Treatment of the sciatic nerve: medications, injections. Drug treatment of inflammation of the sciatic nerve How to treat inflammation of the sciatic nerve drugs

As you know, the sciatic nerve begins from the lumbosacral plexus and, going down the leg, branches into two directions - the tibial and peroneal nerves. Its pinching is accompanied by acute pain, which affects both limbs and limits the patient’s movement.

Only complex treatment, which includes physiotherapeutic treatment and a set of special exercises, can relieve the symptoms of inflammation of the sciatic nerve and correct the situation with pinching. However, in the acute period, drug therapy is inevitable.

In this article we will look at the basic principles of treatment for inflammation and pinched sciatic nerve in adults, and also talk about the first symptoms and causes of this disease. If you have any questions, leave them in the comments.

What it is?

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 called sciatica.

Inflammation of the sciatic nerve is a syndrome or manifestation of symptoms of other ailments. In this regard, inflammation can be caused by problems in the functioning of other organs and systems of the body, but in most cases the occurrence of pathology is associated with problems in the spine.

Causes

What is it and why does it develop? The disease occurs more often in people over 30 years of age, although recently younger people have also been affected by the pathology, which is associated with the early formation of degenerative changes in the soft tissues around the spinal column.

The most common factor in the development of inflammation of the sciatic nerve is a pathological process localized in the lumbar and sacral segment of the spine.

Therefore, the most common cause of pinching is:

1. Complete or partial displacement of the intervertebral disc, accompanied by pinching of the sciatic nerve, narrowing of the spinal canal, growths on the spine;
2. Piriformis syndrome;
3. Damage to organs or the muscular system of the pelvis due to injury or heavy physical exertion;
4. Hypothermia, infectious processes;
5. Presence of neoplasms.

Inflammation of the sciatic nerve may have the nature of a primary lesion, the causes of which are most often hypothermia, an infectious process, or trauma. Secondary pinching occurs when the nerve roots that form the sciatic nerve are pinched as a result of protrusion, herniated disc, bone growths around the spine, muscle spasm due to physical overload, etc.

Symptoms of inflammation of the sciatic nerve

If pinching of the sciatic nerve progresses, the symptoms of the pathology are expressed in an acute form, significantly disrupting the patient’s usual quality of life. The main symptom of the disease is pain, the intensity of which depends on the cause of inflammation:

• pinching of the sciatic nerve by a hernia;
• influenza, malaria and other infections that lead to inflammation;
• stenosis;
• spondylolisthesis.

The nature of the pain must be taken into account. This helps doctors make an accurate diagnosis and then begin treating the inflammation. Therefore, pinching in the lower part of the spine is divided into three groups:

• sitting symptom - the patient cannot sit down;
• Lasegue's symptom – the patient cannot raise his straight leg;
• Sicard's symptom - pain increases with flexion of the foot.

In addition to pain, there are also characteristic symptoms of inflammation of the sciatic nerve associated with disruption of the conduction of nerve impulses along motor and sensory fibers:

1. Decreased sensation (paresthesia)– in the initial stage it manifests itself as a feeling of numbness, tingling of the skin of the buttocks and legs along the back surface. As symptoms progress, other types of sensitivity also decrease, until they disappear completely.
2. Dysfunction of the pelvic organs– occurs due to compression of the fibers of the autonomic (sympathetic and parasympathetic) nervous system passing in the sciatic nerve. There are disturbances in urination (urinary incontinence) and defecation in the form of constipation. This symptomatology develops in severe cases of sciatica with significant infringement of the spinal roots.
3. Disturbances in motor function- the result of infringement of the motor fibers of the nerve. A person experiences weakness in the gluteal, thigh and calf muscles. It is expressed in a change in gait with a unilateral process (limping on the affected leg).

If the above symptoms occur, treatment should begin immediately, because pinching of the sciatic nerve can lead to complete loss of sensation in the legs.

Diagnostics

To determine how to treat a pinched sciatic nerve, you should definitely find out its etiology and, if possible, eliminate all factors that may provoke the development of the disease.

To clarify the diagnosis, it is necessary to conduct a comprehensive examination of the patient - it should include:

• methods of clinical and biochemical laboratory diagnostics;
• examination by a neurologist, and, if necessary, a vertebrologist, rheumatologist and vascular surgeon;
• taking x-rays of the spine in several projections (necessarily in a lying and standing position);
• tomographic studies.

Urgent consultation with a doctor required if:

• against the background of pain, body temperature rises to 38 ° C;
• swelling appears on the back or the skin turns red;
• pain gradually spreads to new areas of the body;
• there is severe numbness in the pelvic area, hips, legs, making it difficult to walk;
• there is a burning sensation when urinating, problems with holding urine and feces arise.

These studies help to find out what to do in order to relieve pain as soon as possible and eliminate inflammation in the sciatic nerve.

How to treat a pinched sciatic nerve

If symptoms of a pinched sciatic nerve occur, treatment should begin as early as possible; based on the results of the diagnosis, the specialist will prescribe appropriate therapy:

1. First of all, determine what caused the pinched sciatic nerve. Treatment may vary depending on the cause. For example, tumors may require surgery.
2. Drug treatment. The first stage of this treatment is aimed at pain relief and relieving the inflammatory process. For this purpose, muscle relaxants and NSAIDs are used.
3. B vitamins(combilipen, milgamma) help normalize metabolism in nerve cells. In the acute period, they are prescribed intramuscularly for a period of 10 days, then switch to oral administration.
4. Physiotherapeutic treatment. Such treatment includes electrophoresis, the use of electromagnetic fields or ultraviolet radiation, massage (impact on certain points, cupping, vacuum types of massage), therapy through paraffin procedures, hydrotherapy.
5. Unconventional treatment, which currently includes many different methods. This includes acupuncture, the use of Kuznetsov’s applicators, stone therapy, hirudotherapy, herbal medicine, and moxibustion.
6. Treatment with traditional recipes. So, when pinched, horse chestnut, bay leaf tincture, cakes made from flour and honey, potato compresses, beeswax, spruce and pine buds, dandelion tincture and many other methods are used.
7. Diuretics used to reduce swelling in the area of ​​nerve roots (furosemide).
8. Physiotherapy. Helps improve blood flow in the affected area and strengthen muscles. The doctor decides which exercises to perform in a particular case, based on the degree of neglect of the disease, the severity of the pain syndrome, the presence of an inflammatory process and other factors.
9. Surgery. If medications and physiotherapeutic procedures are ineffective, the only option for eliminating pinching is surgical intervention: discectomy and microdiscectomy.

