Inflammation of the nerve endings of the spine. Inflammation of the nerve roots of the spine symptoms and treatment

Provoke disability and temporary disability can neurological disease radicular syndrome of the lumbar. This is a complex of symptoms that occur when the spinal roots are compressed and inflamed. Another disease is known as sciatica. The appearance of symptoms suggests that inflammation begins in the nerve bundles.

The main reason for the appearance of the disease is problems with the spinal column caused by its violation. The nutrients that intervertebral cartilage needs are depleted over time. The situation may worsen with age or with excess weight: this leads to sagging of the vertebrae. The spinal nerve exits the cavity in the spinal column, due to which subsidence occurs, the holes narrow, and they are infringed.

In the area of ​​compression, inflammation of the roots begins, characterized by swelling of the tissues. The appearance of edema exacerbates the condition, increases pain.

In addition to osteochondrosis, the development of the disease is read in other processes:

• Intervertebral hernia. When the cartilage is torn and the nucleus is squeezed out of its borders, the outgoing nerves are compressed;
• Violation of the structure and diseases of the spine. These factors often become causative agents of radicular syndrome.
• Incorrect fusion of the vertebrae due to injury.
• Weakening of bone and cartilage tissue caused by infectious diseases.

More often this disease appears in people with a sedentary lifestyle. There are cases when the disease develops with excessive physical exertion or with a “back breakdown”. The appearance of the disease was also noted with hypothermia and the use of certain medications (such syndromes are called pseudoradicular).

The pain begins to spread to the outgoing nerves, which leads to symptoms similar to organ dysfunction. For example, radicular syndrome in the chest gives the impression of developing angina.

As for the classification, there are no specific classes of the disease. The disease is divided conditionally, starting from the affected areas of the spine. This classification denotes a disease:

• cervical;
• Thoracic;
• Lumbar departments.

Less commonly, the disease affects the sacrum and coccyx, which excludes these parts from the classification. Informally, pathology is classified according to the degree of complexity. Sometimes pathology is equated with acquired and congenital, although such a division is quite rare, since the disease is predominantly acquired. Of all the above departments, the violation in this area is the most common.

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Causes and symptoms

What causes the lumbar spine to suffer more often? The source of the appearance of pathology can be:

• A large load affecting the lumbar region. Hard physical work is redistributed here. In addition, other parts of the skeleton located above load the lower back.
• The mentioned department is formed with the help of large vertebrae with rather wide openings that pass through. When the shock-absorbing function is broken, they are easily pinched.
• The fact that the lower back is more mobile than other areas also plays a role in the progression of the disease. Amplitude movements displace the vertebrae in relation to each other and provoke the appearance of pain either.

The functionality of the muscles may be impaired if osteochondrosis of the lower back is not treated for a long time. This atrophies the muscles, as a result of which it becomes impossible to engage in physical work, since the muscles are significantly weakened.

When the nerves are pinched, the symptoms of the disease will begin to appear in the near future. One of the common symptoms is pain of a shooting character, which manifests itself unexpectedly after heavy physical exertion or injury. Pain often accompanies a decrease in sensitivity. This is observed in the place where the nerve is restrained.

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As practice shows, the radicular syndrome is predominantly “double” (at the same time, sensitivity and the level of irritation decrease).

The main signs of radicular syndrome of the spine:

• Pain sensations. They are intense, aching in the area of ​​compression, which spread to the limbs, in rare cases, to the organs;
• Reduced sensitivity. May manifest as paresthesia (goosebumps, coolness on the skin);
• Impaired muscle function or movement. Development occurs due to the death of the nerves responsible for a certain area. Develops muscle weakness and impaired performance.

Diagnostics

When diagnosing a disease, many factors are taken into account. To begin with, the patient's complaints are specified, because they serve as the basis for assumptions about the place of development of the pathology. For more accurate information, it will not be superfluous to use palpation of the alleged area of ​​pain localization - in this case, there is a slight muscle tension. Also, during palpation, the patient can lean towards the site of the lesion: this is how it turns out to reduce the pain syndrome.

An MRI of the lumbar region is considered an accurate diagnosis of the disease. It helps to identify the smallest infringement of the nerves and determines the location of the pathology with an accurate probability. The main difficulty of such diagnostics is the cost. The tomography procedure is not cheap, so not everyone agrees to carry it out.

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Treatment

What to do when lumbar radicular syndrome shows symptoms? Treatment can be started at home or should I make an appointment with a doctor? Treatment of lumbar radicular syndrome should be dealt with without delay and under the supervision of a doctor. Like many diseases of the musculoskeletal system, radicular syndrome can include:

• non-surgical therapy;
• Medical treatment;
• Operational intervention.

When the symptoms do not affect the usual rhythm of life, you can limit yourself to general methods: a balanced diet, limiting physical activity, attending massage sessions.

But if the disease begins to cause concern, the initial stage of treatment involves therapy with non-steroidal, anti-inflammatory drugs such as Diclofenac or Nimesulide. When the pain becomes intense and disturbing, it is recommended to use intervertebral blocks. If the condition worsens, you should consult a doctor to determine the required therapy.

Physiotherapy

According to leading experts in the field of traumatology and neurology, it is quite possible to defeat certain diseases of the musculoskeletal system with physiotherapy, in particular, electrophoresis and electropulse points. With the help of electrophoresis in combination with some medications, it helps:

• Remove the inflammatory process;
• Eliminate pain;
• Improve the metabolism of affected nerves;
• Restore disturbed muscle trophism.

Electric pulse points are aimed at eliminating muscle tension, normalizing nutritional processes in atrophied tissues. The disease can be treated with acupuncture. This technique is not very popular in traditional medicine, but has proven to be effective for many patients.

Surgery

The main factor causing the disease are the symptoms. Surgical intervention is necessary if the symptoms pose a threat to health. Surgery is required if:

• Pain does not decrease with the use of non-steroidal anti-inflammatory drugs;
• The functionality of the limbs is impaired, in which there is a complete loss of activity;
• Irreversible changes occur in the bone-ligamentous apparatus, which leads to compression;
• Exacerbation of the intervertebral hernia.

The operation is performed in a specialized clinic under anesthesia. During the procedure, the doctor removes parts of the vertebra that interfere with the natural location of the spine. If a hernia has formed at the site of localization, the prolapsed area is excised.

Complications and prevention

It is impossible to delay the treatment of pathology, because untimely seeking help can provoke complications:

• The development of lameness due to the position of the skeleton. Often flows into flat feet and aggravates the patient's condition;
• Brief or long-term mental instability. Constant pain will not let you relax at any time of the day. Overwork leads to neurosis and psychosis;
• Severe cases are manifested by complete paralysis;
• The inflammatory process can reach the spinal cord and become an impetus for the spread of inflammation to other parts of the spine, which leads to even more serious diseases.

To prevent the development of severe pathology, you can follow simple rules:

• Exercise in the morning: stretch your muscles, bring them back to normal;
• Try to keep your weight under control;
• If possible, attend massage sessions;
• Eat fully. Often the disease provokes the absence of useful substances for cartilaginous tissues;
• Learn to distribute work and rest: you will not overwork and reduce the risk of injury during exercise.

This disease can be attributed to those that are better to defeat in the initial stage than to carry out a full treatment. By following the simple rules of prevention, you will avoid the appearance of this unpleasant disease.

Your feedback on the article

In neurology, there is such a thing as lumbar radicular syndrome, which is a whole complex of neurological symptoms and signs that arise due to compression of the nerve branches in the spinal canal of the spine.

