Sciatic nerve neuropathy: all about the disease. Cranial diabetic neuropathy. Ointments for the treatment of sciatica

Sciatic nerve neuropathy is a rather insidious and serious illness, which is accompanied by severe pain, which can even lead to temporary loss of ability to work or, even worse, disability.

Causes and symptoms of the disease

What is the sciatic nerve? This is the longest and most powerful nerve that originates in the lumbar region and ends in the feet of the lower extremities.

Sciatic nerve neuropathy occurs due to pinching, inflammation and damage to the spinal nerve roots in the lumbosacral spine. The result is pain that is localized in the buttocks and spreads to the limbs. The resulting pain is divided into two main groups: superficial and deep.

Superficial occurs when small nerve fibers are damaged. It can be described as stabbing, raw, burning, in the form of goosebumps.

Deep pain can be described as aching, pulling, cutting and aching.

Important! The disease affects only one side. In most cases, men have the left, women have the right.

The causes of neuropathy can be different:

Symptoms of sciatic nerve neuropathy are varied and depend on the affected area. Patients may complain of:

• Sharp, burning pain
• Numbness
• Weakness or difficulty moving a limb

IN severe cases the pain can be so severe that a person cannot move, muscle tone decreases. The main provocateurs of this situation may be stress, injury or hypothermia.

Treatment of the disease

Treatment of sciatic nerve neuropathy should be carried out under the supervision of a neurologist in a hospital setting. The disease progresses slowly, severely and for a very long time.

The patient must remain in bed (the bed is flat and firm) and follow all the doctor’s recommendations. First of all, treatment should be aimed at eliminating the cause of the disease, relieving swelling, muscle spasms, as well as reducing pain and resuming movement.

For treatment and positive results use complex therapy: ointments, injections, non-steroidal tablets, anti-inflammatory drugs and vitamin therapy.

If the case of the disease is more serious, the doctor may prescribe exercise therapy and various procedures. This could be acupuncture, reflexology, massage or physiotherapy (laser, electrophoresis).

Exercise therapy occupies a special place in the treatment of neuropathy. A well-chosen set of exercises can reduce trophic disorders, increase blood circulation and prevent muscle weakness.

Quite effective for neuropathy is cupping massage and the use of an orthopedic patch.

Surgery is performed only in very complex and severe cases, where drug treatment is powerless.

People's Directory

I would like to immediately note that folk remedies act as an adjunct to the main treatment of the disease. You can make from the gifts of nature medicinal baths, compresses, ointments, rubbing mixtures, infusions and decoctions for internal use.

Beeswax

The flatbread is prepared from heated steam bath beeswax. The finished cake should be applied to the affected area. If you have burdock oil, you can safely add it to the wax. This will enhance the effect even better!

Honey and radish juice

Squeeze the juice from the radish, mix with honey 1:1 and rub into the affected area.

Decoctions

Decoctions of calendula, parsley and rose hips help to cope with neuropathy of the sciatic nerve. Brew as herbal tea and drink in small portions throughout the day.

Therapeutic baths

As a form of prevention, you can take baths based on a decoction of chamomile, knotweed and sage.

Horse chestnut ointment

Perfectly warms and relaxes. The ointment should be rubbed into sore spot twice a day.

Forecast

The longer the illness lasts, the less likely you are to get positive result. The disease entails a lot of complications that are difficult to cope with. In advanced cases, trophic and vasomotor disorders always occur, the toenails are deformed, and the heels and edges of the feet (in most cases, the outer ones) are also affected by trophic ulcers.

No need to neglect treatment! If the cause of the disease is eliminated in a timely manner, then complete recovery and freedom of movement for many years are possible.

Important! A disease such as sciatic nerve neuropathy is very insidious, so at the first symptoms of the disease, you should immediately consult a doctor.

The disease is diagnosed primarily based on the results of a neurological examination, electrophysiological studies, CT, radiography and MRI of the spine. In the treatment of sciatic neuropathy, along with its elimination etiological factor, carry out medicinal and physiotherapeutic treatment, supplemented by massage and physical therapy (including post-isometric relaxation).

Sciatic nerve neuropathy

Sciatic nerve neuropathy is one of the most common mononeuropathies, second only to peroneal nerve neuropathy in its frequency. In most cases it is one-sided. It is observed mainly in middle-aged people. The incidence among the age group is 25 cases per 100 thousand population. It is equally common in females and males. There are often cases when sciatic neuropathy seriously and permanently reduces the patient’s ability to work and even leads to disability. In this regard, the pathology of the sciatic nerve seems to be a socially significant issue, the resolution of the medical aspects of which is under the jurisdiction of practical neurology and vertebrology.

Anatomy of the sciatic nerve

The sciatic nerve (n. ischiadicus) is the largest peripheral nerve trunk in humans, its diameter reaches 1 cm. It is formed by the ventral branches of the lumbar L4-L5 and sacral S1-S3 spinal nerves. Having passed the pelvis along its inner wall, the sciatic nerve exits through the notch of the same name to the posterior surface of the pelvis. Then it goes between the greater trochanter of the femur and the ischial tuberosity under the piriformis muscle, exits the thigh and above the popliteal fossa divides into the peroneal and tibial nerves. The sciatic nerve does not give off sensory branches. It innervates the biceps, semimembranosus and semitendinosus muscles of the thigh, which are responsible for flexion. knee joint.

In accordance with the anatomy of n. ischiadicus, there are several topical levels of its lesion: in the pelvis, in the area of ​​the piriformis muscle (the so-called piriformis syndrome) and on the thigh. The pathology of the terminal branches of the sciatic nerve is described in detail in the articles “Neuropathy of the peroneal nerve” and “Neuropathy tibial nerve” and will not be considered in this review.

Causes of sciatic nerve neuropathy

A large number of sciatic neuropathies are associated with nerve damage. Injury n. ischiadicus is possible with a fracture of the pelvic bones, dislocation and fracture of the hip, gunshot, laceration or incised wounds of the thigh. There is a tendency towards an increase in the number compression neuropathies sciatic nerve. Compression can be caused by a tumor, aneurysm of the iliac artery, hematoma, prolonged immobilization, but most often it is caused by compression of the nerve in the infrapiriform space. The latter is usually associated with vertebrogenic changes occurring in the piriformis muscle according to the reflex muscular-tonic mechanism during various pathologies spine, such as: scoliosis, lumbar hyperlordosis, spinal osteochondrosis, lumbar spondyloarthrosis, hernia intervertebral disc and etc.