It is worth noting that treating inflammation or pinching of the sciatic nerve at home is a complex, lengthy undertaking that does not always give an immediate effect, so you have to take care of your health over a long period of time.

If the pain does not subside within several months, the patient is prescribed steroid injections administered epidurally into the affected area. This procedure reduces the symptoms of inflammation at the local level, giving an immediate but very noticeable effect.

Mode

One of the main components of treatment is the creation of a therapeutic and protective regime for the patient.

The patient should lie on a hard bed, the possibility of movement is recommended to be limited until the obvious signs of inflammation subside. Bed rest is indicated until the condition improves and pain is eliminated.

Nonsteroidal anti-inflammatory drugs

The most effective painkillers are. This pharmaceutical group of drugs is represented by drugs that stop the action of the COX enzyme and have an anti-inflammatory effect, these include:

• "Meloxicam" ("Movalis", "Amelotex")– Available in tablet and injection forms, it is one of the safest drugs in the NSAID group.
• “Piroxicam” is available in the form of a solution (ampoules of 1-2 ml), tablets, suppositories, gel, cream; it can be used both locally and by injection - 1-2 ml once a day to relieve an acute pain attack.
• "Nimesulide" ("Nise", "Nimesil")– Available in the form of powders, tablets, capsules. The usual dosage is 100 mg per day, in the first days it is possible to increase to 200 mg.
• "Celebrex" - capsules, the recommended daily dose is up to 200 mg, but for severe pain it can be increased to 400-600 mg at the first dose, followed by a subsequent reduction in the dose to 200 mg.
• "Ketonal", "Ketanov" ("Ketoprofen")– is available both in ampoules and capsules, tablets, suppositories and in the form of an ointment; for sciatica, it is most often used intramuscularly (up to three times a day, 2 ml), but the symptoms are also well relieved by local application (ointments).

When pain and inflammation increase, hormonal steroids are sometimes prescribed in short courses; they relieve pain, but do not eliminate the cause of inflammation, and their use has a lot of side effects and contraindications.

See also how to choose effective ones for treating joints.

Muscle relaxants and vitamins

Muscle relaxants prescribed to reduce reflex local muscle tension caused by pain syndrome. This:

• Tizalud;
• Baclofen;

They also produce an anti-inflammatory effect multivitamin complexes based on B vitamins:

• Neurobion;
• Milgamma;
• Combilipen;
• Trigamma;
• Neurovitan.

When physical therapy and medications do not help, they resort to surgical methods - microdiscectomy, or discotomy, in which part of the disc pressing on the sciatic nerve is removed.

Unconventional treatment

In specialized clinics and medical centers, various non-traditional methods are used to treat pinched sciatic nerve:

• phytotherapy;
• acupuncture;
• acupressure;
• warming up with wormwood cigars;
• stone therapy or stone massage;
• vacuum or cupping massage;
• hirudotherapy - treatment with leeches and others.

Spa treatment

Only without exacerbation, sanatorium-resort treatment of inflammation of the sciatic nerve is recommended; mud therapy, hydrotherapy using radon, hydrogen sulfide, pearl baths, and underwater traction courses are especially effective.

Climate therapy always helps strengthen the immune system, reduces the frequency of colds, rest improves mood and creates a positive attitude, which is so important for recovery.

Massage

Massage procedures are allowed after the acute inflammatory process has subsided.

Thanks to this technique, the conductivity of the damaged sciatic nerve increases, local blood circulation and lymph flow are normalized, pain is reduced, and already developed muscle wasting is reduced.

Exercises

After recovery, beneficial physical exercises are especially necessary, but only those in which the load is evenly distributed on both sides of the body (light jogging, race walking, swimming, leisurely skiing).

In addition, there are special exercises that are ideal for all patients in remission. Here is an example of exercises that can be easily performed at home while lying on the floor.

All exercises are performed 10 times, with a subsequent increase in load:

1. Bring your legs towards your body, hug them under your knees. Using your hands, press your legs towards you as much as possible, maintain this position for 30 seconds, then return to the starting position.
2. Legs are straight, toes pointing up, arms along the body. Stretch your heels and the back of your head in different directions for 15 seconds, then relax.
3. Turn to your side, pull your legs towards you. Pull up your socks. Then return to the starting position and turn to the other side.
4. Roll over onto your stomach, lift your torso on your arms, and do push-ups. Do not strain your legs while doing this.

However, you need to know that if a pinched sciatic nerve is caused by a herniated intervertebral disc, you need to select a complex of physical therapy together with your doctor.

Treatment with folk remedies

Traditional medicine is of particular importance to cure pinched sciatic nerve. After all, its remedies become practically the only method of treatment, for example, if a nerve is pinched in a pregnant woman or there are any contraindications to the medications or physical procedures being taken.

The following treatments can be done at home:

1. Bay leaf tincture. You need to take 18 medium-sized bay leaves, pour 200 ml of good vodka into them, leave for 3 days in a cool, dark place. After this period, the resulting infusion must be rubbed into the sacrum area with massaging movements. After the fourth procedure, a positive effect is observed.
2. At night, you can attach a honey cake to the sore spot.. To do this, you need to heat a tablespoon of honey in a water bath, mix it with a glass of flour, form a cake and place it on the sore spot. Cover with cellophane and wrap everything with a warm scarf. This compress will relieve pain.
3. Potato sprout infusion is prepared from sprouted potatoes, or rather their sprouts. To do this, you need to take a glass of sprouts and pour half a liter of vodka. In this form, the mixture is infused for two weeks in the dark. After it is ready, you need to rub it into the affected area twice a day and wrap it in a warm cloth for a while.
4. Dissolve 10 analgin tablets in 200 ml of alcohol solution (at least 70%) and add a bottle of 5% iodine. The resulting mixture should be stored in a dark place for 3 days. Rub the prepared tincture into the problem area before bed, then wrap a scarf around your lower back and sleep until the morning.