As a rule, neurological pathology has a chronic course of a progressive nature, and is the most common symptom among all pain syndromes (dorsopathies) occurring in various parts of the spinal column.

Before treating radicular syndrome, it is necessary to establish the clinical symptoms and causes of neurology. It is believed that the causal relationship of neurological pathology lies in the progressive course of osteochondrosis in the lumbar spine, in which various degenerative-dystrophic processes are formed, for example, the formation of osteophytes, hernias in the vertebrae or protrusion of the intervertebral canal.

Inflammation of the nerve roots is the result of a deformed state of the intervertebral discs, which occurs due to insufficient blood supply and limited metabolic functions in the body of the spine. Due to degenerative transformations, the height of the intervertebral disc changes, which entails its axial displacement, and as a result, compression of the soft tissues of adjacent articular segments. Most often, compression affects the spinal nerve at the outlet of the bone canal of the spine, provoking inflammation of the roots, which are the most sensitive nerve formations of the spinal system. The technical reason for the inflammatory process is the compression of the entire neurovascular system passing through the channels of the lumbar spine.

Other contributing factors to the disease include:

• infectious lesion of the articular components of the lower back;
• the result of weakening of bone tissue after various injuries and diseases;
• static overvoltage and low activity of the lumbar zone;
• hormonal failure and endocrine disorders;
• cicatricial formations, tumors;
• hypothermia of the osteoarticular elements of the vertebral section.

The defective development of the connective tissue, leading to inflammation of the root, can be influenced by a hereditary factor, as the most actively forming a progressive state of radiculopathy (radicular syndrome of the lumbar spine). Improper nutrition can bring the process of degeneration of articular tissues closer, when the body does not receive enough vitamin and mineral microcomponents, as well as alcohol abuse, which will significantly accelerate tissue degeneration of the spine.

Symptoms of nerve root compression

Pain of varying degrees of intensity is the main symptom of lumbar radicular syndrome. Treatment of a neurological condition is impossible without determining the complete clinical picture. In the place of infringement of the nerve root, the pain attack responds: with sharp, cutting, pulsating, aching or pulling pain, which is aggravated by any active physical actions: walking, turning, bending over, coughing and sneezing. The pain syndrome has not only local localization in the lumbar zone. Along the course of the nerve branch, a sharp pain can spread to the gluteal region, the piriformis muscle and the inner thigh.

It is also noted that a sensitivity disorder (paresthesia) occurs, and, in the lower extremities, expressed as tingling, numbness, crawling in the lower articular parts of the skeletal frame. Sometimes an increase in pain syndrome is accompanied by vegetative processes, in the form of swelling, redness of the skin, sweating of the body, and so on.

Irradiation of pain in the pelvic area and inguinal zone causes difficulty in defecation, urination, and also weakens the sexual sensitivity of the human body.

Violation of the innervation of the nerve root provides a person not only with reduced sensitivity to external stimuli, but also causes muscle atrophy of the affected segments of the spine. Such "drying" of the anatomical organs limits their mobility and physical activity.

Diagnostics

It is impossible to provide the correct therapeutic treatment of radicular syndrome in the lumbar spine without a high-quality diagnostic examination. Clinical data confirming the state of the nerve root is a fundamental factor when choosing a drug or physiotherapeutic effect. Only instrumental diagnostics, with a high degree of probability, allows you to correctly determine the location of the neurological disorder. However, with a visual diagnostic examination, an experienced specialist will always be able to determine the lumbar radicular syndrome in certain areas of the spinal column:

1. Compressive pressure of the spinal nerve branch at the level of L1-L3 vertebrae is pain and / or discomfort in the lower back, in the perineum, lower abdomen, inner and front surfaces of the thigh, as well as their numbness and weakened sensitivity.
2. Damage to the spinal zone at the level of the L4 vertebra is atrophy of the quadriceps muscle, paresthesia of the outer femoral surface, pain in the knees and lower legs, which forms an unsteady gait and/or lameness.
3. The compression state in the L5 vertebra is determined by painful sensations in the outer surface of the thigh and lower leg, and also provokes pain symptoms in the inner part of the foot, while disrupting the entire functional work of the musculoskeletal system of the affected limb.

Therapeutic measures are prescribed after the identification of all etiological factors, and only after instrumental diagnosis of radicular syndrome, which includes the following methods of clinical examination:

• X-ray scanning in two projection planes, direct and lateral, allowing to determine the place of narrowing and possible infringement of the intervertebral elements.
• Clinical signs that limit the lumen of the spinal canal are detected using an X-ray contrast study - myelography of the spinal cord.
• A more informative picture of a pathological disorder of the vertebrae and intervertebral discs is given, which determines the degree of narrowing and damage to the neurovascular bundles of the spine.

A comprehensive diagnostic examination will contribute to the qualitative restoration of the articular elements and tissue structures of the spinal system.

Treatment

Drug treatment of radicular syndrome of nerve branches is based on the elimination of pain symptoms and a decrease in the area of ​​inflammation in the affected areas. Relief (radicular blockade) of acute inflammation can prevent the progression of neurological pathology and reduce swelling of the vascular system.

The conservative method of therapeutic action includes:

• The use of painkillers, pharmacological treatments (analgesics): Baralgin, Ketorol, etc.
• Inflammatory processes are eliminated with the help of - Nimesclid, Movalis, Diclofenac, etc.
• Novocaine blockades are an obligatory process of complex therapeutic treatment.
• Muscle relaxants (Sirdalud, Mikocalm, etc.) eliminate spasmolytic muscle tension, which improves the main blood supply to the affected areas of the spine.
• Vitamin combinations based on vitamins B1, B6 and B12 allow normalizing metabolic processes and trophism of nerve branches, as well as improving their impulses.

The final stage of complex therapy is therapeutic exercises, physiotherapy, massage, and special exercises for radicular syndrome.

On a note! In the case of a chronic pathology leading to immobilization of the musculoskeletal system, surgical intervention is provided.

Therapeutic prevention of radiculopathy

Basically, infringement of the spinal roots is a problem of the chronic course of concomitant neurological diseases that must be treated in a timely manner. After eliminating the pain symptoms and improving the condition, doctors recommend that they take a closer look at their health. During rest or sleep, a special orthopedic mattress from a certified manufacturer is needed to prevent spinal deformity.

All fried, salted, smoked and pickled foods are excluded from the diet. A prerequisite is the control of body weight, since overweight people are most often susceptible to pathological disorders of the spinal system.

A daily set of therapeutic exercises allows you to strengthen the vertebral base. We recommend for consideration an effective complex of therapeutic exercises, which can be carried out independently at home:

1. Starting position, lying on your back. With outstretched arms and straight legs, it is necessary to contract the abdominal muscles 15-20 times.
2. Starting position lying. Leaning on the elbow joints, try to alternately touch the chest with the knee. Repeat the exercise 10-15 times.
3. The starting position is the same. Bending your knees, you need to take them to the right side, be sure to touch the floor. The same procedure must be performed on the other side. The exercise is repeated 5-10 times.
4. Starting position, palms and knees on the floor. Having maximally arched your back, it is necessary to alternately lift the straightened right and left legs up. The exercise is repeated 10-15 times.
5. In a sitting position on the floor, it is necessary to perform tilts and turns of the body 15-20 times.

By doing such a complex of physiotherapy exercises every day, you can significantly strengthen the spine, and provide an optimal gap in the intervertebral discs for the healthy functioning of blood vessels and nerve endings.

ethnoscience

In addition to rational nutrition and therapeutic exercises, it is recommended to use traditional medicine.

