The sciatic nerve is the largest and thickest nerve in the human body, formed by the fusion of the lumbar and sacral nerve roots. It is responsible for the movement and sensitivity of the thigh, lower leg, ankle, foot, and toes. A pinched or inflamed sciatic nerve causes discomfort and pain in the lower limbs and lower back. However, pinching of the sciatic nerve can occur without lower back pain, which occurs mainly in women.
What is a sciatic nerve entrapment?
A pinched sciatic nerve is an inflammation of one of the longest nerves in the body, which manifests itself in the lumbosacral spine with severe pain. In medicine, this phenomenon is also known as sciatica .
The sciatic nerve is considered one of the most powerful in the human body. The ilio-sacral junction, which is formed by the roots of the spinal nerves, is the region of its origin. Further, the sciatic nerve passes through the entire thigh, branching out nerve endings along all the tissues surrounding it. In the popliteal fossa, it is divided into parts, ending in the tibial and peroneal nerves. They connect the central nervous system and tissues of the lower leg and foot. Such a wide area of distribution of the sciatic nerve determines the clinical picture of its pinching. The pains cover the lower back, the back of the thigh.
A pinched sciatic nerve is a syndrome or symptom of other diseases. Therefore, inflammation can be caused by problems in the work of other organs and systems of the body, but in most cases, pathologies are associated with the spine.
Symptoms of a pinched sciatic nerve
- Painful sensations.The symptom that accompanies the pinching of the sciatic nerve is always pain of varying intensity. Depending on the cause of the pinching, the pain can be manifested as a weak tingling sensation, or a very strong burning sensation or a dull weight. In some cases, the pain can reach such intensity that the sick person cannot move. Remarkably, pain is mainly felt on one side of the body. If acute pain is felt, for example, in the right leg, then only weakness or numbness can be felt in the left. At rest, the pain is usually not too intense. But as soon as a person gets up, sitting down, bending over or changing position, the pain intensifies. Its intensity often increases at night. Sometimes pain may be preceded by a decrease in the mobility of a limb (foot or knee joint), her weakness and slight tingling sensation. If the sciatic nerve is inflamed, the person may have back pain. It is usually less severe than leg pain, but it also causes significant discomfort.
- Gait disorder. This symptom is also known as intermittent claudication. It occurs due to paroxysmal pain. When the sciatic nerve is pinched, the discomfort increases with movement. To weaken them, a person instinctively changes his gait, which is why a slight lameness is observed. The patient tilts the body in the opposite direction from the one in which the pain is felt. During movement, he chooses a healthy leg as a support, and at the same time bends the patient a little. From the outside, it looks as if the person has an injury that leads to intermittent claudication.
- Sensory impairment. A change in the reaction of nerve endings is observed in that part of the body where the sciatic nerve is pinched. The sensitivity in this area can be either increased or weakened.
- Burning, numbness, tingling. To a greater extent, such sensations are characteristic of the buttocks, back of the thigh, lower leg, and foot. Toes often go numb. Feelings, as well as in violation of sensitivity, the occurrence of pain, are localized in this case in one side.
- Decreased mobility. During the diagnosis of a pinched sciatic nerve, there are difficulties with mobility in the knee joint or in the area of the foot. Changes in leg position are accompanied by pain. Patients are unable to perform flexion-extension movements in the knee joint, to twist the foot.
- Weakening of the musculo-ligamentous apparatus. Patients with pinched sciatic nerve complain of lack of strength. It becomes difficult for them to perform actions that require muscle tension on the affected side.
- Increased body temperature. Thus, the body sometimes reacts to an attack of pinching pain. This dangerous symptom indicates that it is necessary to consult a specialist as soon as possible. On the back, swelling may occur, accompanied by redness of the skin. Patients with entrapment also suffer from pelvic dysfunction. This manifests itself in the form of pain during urination, incontinence, problems with potency in men.