Remember that home treatments cannot replace complex drug therapy; they are intended only to reduce the manifestations of the disease.

Prevention

When a pinched sciatic nerve is diagnosed, medications relieve pain and general discomfort; but it is also recommended to explore preventative measures to prevent relapse:

• you only need to sleep on a hard surface,
• avoid lifting heavy objects
• hypothermia of the extremities,
• do not make sudden movements.

Which doctor should I contact?

If symptoms of sciatica appear, you should consult a neurologist. The treatment involves a physiotherapist, massage therapist, and chiropractor. If necessary, the patient is examined by a neurosurgeon.

Inflammation of the sciatic nerve, or sciatica, is a disease that can bother you for a long time. It is also called neuralgia and even lumbar radiculitis. Sciatica, treatment - medication and physiotherapy - which is aimed at eliminating inflammation and pain, is accompanied by pinching of several spinal roots located in the lumbosacral region.

Sciatica appears in middle and old age and is often accompanied by diabetes, multiple sclerosis, allergies or problems with the circulatory system and metabolism. If the disease appears once, the likelihood of relapse is high even with treatment. However, topical therapy, compliance with medical prescriptions and the use of effective medications can greatly improve the patient’s well-being.

Eliminating the cause of pain during drug treatment of sciatica is the main goal of the disease. To do this, you need to find the place where the nerve is pinched. Acute pain is eliminated using potent blockades with anesthetic drugs. This is carried out in stationary conditions. Then a complex of tablets and other medications is prescribed, which should:

• prevent the appearance of acute pain during a course of treatment;
• reduce the inflammatory process;
• saturate damaged tissues with a sufficient amount of microelements;
• Provide nutrition to the entire body for rapid recovery.

Preventative drug treatment for sciatica is helpful if attacks occur regularly. The drugs used in this case are somewhat different from those prescribed to relieve acute attacks.

Sometimes patients require additional psychotherapy and the use of medications - antidepressants and sleeping pills. They help get rid of anxiety and the constant feeling of aching pain.

The patient is transferred to outpatient therapy when the cause of acute pain is found and home treatment is prescribed. At the same time, a person must move independently.

Nonsteroidal anti-inflammatory drugs

NSAIDs are one of the main groups of drugs that are used in drug therapy for sciatica. Nonsteroidal drugs affect the structure of prostaglandins, which cause pain. The pills stop the production of these cells, the brain does not receive a signal that painful sensations have arisen somewhere.

When treating sciatica, certain groups of medications are used:

• “Ibuprofen” is based on a substance with the same name. Effectively copes with pain, helps get rid of swelling and reduces inflammation.
• "Ketoprofen" is a drug with an additional active ingredient from the ketafen group. Used in the form of rectal suppositories.
• "Pentalgin-N" is prescribed to eliminate pain, relaxation, and spasms. A complex medicine with several active ingredients.
• "Celebrex" is a drug created for the treatment of neuralgia of various types.

Drug treatment of sciatic nerve inflammation using NSAIDs is carried out in the form of injections or oral tablets. It is important to control the dosage to avoid side effects. There are also NSAIDs in the form of gels and ointments that complement drug treatment.

When taking pills and giving injections, you should remember the side effects of NSAIDs:

• Arrhythmia and other heart rhythm disturbances often occur;
• swelling occurs, kidney function deteriorates;
• bleeding may occur;
• increased blood pressure.

Sciatica is often treated with hormonal medications. They have a more pronounced effect on the body and require a minimum period of use, but side effects can also occur in the first days of use. Hormonal medications are prescribed in the first 2-3 days after an exacerbation of sciatica, and then switch to non-steroidal therapy.

What injections are most often prescribed?

Injectable medications are used if sciatica cannot be treated with tablets. For this, the same substances are used, but only in the form of solutions: Diclofenac, Ibuprofen, Indomethacin, Butadione, Ketarolac. There is no acute addiction to non-steroidal medications, but it is still not recommended to take them in the form of injections for a long time.

Milder means include:

• "Movalis" - relieves pain, but does not affect the gastrointestinal tract, after 30 minutes the patient experiences relief;
• “Nimesulide” is the only substance that can relieve pain of any kind.

Some injections can be bought without a doctor's prescription at the pharmacy. But it is dangerous to treat them at home without a prescription.

Steroid medications for treatment

Steroid drugs are prescribed if other groups of drug treatment have not helped. They relieve inflammation and relieve pinched nerves. Most often prescribed for sciatica are: Prednisone, Dexamethasone, Methylprednisone.

These medications do not affect prostaglandins, but they quickly relieve spasms and swelling, thereby reducing pain. Steroid substances are most often used to inject into the tissue around the injured area.

The need to use steroids for a long time should be discussed by several doctors who see the patient.

Muscle relaxants

Medicines are used to relax muscle fibers. Due to this, the transmission of impulses stops and pain decreases. Most often prescribed "Mydocalm". The drug is available in the form of tablets and injections.

Vitamins

Vitamins for sciatica are as necessary as drugs that relieve pain. The doctor should select the complex after diagnosis. Borivit is often prescribed, as well as injections with vitamins B6 and B1, which quickly deliver components to damaged tissues.

When using vitamins, especially in the form of injections, you must follow the doctor's indications and contraindications. Serious side effects may occur with long-term use of these medications.

Also included in the group of vitamins are potent antioxidants, which in concentrated doses help eliminate harmful substances, reduce the degree of damage to nerve structures and restore limb mobility. Most often prescribed for drug treatment of sciatica are: C, E, selenium and copper.