In this case, a complex of pathological symptoms develops, called neuralgia.

Neuralgia - pain along the affected nerve. It is necessary to distinguish the term from the common sciatica among the people. The latter is called the inflammatory process in the region of the spinal nerve root, sciatica is manifested not only by pain (neuralgia), but also by other characteristic symptoms.

It is worth saying that, although neuralgia can affect any nervous structure of the body, most often it accompanies sciatica.

The reasons

What causes inflammation of nerve endings and roots? The following conditions can be the causes of radiculitis and vertebral neuralgia:

• Infectious diseases of the spine.
• Injuries, accidents, traffic accidents.
• Osteocondritis of the spine.
• Osteoporosis and calcium deficiency.
• Herniated disc.
• Spondylolisthesis is a displacement of a vertebra.
• Narrowing of the spinal canal.
• Spondylitis.
• Spondylarthrosis and bone osteophytes.
• Spinal tumors.
• Spinal osteomyelitis.

It should be borne in mind that inflammation can be caused by an infectious agent or a violation of anatomical interactions. In the second case, aseptic inflammation occurs, in the treatment of which it is not necessary to use antibiotics, anti-inflammatory drugs are enough.

The attending physician will help determine the true cause of sciatica.

Symptoms

If excessive force is suddenly applied to the spinal column and roots of the spinal nerves, acute sciatica occurs, the main symptom of the disease will be vertebral neuralgia.

With degenerative and metabolic disorders, the process is chronic, the roots are gradually pressured by an osteophyte, hernia, tumor, or other formation. Symptoms will gradually increase as the disease progresses.

It is worth figuring out how radiculitis of various parts of the spine will manifest itself, since further diagnosis and treatment will depend on this. Inflammation of the roots of the cervical and lumbosacral regions, for example, will have a completely different clinical picture.

Radiculitis of the cervical spine

Diseases of the cervical spine are not uncommon, since this segment of the back is actively involved in holding the head while walking, running, sitting at a table, working at a computer. The vertebrae in this part of the spine have a rather vulnerable structure, and at the same time they are in close interaction with important vessels and nerves.

If diseases of the spine have led to inflammation of the nerve root in the cervical part of the back, the following manifestations are likely to occur:

1. Pain in the back of the head, neck, aggravated by exertion, prolonged immobile work.
2. Pain in the scapula, along the clavicle, in the region of the shoulder joint.
3. Numbness, pain, impaired sensitivity in the hand. Radiculitis of the lower parts of the neck is manifested by a violation of the brachial plexus, which is responsible for the innervation of the upper limb.
4. Loss of muscle strength in the arm.
5. Headaches, migraines, dizziness are a sign of insufficient blood flow through the vertebral artery.
6. Blood pressure disorders.

Most often, the disease is still manifested by neuralgia - pain at the exit site of the root and along the nerve fibers. The remaining signs join if strong pressure is exerted on the nervous structures, or the inflammatory process becomes extensive.

Thoracic sciatica

The rarest form of sciatica is a lesion of the thoracic region. The reason for this phenomenon is that a large number of vertebrae in the thoracic floor of the back take on part of the lost function, the disease is compensated for a long time.

In addition, in the thoracic region there are no such important structures as the nerve plexuses or the cauda equina, therefore only the spinal roots are involved in the process. Radiculitis of the thoracic region is manifested by the following symptoms:

1. Pain in the thoracic part of the back, aggravated by exertion.
2. Shootings along the chest, following the course of the ribs.
3. Intercostal neuralgia can even mimic heart disease, occurring on the left side of the chest.
4. Difficulty in deep breathing due to chest pain.

Poor symptoms lead to the fact that the pathological process is not diagnosed for a long time. Dangerous diseases can be detected too late, so you should consult a doctor at the first symptoms.

Radiculitis of the lumbar spine

The most common localization of sciatica is the region of the lumbosacral segment. This explains the large number of patients complaining of back pain.

The thing is that it is on the area of ​​​​the lumbosacral floor that most of the load falls during active movements, lifting weights, playing sports. Under the influence of these factors, degeneration occurs, which leads to aseptic inflammation of the nerve roots. Symptoms of lumbar sciatica:

1. Pain in the lower back after exercise, bending over, standing for a long time, lifting weights.
2. Shooting pain along the root - in the buttock, thigh, other parts of the lower limb.
3. Violation of skin sensitivity in the leg, numbness, a feeling of "crawling".
4. Pain on pressure on the spinous process of an involved vertebra.
5. Inability to stand for long periods.
6. Pain when trying to straighten the back during an attack of neuralgia.

Sciatica in itself causes a lot of inconvenience, but it is also a manifestation of another disease. If the cause of neuralgia progresses, it can involve the cauda equina nerve structure, which is responsible for the innervation of the bladder and rectum, in the process.

Lower back pain is ignored by patients for a long time, but it can be a symptom of a serious illness. It is necessary to consult a doctor in time for a full diagnosis of the disease.

Diagnostics

The diagnostic search for a doctor begins with a conversation and questioning of clinical symptoms, then the doctor will conduct an objective examination of the spine and specify neurological symptoms. Often, a consultation with a neurologist may be required to determine the cause of the disease.

The next step is to examine the patient's analyzes. A general analysis of blood and urine will allow to exclude or confirm the infectious process. With aseptic inflammation of the roots, the analyzes are uninformative. After a laboratory test, the patient will be referred for instrumental procedures. These include:

1. X-ray of the affected spine - excludes or confirms the pathology of bone formations, including spondyloarthritis, vertebral fractures, osteophytes, spondylolisthesis.
2. CT and MRI are high-precision methods that allow you to detect the process at an early stage. MRI perfectly detects the pathology of the vertebrae, therefore it is the best method for diagnosing osteochondrosis.
3. X-ray contrast methods - myelography. It is rarely used due to the risk of possible complications.
4. Electromyography is an assessment of the conduction of electrical impulses during excitation of muscle fibers. It is used in the presence of symptoms from the upper or lower extremities.
5. Analysis of cerebrospinal fluid. The puncture is associated with certain difficulties and the risk of complications, so it is used if necessary, suspected of infectious causes.

The listed list of studies varies depending on the data obtained, the doctor's suspicion of the presence of a certain pathology.

Treatment

The therapeutic approach to the treatment of sciatica has changed dramatically in recent years. Today, the priority is to find the cause of the disease and its treatment, and not just the elimination of symptoms. The complex of therapeutic measures may include:

• Medical treatment.
• Spinal immobilization.
• Physiotherapy.
• Physiotherapy.
• Massage.
• Surgery.

Different methods are resorted to only if there are indications for their use. Independent choice of treatment method is unacceptable.

Medical treatment

Tablets, injections and ointments can relieve the inflammatory syndrome, eliminate the manifestations of sciatica, but not get rid of the cause. Therefore, you should not be limited only to the use of medicines. Medicines aimed at eliminating sciatica include:

• Non-steroidal anti-inflammatory drugs.
• Analgesics.
• group vitamins
• Muscle relaxants.
• Chondroprotectors.

The method of administration of drugs depends on the severity of the pain syndrome. With low-intensity pain, it is enough to apply ointments and gels to the area of ​​the affected segment. With severe neuralgia, one has to resort to the use of injectable forms.