According to some data, approximately 50% of patients with discogenic lumbar radiculitis have a clinic of piriformis muscle syndrome. However, it should be noted that neuropathy of the sciatic nerve of vertebrogenic origin may be associated with direct compression of the nerve fibers as they exit the spinal column as part of the spinal roots. IN in some cases pathology of the sciatic nerve at the level of the piriformis muscle can be provoked by an unsuccessful injection into the buttock.

Inflammation (neuritis) n. ischiadicus can be observed with infectious diseases(herpes infection, measles, tuberculosis, scarlet fever, HIV infection). Toxic damage is possible both with exogenous intoxication (arsenic poisoning, drug addiction, alcoholism), and with the accumulation of toxins due to dismetabolic processes in the body (diabetes mellitus, gout, dysproteinemia, etc.)

Symptoms of sciatic nerve neuropathy

A pathognomonic symptom of neuropathy n. ischiadicus causes pain along the affected nerve trunk, called sciatica. It can be localized in the buttock area, spread from top to bottom along back surface thighs and radiate along the posterior outer surface of the lower leg and foot, reaching the very tips of the fingers. Patients often describe sciatica as “burning,” “shooting,” or “piercing like a dagger.” The pain syndrome can be so intense that it prevents the patient from moving independently. In addition, patients report a feeling of numbness or paresthesia on the posterolateral surface of the leg and some areas of the foot.

Objectively, paresis (decreased muscle strength) of the biceps, semimembranosus and semitendinosus muscles is detected, leading to difficulty bending the knee. In this case, the predominance of the tone of the antagonist muscle, which is the quadriceps femoris muscle, leads to the position of the leg in a state of extended knee joint. Walking with a straight leg is typical - when moving the leg forward for the next step, it does not bend at the knee. Paresis of the foot and fingers, decreased or absent plantar and Achilles tendon reflexes are also noted. With a sufficiently long course of the disease, atrophy of paretic muscle groups is observed.

Pain sensitivity disorders cover the lateral and posterior surface of the lower leg and almost the entire foot. In area lateral malleolus There is a loss of vibration sensitivity, and in the interphalangeal joints of the foot and ankle there is a weakening of the muscle-articular sense. Typical pain is when pressing on the sacrogluteal point - the exit point n. ischiadicus on the thigh, as well as other trigger points of Valle and Gar. A characteristic symptom of sciatic neuropathy is positive symptoms Bonnet's tension (shooting pain in a patient lying on his back with passive abduction of the leg bent at the hip joint and knee) and Lassègue's (pain when trying to lift a straight leg from a supine position).

In some cases, sciatic nerve neuropathy is accompanied by trophic and vasomotor changes. The most pronounced trophic disorders are localized on the lateral side of the foot, the heel and the back of the toes. Hyperkeratosis, anhidrosis or hyperhidrosis may occur on the sole. Hypotrichosis is detected on the posterolateral surface of the leg. Due to vasomotor disturbances, cyanosis and coldness of the foot occur.

Diagnosis of sciatic nerve neuropathy

The diagnostic search is carried out mainly as part of a neurological examination of the patient. Special attention The neurologist pays attention to the nature of the pain syndrome, areas of hypoesthesia, decreased muscle strength and loss of reflexes. Analysis of these data allows us to determine the topic of the lesion. Its confirmation is carried out using electroneurography and electromyography, which make it possible to differentiate sciatic mononeuropathy from lumbosacral plexopathy and radiculopathies at the L5-S2 level.

Last time to assess the condition of the nerve trunk and its surroundings anatomical formations they use an ultrasound technique that can provide information about the presence of a nerve tumor, its compression, degenerative changes, etc. Determination of the genesis of neuropathy can be carried out using radiography of the spine (in some cases - CT or MRI of the spine), radiography of the pelvis, ultrasound of the pelvis, ultrasound and radiography of the hip joint, CT scan of the joint, blood sugar analysis, etc.

Treatment of sciatic nerve neuropathy

The first priority is to eliminate causal factors. In case of injuries and wounds, plastic surgery or suture of the nerve, reposition of bone fragments and immobilization, and removal of hematomas are performed. In the case of space-occupying formations, the issue of their removal is decided; in the presence of a disc herniation, the issue of discectomy is decided. In parallel, conservative therapy is carried out aimed at relieving inflammation and pain response, improving blood supply and metabolism of the affected nerve.

As a rule, pharmacotherapy includes non-steroidal anti-inflammatory drugs (ibuprofen, lornoxicam, nimesulide, diclofenac), drugs that improve blood circulation (pentoxifylline, a nicotinic acid, bencyclane), metabolites (hydralysate from calf blood, thioctic acid, B vitamins). It is possible to use therapeutic blockades - local administration of drugs into trigger points along the course of the sciatic nerve.

Sciatic nerve neuropathy - treatment in Moscow

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Sciatic nerve neuropathy: all about the disease

Sciatic nerve neuropathy is one of the most common neuropathies. The disease is serious, accompanied by severe pain, and can lead to long-term disability and even disability.

Only one side of the body is affected, and neuropathy of the right sciatic nerve occurs mainly in women, and of the left - in men. This is due to the difference in the functioning of the female and male brain, with physiological characteristics body structure.

What leads to pathology?

The causes of this disease can be different. As a rule, they are not inflammatory in nature, caused by nerve compression and muscle spasm.

The most common is post-traumatic neuropathy, or neuropathy that occurs with various pelvic cysts and diseases of the spine. May be caused by prolonged compression, such as when a limb is immobilized.

Post-injection neuropathy caused by unsuccessful intramuscular injection, happens extremely rarely.

Symptoms

Symptoms are very varied due to the fact that the sciatic nerve is one of the longest nerves in human body. They depend on which area is affected, but all signs are characterized by severe pain along the sciatic nerve and impaired limb function.

Painful manifestations can be localized in the gluteal region, down the back of the thigh, and reach the toes. Patients complain about:

The pain syndrome can be so severe that a person cannot walk independently, and paresis (decreased muscle strength) of the foot or lower leg occurs.

Attacks are often provoked by stressful situations, hypothermia, and injury.

Treatment approaches

The disease in most cases is long-term and severe. Therefore, treatment should be carried out in a hospital setting with strict bed rest. The bed should be flat; it is better for such a patient to sleep on a “board”.

A neuropathologist keeps a medical history, consulting, if necessary, with surgeons or traumatologists. It is possible to perform surgery to remove a cyst or hematoma in order to relieve pressure on the nerve.

Tablets and other means

First of all, treatment should be aimed at eliminating the root cause of the disease, reducing pain, relieving swelling and muscle spasms. As a conservative therapy, complex treatment is used, using non-steroidal anti-inflammatory drugs in the form of injections, ointments, and tablets.