It should be remembered that sometimes the symptoms of a pinched sciatic nerve are similar to those of other, more dangerous diseases. Be sure to seek medical attention if pain in the leg or lower back is accompanied by even a slight increase in body temperature, swelling, redness of the skin, severe pain that does not go away for a long time, or burning sensation when urinating.
Causes of the pinched sciatic nerve
One of the most common causes of such an unpleasant syndrome as pinching of the sciatic nerve is osteochondrosis. In this case, the piriformis muscle and the sacrospinous ligament change and compress the nerve (piriformis syndrome). Displacement of the spinal disc, hernia, all kinds of damage to the muscles and organs of the pelvis, as well as tumors can also provoke pinching.
This condition is the most common cause of a pinched sciatic nerve or sciatica. In the course of its development, the cartilage of the spine is damaged. This process implies a violation of their structure, as a result of which the intervertebral discs cease to perform their functions in the human body. In normal condition, they impart flexibility and elasticity to the spine. The destruction of cartilage tissue leads to problems directly with the vertebrae.
Osteochondrosis caused by various reasons, which are conventionally divided into endogenous and exogenous. The first group includes factors associated with the characteristics of the organism: age, intrauterine development of the spine, genetic predisposition. Uneven distribution of the load on the spine is distinguished as an exogenous cause. It can be caused by carrying weights, stooping, maintaining one position for a long time, infections, weakened back muscles. Not only poor posture causes osteochondrosis. Often, even athletes with well-developed muscles and a trained body are faced with damage to the cartilage tissue, which causes problems with the intervertebral discs. Metabolic disease,
The destruction of the intervertebral discs leads to a reduction in the distance between them, and contributes to the clamping of the nerves. As a result, the patient experiences pain in the neck and spine. Their localization depends on the location of the cartilage problems. Thus, osteochondrosis becomes the cause of pinching of the sciatic nerve. In addition to pain, nausea may develop, turning into vomiting , tinnitus .
It will be possible to get rid of the inflammation of the sciatic nerve by eliminating the manifestations of osteochondrosis. As part of his treatment, they resort to the use of conservative and manual therapy, folk methods, massage, and therapeutic gymnastics.
In medicine, this phenomenon is indicated by the displacement of the vertebrae. It is most often caused by microtrauma of the spine, congenital abnormalities, muscle weakness or ligamentous apparatus. Spondylolisthesis, depending on the factors provoking it, is of several types. So, dysplastic is usually associated with congenital pathologies. Athletes such as gymnasts suffer from isthmic spondylolisthesis. Elderly patients are faced with such a type of this disease as degenerative. It develops due to age-related changes in the vertebrae. Mechanical damage to bone and muscle tissue leads to traumatic spondylolisthesis.
In many cases, the disease is diagnosed only during X-ray examination. Until then, the patient may not experience any discomfort or other problems caused by the displacement of the vertebrae at all. But at some point, they can lead to pinching of the nerves, including the sciatic, and cause severe pain. In women, a factor contributing to the manifestation of the disease is pregnancy. The occurrence of pinching when the vertebrae are displaced is associated with heavy lifting, overwork. Pain in spondylolisthesis is felt in the back and legs.
The disease is dangerous with serious complications: narrowing of the spinal canal and artery spasm, impaired functioning of the lower extremities. You can cope with spondylolisthesis using conservative methods. If they are ineffective, they resort to surgical intervention.
It manifests itself in the form of a decrease in the lumen of the central spinal canal. The process is chronic in nature and is caused by a number of factors, including ischemia, increased epidural pressure and aseptic inflammation. Their formation, in turn, leads to compression of the neurovascular structures in the spinal canal. Its volume depends on the position of the human body. When squatting, the lumbar lordosis is straightened, as a result of which there is an increase in the lumen of the intervertebral foramen. As a result, blood vessels that were previously compressed are released, blood flow and nerve nutrition are restored.