Immobilization

In some diseases, for example, injuries and osteochondrosis, the pain syndrome from the nerve root is associated with the pressure of bone structures on it. In this case, it is necessary to relieve stress by applying the immobilization method.

The vertebrae can be separated from each other using skeletal traction - this is used for injuries, fractures.

Corset structures can also be used to immobilize the motor segment - a Shants collar for the neck, a lumbar belt for the lower back.

Providing rest for the nerve root allows you to reduce symptoms and eliminate the cause of the disease without further progression.

Physiotherapy treatment

In modern medical practice, the significant influence of physiotherapy on the course of the inflammatory process is recognized. Thermal methods of exposure can reduce the intensity of the inflammatory reaction by increasing blood flow in the affected area, relaxing muscle fibers. Possible procedures:

• Paraffin applications.
• Mud applications.
• Radon and hydrogen sulfide baths.
• Electromyostimulation.
• Electro- and phonophoresis of medicines.

It is worth remembering that the use of physiotherapy is dangerous in the presence of an infectious process. The doctor must prescribe treatment in accordance with contraindications.

Exercise therapy and massage

Therapeutic exercise allows you to restore the function of the spine after immobilization or surgical treatment. Exercise therapy also favorably affects the prognosis for osteochondrosis, disc herniation, and spondylolisthesis. When these causes are eliminated, the likelihood of progression of radiculitis and the frequency of its exacerbations are reduced.

It is worth visiting a qualified massage therapist after the exercise therapy complex. Massage allows you to relax muscle fibers, reduce the intensity of back pain.

Surgical treatment

If the above treatments have not been effective, your doctor may recommend surgery to decompress the nerve root.

Some diseases leading to sciatica may be absolute indications for surgery. These include tumors, vertebral fractures, severe forms of osteochondrosis, osteophytes and other pathological processes.

Inflammation of the spine of another localization

Some patients associate back pain solely with sciatica. However, the inflammatory process in the spine may be of another localization. The following structures can be exposed to inflammation:

• Vertebral bodies.
• Intervertebral joints.
• intervertebral discs.
• Ligaments of the spine.
• Back muscles.
• Spinal cord, nerve plexuses.
• Meninges.

Qualified specialists will help to distinguish between diseases, to choose the optimal treatment.

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Radicular syndrome: symptoms and treatment

Radicular syndrome - the main symptoms:

• Skin redness
• Lower back pain
• Stomach ache
• sweating
• Amyotrophy
• Heartache
• Pain in the spine
• Pain syndrome
• Numbness in the affected area
• Puffiness of the skin
• Pain in the limbs
• Loss of sensation
• Violation of pain sensitivity
• Difficulty in making movements
• Shooting pain

Radicular syndrome is a complex of symptoms that occur in the process of squeezing the spinal roots (that is, nerves) in those places where they branch off from the spinal cord. The radicular syndrome, the symptoms of which are somewhat contradictory in its definition, is in itself a sign of many different diseases, which makes it important to diagnose it in a timely manner and prescribe appropriate treatment.

general description

The neurological syndrome we are considering is quite common. Compression (squeezing) of the nerves leads to a variety of pains, which, accordingly, occur in a variety of places: in the limbs, in the neck, in the lower back. Often, pain can also occur in the area of ​​certain internal organs, for example, in the area of ​​\u200b\u200bthe stomach or heart.

Below you can consider what the spinal root looks like, respectively, determining the effect of the lesion in the event of one.

Causes of radicular syndrome

Damage to the spinal roots can be triggered by a number of conditions, among which we highlight the following:

• Spinal hernia;
• Osteochondrosis;
• Certain types of birth defects that are relevant for the structure of the spine;
• Constant overloads concerning the spinal column;
• Sedentary lifestyle;
• Spondylarthrosis;
• Injuries, cicatricial changes and tumors;
• Vertebral fractures resulting from osteoporosis;
• Changes in hormonal status;
• Damage to the vertebrae of the infectious nature of the impact (for example, changes provoked by osteomyelitis or tuberculosis);
• Hypothermia.

As a rule, radicular syndrome does not occur immediately after exposure to one or another of the specified causes. Initially, it is preceded by the development of changes in the area of ​​the intervertebral discs, which, in turn, provoke the occurrence of hernias. Further, the hernia, with its own displacement, begins to compress the spinal root, which leads to difficulty in the outflow of venous blood from it. This subsequently leads to the development of inflammation of a non-infectious nature. Thus, the nerve and the tissues around it begin to surround the formed adhesions.

Radicular syndrome: symptoms

The first, and at the same time the most characteristic symptom of radicular syndrome, is the appearance of pain, which is concentrated along the course of a particular nerve. So, when a process is formed in the cervical region, pain, respectively, occurs in the arm and neck. The process in the thoracic region provokes back pain, in some cases pains concentrated in the stomach or heart area become possible (these pains disappear only when the radicular syndrome itself is eliminated). The process in the lumbar region leads to pain in the lumbar region and buttocks, as well as in the lower extremities.

Movement, like lifting weights, leads to increased pain. In some cases, the pain is characterized as "shooting", which is accompanied by its distribution to various parts of the body, this is in particular due to the location of a particular nerve. A backache that occurs in the lumbar region is called lumbago. In this case, the pain may be permanent, but its intensification in any case occurs in the event of any careless movement.

Not only physical stress can provoke attacks of pain, but also emotional stress, in addition to this, hypothermia also has an effect on its appearance. In some cases, the onset of pain occurs at night, as well as during sleep, which in particular is accompanied by swelling of the skin and its redness, and increased sweating is also noted.

Another sign accompanying the radicular syndrome manifests itself as a violation of sensitivity that occurs in the zone of innervation of the nerve in question. So, a slight tingling with a needle in the indicated zone is accompanied by a sharp decrease in sensitivity, which is observed when compared with an area similar, but located on the other side.

Additionally, among the signs, there is also a movement disorder that occurs with muscle changes. The latter are provoked by damage to the nerves innervating them. Muscles dry out, respectively, they atrophy. In addition, their weakness is noted, which in some cases is also determined visually, especially when comparing both limbs.

Diagnosis of radicular syndrome

In diagnosing radicular syndrome, it is initially important to determine the cause that provokes compression of the spinal nerve. Thanks to research on movement and sensitivity disorders, it is determined within which particular vertebrae the damage has formed. For example, if the root is squeezed in the region of the fifth lumbar vertebra, then this provokes pain in the lower back (ie, lumbalgia). This pain, respectively, gives along the outer surface of the thigh, as well as along the lower leg to the toes (2,3,4). Already this symptom acquires a slightly different definition - lumbar ischialgia.

When nerves are damaged due to infectious diseases, the process may be accompanied by additional symptoms in the form of fever and fever, which, in particular, is concentrated in the region of the root involved in the pathological process.

As a standard instrumental method that provides the possibility of diagnosing the syndrome we are considering, a general radiography of the spine is used. In particular, the focus of diagnosis covers the results of radiography in the lateral and anterior projections. Meanwhile, the most informative and at the same time sensitive diagnostic method today is MRI (magnetic resonance imaging). Whatever method of diagnosis is chosen, the basis for determining the diagnosis is still directly those clinical symptoms that are relevant in each case for the patient.