They can relieve swelling, inflammation, and reduce pain. Vitamin therapy is used to improve tissue nutrition and nerve conduction.

Exercise therapy and procedures

A special place is occupied by exercise therapy for neuropathy of the sciatic nerve. An individually selected set of exercises improves blood supply to the damaged nerve, prevents muscle weakness, and reduces trophic disorders.

The exercises are performed freely, without effort; mild pain during exercise therapy is not a contraindication. Some exercises can be done constantly to relieve minor pain and prevent an attack:

1. Lying on your back, bend your legs as much as possible, trying to press your thighs to your stomach.
2. In the same position, raise and lower the pelvis.
3. Standing on all fours, bend and flex your spine.
4. Walking on your buttocks.
5. Any exercises aimed at stretching muscles.

Various hangs on the bar with small movements of the legs and spine help a lot. They allow you to relax spasmed muscles and reduce pressure on the nerve.

Cupping massage is very effective. It can be done independently at home if there are no contraindications (tumors, inflammation).

It is done using any warming cream: spread the sore spot, place the jar and slowly move clockwise for 10 minutes, repeat the procedure every other day. This will increase blood circulation, relax muscles, and improve tissue trophism.

For sciatic nerve neuropathy, it is good to use orthopedic patches, which, through their local effect on the site of pathology, have an anti-inflammatory and analgesic effect.

Folk recipes

1. Treatment beeswax. A cake is made from wax heated in a water bath and applied to the affected area. You can add burdock oil and St. John's wort oil to the cake.
2. Rub radish juice mixed with honey in a 1:1 ratio into the sore spot. You can rub in just the juice.
3. Baths with a decoction of chamomile, angelica roots, sage, knotweed.
4. It is good to take decoctions of calendula, elecampane root, rose hips, and parsley internally.
5. Helps very well horse chestnut for external and internal use. Using it in the form of rubs and ointments has a warming and relaxing effect and has a beneficial effect on well-being.

In mild cases, such as neuropathy due to overlapping plaster cast, traditional medicine is sufficient for treatment.

Forecast

The outcome of this disease is unfavorable; it often becomes chronic, with periods of exacerbation alternating with remission. The most benign neuropathy of the sciatic nerve is considered to be neuropathy caused by prolonged compression. In this case, with timely elimination of the cause, complete recovery is possible.

For full recovery or to consolidate the achieved remission, it is advisable for patients to undergo Spa treatment using radon, hydrogen sulfide baths, mud therapy.

By the way, now you can get my free e-books and courses that will help you improve your health and well-being.

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Sciatic nerve neuropathy symptoms

Carpal tunnel syndrome

Tunnel syndrome is a whole group of diseases of peripheral nerve fibers that arise due to compression of these nerves in certain anatomical canals (tunnels) of the body, which can be formed by bone, muscle and tendon anatomical structures.

To date, several dozen tunnel syndromes have been described. Some of them are very common, for example, carpal tunnel syndrome, which affects approximately 1% of the entire population, others can be seen quite rarely and are known only to specialized specialists.

Despite the clinical diversity of this group of peripheral pathologies nervous system, the root causes of development are the same - pinching of the nerve fiber in its natural anatomical location. This pathology in the English language medical literature can also be found under the name trap neuropathy, which very well reflects the mechanism of nerve damage.

In addition to compression of nerve tissue, with the development tunnel syndrome there is a disruption in the blood supply to the nerve. This leads to another common name for this group of pathologies – compression-ischemic neuropathy.

Tunnel syndromes of the arms are the most common; the nerve trunks of the lower extremities are much less likely to be affected. As a rule, the onset of the disease occurs in adulthood; women are affected more often than men. The course of the pathology is chronic in nature with periods of exacerbations and remissions, accompanied by 3 clinical syndromes - pain, signs of sensory impairment and motor function limbs, which can be expressed to varying degrees.

Causes

The main significance in the development of compression-ischemic neuropathies is given to microtraumatization of the nerve of a chronic nature, which is of a professional, household or sports nature. That is why they are most often disadvantaged nerve structures, which are in close proximity to moving joints.

Metabolic and endocrine disorders in organism. For example, the disease more often occurs in women during pregnancy, breastfeeding, during menopause, in patients with hypothyroidism, and with long-term use hormonal drugs, including oral contraceptives.

In some cases, severe weight loss may be the cause of a pinched nerve. This reduces the amount of fatty tissue that protects the nerve and performs shock-absorbing functions for it.

Cases of familial tunnel syndromes have also been described in medicine. At the same time, relatives initially recorded pronouncedly narrow canals in which nerve fibers.

The risk of such disorders is also increased in patients with systemic diseases connective tissue, arthritis, arthrosis, injuries and joint surgeries, diabetes mellitus, chronic alcoholism, multiple myeloma and other hematological diseases.

The most common tunnel syndromes are discussed below.

Carpal tunnel syndrome

Carpal tunnel syndrome accounts for approximately 50% of all compression-ischemic neuropathies and in last years its number is increasing sharply, which can be explained by an increase in the number of workers who regularly use a keyboard and computer mouse.

The carpal tunnel (carpal tunnel) itself is very narrow, its bottom and walls are the bones of the wrist, and the canal is covered on top by the transverse carpal ligament. Inside the sheath are the finger flexor tendons and the median nerve.

The median nerve is mixed in function, that is, it provides both sensitivity and motor activity. It takes part in the innervation palmar surface 3-5 fingers of the hand, interdigital areas and the back of the nail phalanges of the first 3 fingers. The motor part of the nerve ensures the normal function of the muscles that form the eminence of the first finger of the hand.

Symptoms of Carpal Tunnel Syndrome

If carpal tunnel syndrome develops, the patient develops compression-ischemic neuropathy of the median nerve. The pathology is characterized by a chronic long-term course. Among the first signs of neuropathy are pain in the area of ​​corresponding innervation, paresthesia (tingling, crawling sensation, numbness), which appear mainly at night and often cause a person to wake up. As the disease progresses, these symptoms bother you both day and night.

At the next stage of disease progression, the sensitivity of the skin gradually decreases and motor disorders appear - a decrease in the muscle strength of the tenor muscles, wasting and atrophy of muscle tissue, weakness in the hand, the inability to perform habitual movements and even hold objects.

Pain from carpal tunnel syndrome is characterized by spreading not only to the hand, but also to the forearm, shoulder and even to the neck. Painful sensations are reduced by rubbing and shaking the hands (the blood supply to the damaged nerve improves).