Droppers

Droppers are used mainly in inpatient settings for drug treatment. To do this, use cocktails that normalize metabolism, relieve spasms, improve nutrition and blood circulation in the nerve roots. Vitamins are often used in the form of droppers.

Antidepressants

The choice of antidepressants is based on various patient test results. They should not be used as advice or general recommendations. Only with the correct dosage and selection of a suitable drug, the patient feels psychological comfort, anxiety and negative emotions associated with constant pain go away.

Antidepressants help get rid of apathy and depression and improve your focus on recovery. You can buy drugs at a pharmacy only with a doctor's prescription.

Ointments for therapy

External medications for the treatment of sciatica are used along with NSAIDs. They help with pain, swelling, inflammation. Recipes based on natural ingredients are very effective: bee venom, hot pepper, camphor, turpentine, snake venom.

They also use pharmaceutical products with synthetic active ingredients: “Fastum Gel”, “Nise Gel”, “Dolobene”, “Voltaren”, “Nurofen”. Creams and ointments should be applied strictly according to the instructions., and not only during the period of exacerbation. To achieve the desired effect, therapy must be regular.

Opiates and opioids

Opiates are powerful substances that can cause acute addiction when used over a long period of time. With the current variety of medications for the treatment of sciatica, they are very rarely prescribed. However, they do an excellent job of treating pain when other substances do not help. There are several modern opiates with a minimum of side effects: morphine, oxymorphine, codeine, hydrocon.

Opiates are used in hospital settings; they are not prescribed by doctor. The side effects of this category of drugs are very serious:

• gastrointestinal disorders: vomiting, diarrhea, nausea;
• insomnia, shallow sleep and other disorders;
• symptoms that are observed in mental disorders, including: delusions, hallucinations.

There must be serious reasons for prescribing opiates.

Blockade

Various medications are used to block sciatica, including steroid drugs. The blockade is necessary for emergency relief of swelling and painful inflammation around the damaged area.

A blockade is an injection into the epidural space, directly into the damaged area. Steroids are used for this, as well as lidocaine, novocaine, Diclofenac, and some other substances. Blockade with medications can only be carried out in a hospital setting.

Antibiotics

This group of drugs is prescribed quite rarely, only if the pinching occurs against the background of an acute infection. They use broad-spectrum drugs to eliminate 100% of microorganisms that cause inflammation.

Physiotherapeutic use of medications

It can be treated using medications during physiotherapy – electrophoresis. This procedure is used when the acute stage of inflammation is over. Electric currents are applied to the lesion, which deliver NSAIDs and other medications to the damaged areas through the skin. Phonophoresis with medications is also prescribed.

Criteria for the effectiveness of drug therapy

The main goal of any drug therapy is to relieve pain. If this does not happen within a certain time allowed for the use of different drugs, then it is necessary to discontinue the medications and prescribe new ones, or completely reconsider the treatment tactics.

It is very important to constantly see a doctor when using any medicines and medicines, including those of natural origin.

Drug treatment of sciatica is a basic method of treating pinched and inflammation of the sciatic nerve. It must take into account the presence of concomitant diseases. It is very difficult to do this at home: first you need to undergo an examination and tests. Based on the data obtained, the doctor will select medications, taking into account contraindications and possible side effects. And then the patient will be able to take some of them at home.

Three types of specialists provide treatment: neurologist, orthopedist and chiropractor. If consultations are necessary, they resort to the help of third-party specialists - oncologists, urologists and gynecologists. How to treat and what methods are effective? You will learn about this from this article.

Drug treatment is based on eliminating pain and eliminating the inflammatory process. The patient is prescribed analgesic and anti-inflammatory medications. Once the pain is relieved, you can begin to diagnose and treat the root cause of the nerve inflammation.

Physiotherapy is often used: UHF therapy, use of magnets and electrophoresis. Traditional methods used include the use of fixation belts that hold the lumbar spine in the desired position. Electrical stimulation, acupuncture and manual therapy are also used.

Reference: in cases where inflammation occurs due to an infection in the body, the patient is prescribed antiviral drugs and antibiotics.

The cause of inflammation may be an intervertebral hernia or tumor. It is often believed that surgical intervention is strictly necessary for a hernia, but this is not true: in most cases, high-quality manual therapy and regular exercise aimed at stretching the spine (stretching, swimming) help. If a tumor appears, surgery is really necessary.

The following indicators should be highlighted as symptoms:

• pain in the buttocks or legs;
• Difficulty in straightening the spine, especially after bending forward;
• Pain when turning the body;
• Inability to lean on a leg that is affected by inflammation;
• Involuntary bowel movements and incontinence;
• General muscle weakness;
• Temperature rise within 38 degrees.

First aid

In order to reduce pain, a person is placed stomach down on a hard surface, while a pillow is placed under the chest. If a person is cold, you can use a blanket or warm clothes, but you cannot use heating pads and compresses, which can increase swelling and worsen pain. Then all that remains is to call a doctor or independently take the patient to a medical facility, where he will receive professional assistance.

All medical procedures must be agreed upon with medical professionals: Do not under any circumstances take any measures, including rubbing with ointments, as this may interfere with diagnosis, treatment, and harm the general condition of the patient as a whole.

In what cases should you urgently consult a doctor:

• Increase in general temperature within 38 degrees;
• Burning when urinating;
• Incontinence and uncontrolled bowel movements;
• The appearance of new swollen areas in the back;
• Spread of pain to previously healthy parts of the body;
• Numbness in the pelvis and hips, limiting movement.

Which doctor should I contact?

It all depends on what caused the inflammation. The complexity of the disease is important. Sometimes the help of several specialists is required, since the cause of the disease is at the intersection of medical disciplines, and one doctor will not be able to achieve the desired result.

Firstly, most often, a neurologist, or neuropathologist, takes part in the treatment and prescribes drug therapy to the patient. Analgesics and anti-inflammatory drugs are used: tablets and ointments.

