Many ignorant ordinary people are sure that sciatica is a separate pathological condition, which is a little wrong. Radiculitis or radiculopathy is a pathological syndrome associated with damage to individual nerves extending from the nerve plexus or node.
In other words, sciatica is deformational changes or inflammatory processes of the spinal root.
The pathology is very common, it occurs mainly in persons with osteochondrosis vertebral lesions or hernial processes on the intervertebral discs.
Sciatica and osteochondrosis – is there a difference?
The pathologies of osteochondrosis and radiculitis have many common manifestations, which causes a lot of discussions between specialists about the terminology of these diseases.
Some experts consider sciatica as a symptomatic osteochondrosis manifestation. In some cases, sciatica acts as an osteochondrosis complication, when the pathology was treated incorrectly or there was no treatment at all.
It is possible to distinguish sciatica from osteochondrosis by the presence of muscle spasms and atrophy, when the patient tries to tilt his head, then severe pain occurs, similar to an electric shock. With osteochondrosis vertebral lesions, similar symptoms are not observed.
With osteochondrosis, pressure on the interosseous points provokes pain. In the case of sciatica, this symptomatology manifests itself only with pressure on the paravertebral muscles.
Symptoms
Most often, the cause of radiculitis is hernial processes between the vertebrae, which occur against the background of osteochondrosis pathology and dystrophic intervertebral changes.
In general, the symptoms of radiculopathic processes arise from physical compression of the nerve spinal roots. The localization of manifestations depends on the department in which the radiculopathic pathological process has developed .
Cervicobrachial and thoracic
For a similar form of radiculitis, the location in the cervical or thoracic spine is characteristic .
Usually, patients with such radiculitis are not able to fully move, it is difficult for them to lie down comfortably before going to bed, and at night they constantly wake up due to severe pain when changing posture.
Cervicobrachial sciatica is characterized by manifestations like:
- Burning, sometimes cutting soreness in the neck, radiating to the chest, shoulder, shoulder region or arms;
- Tone and pain syndrome in all cervical muscles;
- Headaches in the occipital or parietal zone, if the patient lies down, the pain goes away;
- Feeling of general weakness;
- Limited mobility of the neck;
- Tingling sensation in the upper limbs;
- Weakening of the muscles;
- The presence of autonomic disorders such as pressure surges, visual or auditory disorders, coordination disorders;
- Dizziness;
- Soreness when bending the head;
- Sensitivity disorders.
As for thoracic sciatica, it is quite rare and manifests itself:
- Severe chest and interscapular pain, which becomes more intense even with such minor actions as taking a deep breath, coughing, or changing body position during sleep;
- Shortness of breath and wet cough;
- Increased pressure;
- Cutting pain in the night;
- Constipation, intestinal distention, heartburn-like pain in the epigastrium .
If the radiculopathic process undergoes chronicity , then pain and other symptoms become less intense, but become constant.
Lumbosacral
The most common radiculopathic form, manifested by characteristic soreness in the lumbar (more details here), gluteal, femoral zone, in the calf muscles or lower leg.
Lumbosacral radiculitis manifests itself with the following symptoms:
- Sciatica or pain symptoms that occur in the gluteal region can go down the limb, right down to the foot. Sciatica is characterized by shooting soreness in combination with muscle weakness;
- Lumbago or shooting acute soreness in the lumbar region, lasting several minutes (may last for several days). Usually, lumbago is preceded by hypothermia or sudden physical movement. As a result of the pain syndrome, muscle tissue spasm occurs;
- Lumboischialgia – mixed symptoms, containing signs of lumbago and sciatica;
- Decreased sensitivity in the lower extremities up to its complete loss, a feeling of goosebumps, slight burning or tingling in them;
- When an attempt is made to raise a straightened leg from a position “lying on the back”, the patient develops a sharp pain syndrome ( Lasegue symptom ).
Discogenic
The discogenic form of radiculitis is considered the most specific among all types of this pathology; it develops in the lumbosacral vertebral zone and differs significantly from ordinary sciatica.
The discogenic form of radiculitis develops as a result of secondary inflammatory processes, while the main factor in the onset of pain is nerve root compression.
Some experts argue that the more correct name for discogenic radiculitis would not be radiculopathy , but radicalgia .