Simple tests to diagnose carpal tunnel syndrome:

• Tinel test - upon percussion in the area of ​​the damaged nerve, the appearance or intensification of pain and paresthesia in the area of ​​its innervation is observed.
• Test with raising the upper limb - for this you need to raise and extend your arms straight above your head, hold your limbs in this position for 60 seconds. Due to a decrease in blood flow, a patient who has carpal tunnel syndrome experiences pain and paresthesia.
• Flexion test - for this you need to bend the hand at the wrist joint as much as possible and hold it in this position for a minute. Subsequently, when the arm is extended, pain and paresthesia occur in the zone of innervation of the median nerve.
• The bottle test becomes positive only if movement disorders are associated. In this case, the patient cannot lift and hold the bottle by the neck with his thumb and forefinger.

In case of rough pathological changes at a late stage of the disease changes significantly appearance brushes The skin becomes very pale, the tenor's muscles atrophy, and the hand begins to resemble a primate's paw.

Treatment for Carpal Tunnel Syndrome

After the diagnosis is made, conservative therapy is resorted to; surgical treatment can be immediately prescribed only in isolated cases, for example, when nerve compression is caused by injury or callus growth after a wrist fracture.

First of all, you need to get rid of all possible factors that could cause the disease. It is important to ensure complete rest of the hand for a period active phase treatment. To immobilize a limb as much as possible, you can use special bandages, bandages and orthoses for wrist joint. You also need to take care of the ergonomics of your workplace. If you work with a computer, you need to follow some rules for placing your hands on the keyboard and mouse.

There are also various gadgets that allow you to maintain the desired position of your hands when working and prevent further injury to the median nerve, for example, vertical mice, silicone mats with gel pads, and other devices.

From medications analgesics and anti-inflammatory drugs are used. In more complex cases and with severe pain, they resort to blockade using glucocorticosteroids. IN complex treatment Therapeutic exercises, physiotherapy, massage, and acupuncture are also used.

If conservative measures are unsuccessful, then surgery will help cure the neuropathy. In this case, the carpal ligament of the canal is surgically incised and the nerve is released from the trap. There are several ways to perform surgical intervention; in modern clinics, they even use endoscopic equipment for this purpose, which avoids a large surgical incision. The recovery period takes up to 3 months.

Important! Treatment for carpal tunnel syndrome should be started promptly. If long time do not take any measures, in the tissues of the median nerve may occur irreversible changes, which will lead to complete loss of nerve fiber function.

Cubital tunnel syndrome

Among the tunnel syndromes of the upper limb, it is worth highlighting the cubital tunnel syndrome, which occurs as a result of strangulation ulnar nerve in the cubital canal.

Due to the superficial passage of the nerve fiber in this place and the high mobility of the elbow, the ulnar nerve is prone to damage in the cubital canal area. This pathology is in second place among carpal tunnel syndromes after carpal tunnel damage.

Most often, the cause of the development of pathology is damage to the nerve fiber due to prolonged static overvoltage and pressure on the nerve, for example, the habit of talking on the phone for a long time, resting the elbow on the table, etc. Metabolic and endocrine diseases, injuries, surgeries elbow joint, arthritis and arthrosis of this joint.

Symptoms of neuropathy also include three main points:

• pain in the area of ​​innervation of the ulnar nerve;
• sensory disorders - insemination, paresthesia, decreased sensitivity;
• movement disorders that occur as the disease progresses - weakness of the 4th and 5th fingers of the hand, atrophy of the hypotenor muscles and interosseous muscle fibers, a characteristic position of the hand like a clawed paw.

In the treatment of this pathology, both conservative and surgical methods are used. It is important to fix your arms in an extended position; for this, there are special splints that can be worn at night while sleeping at home. In the complex of therapy, medications, physiotherapy, folk remedies, and physical therapy are used.

Operation is prescribed in case of ineffectiveness conservative treatment. During the manipulation, the ligament that covers the cubital canal from above is dissected and, thus, the nerve is released, which gradually restores its functions on its own (if the disease has not gone too far).

Radial nerve neuropathy

The radial nerve can be compressed in several places along its course, but most often this occurs at the level of the distal portions of the brachial canal.

In this case, signs of complete damage to the trunk of the radial nerve are observed:

• paralysis of the muscles that extend the hand and fingers (“droopy hand”);
• sensory disorders on the back of the forearm and on the back of the radial half of the hand (1st and 2nd fingers);
• pain on palpation of the affected area.

This disease is also called Saturday night paralysis or honeymoon paralysis.

How to treat radial nerve neuropathy? Treatment can be conservative or surgical. If a complex of various therapeutic measures is ineffective, they resort to surgery.

Peroneal nerve neuropathy

Most often, pinching of this nerve occurs between the head of the fibula and the edge of the long tibial muscle. This situation occurs with sharp plantar flexion of the foot, in case of sprain of the ankle joint.

The result is injury to the fibular nerve, which can become chronic with the development of neuropathy. Also, compression of the nerve can be observed when performing certain types of work while squatting, sitting in a cross-legged position, or when applying a tight plaster cast.

In this case, there is paralysis of the muscles that extend the foot and toes, decreased sensitivity of the outer surface of the lower leg, the back of the foot and 1-4 fingers. If neuropathy persists for a long time, atrophy of the anterior and posterior groups of the lower leg muscles develops. Upon palpation and percussion of the affected area, the patient feels pain and the occurrence of paresthesia.

Roth's disease

This is one of the common lower limb tunnel syndromes. In this case, compression-ischemic damage to the lateral cutaneous femoral nerve occurs. The nerve performs only a sensory function and does not contain motor fibers; it innervates the skin of the anterior outer surface of the middle third of the thigh.

The main symptom of the pathology is numbness and burning pain in the corresponding innervation zone. In the later stages of development of the pathology, there is a complete loss of sensitivity in this area of ​​the skin. When the hip is extended, the pain increases, and when it flexes, it decreases.

As a rule, this disorder does not cause serious inconvenience for the patient, but in some cases the pain becomes very severe. This situation is an indication for surgery in the area of ​​the inguinal ligament.

Interestingly, neuropathy of the lateral cutaneous nerve Sigmund Freud suffered from hip pain, believing that this pain was psychogenic in nature.

Tarsal tunnel syndrome

When tarsal tunnel syndrome develops, the tibial nerve is compressed. Compression occurs predominantly in the area of ​​the osteofibrous tarsal canal (tarsal).

The main symptom of the disease is pain felt in the area of ​​the sole of the foot and toes. Painful sensations arise or intensify when walking, and a symptom of intermittent claudication occurs. The pain also occurs spontaneously at night and helps the patient wake up. Very often the pathology is bilateral.

