Edema of the knee when pinching the sciatic nerve

Pinching of the sciatic nerve isa pathological condition that develops by squeezing the largest nerve in our body in the musculoskeletal tunnel and is accompanied by severe pain in the leg.

Almost always pathology develops with oneparties; more risk to "earn" sciatica men engaged in heavy physical work. Diagnosis is not difficult. With the timely and comprehensive treatment, the disease is completely reversible.

The sciatic nerve is the nerve fiberconsiderable thickness, formed by the roots of the last two lumbar and all sacral spinal nerves. He exits the pelvic cavity through an opening in the muscle fibers and lies between the muscle groups that form the buttocks.

Then it passes over the posterior femoral surfaceup popliteal fossa, where it divides into two nerves - tibial and fibular. It is this nerve that innervates the hip and knee joints. It includes not only motor, but also sensitive fibers.

Causes of pinch of the sciatic nerve

The pinch of the sciatic nerve develops due to such reasons:

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  1. 1) Intervertebral hernia in the lumbar region: the protruding jelly-like part of the intervertebral disc - gelatinous nucleus - pinches the sciatic nerve at the exit.
  2. 2) Osteochondrosis of the lumbar region. when the nerve is compressed between vertebrae, displaced due to changes in the thickness of the intervertebral disc.
  3. 3) Pregnancy - squeezing of the sacral plexus, from which the sciatic nerve emerges, the pregnant uterus in the third trimester.
  4. 4) Injuries of the spine with displacement of the vertebrae: dislocations, subluxations, fractures.
  5. 5) Abscesses of the rectum, located near the lumbar region.
  6. 6) Nerve compression by spasmodic muscles that can develop due to significant physical exertion, trauma or inflammation of these muscles.
  7. 7) Spondylosis of the lumbosacral spine.
  8. 8) Tumors of the spine.
  9. 9) Degenerative spondylolisthesis.
Risk factors the occurrence of this condition are:

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  • supercooling of the waist.
  • herpes zoster in the projection of the branches of the sciatic nerve.
  • polyradiculoneuritis.
  • tubercular lesion of the spine.
  • diabetes. leading to a disruption of the nourishment of the sciatic nerve.
  • brucellosis.
  • impact of neurotropic toxins, heavy metals.
  • multiple sclerosis .
  • excess weight.
  • inflammatory diseases of pelvic organs, which can lead to inflammation of the pear-shaped muscle, and it can pinch the sciatic nerve at the exit.

Symptoms of pinch of the sciatic nerve

Pinched sciatic nerve, the first symptoms of which is characterized by the development of an attack of severe pain in the buttock and leg. Pain has these characteristics:

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  • so intense that a person can lose consciousness;
  • burning, cutting, stitching;
  • requires a certain lying position; if it is necessary to stand, a person will not rely on a sore leg;
  • begins often at night after a person has physically worked (especially if it was in the cold);
  • first localized on the back of the thigh, later "down" to the shin and foot;
  • strengthens with prolonged standing, sitting on a hard surface, walking;
  • intensified by sneezing, coughing, laughing;
  • after taking painkillers or spontaneous stihaniya attack residual pain is localized in the lumbar region.
Pain is accompanied:

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  1. 1) Violation of gait;
  2. 2) Perspiration of feet;
  3. 3) Tingling or burning in the shin and foot;
  4. 4) difficulty in bending the leg in the knee;
  5. 5) Violation of the bending of the fingers and the turn of the foot.

Diagnosis of pinch of the sciatic nerve

The inflammation of the sciatic nerve testifiesbright clinical picture, described by the patient. Also, the doctor will note the change in tendon reflexes, as well as the sensitivity on the side of the lesion. This does not mean that you do not need to conduct other studies, because if you do not find out the reason, the pinching will be repeated again and again, and it will be more difficult to cure it.

