Pain in sciatica: sciatica symptoms
Careless movement, heavy lifting or a wrong stooping: sciatica symptoms appear suddenly and unexpectedly. They usually begin as a pain in the lower back and buttocks and radiate from there into the leg, sometimes even into the foot or toes. The pain is usually very severe and makes every form of movement a pain. Sciatica is often thought of as a herniated disc. However, a closer look reveals different symptoms, which refer to a variety of possible causes and causes.
Sciatica, the sciatic nerve (also known as the "ischial nerve" or "hip nerve"), is the longest peripheral and at the same time largest and thickest nerve of the human body. It guides nerve fibers for the movement of the muscles and for the sensitivity from the spinal cord to the leg.
The sciatic nerve has its origin in the lumbar-sacral nerve network (plexus lumbosacralis), which supplies the legs and the buttocks region. From there, it first runs under the largest gluteus muscle (gluteus maximus) through the large ischial hole (foramen ischiadicus majus) and then runs on the back of the thigh between the hamstrings. Shortly before the hollow of the knee, it branches into the fibula nerve (common fibular nerve) and the shin nerve (tibial nerve), both of which continue along the lower leg towards the foot.
Pain in sciatica, medically known as "sciatica" or colloquially often simply referred to as "sciatica", is therefore strictly speaking a neuralgia (nerve pain), which is caused by damage or irritation of the nerve.
Symptoms of sciatica
Sciatic pain is typically perceived as a strong pull in the lower back at the level of the lumbar spine. This can radiate up to the leg or even into the foot and is usually intensified when coughing or pressing. In addition to the sometimes very severe pain, further symptoms can occur in the context of sciatica. These include, for example, feelings of numbness, tingling, decreased coordination or paralysis and, in very severe cases, bladder and bowel disorders (incontinence).
If the cause of the symptoms is a herniated disc, the symptoms mostly appear suddenly and very violently and are described by those affected as tearing and stinging. Sciatica is often confused with lumbago, which only affects the back and does not cause leg pain. Sciatica and lumbago can occur at the same time (lumboischialgia).
In general, pain in sciatica often causes problems with everyday movements (sitting, walking, standing, running, etc.), which usually do not subside even when lying down, but persist day and night. How long they last depends on the degree of nerve damage. With mild to moderate damage, the symptoms usually disappear after a while, the duration can vary between a few days and several weeks. In very severe cases, however, only surgery can bring lasting relief.
Causes of sciatica pain
The symptoms always arise when the sciatic nerve is blocked or damaged. This can happen, for example, due to blockages or muscle tension in the area of the thighs and buttocks as a result of excessive sitting or insufficient physical exercise or incorrect exercise during sporting activities (e.g. incorrect running style). Different leg lengths and the resulting misalignments or postural errors when sitting and standing are also possible triggers.
Reason a pinched sciatic nerve z. B. as a result of incorrect posture or accidents. Broken bones, dislocations and intramuscular injections (e.g. into the buttocks) are also conceivable, since these can lead to injuries to the sciatic nerve and thereby trigger the symptoms.
In addition, anything that puts pressure on the nerve can in principle cause pain. These include e.g. Circulatory disorders, bony changes in the vertebral joints, fractures and thickened ligaments. Inflammation is possible, for example as a result of a tick bite (borreliosis) or a so-called "shingles" (herpes zoster).
In rare cases, rheumatic diseases, pronounced vertebral sliding (spondylolisthesis) or narrowing in the vertebral area due to tumors are the cause. Therefore, the reason for the complaint should always be clarified by a doctor.
Degenerative changes in the intervertebral discs
A major cause of sciatica is degenerative changes in the lower two intervertebral discs of the lumbar spine. If an increased pressure is exerted on these fibrous-cartilaginous connections, which are located between the vertebral bodies as a “shock absorber” (e.g. due to a jerky movement when bending over), this can lead to a bulging of the intervertebral discs or a herniated disc at the level of the root of the sciatic nerve. In this case, in addition to the typical sciatic pain in the lower back area, there are also leg pain and sometimes emotional disorders or paralysis.