Piriformis syndrome

In the case of the development of compression-ischemic neuropathy of the sciatic nerve, they speak of piriformis syndrome. It arises as a result spastic contraction the latter, due to which the sciatic nerve is pressed against the sacrospinous ligament. Similar situation often observed in patients with degenerative-dystrophic lesions of the spine.

Signs of the disease include burning pain and the development of paresthesia in the area of ​​innervation of the common tibial nerve. Patients also experience a decrease in the Achilles tendon. Over time, weakness of the lower leg muscles develops.

The development of carpal tunnel syndrome significantly affects the quality of life of patients. But the forecast is timely established diagnosis And proper treatment favorable. That is why you do not need to delay your visit to the doctor if you are concerned about the symptoms described in the article. It should be understood that there are a lot of diseases of the peripheral nervous system, and only a specialist can find out the cause and make an accurate diagnosis.

Lower back pain radiating to the leg - complete analysis, causes, treatment and prevention

Any pain that occurs for no apparent reason should immediately alert the person suffering from it. It is known that nothing can hurt for nothing. You should be especially concerned about those cases when pain occurs in one place, but flows or radiates to another. For example, a sharp pain radiating to the right or left leg, and arising in the lower back.

Introduction

With the first signs of the onset of the disease, a person is lost and does not know what to do in this or that situation, which doctor to contact and what is the cause. The most common in such situations are visits to a neurologist, orthopedist, rheumatologist, osteopath, and gynecologist. Sometimes the request does not end with one specialist, and you have to ask several doctors for help at the same time.

The causes of pain in the lower back, radiating to the right or left leg or to both legs at once, are different and depend on the exact situations in which it occurs, how long the lower back hurts, what the nature of the pain is, etc.

Causes of pain radiating to the leg

Pain in the lower back radiating to the leg can occur for the following reasons:

1. Intervertebral hernia.
2. Spinal cord tumors.
3. Protrusion of intervertebral discs.

This is not a complete list of reasons that cause discomfort in the lumbar spine, radiating to the leg on the left or right. The reasons are very serious and require an immediate visit to the doctor and high-quality treatment, which will be prescribed only by a doctor who has thoroughly studied the problem and causes.

Location of pain and its nature

Based on what exactly caused the pain in the lower back, to which part of the leg it radiates, and what its nature is, we can talk about the specific cause of the pain.

1. Pain in the lumbar region with radius to the hip suggests that its cause was either an intervertebral hernia or protrusion (that is, swelling). If the pain is accompanied increased sweating, then this indicates spinal cord tumors or injuries to the sciatic nerve.
2. Pain in the lower back that radiates to the back of the leg indicates a pinched sciatic nerve.
3. Lower back pain radiating to the side of the leg (lamp-shaped pain) indicates herniated discs, pinched nerve roots of the spinal cord, and weakness of the thigh muscles.
4. Lumbar pain radiating to the anterior side of the thigh is a consequence of damage to the femoral nerve.
5. Dull pain in the lower back and knee at the same time indicates oncological diseases internal genital organs, damage to the hip joint.

Common diseases for lower back pain radiating to the leg

Long-term practice of doctors involved in the treatment of the musculoskeletal system has shown that the most common diseases associated with neuralgia in the lumbar spine, extending to the leg, are such phenomena as:

• Sciatica is compression of the nerve roots of the sacral region of the spine. In such cases, pain occurs in the lower back and radiates to the buttocks and knee.
• Lumboischialgia is compression of the nerve roots of the entire spinal column. With this phenomenon, the pain is localized in the lower back and spreads upward, along the spinal column, ending in the leg just below the hip. Lumboischialgia can be a consequence of many orthopedic and rheumatic diseases (osteochondrosis, chondrosis, rheumatism).
• Radiculitis is, as a rule, a consequence of lumboischialgia and sciatica. The nature of neuralgia in radiculitis of the lumbosacral region is acute, shooting pain in the lumbar region, sometimes radiating to the right or left leg. Occurs after prolonged hypothermia, physical, sudden movements, loads, heavy lifting.
• Somatic diseases (urological and gynecological). Often lower back problems due to urological or gynecological diseases begins in the groin area and flows into the lower back and legs.

Treatment for lumbar pain radiating to the leg

Neuralgia in the lower back is a widespread phenomenon and has been studied in sufficient detail. Therefore, modern medicine has an extensive list of methods for treating such ailments.

After an initial examination by a doctor, tests are prescribed to determine the diagnosis. During the examination, the doctor determines whether tension appears in the leg on the right or left, in which part of the limb, and finds out the reasons that provoked the pain.

Treatment is prescribed only after diagnosis!

Treatment for orthopedic problems

If the reasons are orthopedic, rheumatic, then a course consisting of the following drugs:

1. Non-steroidal anti-inflammatory drugs.
2. Analgesics.
3. Chondroprotectors.

After relieving inflammation, pain, muscle relaxation, and restoring normal blood circulation in the tissues, treatment continues:

• Physiotherapy;
• Massage;
• Therapeutic baths (iodine-bromine, mud, hydrogen sulfide);
• Therapeutic gymnastics.

For non-orthopedic causes of discomfort in the lower back, the causes are first determined, and then treatment is prescribed by a doctor in the area in which the problems were found.

Prevention of orthopedic diseases

Prevention of musculoskeletal diseases plays an important role. Have a good effect on general health people use:

1. Orthopedic mattresses and pillows.
2. Maintaining a healthy lifestyle.
3. Walks in the open air.
4. Swimming.
5. Horse rides.
6. Daily physical exercise.
7. Maintaining a daily routine.
8. Seasonal intake of vitamins and minerals (spring and autumn).

Simultaneous pain in the leg, right or left, and lower back is a reason to seek treatment. medical care as soon as possible without waiting for it to go away on its own. Of course, you can temporarily help yourself on your own if the problem takes you by surprise. Give an anesthetic injection, rub anesthetic and warming ointment, take a comfortable body position, but you should not avoid treatment at all.

Conclusion

Thus, when neuralgia occurs in the lumbar spine, treatment is based, first of all, on identifying and eliminating the cause of neuralgia, relieving the inflammatory process and pain syndrome, and maintaining the spine in in good condition. The causes of discomfort in the lower back are orthopedic and non-orthopedic.

For non-orthopedic cases, it is not advisable to take non-steroidal anti-inflammatory drugs, since the cause is not in the spine, but in problems with the internal organs. With orthopedic diseases, an important role is played by how quickly the causes were identified, treatment was started and the correct diagnosis was made.

