It is established that the sciatica complains about 80% of people. By the number of sick leave sciatica is second only to colds. While most sciatica is evidence of irregularities in the spine, it can also be the result of the urogenital, gastrointestinal, cardiovascular disease or tumor development. Imbalance as a result of pregnancy can also cause sciatica .
This pain is most often seen in the lower back or lumbosacral region. It may be a reflection of the pain in his stomach or side, evidence of such life-threatening diseases such as Perforated ulcer, acute pancreatitis or abdominal aortic aneurysm.
Localization, distribution, development of pain, patient's response to the motion or state of rest can help identify causes pain disorder. This pain can be acute, chronic, permanent, temporary, localized or propagating along the spine or the legs. Usually the pain is magnified when the patient is in motion - walking, tilting, lifting weights. At rest, it may subside, but may persist.
Mechanism
Internal sciatica are the result of muscle spasm, nerve irritation, fractures, or a combination of some of the following reasons.
Possible causes of sciatica
Central nervous system
Chordoma. With the development of tumors observed in constant pain in his lower back, lower back and tailbone.
Spinal cord tumor (benign). Usually, this disease causes severe sciatica and scoliosis.
Cardiovascular disorders
Abdominal aortic aneurysm. With a life-threatening abdominal aortic bundle there pain in his lower back and dull pain in lower abdomen. More pain in the upper abdomen.
Diseases of the digestive tract
Appendicitis. In this life-threatening disease, there is a dull ache in the epigastrium and umbilical region. Pain moves to the point of Mac Berneya in the lower right quadrant of the abdomen. In the lumbar appendicitis pain can give back. Offset pain is preceded by anorexia and nausea.
Cholecystitis. This disease is accompanied by severe pain in the upper right quadrant of the abdomen. The pain may be given in the right shoulder, chest or back. Pain or occur suddenly or develop gradually over several hours.
Pancreatitis (acute). In this life-threatening disease, as a rule, there is a strong long-lasting pain in the upper abdomen, which runs counter to both the sides and back. To ease the pain a patient may bend forward, knees pressed to his stomach or whirl from side to side.
Perforated ulcer. In some patients, gastric ulcer or intestinal causes severe pain in the epigastrium, which may give in his back and into all areas of the abdomen.
Genitourinary diseases
Carcinoma of the prostate. Chronic sciatica may be the only symptom of this disease. Carcinoma of the prostate can also cause the appearance of cloudy urine, and hematuria.
Pyelonephritis (acute). This disease causes progressive pain in the sides and abdomen, and sciatica (especially in the costovertebral angle).
Kidney stones. In the formation of kidney stones colic occur due to irritation of the ureters, which increases with the reduction of internal muscles. The pain spreads from the costovertebral angle to the sides, the pubis and genitals. In moving the stones, the pain may increase.
Musculoskeletal disorders
Ankylosing spondylitis. This is a chronic, progressive disease causes pain in the back and spine. The pain intensified with increasing pressure on the spine, especially badly they appear in the morning, after a period of immobility. Rest usually does not bring relief.
Vertebral disc displacement. At the same time shifting suddenly or gradually, a strong pain in his lower back, which can give a leg. In rare cases, there is only pain in the legs. Much more often the pain extends from the back of the buttocks and legs. Of movement, coughing, sneezing, pain increases, and during the holiday passes.
Stretching the lower back. With this extension there is localized pain caused by muscle spasms or movements. To ease the pain the patient is usually bend at the knees and hips. Flexion of the spine intensifies pain, and relaxation - making it easier to.
Myeloma. sciatica during the formation of such tumors usually occur suddenly and increases with exercise.
Reiter's syndrome. In some patients, pain in the rump - the first sign of this disease.The pain is accompanied by the classic triad of symptoms - conjunctivitis, urethritis, and arthritis.
Stretching the sacrum. Pain in the sacrum can give to the buttocks, hips and inner thigh. The pain increases with weight lifting and shifting of weight on his feet.
Stenosis of the spine. The pain is similar to that which occurs when the displacement of the spinal disc. sciatica may be accompanied by sciatica.
Spondylolisthesis. With this shift of the vertebrae relative to each other or no symptoms is not found, or there is pain in your lower back from touching the nerve endings.
Transverse fracture of the spine. This fracture causes severe local pain, muscle spasm and hematoma.
Compression fracture of the spine. Initially, this change can be painful. A few weeks may be a pain in the back when lifting heavy objects. Fracture of thoracic vertebrae can cause pain.
Caries spine. Initially, this disease causes pain in the back, which eventually becomes constant, worse at night and during movement.
Osteoporosis spine. This disease causes chronic sciatica , aggravated by movement and calm down during the holidays. Gynecological Diseases
Endometriosis. This disease causes severe pain in the sacrum and spasms in the lower abdomen. The pain is worse during menstruation and in front of it, can be facilitated during a bowel movement.
Tumors
Metastatic tumors. These tumors are usually distributed along the spine, causing pain in his lower back 25% of patients. Usually the pain begins abruptly, is accompanied by muscle spasms and does not cease during the holidays.Diagnostic tests
Temporary sciatica can cause puncture lumbar myelography and even.
Clinical indications
• If sciatica indicates life-threatening
violation:
- Should quickly check vital evidence and an inspection;
- Immediately inform your doctor.
• The need for immediate intervention or surgery should be to prepare the patient.
• If there is no danger to life:
- Should get the full history of the patient and make his inspection.
• Diagnosis may involve blood tests, chest x-ray of the abdomen and spine, CT scans of the spine biopsy.
• Prior to diagnosis is not recommended for pain medication because they can mask the causes of pain.
• Should help the patient to take as much as possible comfortable position for him.
• If a patient has chronic sciatica should be advised him bed rest, warm baths, pain medications and appropriate exercises (see Exercises for chronic pain in lower back
• The patient may need to brace or support arrangements for the back.
• The patient should be assisted in changing lifestyles. For example, to advise him to lose weight or to correct posture.
• You need to tell patients about alternative pain relief procedures, such as electrical stimulation of nerve endings.
• To relieve the pain can also recommend treatment with cold or warm, special boards for sleep or a massage mattress, as well as spinal traction.
• sciatica - an important feature of malignant tumors. Therefore, upon detection of a tumor patient should be referred to a psychologist or physical therapist.
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