Sciatica

Sciatica (disease of the spinal nerve roots), diseases of the sciatic nerve and back pain are common. Every second adult he had noticed the pain in the lumbar region. According to P. I. gotovceva (1964), Etc., Fanagorisky (1964), this form is in athletes from 10 to 20 % of all diseases of the nervous system. Most often ishialgii occur in weightlifters, hockey, football, athletics, rowing, skating, jumpers from a springboard, motorcyclists, gymnasts.
Cause pain in the sciatic nerve neuralgia caused by irritation of the muscular-ligamentous apparatus or sdavlennoy the back of the spinal nerve root in the lumbar region. Often the pain syndrome in this disease occurs due to degenerative changes in the spine (osteochondrosis), as well as with congenital defects of the spine: cleft bow vertebra (spina bifida), sacralization, lambrisare, spondylosis (the formation of cracks in interarticular part of handles), spondylolisthesis (slippage vertebra forward or backward).
In athletes provoking moments of occurrence of pain are excessive strain and injuries (resulting from lack of warm-up), cooling (sitting on the damp earth, being in a wet track suit and shoes after class, draughts in the shower and so on), infections (influenza, angina, chronic infections). Duration of disease (omissions training and competitions), a hospital stay in athletes significantly less than those of the same age, are not involved in sports.
The main symptom of this disease are pain aggravated by movement. This is usually lower back pain, radiating in the buttocks, the back surface of the hips, groin, the scrotum, a feeling of numbness in the leg, crawling, reduction of power. These symptoms occur in athletes suddenly during training, after injuries, when hypothermia. Are severely sensitivity to cold, forced position of the body (protective posture), leading to scoliosis, lumbar lordosis is smoothed. Tendon reflexes in the acute stage of the disease quickened, chronic is sharply reduced, and often missing. Palpation revealed weak points Walle in paravertebral region, especially on the affected side, in the area of the buttocks (the lower outer quadrant), on the back of the thigh: the upper - back of thigh, the middle in the middle of the back surface and lower - medially from the biceps tendon (in the lower third of the thigh) in the popliteal fossa behind the head of the fibula, the outer ankle. During the inspection revealed painful symptoms of tension - Lasaga (according to our data, this symptom is observed in 90 % of cases), Bekhterev (lifting outstretched healthy feet causes pain in the affected), Neri (when the tilt of the head, the pain in the lower back, buttock, surrender pace). Most athletes celebrated reflex increase the tone of the long muscles of the back. With the protracted course of the disease is detected hypotension, and sometimes muscle atrophy sick leg and buttock muscles as a result of violations of trophism. In the acute stage of the disease sometimes raises the body temperature, increased ESR, you receive a leukocytosis (to measure body temperature and to examine the blood should be a must!). Alone decrease pain, back sharply increase. May cause muscle aches and pains in the tendon, which are detected by palpation. In the area of innervation of the sciatic nerve often marked Oneonta, pokalyvanie, sense of crawling and sometimes discomfort (hyperesthesia, hypesthesia, anesthesia).
Depending on the nature and severity of symptoms distinguish neuralgia (ishialgia) and neuritis (sciatica) sciatic nerve.
The first is characterized by pain, paresthesia, and signs of tension in the absence of signs of loss of function. For neuritis characteristic, besides pain syndrome, the symptoms of loss of function.
There are several forms of sciatica depending on the level of destruction: radicular sciatica (sciatica), average sciatica (lumbosacral plexitis), bottom (stem) sciatica and radiokulonevrity. There is also the primary and secondary sciatica. In the first case the sciatic nerve is affected primarily (infection, intoxication, trauma, cooling). Secondary sciatica may be a symptom of osteochondrosis, deforming spondylosis, hernia of intervertebral disk, the tumor.
During treatment it is necessary to consider etiologic factors. At the inflammatory nature of the disease - inflammatory and desensitizing treatment. After the withdrawal of acute pain, it's advisable to intradermal blockade of 0.5 % solution novokaina or 25-50 % solution of dipyrone intramuscularly, intramuscular injections of vitamins B1 and B12, which are entered separately - one day vitamin B1 other B12, physiotherapy (Bernard currents, electrophoresis of potassium iodide, novocaine, lithium, ultrasound with novocaine, manual vibration or underwater massage).
In the treatment of secondary isordilb after the withdrawal of acute pain syndrome in the first place are orthopedic measures (traction, handling corsets), massage, exercise therapy, hydrotherapy, radiotherapy.
With persistent riordinata usage of biogenic stimulators (intramuscular injection of aloe extract or vitreous body). In the acute stage of the disease - in bed with further exemption from training for 10 days. Prevention of isordilb is to prevent hypothermia and injuries, versatile physical training.