Timely consultation with a doctor and correctly prescribed treatment is the key to success and health.

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This pathology is one of the most common, and its peculiarity is that it is only one-sided. Most often, people aged 40 to 65 years come to specialists with sciatic nerve neuropathy, and the disease occurs equally in both sexes. The patient experiences unilateral numbness of the foot and lower leg, and paralysis of the fingers and toes may develop in the part of the body where the sciatic nerve was affected. Neuropathy of the sciatic nerve in ICD-10 is listed under code G57.

Main reasons

A factor in damage to the sciatic nerve may be restriction (squeezing, irritation) intervertebral hernia, spasm of the piriformis muscle, gluteus maximus muscle.

The main factors for inflammation of the sciatic nerve can be hypothermia, spine diseases, spine injuries, joint inflammation, diabetes mellitus, severe physiological overload, and various infections.

What diseases cause pathology?

This pathology can be caused by various serious and dangerous diseases, such as, for example:

• tumor development processes;
• diabetes;
• drinking alcohol too often;
• herpes;
• AIDS.

In addition, traumatic sciatic neuropathy can also develop after cutting or lacerations in the thigh area, as well as due to a gunshot wound to the same part of the body. This pathology often appears with dislocations, fractures pelvic bones and other injuries that affect the sciatic nerve.

Doctors also note that neuropathy of the sciatic nerve can develop against the background of any hereditary or acquired pathologies of the spine, such as, for example, a herniated disc or scoliosis. In addition, according to medical data, almost 54% of patients suffering from discogenic lumbar radiculitis have this disease.

Very rarely, sciatic nerve neuropathy develops after an incorrectly performed injection into the buttock area. This pathology is often observed with scarlet fever, tuberculosis at a certain stage, as well as with measles. Possible damage to the sciatic nerve chronic alcoholism, drug use, as well as severe arsenic poisoning.

Symptoms

Signs and symptoms of this disease depend on the location and extent of the leg involvement, but almost all patients with sciatic neuropathy complain of loss of sensation in the affected area of ​​the limb. There are other symptoms of sciatic nerve neuropathy, and these include the following:

• the leg may be slightly concave inward;
• inability to freely straighten or bend your toes;
• severe burning sensation in the calf muscles or toes;
• severe weakness in only one or both legs.

Pain as the main symptom

In addition, the patient may feel severe pain when trying to sit down. This symptom may be accompanied by a feeling of a sudden change from cold to heat, which occurs in the lower extremities. If the disease is at its last stage, then complete muscle atrophy occurs in the part of the limb where neuropathy of the sciatic nerve occurred.

Other signs

There are other symptoms of this disease, such as a strong change in gait; patients are often forced to be in a position in which lower limbs find themselves bent at the hip joint. With sciatic nerve neuropathy, a feeling of heaviness may be felt in the lower part of the damaged limb, which is often accompanied by a stringy and dull pain.

It should be noted that the above pain sensations intensify when sneezing or coughing. If the sciatic nerve has been affected in the hip area, then the patient has problems bending the knee, this also leads to a change in gait, since the patient has to walk with straightened legs. During an external examination by a doctor and when palpating the muscle attachment sites, the patient may feel severe pain, and the pain may also spread to the part of the buttocks where the sciatic nerve exits from under the piriformis muscle.

Diagnostics

Diagnosis of the disease is most often made during a neurological examination by a specialist of the patient. The neurologist studies most carefully how exactly the disease manifests itself according to pain, examines the firewood of hypoesthesia, checks the weight and compares it with what was previously and looks at the person’s reflexes. Thanks to a detailed study of these indicators, it is possible to determine exactly how much the disease has affected the body. Confirmation of the conclusions made by the doctor is made using electromyography and electroneurography, thanks to which it becomes possible to distinguish sciatic mononeuropathy from lumbar plexopathy and some radiculopathies.

Currently, to examine the nerve trunk and possible formations, in terms of anatomy, ultrasound therapy is used, thanks to which it is possible to determine whether there are any tumors on the nerves, whether it is compressed or whether there are any other changes. In addition, you can determine the genesis of neuropathy using an X-ray of the spine, sometimes you can do magnetic resonance therapy, an X-ray of the pelvic area, or also an ultrasound of these areas, in addition, you can take tests to determine blood sugar levels.

Treatment

Elimination of areas of pain that arise during the process requires diligent work to eliminate of this disease. To block the pain syndrome, as well as relieve inflammation in the nerves, and for your own prevention, you will need to conduct a short course of treatment for sciatic nerve neuropathy. First you need a consultation and examination with a doctor. Usually, in case of injuries and wounds, plastic surgery of bone fragments and immobilization are performed. A course of exercise therapy and massage procedures is required.

Exercises

At home physiotherapy very useful for improving your health, as well as relieving inflammation in the nerves. Exercises recommended by doctors:

1. You need to relax and then start rolling your shoulders to warm up your muscles.
2. You need to lie on your back, bend your knees and place your feet on the floor, cross your arms over your chest. When inhaling, be sure to lift your body so that your shoulders come off the floor. When exhaling, return to the starting position. You need to repeat this exercise approximately 10-15 times.
3. Get on all fours and begin to bend and arch your back. This exercise will have a very good effect on your general state.
4. If you are in pain, there is a simple exercise that will not cause you discomfort. Sit on a chair, straighten your back, cross your legs, and then raise your hands behind your head and begin to twist to the side. It is necessary to make 5-10 turns in each direction. Take your time, warm up diligently, but to the best of your ability.

These are basic exercises, but exercises to stretch the muscles that eliminate painful spasms and relax the body. You need to pay attention to the clothes you wear! It should not hinder your movements or interfere with free blood circulation.

Massage, which is aimed at improving blood circulation, helps a lot. Cupping massage helps very well. The duration of this procedure should not exceed 15 minutes. Among the folk recipes, a decoction of calendula, rose hips, and parsley is very effective. You can rub a mixture of radish juice and honey, taken in a one-to-one ratio, into the sore spot. Must be included in diet sauerkraut, since it contains healthy vitamins, which help speed up the metabolic process. If you have been given this diagnosis, it is necessary to start treatment now. Exercise, eat healthy and live healthy.

Occurs in people over 40 years of age. It manifests itself in sharp pain in the lumbar region or hip area. When the first symptoms appear, you should consult a specialist.

Treatment should be carried out comprehensively using medications, physiotherapeutic procedures, rubbing, massage and physical therapy.