In some cases, stenosis of the spinal canal is a consequence of osteochondrosis, developing in the later stages of this disease. The instability of the vertebral elements leads to the formation of osteophytes. These are growths on bone tissue that help stabilize the musculoskeletal system. The formation of osteophytes is the cause of stenosis of the spinal canal.
The pathological processes caused by this disease are manifested in the form of pinching of the sciatic nerve. Among his symptoms are also pain in the lower back and legs, weakness of the lower extremities, impaired sensitivity and functions of the pelvic organs. For the treatment of spinal stenosis, antalgic, vascular, anti-inflammatory drugs are used as part of conservative therapy. Most patients need surgery.
The sciatic nerve in this case is compressed between the piriformis muscle, which is just behind it, and the sacrospinous ligament. This reason is more typical for women than for men. Pinching of the sciatic nerve is accompanied by pulling and aching pains in the sacral and hip joints, as well as in the buttocks. Some patients complain of numbness or burning sensation in the legs, possibly the development of intermittent claudication. It manifests itself in the form of intermittent pain that bothers only during movement. At the same time, the skin of the limbs turns pale. The patient has to stop frequently while walking to rest or change the pace.
Piriformis syndrome is diagnosed by palpation. Treatment includes the use of non-steroidal anti-inflammatory drugs and superficial thermal procedures. The most important thing is to keep the sore muscle at rest. After the discomfort subsides, you can perform special exercises, conduct sessions of health-improving and relaxing massage. All these tools will allow you to get rid of the piriformis syndrome, which means, eliminate the pinching of the sciatic nerve.
The intervertebral disc acts as a kind of shock absorber in the body, protecting the vertebrae from excessive stress. His hernia implies displacement of the intervertebral disc, which leaves the zone of its natural localization, breaking the annulus fibrosus. Trauma or degenerative changes can cause this process. It all starts with a minor deformity known as disc protrusion. In the future, it develops into a hernia. A nerve root comes out of the intervertebral foramen, which is compressed or pinched. The result is sciatic nerve neuralgia.
Symptoms of a hernia suggest the occurrence of local pain at the site of the affected intervertebral disc. It can spread to the buttock and thigh. The lower extremities are numb, tingling is felt in them. Even loss of sensation in the legs is possible. As additional symptoms, which determine the hernia of the intervertebral disc of the back, dysfunction of the pelvic organs is distinguished.
Surgical intervention is required if conservative treatment involving the use of non-steroidal anti-inflammatory drugs that relieve pain does not give positive results. In addition to the operation, therapeutic exercises, massage, therapy with multifunctional electrodes helps to relieve pain in a herniated disc and at the same time get rid of pinching of the sciatic nerve.
Sacroiliac joint dysfunction
In manual therapy, this term refers to problems with a joint of a mechanical nature. Dysfunction pain in this case occurs in the sacrum region, spreading from the buttocks along the back of the thigh to the knee. The most severe discomfort is felt in the morning after waking up and gradually decreases towards the evening. Patients are especially concerned about pain while walking. Irritation of the fifth lumbar nerve root, which runs in the region of the sacroiliac joint, leads to pinching of the sciatic nerve. With dysfunction, the iliopsoas muscle is stretched, as a result of which discomfort may occur in the lower abdomen.
Dysfunction is diagnosed on the basis of various tests: for mobility, flexion, pressure. In this case, injections of local anesthetics and corticosteroids help to relieve acute pain. In the future, they resort to manual therapy, physiotherapy, gymnastics.
Radiculitis of the lumbosacral spine
It is often a consequence of osteochondrosis and is a radicular pain syndrome. As a common cause leading to its development, there are problems with the sacro-lumbar region, which is experiencing heavy loads. In the course of osteochondrosis, deforming spondyloarthrosis, intervertebral hernias and other degenerative-dystrophic processes, the spine is damaged, which becomes the cause of such a pain syndrome. With cerebrospinal meningitis, flu, syphilis , brucellosis, tuberculosis , rheumatism, similar back problems also occur.