Sciatica problems from hip surgery
The problems can occur after the surgical insertion of a hip prosthesis. If hooks are inserted during the operation to expose the hip joint, the blood flow to the nerve may occasionally be reduced. This can result in uncomfortable and long-lasting symptoms. In this case, a thorough examination by the doctor, orthopaedist or neurologist brings clarity.
In order to be able to treat the complaints in a targeted manner, the doctor must first find out whether it is actually a sciatic nerve disease and not e.g. to another form of back pain or lower back pain. Therefore, in the context of the diagnosis, the first question asked is how the pain actually occurs (localized or radiating), when or in which situations and whether back problems may have occurred in the past.
In addition to the subsequent clinical examination, X-ray and ultrasound examinations, computer and magnetic resonance imaging as well as blood, brain and spinal cord fluid are also used in the diagnosis. If necessary, various neurological methods help to check possible emotional disorders or sensations.
It is important to examine the patient for possible misalignments as a result of different leg positions, which must be compensated for in the subsequent treatment by specially adapted orthopedic insoles.
First aid for sciatica
As a first aid measure for severe sciatica pain, it is often helpful to lie flat on your back, lifting your legs and placing your lower legs on a chair at approximately the right angle to your thighs. This so-called “step positioning” relieves the lumbar region and at the same time stretches it. In many cases, careful movement is also beneficial. Sitting as well as too long protection usually increase the symptoms.
Treatment options for sciatica
The focus of the treatment is on quickly eliminating the pain and rectifying its causes. Since an inflamed sciatic nerve can be extremely painful, pain and anti-inflammatory drugs (e.g. cortisone) are usually prescribed first. Attention: However, these should only be taken after a precise medical consultation and only over a short period of time. A rapid improvement in the symptoms brings narcotics injected directly into the tense back muscles.
In addition to acute pain treatment, depending on the cause, bed rest, general protection, warmth (e.g. through heat plasters or warm compresses) and light massages provide relief from pain in most cases. Too long protection should be avoided, since exercise and sporting activity are essential for a healthy, symptom-free back.
In general, 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. In the case of recurring problems with sciatica, so-called “back training”, physiotherapy, osteopathy, chirotherapy, massage or acupuncture often have a positive effect.
In some cases, surgery may be necessary. Examples include a severe or repeated herniated disc or increasing motor disorders such as accompanying functional impairments of the bladder and intestine. The latter are always an alarm signal that a visit to the neurosurgeon should follow. Surgical treatment is also considered for reflex or sensory disorders. The success of such an intervention depends, among other things, on the degree of damage to the intervertebral discs and nerves and the age of the patient. For young patients (under 35 years of age) there are usually no problems.
Important: In principle, in the event of persistent or repeated pain in sciatica, seek medical treatment as quickly as possible - this is the only way to reduce the risk of chronic complaints.
Naturopathy for sciatica pain
The field of natural medicine offers a wide range of applications for sciatic pain. If tension is the trigger, the so-called "Kneipp casts" or in this case the "warm castings" have proven their worth. For this, the water is set to approx. 42 ° and blasted on the aching muscles for up to 5 minutes. In most cases, the symptoms are quickly relieved.
The Rügen healing chalk is a special remedy for problems with sciatica: It is mined in the interior of the Baltic Sea island and used for both cosmetic and medical purposes, the most important properties of which are good heat storage and fineness. If there are problems with sciatica, the chalk is used as a bath additive.Chalk bath for sciatic pain:
- Put the Rügen healing chalk (from the pharmacy) in bath water at 38 to 40 ° C
- Bathe in the chalk water for 20 minutes
- Then take a warm shower and sweat in the preheated bed for about half an hour
How much chalk is needed for the bath depends on the degree of grinding. Information about this can usually be found on the product packaging.
Tip: If the chalk bath is to be taken in an appropriate therapy facility, prior contact with the health insurance company is recommended - because the chalk is recognized as a local remedy and can therefore be billed by approved institutions (e.g. physiotherapy). In the case of an outpatient treatment, most health insurance companies even subsidize accommodation.
Homeopathic remedies are well suited for the natural treatment of sciatica, and Schuessler salts are also frequently used. In both cases, however, the specific selection, dosage and form of application should be made with the help of appropriate experts. (No)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch
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