The sciatic nerve is the longest and most important nerve trunk in the human body. It begins in the lower lumbar region between the piriformis muscle and the sacral ligament. This is where it is most often subject to compression. It then passes through the back of the thigh, where, reaching the popliteal fossa, it divides into the peroneal and tibial branches. After passing through the lower leg, the sciatic nerve ends in the foot area.

Sciatic nerve neuropathy is rarely caused by damage directly to the trunk of the sciatic nerve. Usually it occurs as a defense against the influence of some irritant, for example, compression nerve endings or hypothermia. This is what brings unbearable pain, which is characterized by sharp shooting pains in the lumbar and thigh areas. Most often, neuropathy affects one side.

By International classification diseases (ICD 10) neuropathy of the sciatic nerve refers to diseases of the nervous system, it is assigned the following code - G57.0.

Causes of neuropathy

The causes of sciatic nerve neuropathy may be as follows:

• infections introduced into the human body by diseases such as herpes, measles, scarlet fever, tuberculosis;
• diseases of the pelvic organs;
• hypothermia;
• intervertebral hernia;
• malignant tumor;
• fracture of the pelvis or spine, dislocation of the hip, lacerations and incised wounds of the thigh;
• severe bruises leading to the formation of hematomas;
• metabolic disorders in the body associated with diseases such as diabetes or gout.

Symptoms of neuropathy

Sciatic nerve neuropathy has characteristic symptoms:

• On palpation in the lumbar region, the patient feels a piercing, burning pain in the hip area;
• At the site of inflammation, the skin may have redness;
• The appearance of a burning sensation in the limb, as well as a feeling of muscle weakness;
• The pain syndrome can be localized in the buttock, thigh, as well as the back of the leg or even the foot. There may be numbness and partial paralysis of the foot and back of the leg;
• The temperature usually stays above normal.
• There are difficulties when urinating;
• In the supine position, when the straightened leg is abducted, a shooting pain is felt;
• There are trophic disorders: hyperkeratosis (keratinization of the skin), hypertrichosis ( overgrowth hair), trophic ulcers on the foot in the heel and big toe.

Features of sciatic nerve neuropathy after endoprosthetics

After surgical interventions, for example, such as hip replacement, complications often occur. They are associated with the formation of scars and adhesions that put pressure on the nerve fibers of the sciatic nerve. This is what most often causes sharp pain in the hip and lower back.

Diagnostics

To diagnose sciatic nerve neuropathy, you need to consult a specialist - a neurologist. The doctor will examine the patient. The main sign of damage to the sciatic nerve is the presence of Lasegue's symptom. It consists of the following: the patient lies on his back on the couch, the doctor bends his leg at a right angle and slowly begins to straighten it. Pain during extension indicates disturbances in the nerve endings. By the size of the extension angle, which is formed at the first signs of pain, the neurologist judges the degree of development of the sciatic nerve disease.

After the examination, the doctor prescribes laboratory and instrumental tests. Additionally, consultation and examination with specialists such as a rheumatologist, vascular surgeon, or vertebrologist may be required.

• X-ray. It is considered the most accessible method diagnostics, which can be done in any clinic. The x-ray is taken in two projections - frontal and lateral. This allows us to determine whether the source of sciatic neuropathy is changes in the intervertebral discs.
• On computed tomography or MRI the patient is referred if x-rays do not help identify the etiology of the disease. These methods establish the cause if it is associated with changes in the spinal cord or vessels of the nerve plexus.
• Radioisotope scanning carried out if the doctor suspects the patient has a tumor. It is especially indicated for those who have been taking corticosteroids for a long time or are HIV-infected patients.
• Electroneuromyography allows you to use an electrical impulse to determine the condition of the muscles and peripheral nervous system. The examination helps to determine the location of inflammation or damage, as well as to find out how the process of restoration of nerve fiber tissue proceeds.

Treatment

Treatment of the disease should be carried out comprehensively and include medication and physiotherapy during an exacerbation, massage and exercise therapy during remission. It is important to remember that sciatic nerve neuropathy requires long-term treatment, which is best done in a hospital with bed rest. Moreover, the patient must sleep on a hard bed.

Drug treatment

In the stage of exacerbation of the disease, the neurologist prescribes the following groups of drugs:

1. Nonsteroidal anti-inflammatory drugs ( NSAIDs) taken for pain relief and treatment inflammatory processes. In the acute phase of the disease, they are administered intramuscularly for no more than 3 days, then proceed to taking tablets. To the most effective drugs NSAIDs include:

• Nimesulide, which is available in the form of powder, tablets, and intramuscular use is also possible.
• Meloxicam or Movalis administered in the form of injections, and also consumed in the form of tablets.
• Ketonal, Ketanov are produced not only for internal treatment, but also in the form of ointments and gels. They relieve pain and inflammation well when used in combination.

Important: All NSAIDs have a lot of contraindications: gastrointestinal diseases, kidney disorders, hypertension, bleeding. NSAIDs should not be used for long periods of time.

1. Muscle relaxants– these are drugs that relieve muscle spasms, reduce pain, and reduce muscle tone. Among the muscle relaxants, the most famous and most commonly used are Mydocalm, Sirdalud, and Baclofen.
2. Antioxidants serve to normalize the nutrition of tissues and nerve endings. Vitamins E and C, as well as selenium and copper are used as such medicines. They have no contraindications other than individual intolerance.
3. Vasoactive drugs– nicotinic acid, pentoxifylline – are used to improve microcirculation processes.
4. Metabolites serve to improve nutrition of the spinal cord roots and the sciatic nerve itself. With their use it improves physical activity limbs, their sensitivity is restored. Metabolites include the following drugs:

• Inosine;
• Elkar;
• Meldonium;
• Carnicetine.

1. Vitamins. Usually the doctor prescribes drugs such as Combilipen or Milgamma, which are based on B vitamins. They help restore the metabolism of nerve cells. Vitamins are prescribed intramuscularly for 10-15 days.
2. is one of the methods of drug treatment. Its principle is based on the introduction of a drug (most often an anesthetic) into the place where the affected area is located, which allows blocking pain impulses that are transmitted to the central nervous system. A blockade is made for a period of 12 hours to 3 days with one of the following drugs: novocaine, diclofenac or lidocaine. This method treatment has contraindications due to diseases associated with cardiovascular system, liver disorders and allergic reactions.