So, radiculitis of the lumbosacral spine manifests itself in the form of sciatica or as pinching of the sciatic nerve. The pain syndrome and its causes should be eliminated in a comprehensive manner, only then it is possible to get rid of the unpleasant sensations for a long time. The treatment is carried out in 2 stages. In the first of them, the pain syndrome is eliminated, and in the second, the deep causes of the disease are eliminated. For this, hondoprotectors are prescribed, vitamins are taken, special exercises for the back are performed. Massage helps with radiculitis. The use of alternative methods is also possible, but only in combination with traditional methods of treatment.
Tumors, fibromyalgia, abscesses, blood clots, all kinds of infections – all this can also cause pinching of the sciatic nerve, but it is much less common.
Treating a pinched sciatic nerve
Diagnosis of a pinched sciatic nerve is carried out on the basis of X-ray examination, magnetic resonance imaging and a biochemical blood test. Based on the results of the examination, the doctor confirms the presence of inflammation.
Since a pinched sciatic nerve is considered a pain syndrome caused by other serious diseases, it can be eliminated only by dealing with the causes. Therefore, therapy should be comprehensive.
First of all, the pain is stopped. For this, non-steroidal anti-inflammatory drugs are used, for example:
- Diclofenac .It can be applied in both local and general forms. To eliminate the discomfort when the sciatic nerve is pinched, injections and tablets of this drug are used. It has antirheumatic, anti-inflammatory, analgesic, analgesic effects. The duration of use and the form of Diclofenac is determined by the doctor based on the strength of the pain syndrome and the danger of the patient’s condition. As a rule, the use of the drug in the form of ointments and gels lasts for a week. Injections are applied for a shorter period of time. It is not recommended to use the drug on your own, as side effects and overdose are possible. In addition, when used over a long period of time, Diclofenac can be addictive. If you experience nausea, vomiting, dizziness, you should stop using the drug.insomnia .
- Ibuprofen. This drug belongs to the category of non-steroidal anti-inflammatory drugs. The advantage of ibuprofen is that it quickly has a decongestant and analgesic effect, relieves morning stiffness when the sciatic nerve is pinched, and relieves the limitation of joint mobility. The effect of the drug lasts for 8 hours. It is not recommended to combine it with other non-steroidal anti-inflammatory drugs, as this leads to a decrease in its effectiveness. To eliminate bouts of acute pain with pinching, Ibuprofen is administered orally. Before use, you must consult a doctor, as there are contraindications and possible side effects.
- Ketoprofen . Another drug belonging to the group of non-steroidal anti-inflammatory drugs. It helps to quickly cope with pain, has an antipyretic effect, and increases the motor activity of patients with a pinched sciatic nerve. After its application, there is a decrease in morning stiffness in the joints. The anti-inflammatory effect is due to the cumulative effect of the drug and appears 7 days after the start of its administration. Ketoprofen is most rapidly and completely absorbed when taken orally. For this reason, it is used in the form of tablets to achieve the fastest possible result. When applied externally, the effect appears only after a few hours.
Along with non-steroidal anti-inflammatory drugs, various ointments and gels are used to quickly relieve pain. They act more slowly, but they are warming and relaxing, allowing freedom of movement.
The most effective remedies for pinching the sciatic nerve are:
All these ointments have a warming and irritating effect. After their application to the diseased area, blood circulation in it increases, which makes it possible to expand blood vessels and improve tissue nutrition.
Of the homeopathic ointments used “Purpose T”, “Traumeel S”. The main effect of these agents is to provide anesthetic and anti-inflammatory effect. Natural composition is considered a significant advantage of such preparations. However, you should consult a specialist before use. It is not recommended to use these drugs for pregnant and lactating women, patients suffering from allergic reactions.