To identify the cause of pinching of the sciatic nerve, the following studies are carried out:

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  1. 1) Radiography of the spine: it can reveal a rough bone pathology: bone "spines" (osteophytes), displacement of the vertebrae, their fractures or dislocations;
  2. 2) Computer tomography of the lumbosacral section - a more accurate radiographic method, which allows to diagnose even minimal changes in the spinal column;
  3. 3) Instead of computer (with contraindications to it), magnetic resonance imaging can be used;
  4. 4) Ultrasound (in some cases, computer tomography) study of pelvic organs with suspicions of the pathology of the organs localized there;
  5. 5) Radioisotope scanning of the spine with suspected tumor.

Treatment of a pinch of the sciatic nerve

There are two main approaches to the therapy of pinch of the sciatic nerve - conservative and operative. Begin treatment conservatively, with the help of several methods (integrated approach).

Mode - in an acute period, bed rest is necessary(while a person needs to lie on a hard mattress). Motor activity is minimal. Going to the toilet, carrying out hygiene measures are carried out with support. When the pain subsides, the regime expands, you can only walk with a cane.

Diet - at home, adherence to a special foodthe diet is needed only in an acute period, when a person should lie: food should be warm, not spicy, not smoked or fried, the priority use of liquid food (milk, meat and vegetable soups, milk porridge). So you can avoid constipation and the associated deterioration of the condition.

Medication Therapy

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  1. 1) The main group of drugs used fortreatment of pinch of the sciatic nerve - non-steroidal anti-inflammatory drugs: Orthofen, Ibuprofen, Denebol, Dexalgin, Ketanov. Initially, they are injected intramuscularly, then they switch to taking drugs from this group, which are produced in tablets and capsules. Supplement the treatment can be ointments and gels: "Finalgon", "Voltaren", "Diclofenac."
  2. 2) The above preparations are taken together withmedicines that protect the gastric mucosa from their adverse effects: "Ranitidine", "Kwamatel" or "Nolpaz", "Rabeprazole" are taken with Almagel, "Fosfalugel" or "Maalox"
  3. 3) B-group vitamins to improve the interaction of the inflamed, clamped nerve with the tissues: Milgamma, Neurorubin.
  4. 4) With a strong spasm of the muscles of the back, legs or buttocks, the purpose of the drugs that remove this spasm is shown: "Midokalm", "Sirdalud".
  5. 5) With severe pain, novocain blockades can be used.

From the second day of illness,exercise exercises, which in this case include movements of the fingers and feet. In a subacute period, a person is selected a complex (depending on the cause of the pathology), which can consist of the following types of exercises:

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  • walking on the buttocks on the bottom (performed in a horizontal position);
  • flexion of the legs in the knee;
  • lying on the back with legs raised at right angles, while the buttocks rest against a wall or other fixed surface;
  • "Bicycle" with a gradual increase in the amplitude of the rotations.
During the restoration phase, you can not do without half-squats with support, rotation of the hips, lifting the legs in an upright position.

Such treatment is very important to use, as it will not only achieve good results, but also enhance the effect of drugs, reduce their dosage.

So, apply:

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  • electrophoresis with no-shpoy, midokalm, novocaine;
  • UHF;
  • paraffin applications;
  • magnetotherapy;
  • phonophoresis;
  • UFO sick area;
  • magnetic laser therapy.
At stihanii inflammatory process and absence of contraindications have proved the efficiency:

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  • massage;
  • application of needle applicators (such as Kuznetsov);
  • canned massage;
  • acupuncture;
  • cauterization of biologically active points;
  • hirudotherapy.

Such treatment is effective beyond the period of exacerbation. The following methods are used:

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  • mud treatment;
  • baths: radon, pearl, hydrogen sulphide;
  • underwater traction;
  • climatotherapy.

In order to prevent the pinch of the sciatic nerve, follow these rules:

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  • learn to squat right.
  • X-ray or CT of the spine, treat vertebral diseases.
  • periodically take courses of general massage.
  • watch your weight.
  • sleep on a hard bed.
  • Do not lift heavy weights without preparation.
  • watch your posture.
  • perform a minimum daily charge.

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