A chiropractor often works with him, who directly affects the source of inflammation and gradually eliminates it, restoring the cartilage tissue of the affected intervertebral discs. When visiting a private clinic, the work of a chiropractor is often replaced by a specialist in osteopathy.

Important: one should be careful, since this discipline belongs to alternative medicine and official science does not fully accept them due to the controversial methods of diagnosis and treatment.

How long does the pain last?

Pain syndrome accompanies inflammation all the time until the disease is stopped. It is paroxysmal in nature. It is noted that unpleasant sensations and sharp “shots” come only from time to time and do not accompany the sick person constantly. But the so-called aching pain in the lumbar region and lower extremities is constantly present. This is accompanied by a feeling of numbness in the lower part of the body and low sensitivity.

Causes and diagnosis

Sources of inflammation can be very different:

• Being in a cold temperature, which leads to cold of the sciatic nerve;
• Infections, incl. Lyme disease, herpes;
• Uncontrolled physical activity, including those leading to thrombosis;
• Diseases associated with the musculoskeletal system: spinal injuries, osteochondrosis, spondylosis, intervertebral hernias, injuries of the pelvis and its organs, spinal canal stenosis, Reithar's disease (also affects the genitourinary system);
• Associated with the endocrine system: gout, diabetes;
• Gynecological and urological diseases;
• Pregnancy and consequences of childbirth.

The following diagnostic tests and procedures are performed:

• Valsalva maneuver - imitation of breathing when the respiratory organs are blocked. To suspect inflammation of the sciatic nerve, the pressure in the abdominal area should increase;
• Lasegue test - raising the leg from a lying position (if the pain goes away when lowering the leg, it may be inflammation);
• Magnetic resonance imaging;
• Radiography;
• Electroneuromyography.

Treatment

Drug therapy

Non-steroidal anti-inflammatory drugs (NSAIDs). They help relieve swelling and minimize pain:

• Acetylsalicylic acid;
• Ibuprofen;
• Naproxen;
• Ketaprofen;
• Tolmetin;
• Tramadol.

Muscle relaxants

They reduce muscle tone, which allows the patient to remain at rest and avoid body movements that can lead to severe pain. The following drugs are prescribed:

• Sirdalud;
• Mydocalm.

Painkillers

Necessary for pain relief so that a person does not suffer. These are traditional analgesics (tablets and ointments) that are available in every home medicine cabinet:

• Nurofen
• Nise (Nise gel)
• Voltaren
• Dolobene

Hormonal drugs

They have an anti-inflammatory effect and promote immediate pain relief. The most commonly used drugs are from the group of glucocorticosteroids:

• Hydrocortisone
• Dexamethasone
• Cortisone
• Prednisolone

Antidepressants

They are used only in isolated cases and under strict medical supervision to normalize the sleep of a patient who is disturbed by pain:

• Paroxetine
• Venlafaxine

Broad spectrum antibiotics

Used to eliminate the bacterial root cause of inflammation:

• Penicillins: Augmentin, Amoxicillin, Ampicillin.
• Tetracycline.
• Aminoglycosides: Streptomycin.
• Amphenicols: Levomycetin.
• Fluoroquinolones: Levofloxacin, Ciprofloxacin.

Vitamins

Necessary for the restoration of nerve fibers and for maintaining the general tone of the body in a stressful situation. First of all you need:

• Vitamin complex Borivit (contains B vitamins)

Therapeutic treatment

Mode

The patient must be guaranteed bed rest and minimize body movements. He also needs constant care that could provide comfort and the ability to provide assistance, since the person must be as immobilized as possible and in a state of complete rest.

Physiotherapy

If the patient is being treated in a medical institution, he may be prescribed physiotherapy. In this case, electrophoresis and magnetic therapy will be used. It is possible to use manual therapy to relieve tension from the damaged part of the spine.

Sciatica is a pinched and inflammatory process occurring in the area of ​​the sciatic nerve. This is a rather unpleasant disease, accompanied by acute pain. Drug treatment for sciatica is aimed at eliminating pain and reducing the inflammatory process, which will quickly get rid of the main signs of the disease.

Since the pathology affects the spine in the lumbar region, pain initially appears in the leg. Often, an attack of sciatica occurs as a result of damage to one or several roots of the lumbar spinal cord.

The inflammatory process occurring in the area of ​​the sciatic nerve can be provoked by a variety of pathologies of the spine, in particular, diseases of the internal organs. Sciatica often occurs in the presence of the following diseases:

• osteochondrosis;
• intervertebral hernia;
• infectious and inflammatory processes;
• intoxication of the body.

Often, one of the main factors provoking inflammation of the sciatic nerve is significant hypothermia. Under the influence of low temperatures, the body's own protective reactions worsen, and signs of the inflammatory process intensify.

Symptoms

The main sign of a pinched sciatic nerve is the occurrence of painful sensations along the nerve endings. Neuralgia is often unilateral, but can affect both limbs. The painful sensations are sharp and intensify significantly with loads and movements.

There may be other signs of the disease, such as:

• burning, numbness of the skin;
• decreased level of sensitivity;
• gait disturbance.

All these symptoms make it very easy to recognize the presence of a problem, however, despite the rather pronounced symptoms, only a doctor can make a diagnosis and prescribe therapy.

Treatment

Drug treatment of sciatica involves an integrated approach, since this technique allows you to get the best results, eliminate pain and inflammation. The therapy regimen includes not only medication, but also manual therapy, physiotherapy, therapeutic exercises, and osteopathy.

To eliminate pain and inflammation, drugs are used for intravenous and intramuscular administration. Medicines in tablet form are practically not used, since the symptoms of the disease are quite pronounced. In some cases, treatment involves the injection of drugs into the spinal canal.

When carrying out drug therapy, the following drugs are widely used:

• non-steroidal anti-inflammatory drugs;
• steroids, epidural injections;
• muscle relaxants;
• gels and ointments;
• antidepressants;
• vitamins.

Important! Before using medications, you should first consult your doctor.

