Sciatica

Overview is the sciatic nerve lesions, along sciatic nerve pathway that is waist, hip, thigh, Sural and the lateral foot pain group. Sciatic nerve causes lumbar 5 from 3-sacral nerve root component. By root-lesion site and two dry sciatica, which was mostly located in root canal lesions sciatica, Etiology of lumbar disc herniation to see the most, followed by a spinal tumor, spinal tuberculosis, lumbosacral nerve root rheumatoid. Dry sciatica is the main lesion in the spinal canal trip outside the sciatic nerve, it causes Sacroiliac arthritis, pelvic tumors. uterus oppression, buttocks injury, piriformis syndrome, and gluteal injection diabetes and other misconduct. Clinical manifestations of the disease was mostly young men, unilateral more. Pain and time associated with the etiology and the onset priorities. 1, with the onset of sciatica root causes were different. The most common lumbar disc herniation, often forced, bending to intense activities or incentives, acute or subacute onset. Chronic onset of the minority. Constant pain to the side of the waist buttocks, thighs, popliteal fossa, the lateral leg and foot radiation, was burning or knife-like pain. cough and exertional pain may increase, even at night. Sick to avoid nerve stretching, compression, and often take special pains to reduce positions, such as lying to sleep when the contralateral hip, knee flexion relations, standing focus on the healthy side, the lack of scoliosis caused more bent towards the healthy side, seating into contralateral hip to tilt, to relieve the nerve root compression. Distraction could be induced by sciatic nerve pain, or pain, such as Kernig levy positive (patient supine. first hip flexor and knee perpendicular, and then shank crucifixion. As flexor cramps, thus restricted knee and less than 130 degrees and the pain and resistance); straight leg raising test (Lasegue levy) positive (patient supine, up under the lower extremities. Limb crucifixion less than 70 degrees and caused leg pain). Sciatic nerve pathway may have tenderness, such as lumbar side, buttocks, country, and ankle plantar points, and so on. Ectocnemial limb and foot numbness and often feeling dissipated. Gluteal muscle tension relaxation, and the thumb flexor extensor pollicis muscle weakening. Achilles tendon reflex weakened or disappeared. 2, dry Sciatica : With the onset etiology priorities are different. If catch cold or injury to those induced by acute onset. Pain often from the hip to the Shares, the lateral leg after radiotherapy and lateral foot. Walk, exercise and traction sciatic nerve pain increased. Trigger point below the buttocks, Lasegue Kernig levy and the levy was more negative, Scoliosis more bent towards the affected side in order to reduce the sciatic nerve stem stretch. Diagnosis and differential diagnosis based on the pain location and direction of radiation, the pain intensified, reducing pain posture Traction pain and tenderness points diagnosis is not difficult but very important to determine cause. A lumbar disc herniation : sick more often repeated long history of low back pain, or heavy physical labor history, Standing at a waist injury or stoop labor acute onset of the disease. Apart from the typical root of sciatica symptoms and signs, and muscle cramps, and the limitation of lumbar Health disappear volume degrees flexion, parts of the vertebral disc space can be marked tenderness and back pain. X-ray may be involved intervertebral space narrowing, CT can be diagnosed. 2, Mawei tumor : rapid onset slow and gradual increase. Early disease often unilateral radicular sciatica, the progressive development of bilateral. Night obvious pain intensified, the sexual heavier course. And the emergence sphincter dysfunction and sellar region feeling dissipated. Lumbar puncture obstruction and subarachnoid cerebrospinal fluid protein increased significantly, even Froin levy (CSF yellow, placed themselves after solidification), spinal cord or iodine contrast MRI water can be diagnosed. 3, lumbar canal stenosis : more common in middle-aged men, often early "intermittent claudication" After the leg pain increased, But bent over walking or rest after symptoms ease or disappear. When the nerve root or cauda equina compression serious, there will be one side or both sides of sciatica symptoms and signs, Sexual course was increased traction bed rest or other treatment fails. Lumbosacral X-ray or CT can be diagnosed. 4, lumbosacral nerve root Yan : infection, poisoning, nutrition metabolism disorder or fatigue, and other factors catch cold incidence. General onset hurried, and often beyond the scope of damage to the sciatic nerve disclaimer region, the performance of the entire lower extremity weakness, pain, mild muscle atrophy, with the exception of the Achilles tendon reflex, knee jerk reflex is often diminished or disappeared. In addition, the need to consider the spinal tuberculosis, and other vertebral metastases. Dry sciatica, attention should be given to whether catch cold or infection, and the sacroiliac joints, hips, buttocks and pelvic lesions. OK except when necessary lumbosacral X-ray, but also sacroiliac joint X-ray, referring to anal, gynecological examination and pelvic organ B superfine checks to clear etiology. A treatment, bed rest : Particularly hard disc early sleeper bed rest 3 -4 weeks, and some patients to alleviate symptoms. Second, drug therapy : analgesics, vitamins B, short of corticosteroid oral could be beneficial to resume. 3, physiotherapy : FM acute available therapies, erythema ultraviolet radiation and other treatment. Chronic HF available iodine therapy DC iontophoresis.