Treatment of radicular syndrome

Treatment methods for radicular syndrome are determined solely on the basis of a consideration of the possible causes, as well as the selection of the main one, that is, the one that, in fact, provoked this syndrome. Patients are assigned the strictest bed rest, which should lie exclusively on a hard surface. Additionally assigned:

• Analgesics (ketorol, baralgin). Their use allows to eliminate/reduce the pronounced painful manifestations.
• Anti-inflammatory nonsteroidal drugs (nurofen, diclofenac, movalis). With their help, not only the inflammation formed in areas with damaged nerves is reduced, but also pain is relieved. Their long-term use, meanwhile, is associated with a number of side effects. By the way, the use of drugs of this type is possible in the form of ointments, gels (fastum, ketonal), which, accordingly, provides for their external use while reducing possible adverse effects.
• Muscle relaxants - drugs designed to eliminate muscle spasms. They can only be used as directed by a doctor.
• Vitamins corresponding to group B. Their action is focused on improving metabolic processes in nerve tissues.
• Chondroprotectors are drugs for stimulating recovery processes and slowing down cartilage destruction in the area of ​​intervertebral joints.
• Non-drug treatment (massage, gymnastics, physiotherapy, reflexology). These treatment options are relevant in all cases except tumors.

Some diseases may require surgical intervention, which is possible with neoplasms and intervertebral hernias.

To diagnose radicular syndrome, as well as to prescribe adequate treatment, you need to contact a neurologist.

If you think that you have radicular syndrome and the symptoms characteristic of this disease, then a neurologist can help you.

We also suggest using our online disease diagnostic service, which, based on the symptoms entered, selects probable diseases.

Intercostal neuralgia is a painful condition caused by irritation or compression of the intercostal nerves. Intercostal neuralgia, the symptoms of which are usually observed in older people, is explained by age-related changes that are relevant to the state of their vessels. As for children, this disease is extremely rare in them.

Radiculitis is a disease of the nervous system in which the roots of the spinal nerves are affected. Radiculitis, the main symptom of which is pain in the neck or back (depending on such a lesion), can also be referred to in medical practice as radiculopathy.

Sciatica is inflammation of the sciatic nerve. In some sources, the disease may be referred to as sciatic neuralgia or sciatica. The most characteristic symptom for this ailment is back pain, which radiates to the lower limb. The main risk group is people over 30 years of age. At an earlier age, the disease is almost never diagnosed.

Lymphocytic leukemia is a malignant lesion that occurs in the lymphatic tissue. It is characterized by the accumulation of tumor lymphocytes in the lymph nodes, in the peripheral blood and in the bone marrow. The acute form of lymphocytic leukemia has recently been classified as a “childhood” disease due to its exposure mainly to patients aged two to four years. Today, lymphocytic leukemia, the symptoms of which are characterized by their own specificity, is observed more often among adults.

Raynaud's disease is a disorder of the paroxysmal type in the arterial blood supply to the feet and / or hands, which occurs against the background of prolonged exposure to stress, cold, and some other factors. Raynaud's disease, the symptoms of which are more common among women, is distinguished primarily by the symmetry of the lesion of the limbs.

With the help of exercise and abstinence, most people can do without medicine.

Symptoms and treatment of human diseases

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Questions and suggestions:

Inflammation of the nerve roots or sciatica, which is correct?

Many have heard of such a disease as sciatica. However, its full name sounds like inflammation of the nerve roots or radicular syndrome (the concept of sciatica is not applicable to all roots). This disease is characteristic of any age and is manifested by severe pain in the area of ​​​​inflammation, however, first things first.

general description

The human nervous system is a complex mechanism that has a branched structure. At the end of this structure is the root and similar roots in the body 62, in addition, the system includes fibers and bundles. These nerve fibers roots and bundles act as messengers. In the event of any impact on the body (heat, cold, pain, etc.), this impulse is transmitted to the spinal cord, after which it is transmitted to the brain. It happens almost instantly.

The anatomy of the nerve roots is simple. There are two subspecies:

The anterior ones are formed by axons of efferent neurons. The main function that the anterior roots perform is motor activity and reflex contractions.

The defeat of the anterior roots does not cause pain in a person, but leads to motor disorders and disorders in reflexes. Nevertheless, among this group there are also afferent fibers (responsible for sensitivity). There are not so many of them, but when they are damaged, severe pain can occur. These fibers can come out in the region of the posterior roots.

The posterior roots, in turn, consist of afferent fibers and are responsible for sensitivity and pain. It is damage to these nerves that causes severe pain. In addition to the pain reaction, there may be a loss of sensation in that part of the body for which the affected nerve is responsible.

It is precisely because of the internal structure that inflammation of the nerve roots is primarily associated with vertebral disorders (lower back pain, etc.)

In addition, according to the location, the roots are divided into:

• cervical (cervical, cervicobrachial, cervicothoracic);
• Good (innervate the chest around);
• lumbar;
• sacral (innervate the sacrum);
• coccygeal.

The roots located in the lumbar and sacral region are often combined into one subspecies - lumbosacral.

The reasons

There are several reasons that can provoke inflammation, from a banal pinched nerve root in the lumbar spine to the presence of a hidden disease that provokes the formation of a hernia or tumor.

The root can become inflamed for the following reasons:

• infectious diseases affecting the vertebra;
• trauma (in this situation, a fragment or a displaced vertebra can pinch the nerve);
• osteocondritis of the spine;
• osteoporosis;
• herniated disc;
• displacement of the vertebrae;
• narrowing of the spinal canal;
• osteomyelitis;
• tumor in the spine;
• hypothermia (in this situation, as such, there is no infringement, perhaps the development of an inflammatory process);
• hormonal disorders;
• sedentary lifestyle;
• birth defects (narrow opening through which the nerve passes, etc.).

The presence of a concomitant problem in the body does not immediately cause neuralgia, it takes time. For example, an intervertebral hernia begins to grow and gradually compresses the nerve root, thereby pinching it, disrupting the function of transmitting nerve impulses.

Symptoms

The nerve roots of the spine are located in the body in certain places, which indicates the classification of the inflammatory process. So, the following variants of the disease are distinguished:

• cervical;
• chest;
• lumbar;
• mixed (cervical-brachial, lumbosacral, etc.).

The inflammatory process can occur as a result of external influence on the root, then we are talking about a secondary type of disease, and directly due to problems with the nervous system, then we are talking about the primary type of disease.

Symptoms for each subspecies are individual, but there are symptoms that are common to all, including:

• increase in body temperature;
• pain syndrome along the course of the nerve;
• increased pain during sharp turns of the body, coughing;
• restriction in movements (depending on the type of ailment);
• decreased sensitivity;
• weakness;
• increased pain on palpation of the spinal spinal column.

cervical sciatica

The cervical region is located as close as possible to the vessels of the head, therefore, when the roots of the cervical region are squeezed, the pain spreads towards the back of the head and parietal region. In addition, pain in the shoulder blade or arm can be diagnosed.

Signs of cervical sciatica:

• loss of sensation in the fingertips;
• pain in case of a change in the position of the hands or movement of the shoulder blades;
• difficulty breathing;
• pain similar to heart;
• burning, tingling and tension in the muscles of the neck;
• violation of posture;
• change in the neck.

Due to the proximity of the neck to the head, the following manifestations are possible:

• migraine;
• nausea;
• vomit;
• dizziness;
• increase in pressure.

Thoracic sciatica

The least common disease, since inflammation in the thoracic region is one of the rarest manifestations. As a rule, it is associated with the presence of infectious diseases of the respiratory system, as well as with herpes ganglia.

• aching pain;
• breathing problems (it is difficult for the patient to breathe);
• pain is localized in the region of the ribs;
• increase or decrease in sensitivity at the site of pinching;
• possibly a vegetative manifestation (bubble rash at the site of pinching).

