes of a trapped sciatic nerve are manifold, but in most cases, the pain is caused by a herniated disc, in which by the displaced intervertebral disc pressure is exerted on the sciatic nerve, which eventually leads to an entrapment and lack of supply. Here, it is often assumed that the lower spinal column segments in particular are affected by the herniated discs, since above and below sections are very strong and thus less susceptible to exiting tissue material.

Another common cause of a trapped sciatic nerve is the so-called "piriformis syndrome," which occurs when the piriformis muscle (an internal hip muscle), the sciatic nerve, or one of its branches pinches when passing from the pelvis to the thigh.

Among other things, this can be triggered by a one-sided overload, which affects in particular people who often have to lift out of a straddle out hard, spend a lot of time sitting or who always stoop a lot and usually wrong. In addition, the Piriformis syndrome can also be caused by fall injuries in the buttocks area.

An increased risk that the sciatic nerve can be trapped, there is also for runners. Although running is on the one hand a good prevention against back problems of any kind, nevertheless the sciatic nerve causes some assets sometimes great problems - because by lifting the legs in the course of the running movement it can lead to muscle tension, which usually results from muscle shortening insufficient stretching exercises the thigh backs comes. In turn, muscle shortening often results in erroneous running posture, which can eventually cause the sciatic nerve to become pinched or pinched, potentially causing massive pain.

Other causes of a trapped sciatic nerve include structural causes, such as decreased intervertebral discs (osteochondrosis), degenerative changes of the vertebrae (spondylosis) or spondylolisthesis (spondylolisthesis).

diagnosis

Frequently, the diagnosis "pinched sciatic nerve" is made by those affected themselves, so it is often not easy to clearly distinguish pain, which actually come from a trapped sciatic nerve, from diagnoses with a similar symptomatology and thus to achieve the most effective treatment possible. To be sure that the pain is actually related to the sciatic nerve and not, e.g. Accordingly, the patient is first questioned exactly to the nature and circumstances of the complaints by other forms of back pain or back pain. In addition, the clinical examination is carried out, in addition to the diagnostics in some cases, X-ray and ultrasound examinations, computer and magnetic resonance imaging and blood, cerebral and spinal fluid, as a jammed or damaged sciatic nerve not only prepares The typical buttocks or leg pain, but may also be accompanied by incontinence, emotional and motor disorders or a disturbance of the reflexes.

treatment options

As an immediate measure in case of pain by a trapped sciatic nerve, the so-called "step bearing" helps in many cases - here, the lower legs are stored on a chair or a box from the supine position so that they lie at a 90 ° angle to the thighs. As a result of this exercise, one should always get up and move easily, e.g. slow and short walks or some gentle back exercises, but those affected should be instructed by an expert first to avoid aggravating the pain of wrong movement. A longer bed rest, however, should be avoided in a trapped sciatic nerve, as heavy lifting and carrying. In addition, heat helps in most cases, as it leads to a relaxation of the muscles and thus often to a relief of the pain. Recommended here are e.g. Thermal patches from the pharmacy, heating or grain pillows, fango and peat packs or a hot water bottle, in addition, a warm bath with a muscle relaxant or relaxing bath additive can be beneficial - this should only be taken in the presence of other people, in case of emergency To help you to leave the tub.

However, if the pain continues despite these measures over a longer period of time or strengthen, but should urgently consult a doctor, because only this can make a sound diagnosis and exclude more serious causes such as a herniated disc and physiotherapy, massages or if necessary prescribe pain medications.

If the trapped sciatic nerve is the result of a herniated disc, it must be treated first of all. In this case, a short bed rest is necessary to relieve the spine, but longer periods should be avoided - instead, careful and slow movement is advisable to loosen up the tense muscles and stimulate the blood circulation. To relieve pain in a herniated disc usually at the beginning of pain and anti-inflammatory agents are used, occasionally be injected with very strong pain and locally anesthetic drugs or cortisone. If the patient can move pain-free again through the pain therapy, the next step in a herniated disc is the strengthening of the back muscles by means of suitable physiotherapeutic exercises, massages, relaxation exercises, such as massage. Progressive muscle relaxation according to Jacobson or special exercise therapies such as aqua-gymnastics. While these conservative measures can successfully treat 90% of the herniated discs, the remaining 10% usually only aid one operation - especially if paralysis occurs or the pain killers have no effect. During surgery, the herniated disc is surgically removed, thereby relieving the trapped sciatic nerve. Following the operation or the usually relatively short stay in the clinic, an outpatient or inpatient follow-up treatment in the form of rehabilitation ("rehab") is recommended..

If the cause of the trapped sciatic nerve in the "Piriformis syndrome", are also physiognomic exercises in the center, in addition may also be physical therapy applications such as electrotherapy used. In the case of severe pain, physicians often recommend the short use of an analgesic or muscle-relaxing medication. If trigger points are found, the doctor can treat them directly with the local injection of an anesthetic. In addition, "Transcutaneous Electrical Nerve Stimulation" (TENS) also provides relief in some cases by attempting to minimize pain by electrically irritating the skin in the pain region.

Naturopathy pinched at sciatic nerve

In addition to conventional medicine, naturopathy offers various approaches to explain the causes of a trapped sciatic nerve and - depending on the case - an alternative or supplementary a number of therapeutic approaches. For example, see osteopathy in the sense of its "holistic approach" in a trapped sciatic nerve, a connection to the sacrum-iliac joint, the so-called sacroiliac joint and focused in the therapy accordingly not only on the complaint site, but involves in the manual treatment of the whole body ie Muscles, joints, organs and their connections. Also, the concept of trigger points is often used in osteopathy, here e.g. In addition to the manual therapy with the so-called "dry needling" are treated: It is engraved with a thin acupuncture needle precisely in the trigger point, which is regarded as a trigger for the current symptoms. This irritation relieves existing cramps, improves local circulation and inhibits inflammation - without the need for medication. The effect is here by the precise stitch of the needle in the trigger point, hence the term "dry needles".

Another option for manual treatment of a trapped sciatic nerve is "rolfing," which loosens hardening and shortening to the deepest layers of connective tissue, resulting in more mobility, better posture, freer breathing, and relieves pain. In some cases, neural therapy also relieves pain caused by a trapped sciatic nerve, as local anesthetics are injected on the lower back into specific points near the nerves with the goal of balancing neural irritation and activating the self-healing powers of the body. In addition, Naturopathy offers a variety of other uses for sciatic pain, such as Procedure according to Sebastian Kneipp or Hildegard von Bingen. (No)