Physiotherapy

Physiotherapeutic procedures are prescribed by a physiotherapist on the recommendation of the treating neurologist. Such procedures are carried out:

• UHF. Warms up the area to which it is applied. This allows you to accelerate the blood, and as a result, relieve pain and inflammation.
• Magnetotherapy. Eliminates pain syndrome due to the reduction of swelling and inflammation of the sciatic nerve as a result of the procedure. Magnetic fields help more rapid recovery fabrics.
• Laser therapy. Improves blood flow in small vessels, stimulates metabolic processes in tissues, which also helps reduce swelling and pain.
• Electrophoresis. Helps restore microcirculation and reduce swelling. When using this procedure, enter medicinal product, which acts directly on the tissues surrounding the sciatic nerve. The following drugs can be used: aminophylline, papaverine, procaine.

Physiotherapy has contraindications:

• hypertension;
• epilepsy;
• blood clotting disorder;
• oncology;
• skin diseases;
• infectious diseases.

Massage

Massage is never prescribed during an exacerbation of the disease. This procedure is used during remission or as a preventive measure. Usually 10-15 sessions are required. Massage is used to improve blood flow, reduce swelling, normalize muscle tone, and relieve muscle spasm. The massage is carried out in a certain sequence. First, the lower back and sacrum are massaged. Then move on to the buttocks. After this, they begin massaging the healthy limb, after which they move on to the sore leg. At the end of the massage, relaxing strokes are performed.

Manual therapy

This treatment method helps relieve stress from the lumbar region by eliminating pinched sciatic nerves. It restores mobility to the patient. This procedure is not recommended for intervertebral hernia.

When using manual therapy the following techniques are used:

• Relaxation. The muscles are first subjected to tension and then sharply relaxed.
• Stretching. Usually a compaction forms at the site of inflammation. Chiropractor stretches muscle tissue, making it elastic and soft.
• Pressure. Reminds me acupressure, aimed at specific places and allowing you to remove spasms.

Exercise therapy

Physical therapy exercises for sciatic nerve neuropathy are performed strictly only during the period of remission, since during an exacerbation the patient must remain at rest. Complex therapeutic exercises can be performed standing, lying and sitting. Various lifting and lowering of the legs and twists of the torso are suitable exercises for this disease. Imitation of walking on the buttocks is especially useful. All exercises should be aimed at strengthening the muscles of the back, lumbar region and hips. It should be remembered that exercise therapy should be performed without weights.

• compliance with all doctor's orders and prescriptions;
• conducting course massage sessions;
• performing physical therapy exercises.

Treatment in sanatoriums where hydrogen sulfide baths are used, as well as healing mud. But this can only be done during the period of subsidence of the disease. Swimming in the pool will also be beneficial.. Should also be observed balanced diet, which should contain magnesium, iron, calcium, as well as vitamins A, C, E and B.

Disease prevention

As a preventative measure you should:

• Do exercise therapy to strengthen your back muscles and ensure correct posture.
• Do not lift heavy objects, avoid injuries and falls.
• You should not get too cold; you should always dress appropriately for the weather.
• If the work is sedentary, then it is necessary to take breaks every hour. Get up from the table and do several squats and bends.
• Monitor your body weight. If it exceeds the norm, then it must be reset.
• Avoid infections and colds.

Useful video

Read more about pinched sciatic nerves below.

Conclusion

If you experience pain in the lumbar region, you should consult a doctor who will necessary examinations and will appoint individual treatment. All his recommendations must be strictly followed - this is the only way to get rid of sciatic nerve neuropathy. In the stage of remission it is necessary to carry out active image life and adhere to proper nutrition.

Lesions of the sciatic nerve occur quite often, both in peacetime and in wartime, we have already written an article about. Here we will talk about damage to the actual trunk of the sciatic nerve at various levels, with its asymmetric damage. The manifestations of symmetrical polyneuropathy, in which nerve damage occurs distally, like “socks,” and is caused by harmful substances in the blood: hyperglycemia in diabetes mellitus, or excess ethyl alcohol in alcoholism, will not be affected. . And, radicular symptoms, in which the root is pinched, which then becomes part of the lumbosacral plexus. This pathology is discussed in the section on lumbar pain.

Common signs of sciatic nerve neuropathy

It is worth paying attention to possible violations associated with compression of the sciatic nerve, which can occur in its various parts, since this nerve is the longest and thickest of all peripheral nerves person.

Sciatic nerve - anatomical image

With compression-ischemic neuropathies, as well as with sciatic neuralgia, the following characteristic disorders are possible:

• aching or burning pain, most often, along the back of the thigh, which descend into the popliteal fossa, and sometimes further - onto the lower leg and foot. With a high lesion, pain occurs in the buttock area, the pain intensifies when trying to change the position of the leg;

• a forced posture appears, voluntary movements are limited. This pose is designed to reduce pain, which is why it is called antalgic. With neuralgia, tendon reflexes increase, and with neuropathy of the sciatic nerve, these reflexes are reduced or absent altogether (for example, the Achilles reflex);

• With neuropathy, weakness occurs in the muscles of the foot. Most often, this is either a violation of flexion (with tibial nerve neuropathy) or extension (with damage to the peroneal nerve). Both of these nerves are branches of the sciatic nerve. With general damage to the nerve up to the popliteal fossa, simultaneous weakness of both the flexors and extensors of the foot occurs with the inability to walk on toes and on heels;

• with high lesions, the tone of the gluteal muscle decreases; with the conductive nature of the disorders, the tone of the calf muscle on the affected side decreases;

• Autonomic disorders occur: hair loss occurs on the back of the thigh, and also occurs on the lower leg area. Asymmetric hyperhidrosis of the foot often occurs, that is, the foot on the affected side will be wetter than on the healthy side;

• sensory disturbances occur: the entire back and outside surface the skin of the thigh becomes insensitive, the same is possible on the same side of the lower leg and foot.

Violation of types of voluntary movements

If the sciatic nerve is completely damaged, the following types of voluntary movements will be impaired:

• extension of the knee joint, straightening of the leg. On the affected side, climbing stairs is difficult;

• external rotation of the hip and its abduction;

• extension of the leg in the hip joint is impaired (abduction of the leg backward). In this case, hypotrophy of the gluteal muscle occurs.

Of course, high nerve lesions are most often observed during injuries (for example, a road traffic injury with a fracture of the pelvic bones, the occurrence of a hematoma), or when gunshot wounds. IN clinical practice Most often, separate lesions of the tibial and peroneal nerves occur, which can be caused by compression of certain areas of the root by an intervertebral hernia.

In order to obtain reliable information about the nature of nerve damage, you need to visit a neurologist and then perform a study called electroneuromyography. Sometimes it is necessary to do a computer or magnetic resonance imaging scan, which can show the location and nature of compression in the case of radicular symptoms caused by exacerbation of osteochondrosis.