Lumbar sciatica

This disease is one of the most common. The nerve roots of the lumbar suffer from pinching more often than others due to heavy loads on this department and have the following symptoms:

• tension in the muscles of the lower back;
• sudden and gradually increasing pain;
• shooting pain in the leg or buttock;
• numbness of the toes;
• pain syndrome during back extension.

The pain does not allow the patient to be in a standing position for a long time, forcing him to take a sitting or lying position.

Diagnostics

The study of the patient's condition begins with the collection of anamnesis of the patient. So, the doctor conducts a survey and initial examination of the patient, paying special attention to the localization of pain and the nature of its occurrence.

The standard set of tests for all medical institutions (general clinical blood test, urine test) is not very informative and the specialist prescribes advanced diagnostics, which includes:

• x-ray of the inflamed spine;
• computed tomography (CT);
• magnetic resonance imaging (MRI);
• study of the spinal fluid through a puncture of the spinal cord;
• electromyography;
• myelography (a study based on the use of contrast fluid).

Treatment

Currently, the approach to the treatment of inflammation or pinched roots has changed significantly. The basis is not the elimination (blockade) of the pain syndrome, but the identification and elimination of the cause of pain.

There are the following treatment options:

1. Medical (conservative) treatment.
2. Operative (surgical) intervention.

The above options are the basis, and in addition, physiotherapeutic procedures, immobilization therapy, as well as folk remedies can be used.

Medical therapy

This complex of medical procedures is designed not to treat the cause, but to eliminate the consequences, and includes the appointment of the following drugs:

• non-steroidal anti-inflammatory drugs;
• analgesics;
• a complex of vitamins;
• muscle relaxants;
• chondroprotectors.

Depending on the severity of the disease, certain medicinal methods are used. For example, with a moderate pain syndrome, it is enough to apply an ointment to the site of pain localization or take a pill, while severe pain requires the administration of a medicine through an injection (shot).

Concomitant treatment

In the case of sciatica, it is impossible to get by with tablets and ointments alone, complex treatment is necessary, which includes:

• physiotherapy treatment (UHF, ultraviolet irradiation, mud applications, radon and hydrogen sulfide baths, electromyostimulation, phonophoresis, electrophoresis);
• physiotherapy exercises (LFK);
• massotherapy;
• immobilization.

Physiotherapy has a beneficial effect on the body, helping to relieve inflammation, relaxing muscle fibers and increasing blood flow.

Immobilization is carried out through the use of various corsets and restraints.

As for exercise therapy and massage, they are necessary for the rehabilitation of the patient after immobilization and surgery.

Surgical method

This method is necessary in the case when it is impossible to achieve the elimination of the cause in another way. It is not always possible to change the patient's condition with pills alone.

So, one of the most common operations is decompression of the nerve root. Decompression is necessary when it is not possible to release it from pressure by physiotherapy or immobilization (as a rule, this happens due to trauma or tumor processes).

Prevention and prognosis

After the end of medical or surgical treatment, it is necessary to exclude the possibility of re-development of the disease, for which the patient is required to comply with the following recommendations:

• weight loss (carried out as part of reducing the load on the spine and legs);
• reduce weight lifting
• use more opportunities for walking;
• avoid hypothermia;
• pay attention to posture (curvature of the spine is unacceptable).

The prognosis of this disease in most cases is favorable. However, in case of untimely treatment or its complete absence, sciatica can flow into a chronic phase, which is treated longer than usual.

So, inflammation of the nerve roots is a rather unpleasant, but curable disease that must be treated under the supervision of a specialist. In the absence of proper treatment, severe pain is not ruled out. Do not joke with your body, treat yourself correctly!

Inflammation of the roots of the spinal nerves - where and how they are pinched, causes, treatment

The spine is an organ responsible for the normal functioning of the musculoskeletal system and internal organs, each of which has a network of nerve endings.

Nerve trunks originate from the roots coming from the posterior and anterior horns of the spinal cord.

There are 62 nerve roots in the spine, respectively, there are 31 pairs of them.

The roots of the spinal nerves transmit signals from the internal organs to the spinal cord, and then to the brain - the central "control system" of the body.

The “commands” coming from the brain are first received by the spinal cord, which distributes them throughout the body through the nerve endings.

Functions of the spinal roots and deviations from the norm

The specified number of paired roots is due to the structure of the spinal column. The spinal roots extend from the vertebrae of the neck (8 pairs), from the vertebral segments of the chest (12 pairs), lower back (5 pairs), sacrum (5 pairs), coccyx (1 pair).

Inflammatory processes in these areas lead to pinching of nerve fibers, severe pain and disruption of the innervation of internal organs, arms, legs, and skin.

• The posterior roots regulate the activity of pain receptors and are responsible for sensory perception. They are made up of afferent fibers. When the posterior roots are damaged, neurological disorders are observed. With a strong compression of these fibers, an acute pain syndrome develops, and muscle trophism is disturbed. With any attempt to move, the pain intensifies, as compression on the spinal nerve increases. If it is damaged, motor functions are preserved, but the sensitivity of skin receptors is lost.
• The anterior roots are formed by the axons of efferent neurons. They are responsible for movements and reflexes, contractions of ligaments. Without these fibers, motor activity would be impossible: a person could not pick up objects, walk, run, or perform physical work. The nerve formed from the anterior roots of the spinal cord, when damaged and excised, does not cause pain, except in cases of recurrent reception (in the anterior root of the spinal nerve, afferent fibers can be found passing through it, then turning into the posterior root and going to the spinal cord). Their damage causes severe pain, which disappears when 2-3 posterior roots are excised.

Squeezing and infringement of the posterior and anterior roots becomes not only the cause of a painful condition, but also, if left untreated, leads to disability.

If an arm or leg loses sensitivity, “goosebumps” and numbness appear in the soft tissues, movements in them are limited - you need to urgently consult a doctor to establish an accurate diagnosis.

The disease in an advanced stage may require a radical method of solving the problem - surgical intervention.

The reasons

Since the roots contain fibers on which the receptor sensitivity of soft tissues and the functioning of the musculoskeletal system depend, immediate hospitalization and a thorough examination of the patient make it possible to bypass the worst - paralysis of the arms and legs, atrophy of muscle tissues.

In the process of diagnostic measures, the true causes of the pathological condition are also established. It:

• Protrusions and hernias of intervertebral discs.
• Injuries.
• Degenerative changes in bone tissue caused by osteochondrosis, spondylosis, osteoporosis, arthritis.
• Tumor formations.
• Postoperative complications.
• Wrong posture.
• A long static posture in which a person stays regularly for several hours.

Data from MRI, CT, X-ray and ultrasound examinations and other diagnostic measures allow us to assess the degree of damage to the spinal roots, determine the location of the process, after which specialists decide on the direction of treatment and prescribe a set of treatment procedures.

Treatment

Traditional methods of therapy consist of taking painkillers and non-steroidal anti-inflammatory drugs, limiting motor activity, using muscle relaxants, and vitamin preparations.

But if the symptoms do not lose their severity and continue to grow, then specialists can decide on the advisability of surgical intervention. It can be:

• Microdiscectomy.
• Operative root decompression.
• Pulse radiofrequency ablation (Latin for the word "ablation" translates as "taking away").

Microdiscectomy is a minimally invasive method that does not violate the structure of nerve fibers, but allows them to be released from compression by removing part of the bone tissue, due to which the inflammatory process began.