Nonsteroidal drugs

Medical treatment of sciatica involves the use of non-steroidal anti-inflammatory drugs, which have a pronounced analgesic nature. Among non-steroidal drugs, it is worth highlighting Ketoprofen, Analgin, Ibuprofen, Celebrex. The action of these drugs is based on blocking the released prostaglandin, which provokes a painful spasm. In addition, they have an antipyretic and pronounced anti-inflammatory effect.

They must be used when the very first signs of sciatica appear. Probiotics must be used during long-term therapy with anti-inflammatory drugs. If you have gastritis or a stomach ulcer, it is preferable to use injections or suppositories.

Steroid medications

Steroid medications for sciatica are hormonal medications. Diprosan, Kenalog, Hydrocortisone and others are used for therapy.

Steroid medications do not have a pronounced analgesic effect, but they help quickly eliminate inflammation and reduce tissue swelling, which quickly eliminates pain. In this case, there is often a need to inject medication into the tissues located around the damaged nerve. This procedure is called a blockade and is performed only by a doctor.

The main advantages of such drugs are that they act directly on the affected area, which reduces the occurrence of side effects. Such drugs are prescribed only by a doctor indicating the exact dosage, and at the same time supplemented with other methods.

Muscle relaxants

Muscle relaxants have a relaxing effect on the muscular system and prevent the transmission of nerve impulses to the muscles, which helps to quickly eliminate even the most severe pain. Among the main drugs, Mydocalm should be highlighted.

This medicine can be used in tablet form, as well as in injection form. Contraindications to its use may be hypersensitivity to individual components, bearing a child and the feeding period.

Ointments and gel

To eliminate moderate pain, external agents are used, in particular ointments and gels, as they have a low level of side effects. According to their composition, they are divided into:

• anti-inflammatory;
• complex action;
• chondroprotectors;
• homeopathic.

Anti-inflammatory ointments include products that contain non-steroidal drugs. In particular, Ketoprofen, Fenal, Indomethacin, Nurofen relieve pain well. Capsicam, Finalgon, Viprosal, and turpentine ointment have a warming and analgesic effect. To achieve a better result, after applying the ointment, you need to wrap the sore spot in a woolen scarf.

Ointments with complex effects are used as an anti-inflammatory, restorative and analgesic agent. In particular, Dimexide can be distinguished, which reduces the conductivity of impulses in nerve fibers, which promotes rapid pain relief and reduction of inflammation.

For sciatica, chondroprotective ointments are used, since they contain chondroitin, which promotes the rapid restoration of connective tissue and the production of the required joint fluid. They also have an analgesic effect and help eliminate inflammation.

Homeopathic ointments contain substances and medicinal plants that help reduce the intensity of the inflammatory process and relieve pain. Such products include Sabelnik, Zhivokost, ointments containing bee venom. Such medications must be used very carefully, as there is a high probability of allergies.

Important! Before using medications, you need to conduct an allergy test.

Vitamins

Vitamins help maintain good functioning of the nervous system and also help strengthen the body. To eliminate painful sensations, injections of B vitamins are prescribed, which are always used in combination with other therapeutic methods.

Among the vitamin injections, one can highlight Borivit, which contains vitamins B6 and B1, however, this remedy has certain contraindications that must be taken into account before starting to take the medicine.

Antidepressants

Antidepressants are prescribed as adjunctive therapy. They help you quickly relax, calm down and relieve painful muscle tension. The form and dosage of the medicine is prescribed only by the attending doctor.

There are many different remedies available to combat sciatica. The method of therapy used will be effective only if treatment is started in a timely manner. When the first signs of the disease occur, acute pain can be eliminated with the help of medications. After relief of acute pain, you need to consult a doctor for diagnosis and choice of course of therapy.

Sciatica is a serious enough disease to require timely treatment. Once you get used to it, you won’t be able to ignore it.

The pain with sciatica is always very severe, but at first it does not last very long. A person uses painkillers to get rid of pain, but only relieves the symptom, and even then only for a short time. Sciatica won't go away on its own, very soon the pain will become so strong and sharp that it will be impossible to walk, stand, and sometimes even lie, and any movement will only cause suffering. Let's figure out how to treat sciatica and what medications for sciatica will really help overcome the disease.

Uncured, but subdued sciatica will certainly lead to serious complications:

The lower limb may lose sensation; The motor function of the affected leg will be impaired; The foot may sag; Muscle atrophy and even paralysis are possible; Probably disruption of the intestines and bladder.

The treatment regimen for sciatica has long been developed and includes manual therapy, physiotherapeutic procedures, acupuncture, physical therapy and mandatory drug therapy.

The goal of this therapy is to relieve pain and relieve inflammation.

Pills

To begin with, use non-steroidal. Sciatica treatment drugs:

Analgin; Celebrex; Ketoprofen; Ibuprofen; Indomethacin.

This anti-inflammatory, antipyretic and analgesic medications for sciatica. They block the body's secretion prostaglandin- a substance that causes spasm, that is, pain.

Note! Tablets for sciatica (inflammation of the sciatic nerve) can be used independently, following the package insert. Consultation with a doctor is not necessary.

More drugs:

Katodolon(a drug with a strong analgesic effect, used if other drugs are contraindicated or have not worked); Neuromidin(stimulates the conduction of impulses along nerve fibers, enhances the contractility of smooth muscles of organs).

Since the pain syndrome with sciatica is too intense, then tablets are used infrequently.

Ointments for sciatica

The effectiveness of ointments and gels for sciatica is lower than that of injections, but they have no side effect. Ointments are divided into groups according to the nature of their effects:

Homeopathic(“Traumeel S”) improve metabolic processes and relieve pain. Contains herbal extract; Irritating and warming(“Capsicam”, “Nicoflex”, “Efkamon”, “Viprosal V”, “Finalgon”, “Betanicomylon”) relieve pain, reduce inflammation, improve nutrition, and saturate the pinched nerve with oxygen. Contains natural irritants (camphor, turpentine, pepper tincture, ethers); Chondroprotectors(“Chondroxid”, “Chondroitin Akos”, “Teraflex M”, medicinal cream “Sofya”) treat the very cause of pinching of the sciatic nerve - degradation of the disc between the vertebrae. They contain sulfur compounds, which are a building component of cartilage and ligament tissue. Non-steroidal anti-inflammatory drugs (Diclofenac, Butadione, Voltaren, Ketoprofen, Nimulid, Bystrumgel, Nurofen) are the most effective. Contains non-steroidal anti-inflammatory substances. Have many contraindications; Combined ointments for the treatment of sciatica (Dimexide, Dolobene), in addition to the anti-inflammatory and analgesic effect, they also have a thrombolytic effect, that is, they enhance tissue regeneration.