The characteristic manifestations of discogenic radiculitis are:
- Sudden pain syndrome, often radiating to one of the limbs;
- Sensitivity disorders;
- Movement disorders;
- Violations of the activity of some internal organs (in severe form);
- Deformation of tendon reflexes;
- Irritability, up to aggressiveness, due to the strongest pain sensations.
Pain symptoms, as a rule, make themselves felt after lifting weights or long activity in a bent position or a sharp turn of the trunk.
Signs
The specific symptoms of various types of radiculitis have been described above, but this pathology has some common features of the manifestations.
In general, signs begin to manifest themselves even in the patient’s behavior:
- With radiculopathy, patients become noticeably constrained in their movements;
- In an attempt to get rid of the pain, the patient often tosses and turns, looking for a comfortable position in which the pain will not be so intense;
- If you press on the affected area, the patient will feel a sharp painful lumbago.
Radiculopathic processes can occur on both sides or affect only one half of the body.
Causes of occurrence
As specified above, in most clinical cases (≈95%), the cause of radiculopathy is osteochondrosis processes associated with hernial protrusions and osteophytes. The remaining cases of pathology account for causes associated with paravertebral inflammatory pathologies, previous vertebral injuries, tumor conditions, etc.
The most common factor provoking pathology is hernial intervertebral processes. A hernial protrusion compresses and irritates the spinal nerve roots.
In addition, the formation of bone growths (osteophytes), narrowing of the canal in which the spinal cord passes (vertebral stenosis) contributes to the nerve-root irritation.
Sometimes the reasons for the development of radiculopathy are prolonged stress, material exchange disorders, hypothermia, pathological conditions of an infectious origin.
Diagnostics
Diagnostic practice begins with an analysis of patient complaints, a doctor’s examination in order to detect neurological symptoms.
Among the hardware procedures most often resort to computed tomography, magnetic resonance imaging and X-ray examination, spondylogram , myelography .
Sometimes a laboratory analysis of cerebrospinal fluid, blood is prescribed, a lumbar puncture is performed.
How to treat chronic sciatica at home
Home therapy for sciatica consists in the use of various anti-inflammatory and analgesic ointments that relieve spasms and soothe muscle tension.
Often, such ointment preparations are made on the basis of bee or snake venom, camphor or formic alcohol, red pepper extract, etc.
Among the pharmacy products, ointments like Ketonal , Viprosal , Finalgon, Nise or Voltaren are most effective . Rubbing with mustard oil is considered an effective home method, which is recommended for the night.
What helps with acute pain
In the case of a sharp exacerbation of chronic sciatica, characterized by acute shooting pain, which does not allow the patient to move. A person cannot turn his neck (with cervical radiculitis) or straighten out (lumbosacral form) and with great difficulty gets to the sofa.
In such a situation, it is recommended to lie down on a hard surface, take a comfortable position that delivers a minimum of pain, and take two capsules of a potent pain reliever to relieve pain.
It is recommended to rub an ointment with an anesthetic and warming effect into the affected area (Apizartron, Finalgon, etc.), you can use a pepper plaster or rub in some kind of warming solution like alcohol, novocaine, pepper tincture or chloroethyl.
Treatment of the disease during pregnancy
During pregnancy, sciatica is treated mainly by non-drug methods:
- Complete rest, bed rest for 2-3 days;
- Exercise therapy;
- Massage;
- Compresses.
It is allowed to resort to the help of pain medications, but only in extreme cases.
Consequences
If you do not start the timely treatment of radiculopathy , then the pathological processes will turn into a chronic course. If the hernia squeezes not only the roots, but also the vessels, then this is fraught with infarction of spinal cord injury.
Prophylaxis
The main preventive measures for sciatica are:
- Follow a healthy lifestyle;
- More physical activity;
- Use of orthopedic bedding;
- Implementation of a preventive exercise therapy complex;
- Avoid spinal injuries, hypothermia, stress, heavy physical exertion or long work in an uncomfortable position.
Answers on questions
Is it possible to take a steam bath?
Experts categorically prohibit visiting the bathhouse at the stage of acute radiculitis, since the fever will only increase the pain symptoms. Bath days are allowed only during remission or after recovery.
How many days do you get sick leave?
A sick leave for radiculitis is issued only in case of frequent pain attacks, as a result of which the patient is not able to engage in his professional activities. The duration of the sick leave is established by the doctor.
Which doctor is treating?
A neurologist is involved in the treatment of radiculopathic lesions, sometimes an orthopedic consultation is necessary.