Operative root decompression is used for hernias and tumors, which, increasing in size, cause infringement of nerve fibers. The purpose of the operation is to remove partially or completely these formations.

Pulsed radiofrequency ablation in 80% of cases gives the desired result, because the integrity of the vertebral segments is not violated during the operation.

By puncture, an electrode is inserted into the area of ​​the hernial formation, and cold plasma pulses flow through it. The hernia begins to "melt", noticeably decreases in size and in some cases is set back.

But this is possible if the fibrous ring has not ruptured, and the gelatinous contents remain within this shell.

Vertebral pathologies are dangerous because any delay and ignoring a deteriorating condition can lead to a real disaster. The spinal cord is inextricably linked with the brain structures of the head.

Sympathetic nerve fibers that run from the vertebral segments to the internal organs transmit signals about malfunctions to the "main center".

And if the work of any of the links in this chain is disrupted, then the consequences of a late visit to the doctors may have to be corrected for all the remaining years.

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Radiculitis(lat. radicula root + -itis) - damage to the roots of the spinal nerves, characterized by pain and impaired sensitivity of the radicular type, less often by peripheral paresis. Although radiculitis in the direct sense means inflammation of the roots of the spinal nerves, only in 4-5% of cases there are infectious and infectious-allergic radiculitis, in which the membranes of the spinal cord are often involved in the pathological process, and the pathological process is essentially meningoradiculitis.

The main reason for the development of radiculitis is osteochondrosis of the spine, degeneration of the intervertebral discs, often with their displacement (disc hernia). Less commonly, sciatica occurs with congenital malformations of the spine, diseases of internal organs, inflammatory-dystrophic lesions of the spine and joints, tumors of the peripheral nervous system, bone and ligament apparatus, gynecological diseases, spinal injuries, infectious diseases of the nervous system. Depending on the localization, lumbosacral, cervicothoracic and cervical sciatica are distinguished. The division is conditional.

Symptoms sciatica in different places has common features: it is spontaneous pain in the zone of innervation of the affected roots, aggravated by movements, coughing, sneezing and straining; restriction of mobility of the spine, protective (pain) posture of the patient, soreness with pressure on the spinous processes of the vertebrae and at paravertebral points, increased or decreased sensitivity, motor disorders - weakness and hypotrophy of muscles in the zone of radicular innervation.

In clinical practice, the most common sciatica caused by osteochondrosis of the spine. The lumbosacral spine bears the greatest functional load, and, accordingly, the intervertebral discs at this level undergo the most significant changes. Dystrophic changes in the intervertebral disc are accompanied by narrowing of the intervertebral fissure, compression of the spinal roots in the intervertebral foramens with radicular symptoms, muscular-tonic disorders with reflex tension of the innervated muscles, vegetative-vascular disorders, changes in the tendons, ligaments, symptoms of compression of the vessels of the spinal cord.

During lumbosacral sciatica, lumbar and radicular stages are distinguished. In the first stage, there is a dull, aching, but more often acute pain in the lumbar region. Pain can occur suddenly, first in the muscles, after exercise, cooling, or increase gradually, aggravated by coughing, sneezing, etc. There is a limitation of mobility in the lumbar spine, flattening of the lumbar lordosis, tension and soreness of the muscles of the lumbar region.

As you move to the second, radicular, stage, the pain intensifies, changes its character, begins to radiate to the gluteal region, along the posterior surface of the thigh and lower leg. There are symptoms of root tension - Neri's symptom (pain in the lumbar region when the head is tilted forward), Dejerine's symptom (pain in the lumbar region when coughing, sneezing).

Depending on the location of the affected intervertebral disc or herniated (bulging) disc, sensitivity disorders are detected in the corresponding areas. So, with damage to the IV lumbar root, pain, hyperesthesia or hypoesthesia are localized in the lumbar region, along the anterior inner surface of the thigh and lower leg, and the medial edge of the foot. With the defeat of the V lumbar root, the pain is localized in the lumbar region, the upper quadrants of the gluteal region, along the posterolateral surface of the lower leg, on the back of the foot. The defeat of the intervertebral disc L5-S1 is accompanied by compression of the first sacral root. Pain and sensitivity disorders are localized in the sacrum, gluteal region, back of the thigh, lower leg, outer edge of the foot.

In some cases, the pathological process spreads from the roots to the sciatic nerve, which is accompanied by the development of symptoms of damage to the nerve trunk (sciatica): pain in the lumbar region and along the sciatic nerve, atrophy of the anterior leg muscles with drooping foot, decrease or disappearance of the Achilles reflex. Pain along the nerve trunk, pain when pressing on the transverse processes of the IV and V lumbar vertebrae (posterior point of Hara), in the region of the midline of the abdomen below the navel (anterior point of Hara) are also characteristic.

Positive pain reflexes of tension:

Lasegue's symptom - raising the extended leg of the patient, who is in the prone position, causes acute pain in the lumbar region with irradiation along the sciatic nerve (first phase), after bending the raised leg in the knee joint, the pain disappears (second phase);

Bonnet's symptom - pain along the back of the thigh when abducting or adducting an extended leg;

Ankylosing spondylitis - pain along the sciatic nerve with vigorous pressing to the bed of the patient's leg, unbent at the knee joint;

The symptom of landing is the appearance of pain in the lumbar region and in the popliteal fossa when the patient moves from a lying position to a sitting position with legs extended.

Cervical-thoracic sciatica occurs in deforming spondylosis, osteochondrosis, traumatic and tumor lesions of the spine, additional ribs, diseases of internal organs, etc. Infectious lesions of the roots, viral damage to the intervertebral sympathetic nodes occur much less frequently.

cervical sciatica characterized by sharp pains in the neck, nape with irradiation to the arm, shoulder blade. There is tension in the neck muscles, forced position of the head, sensitivity disorders, pain when pressing on the spinous processes of the cervical vertebrae and at paravertebral points, as well as when the head is tilted forward with pain radiating to the shoulder blade and arm.

Depending on the level of damage to the roots, the functions of certain muscle groups are disrupted. So, with the defeat of the III-IV anterior cervical roots, the muscles of the diaphragm are affected, the V-VI roots - the muscles of the shoulder and shoulder girdle, the VIII cervical and I thoracic roots - the muscles of the hand.

Thoracic sciatica occurs in isolation in diseases of the lungs, organs of the posterior mediastinum, lesions of the pleura, vertebrae and ribs, infections, including herpetic lesions of the ganglia of the sympathetic trunk (ganglionitis). Pain spreads along the course of one or more intercostal nerves, often aching in nature, less often paroxysmal. Soreness is noted in the paravertebral points, in the intercostal spaces; hyperesthesia or anesthesia in the areas of radicular innervation, sometimes bubble rashes in these areas.

The occurrence of a radicular syndrome in a patient requires a thorough clinical examination. All patients undergo X-ray of the spine in frontal and lateral projections. Myelography allows you to clarify the level and nature of the lesion. It is recommended to consult a gynecologist, urologist, oncologist to exclude neoplasms or their metastases in a particular area, which can compress and irritate the spinal roots.

Treatment of sciatica complex and can be recommended only after a thorough examination of the patient. Conservative treatment in the acute period includes strict bed rest for 6-7 days on a hard bed, taking analgesic, anti-inflammatory drugs, novocaine blockades, blockades with lidocaine, trimecaine. The position of the patient on a rigid inclined plane with a raised head end or horizontal traction with small loads on a special table with a device for reducing lumbar lordosis contributes to the reduction of pain syndrome. In some cases, proteolytic enzymes (papain) are injected into the intervertebral discs.