Antibiotics

If the disease occurs against an infectious background, then use antibiotics for sciatica broad spectrum, have a detrimental effect on all groups of pathogenic microorganisms.

Injections for sciatica - which ones are prescribed

It happens that taking pills is contraindicated. Then it is possible to use injections:

Indomethacin; Ibuprofen; Butadion; Ketarolac; Diclofenac.

These are non-steroidal drugs for the treatment of sciatica, relieving inflammation and swelling of nerve fibers.

Important! The body does not get used to non-steroidal drugs, but they cannot be used for a long time.

Eat drugs with a milder effect, they can be used longer:

Movalis(or Meloxicam) is an effective drug. Eliminates pain, inflammation, does not harm the gastrointestinal tract, brings relief within 30 minutes; Nimesulide– the only non-steroidal drug that has an effect on all pain mediators.

If the pain is very severe, then used for injection steroid drugs:

Dexamethasone; Diprospan; Prednisolone.

These injections are made as close to the sciatic nerve as possible in order to affect it locally. This gives a quick effect.

Attention! Long-term treatment with steroids can have side effects such as weight gain and stomach ulcers.

Blockade for sciatica

For rapid relief of swelling and inflammation You can make a blockade. This is the name of the procedure of injection into the epidural space, that is, directly into the affected area.

Various drugs are used for blockade:

Steroid(dexamethasone, prednisolone); Novocaine; Lidocaine; Diclofenac; Movalis.

The blockade is carried out only in a medical facility.

Droppers

The medications for the IV are prescribed by the doctor. Typically, such a therapeutic cocktail includes drugs that restore metabolic processes, relieve muscle spasms, normalize the blood supply to nerve endings, and vitamins. Sometimes (for severe pain) antidepressants and sleeping pills are prescribed.

Vitamins

Vitamins for sciatica are an important component of therapy:

Vitamins B12, B6, B1 prescribed by injection. Vitamins of this group relieve pain (sometimes a paired injection of vitamin B12 and voltaren is given), normalize the functioning of the nervous system; Benfolipen– multivitamin complex of B vitamins (tablets); Vitamin complexes with vitamins C, D, E and a group of minerals(calcium, magnesium, phosphorus, selenium).

Vitamins are necessary for tissue regeneration in the body and to stimulate the immune system.

The sequence of use of medications in the treatment of sciatica is determined by the doctor. From a patient only timely contact with a specialist is required. Treatment will be more effective the earlier it is started.

Sciatic nerve inflammation is a clinical condition that occurs due to traumatic or inflammatory damage to the sciatic nerve and is accompanied by severe pain that spreads throughout the lower limb.

Causes of inflammation of the sciatic nerve

Inflammation of the sciatic nerve or sciatica is a fairly serious disease, in the treatment of which it is necessary to pay attention not only to the clinical picture, but also to its causes. Therefore, it is very important to determine the etiological factors of the pathology in order to direct treatment in the right direction and quickly get rid of the problem.

The main causes of inflammation of the sciatic nerve

Injuries and heavy physical activity. These causes are the most common in the process of inflammation of the sciatic nerve. As a rule, this etiology of sciatica is typical for representatives of blue-collar professions who are constantly engaged in physical labor. Infectious processes against the background of hypothermia. The nerve, like any other organ, can be damaged by an infectious pathogen or a cold. This suggests that inflammation of the sciatic nerve can occur on its own, without additional damage to this anatomical site. Malignant or benign neoplasms of the pelvic organs and surrounding tissues that can damage or irritate the sciatic nerve itself. This contributes to the development of a typical clinical picture of inflammation of the sciatic nerve. Displacement of the vertebrae, their fractures and curvature of the spine. Despite the fact that vertebral displacements are quite rare in the lumbar region, sometimes they can be the cause of inflammation of the sciatic nerve. Again, people who engage in constant physical labor and weightlifters can be considered a risk group for these reasons.

Before treating the sciatic nerve, it is necessary to find out the exact cause of the pathology in order to influence it with therapeutic measures. This not only contributes to a faster recovery, but also prevents any relapse of the disease.

Clinical picture of inflammation of the sciatic nerve

Symptoms of inflammation of the sciatic nerve depend on the side and extent of the lesion. As a rule, the clinical picture of the disease is quite specific and allows one to determine the disease by symptoms alone.

The main clinical signs that accompany inflammation of the sciatic nerve:

Pain syndrome. Since the nerve is rich in a large number of sensory receptors, any damage to it is manifested by severe pain in a certain anatomical area. As a rule, pain manifests itself on one side. Bilateral inflammation is very rare. The main place of pain is the gluteal region, from where pathological symptoms can spread to the lower limb. The area of ​​distribution of pain depends on the degree of damage to the sciatic nerve. In some cases it is limited to the gluteal region, and sometimes it reaches the foot or even the toes. Movement disorders. The basis of this pathological symptom is not a violation of innervation and muscle function, but the same pain syndrome, which intensifies with movement, coughing and even breathing. Among other things, the sciatic nerve also has a sensitive branch, which leads to disruption of sensations during its inflammation. Like pain, sensory impairment can occur both in the gluteal region and throughout the lower limb.

In order to effectively treat inflammation of the sciatic nerve, it is necessary to carefully familiarize yourself with its clinical picture in order to at least approximately determine the extent of the damage.