Exercises for pinching the sciatic nerve
You can switch to remedial gymnastics only after the pain syndrome has passed. Perform the exercises for the first time with a specialist. Movement should not cause pain. If you experience discomfort, stop the activity.
Yoga, gymnastics in the pool can act as physiotherapy exercises. But first of all, it’s worth starting with traditional exercises. They must be performed in comfortable clothing and shoes designed for sports. You can not make jerky sudden movements. They should be smooth, gradual to prevent possible pain. Exercises are performed 6-7 times. Gradually, the number of repetitions should be increased up to 10-12 times.
- It is recommended to perform the following exercises from a standing position: walk, raising your knees high; tilt the body in different directions; holding on to the back of a chair or other support, raise your leg as high as possible;
- In a lying position on your side, bend the lower leg at the knee, and straighten the upper leg and perform back and forth movements;
- Lie on your back and perform circular movements with the foot, then pull your toes well forward;
- Standing on all fours, swing your legs alternately back and forth. At the same time, movements should be very smooth, without jerking;
- Lying on your side, bend your legs to pull them to your chest. After completing the movement, return the limbs to their original position;
- Lie on your back, bend your knee, lift and straighten at a right angle. After doing the movement several times, lower it to its original position;
- Standing on all fours, straighten your leg and try to draw an imaginary circle in the air.
In addition to the usual remedial gymnastics, when the sciatic nerve is pinched, as well as to prevent such problems, they resort to yoga. It is best to start doing it during the period of remission. For patients who have not previously practiced yoga, the initial exercises will suffice. They are not difficult and do not require special physical training, although they have a very good effect on the back. As you acquire the necessary skills, the program becomes more difficult. It is necessary to do yoga under the guidance of a competent instructor, since it is important not only to observe the technique of movements, but also to breathe correctly.
Therapeutic exercises for pinching the sciatic nerve can be practiced in the pool, and in the warm season, even in an open reservoir. Such physical education involves walking in place with overcoming resistance, performing leg swings in different directions and drawing an imaginary circle with them. For patients who have back problems, it is also recommended to swim more. This sport develops and strengthens muscles, but at the same time relieves unnecessary stress on the spine.
How to relieve sciatic nerve pain in 2 minutes?
Massage for pinched sciatic nerve
Physiotherapy exercises the greatest effect can be achieved when combined with massage. It can be performed only after the pain syndrome has been eliminated, that is, during the period of remission. In the presence of discomfort, massage sessions are not only useless, but can even aggravate the situation. When an exacerbation of the pinching of the sciatic nerve passes, it is necessary to consult a specialist. The massage therapist must have the appropriate education, it is worth asking for reviews and his experience. A competent doctor with massage will help get rid of pain for a long time, otherwise the desired effect will either not be achieved, or incorrect movements will harm.
The course usually consists of a large number of sessions. Most often, you have to visit a masseur at least 10 times. For preventive purposes, in the future, it is recommended to repeat the course every six months. During the massage, the sciatic nerve is released in order to restore the passage of nerve impulses. After the session, muscle spasms disappear, the gap between the vertebrae increases. But the most important effect that massage provides is stimulation of blood circulation, which makes it possible to enhance tissue nutrition, restore metabolism in them. Thus, in the course of manual therapy, it is possible not only to prevent the appearance of pain associated with pinching of the sciatic nerve, but also to completely restore all its functions. If in the future you regularly repeat the course of massage, the inflammation will not worsen.
As part of the prevention of pinching of the sciatic nerve, you should go in for sports, including daily performing a set of simple gymnastic exercises aimed at different muscle groups. It is important to monitor your posture, keeping your back always straight. Women with back discomfort or pinching attacks should refuse to wear high-heeled shoes. You should not lift weights, expose the body to hypothermia. During an exacerbation of the pinching of the sciatic nerve, bed rest must be observed and be sure to consult a doctor to identify the causes of inflammation. By eliminating them, it will be possible to prevent new bouts of pain in the future.