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Sciatic pain - sciatic discomfort
Pain in sciatica: sciatica
A careless movement, heavy lifting or a wrong stooping: Sciatic complaints occur suddenly and unexpectedly. They usually begin as a pain in the back and the back and radiate from there into the leg, sometimes even into the foot or toe. The pain is usually very strong and can be any form of movement to torment. Sciatica is often thought of as a herniated disc. But on closer examination, different symptoms, which point to a variety of possibilities of origins and causes.
contents
- Pain in sciatica: sciatica
- definition
- Symptoms of sciatica
- Causes of sciatic pain
- Degenerative changes of the intervertebral discs
- Sciatica problems due to hip surgery
- diagnosis
- First aid with sciatica
- Treatment options for sciatica
- Naturopathy with sciatic pain
definition
The sciatic nerve, referred to as the sciatic nerve (also called "ischial nerve" or "hip nerve"), is the longest peripheral and largest and thickest nerve in the human body. It guides nerve fibers for movement of the muscles as well as sensibility from the spinal cord to the leg.
The sciatic nerve is the biggest nerve in the whole body and can cause massive pain without warning. (Image: bilderzwerg / fotolia.com) The sciatic nerve has its origin in the lumbar-sacral network (plexus lumbosacralis), which supplies the legs and the buttocks region. From there, it first passes under the largest gluteal muscle (gluteus maximus muscle) through the large ischial bone (foramen ischiadicus majus) and then runs between the thigh flexors at the back of the thigh. Just before the popliteal fossa, it branches out into the fibular nerve (common fibular nerve) and the tibial nerve (tibial nerve), both of which continue along the lower leg towards the foot.
In case of pain in sciatica, medically referred to as "sciatica" or colloquially often simply as "sciatica", it is therefore actually a neuralgia (nerve pain), which is caused by damage or irritation of the nerve.
Symptoms of sciatica
Sciatic pain is typically perceived as a severe low back pull at the level of the lumbar spine. This can radiate into the leg or even into the foot and usually intensifies when coughing or pressing. In addition to the sometimes very severe pain, further symptoms can occur as part of a sciatica. These include, for example, numbness, tingling, decreasing coordination ability or paralysis and, in very severe cases, bladder and bowel disorders (incontinence).
If the cause of the discomfort is a herniated disc, the symptoms are predominantly sudden and very violent and are described by those affected as tearing and stinging. The sciatica is often confused with the so-called lumbago (Lumbago) - in which only the back is affected and the affected person feels no leg pain. A sciatica and a lumbago, however, can occur at the same time (lumboischialgie).
Everyday movements are often felt by sciatica sufferers as very painful. (Image: Ana Blazic Pavlovic / fotolia.com) In general, pain in the sciatica often causes problems with everyday movements (sitting, walking, standing, running, etc.). These problems usually persist day and night, even when lying down. How long they last depends on the degree of damage to the nerve. In mild to moderate damage, the symptoms usually disappear after some time, the duration may vary between a few days and several weeks. However, in very severe cases, often only surgical intervention can provide lasting relief.
Causes of sciatic pain
The complaints always occur when the sciatic nerve is blocked or damaged. This can happen, for example, due to blockage or muscle tension in the thighs and buttocks due to over-sitting, or too little physical activity or improper exercise (e.g., improper running style). Similarly, different leg lengths and resulting malpositions or postural errors when sitting and standing as a trigger into consideration.
Reason may be a trapped sciatic nerve z. B. as a result of bad posture or accidents. Furthermore, fractures, dislocations and intramuscular injections (for example in the buttocks) are conceivable, since they can lead to injuries of the sciatic nerve and thereby trigger the symptoms.
Moreover, in principle, anything that puts pressure on the nerve can cause pain. These include e.g. Circulatory disorders, bony changes in the vertebral joints, fractures and thickened ligaments. Possible inflammations, for example, as a result of a tick bite (Lyme disease) or a so-called "shingles" (herpes zoster).
In rare cases, rheumatic diseases, pronounced spondylolisthesis (spondylolisthesis) or narrowing of the spinal area caused by tumors are the cause. Therefore, the cause of the complaint should always be clarified by a doctor.
Degenerative changes of the intervertebral discs
One of the main causes of ischialgia is degenerative changes in the two lower intervertebral discs of the lumbar spine. Excessive pressure applied to these fibrous tourniquet connections, which act as "shock absorbers" between the vertebral bodies (e.g., by a jerking motion during stooping), may result in disc protrusion or herniation at the root of the sciatic nerve. In this case, in addition to the typical sciatic pain in the lower back, also leg pain and sometimes emotional disorders or paralysis.