Diagnosis of inflammation of the sciatic nerve

As a rule, the diagnosis is made on the basis of the clinical picture alone, which is so specific that it is almost impossible to confuse it with other diseases. True, the purpose of diagnosis for this disease is not only to confirm the diagnosis, but also to identify its immediate cause.

The simplest diagnostic method, which must be performed first, is radiography of the spine and pelvis. It allows us to exclude such pathological conditions as displacement of the vertebrae, fractures of their bases and injuries to the bone apparatus of the pelvic ring.

Computed tomography is used in the diagnosis of inflammation of the sciatic nerve when the presence of neoplasms of the pelvic organs is suspected. A CT scan helps determine the location and size of the tumor, as well as its effect directly on the sciatic nerve.

Treatment of inflammation of the sciatic nerve

Treatment of inflammation of the sciatic nerve is based on several principles that must be followed for a quick positive effect.

Elimination of the causative factor. Despite the fact that patients require quick relief from pain, first of all, it is necessary to think about how to identify the etiological factor and eliminate its influence. For example, if the vertebrae are displaced, the latter must be straightened, and if they are fractured, an external fixation device can even be used, which must be worn for up to one year. In addition, surgical treatment should be used for pelvic fractures and malignant neoplasms. If in the case of fractures the same external fixation devices are used, then in the case of a tumor the latter must be removed by abdominal surgery. Elimination of pain syndrome. At the very beginning of the disease, it is necessary to use exclusively tablet painkillers, such as analgin or ketanov. And only if they are ineffective, you need to switch to injectable forms of these medications. As a rule, the same analgin is used, only in ampoules. The course of such treatment should continue until the clinical symptoms completely disappear. There is no need to be alarmed if you are prescribed a course of injections lasting up to ten days. With inflammation of the sciatic nerve, this is absolutely normal. Antibacterial therapy. In case of inflammation of the sciatic nerve against the background of an infectious disease, it is necessary to use antibacterial therapy to destroy the pathogen. As a rule, today the priority is broad-spectrum antibiotics, which affect almost all groups of pathogenic microorganisms that can cause inflammation of the sciatic nerve. Anti-inflammatory therapy. As a rule, inflammation of surrounding tissues develops against the background of pain. If it is not cured in time, then compaction of the surrounding tissues may occur, which ends in chronic irritation of the specified nerve. Such a complication requires surgical intervention and to avoid it, it is necessary to prescribe anti-inflammatory drugs in a timely manner. The latter can be diclofenac or paracetamol. The drug must be administered daily for ten days intramuscularly or directly into the site of pinching of the sciatic nerve. Physiotherapeutic treatment. This type of therapy is not the main one for inflammation of the sciatic nerve, but it is almost always used in the later stages of the disease. The goal of physiotherapy is to prevent long-term complications and restore normal limb function. For such procedures, phonophoresis, electrophoresis, UHF or magnetic therapy can be used. The effectiveness of treatment increases several times if physiotherapy is combined with drug treatments. Massotherapy. This type of massage is somewhat different from the usual one, at least in that it must be performed by a specialist who is licensed to provide medical services. The main mechanism of action of massage is to improve blood supply, increase lymph flow and prevent muscle hypertrophy. As for the latter, it needs to be taken care of to a greater extent, since a hypertrophied muscle can be both a cosmetic effect and an irritant for the treated nerve. Physiotherapy. Because the treatment of sciatic nerve inflammation uses a special regimen that limits the movement of the limb, this can lead to a sharp weakening of muscle strength. It is necessary to begin to restore it while still in the hospital. For this purpose, special exercises are used that can be performed even in a lying position. In the long-term period of the disease, along with other physical exercises, it is necessary to give preference to exercises in the pool. In addition to the fact that water trains muscles, it makes movements a little easier, relieves spasms and pain. At the same time, it must be remembered that such procedures should be carried out only in warm water, since hypothermia can lead to a relapse of the disease.

Prevention of inflammation of the sciatic nerve

Like many other diseases, inflammation of the sciatic nerve is much easier to prevent than to cure. Prevention of pathology is quite difficult, since the disease has many causes that can contribute to its development.

Prevention of pinching and inflammation of the sciatic nerve

Avoiding injuries and overloads of the spine. If a person is not a representative of a working profession, then his back is not adapted to serious loads. This must be kept in mind when lifting heavy objects. The peculiarity of inflammation of the sciatic nerve is that its development requires a single sign of damage to this anatomical formation, and not a long process, as with other inflammations. This feature means that once you thoughtlessly lift a load, you can create a problem for yourself for the rest of your life. Avoiding hypothermia of the sciatic nerve site. Many people believe that short blouses in summer and down jackets in winter are the direct cause of inflammation of the sciatic nerve. Most likely, with such a wardrobe, the kidney can catch a cold, but not the sciatic nerve. The latter can be supercooled under a flow of cold air, but not in low temperature conditions. Training of the muscular and ligamentous apparatus of the back. If it is not possible to change jobs or the patient is a professional athlete (for example, a weightlifter), then it is necessary to prevent damage and displacement of the vertebrae in a different way. Running or swimming trains the back muscles well, during which the latissimus muscle actively works, which is the main muscular support of the spinal column. Gymnastics and control of correct posture. This point primarily concerns children, for whom it is very important to form correct posture in order to avoid back problems later. First, it is necessary to teach the child to sit correctly at the table, so that the back is parallel to the back of the chair. Any other positions of the spine, especially asymmetrical ones, have a very bad effect not only on the functional state of the back, but also on the health of the internal organs.

Prognosis for inflammation of the sciatic nerve

The prognosis for this disease depends entirely on its cause. If, for example, the pathology is caused by a tumor in the tissues of the pelvis, then the prognosis is favorable, since for a complete cure it is enough to remove the pathological tumor. In principle, a similar picture is observed with displacement of the vertebrae and their fractures.

But with primary inflammation of the sciatic nerve with hypertrophy of surrounding tissues, the prognosis is unfavorable. Enlarged muscles around the nerve will constantly have a pathological effect on it.