Often a herniated disc is the cause of the sciatic pain. In this, the inner core of the disc shifts and presses on the nerve roots in the lumbar spine. (Image: Henrie / fotolia.com) Sciatica problems due to hip surgery
The problems can occur following the surgical insertion of a hip prosthesis. Because hooks are hooked during the operation to expose the hip joint, it sometimes leads to a temporary reduced blood flow to the nerve. This can cause unpleasant and prolonged symptoms. Clarity in this case brings a thorough examination by the doctor or orthopedist or neurologist.
diagnosis
In order to be able to treat the complaints in a targeted manner, the doctor first has to find out whether it is actually a disease of the sciatic nerve and not, for example. another form of backache or low back pain. Therefore, in the context of the diagnosis, it is first asked how the pain actually occurs (locally limited or radiating), when or in which situations, and whether possibly back pain has already occurred in the past.
In addition to the subsequent clinical examination, X-ray and ultrasound examinations, computer and MRI scans, as well as blood, cerebral and cerebrospinal fluid examinations are also used in diagnostics. If necessary, various neurological methods help to check possible feelings or misperceptions.
It is important to examine the patient for possible misalignments as a result of different leg positions, which must be compensated in the later treatment by specially adapted orthopedic insoles.
First aid with sciatica
As a first aid measure for severe pain in the sciatic, it is often helpful to lie flat on your back, while raising your legs and put the lower legs in a right angle to the thighs on a chair. Through this so-called "stage storage" the lumbar area is relieved and stretched at the same time. In many cases, a gentle movement also has a beneficial effect. On the other hand, sitting and overprotecting usually increase the discomfort.
Staging is a helpful exercise for acute sciatic pain to relieve the lumbar area. (Image: Clemens Schüßler / fotolia.com) Treatment options for sciatica
The focus of treatment is the rapid elimination of pain and its causes. Since an inflamed ischemic nerve can be extremely painful, it is usually first prescribed painkillers and anti-inflammatory drugs (such as cortisone). Attention: These should only be taken after careful medical consultation and only for a short period of time. A quick improvement in the discomfort will bring narcotic injections directly into the tight back muscles.
In addition to the acute pain treatment - depending on the cause - in most cases bed rest, general protection, warmth (for example, by heat patches or warm compresses) and light massages for the relief of pain. A too long protection should be avoided, because exercise and physical activity are basically essential for a healthy, symptom-free back.
Generally and especially for the prevention or therapy of back problems, it is therefore advisable to ensure adequate and regular exercise and to strengthen the back muscles. With recurring problems with sciatica also so-called "back schools", physiotherapy, osteopathy, chiropractic, massage or acupuncture often have a positive effect.
In some cases surgery may be necessary. Examples are a strong or recurrent disc herniation or increasing motor disturbances such as concomitant functional impairments of the bladder and bowel. The latter are always an alarm signal, which should be followed by a visit to the neurosurgeon. Furthermore, in case of reflex or sensory disturbances an operative treatment is considered. The success of such an intervention depends, among other things, on the degree of disc and nerve damage as well as the age of the patient. In young patients (under 35 years) there are usually no problems here.
Important: Basically, in the case of persistent or recurring pain in sciatica as soon as possible to seek medical treatment - because only then can the risk of chronic complaints be mitigated.
Naturopathy with sciatic pain
The field of natural medicine offers a variety of uses for sciatic pain. If tensions are the trigger, the so-called "Kneipp castings" or, in this case, the "warm castings" have proven themselves in many cases. For this, the water is adjusted to about 42 ° and blasted up to 5 minutes on the aching muscles. In most cases, this will quickly lead to a significant relief of the symptoms.
Rügen healing chalk can be very helpful in sciatica, because it warms and relieves pain. The remedy is obtained from the natural chalk deposits of the island. (Image: Igor Tarasov / fotolia.com) The Rügen healing chalk is a special remedy for problems with the sciatica: It is degraded in the interior of the Baltic Sea island and used for both cosmetic and medical purposes, with their main properties are a good heat storage and fineness. In case of problems with the sciatica, the chalk is used as a bath additive.
Kreidebad against sciatic pain:
How much chalk is needed for the bath depends on the degree of grinding. Information on this can usually be found on the product packaging. |
Tip: If the chalk bath is to be taken in a suitable therapy facility, a prior contact with the health insurance is recommended - because the chalk is recognized as a localized remedy and can thus be billed by approved institutions (eg physiotherapies). In an outpatient treatment, most funds even take a subsidy for the accommodation.
Homeopathic remedies are well suited for the natural treatment of sciatica, as well as Schüssler salts are often used. However, the specific selection, dosage and form of application should be made in both cases with the help of appropriate experts. (nr, last updated on 11.1.2017)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)