The arsenal of conservative treatment also includes vitamins (B1, B12), dehydration therapy (lasix, furosemide, diacarb), ganglioblockers (hexonium, pentamine), muscle relaxants, hormonal drugs. With a decrease in acute pain, physiotherapy is prescribed (Bernard currents, UV irradiation, UHF, inductotherapy, electrophoresis with prozerin), therapeutic exercises, massage of the muscles of the neck, back, limbs, underwater traction in the pool or in a special bath on the traction shield, underwater massage. In addition, drugs that improve microcirculation (theonicol, trental, complamin), biogenic stimulants (FiBS, etc.) are used. Outside the stage of exacerbation, sanatorium treatment (balneotherapy, mud therapy) is recommended.

Physiotherapy exercises are prescribed taking into account the patient's condition, the localization of the process. Contraindications to the use of exercise therapy are a pronounced pain syndrome, increased pain during exercise. Thanks to specially selected physical exercises, the natural "muscular corset" is gradually strengthened, metabolic processes in the affected segment are normalized. The use of therapeutic exercises and massage leads to a decrease in pain, an increase in the strength of the abdominal muscles, hip extensors, intercostal muscles, and long back muscles.

The exercise therapy technique is determined by the level of damage and the nature of movement disorders. With lumbosacral sciatica, certain facilitating starting positions should be selected. So, in the supine position on the back, a roller is placed under the knees, in the prone position on the stomach - a pillow under the stomach; to unload the spine, a knee-elbow position is used with an emphasis on the knees. Before doing therapeutic exercises, it is recommended to lie on an inclined plane (angle of inclination 15-40 °) with emphasis in the axillary areas. This procedure, lasting from 3-5 to 30 minutes, helps to stretch the spine, expand the intervertebral fissures, and reduce the compression of the roots.

With the ineffectiveness of conservative treatment, surgical decompression of the roots is performed with suturing of the disc herniation or removal of the disc (discectomy). Indications for surgery are strictly individual. Absolute indications are symptoms of compression of the cauda equina or spinal cord. In all other cases, indications for surgical intervention are relative.

AT prevention sciatica, an important role belongs to the development of correct posture, the rational organization of work and rest. To prevent exacerbations of sciatica, patients should sleep on a hard bed; the pillow should be low, which eliminates a sharp bend in the neck during sleep. The load should not be lifted with the "back" (bending over, on fully extended legs), it is better to use the weightlifter's technique - lifting the load with the "legs" (squatting a little). Persons whose profession is associated with prolonged sitting, it is useful to learn how to sit, leaning on the back of a chair and placing emphasis on both legs, it is recommended to avoid prolonged uncomfortable postures.

Medical sections: diseases of the musculoskeletal system

Medicinal plants: marshmallow, drooping birch, sarepta mustard, elecampane high, medicinal ginger, Norway maple, European larch, large burdock, sunflower, common radish

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Radicular syndrome or radiculopathy is a collection of neurological symptoms that occur when compression (squeezing) of the spinal nerves in the region of the branch from. The pathological process is often found in medical practice and is a manifestation of a chronic progressive course, primarily of a degenerative nature - dorsopathy.

According to statistics, in 80% of cases, radicular syndrome of the lumbar spine is diagnosed due to the mobility of the vertebrae, weakness of the muscular-ligamentous apparatus in this area and a large load during physical activity.

The reasons

The most common cause of radicular syndromes is the progressive course of osteochondrosis with the formation of protrusions, hernias, and osteophytes. The disease is accompanied by deformation of the intervertebral discs as a result of metabolic disorders and insufficient blood supply. As a result, the height of the disc decreases, which is displaced beyond the boundaries of the vertebrae, compressing the nearby soft tissues. In this case, the root suffers - the spinal nerve at the base of the spinal cord, passing in the bone canal before exiting the spine. The spinal root consists of sensory and motor nerve fibers and is in conjunction with the vertebral vessels. Compression of the neurovascular bundle by a hernia or osteophyte leads to the appearance of neurological symptoms.

Other causes of radiculopathy include:

• congenital pathology of the spinal column;
• spondylarthrosis;
• vertebral fractures resulting from osteoporosis (weakening of bone tissue);
• infections (osteomyelitis, tuberculosis);
• intense axial loads on the spine (carrying weights, sports overload);
• sedentary lifestyle (physical inactivity);
• prolonged stay in static postures (computer work);
• frequent hypothermia;
• chronic stress;
• endocrine disorders, hormonal imbalance (obesity, diabetes mellitus);
• tumors, cicatricial changes in the spinal column;
• injuries (fractures, bruises, sprains);
• flat feet.

Nerve root compression often occurs during the formation of a herniated protrusion of the intervertebral disc

In the development of degenerative-dystrophic processes of the spinal column in recent years, the role of a hereditary factor that affects the inferior development of connective tissue has been proven. As a result, a pathology of the spine is formed with a rapidly progressive course and the formation of radiculopathy. In the appearance of the disease, irrational nutrition, nicotine addiction, and alcohol abuse are of no small importance.

Clinical picture

A constant manifestation of the radicular syndrome is pain of varying intensity, which occurs at the site of infringement of the neurovascular bundle and in other parts of the body along the innervation of the affected nerve.

It can be aching, twitching, burning, cutting. It gets worse when walking, bending over, turning, sneezing or coughing. Sometimes the pain syndrome occurs in the form of a backache - a sharp pain from the lumbar region spreads along the course of the nerve. The phenomena of parasthesia are characteristic - numbness, tingling, a feeling of "crawling" in the lower extremities.

This condition is called lumbago, and periodically shooting pains - lumbalgia. Lumbago can appear with an awkward turn during a night's sleep, bending over, lifting weights. In this case, the pain is accompanied by vegetative disorders: reddening of the skin, sweating, swelling over the area of ​​root compression. Depending on the level of damage to the lumbosacral region, pain can radiate to the groin, buttocks, lower limbs on the side of the lesion, cause impaired urination, defecation, and weaken potency.

On the MRI image, arrows indicate pathological changes in the intervertebral discs in the lumbar region

As part of the spinal root are sensory and motor nerve fibers. Their compression causes swelling and inflammation of the nervous tissue, impaired conduction of the nerve impulse from the central sections to the periphery. As a result, the lower limb on the side of the lesion suffers. At the same time, sensitivity is disturbed - the sensation of tactile touches, temperature and pain stimuli of the lower limb is weakened. The innervation of the muscle fibers of the thigh, lower leg, foot also changes and their atrophy (“shrinkage”) develops. Weakening of the muscles causes a violation of the ability to move normally. Atrophied muscles decrease in volume, which can be seen when visually comparing the diseased and healthy legs.

Diagnostics

For the diagnosis of radicular syndrome, clinical data of the disease are of great importance. The lumbosacral region is affected at different levels, and according to the specifics of the symptoms, it is highly likely to assume the localization of the pathological process.

1. Compression of the spinal root at the level of 1-3 lumbar vertebrae (L1-L3) is accompanied by discomfort in the lower back, pain in the perineum, pubis, lower abdomen, inner and anterior thighs. In this area, paresthesia and numbness of the skin are observed.
2. Compression of the spinal roots at the level of the 4th lumbar vertebra (L4) is characterized by pain sensations on the anterior and outer surface of the thigh, which descend to the knee joint and lower leg. There is a decrease in the volume of the thigh due to atrophy of the quadriceps muscle and a weakening of movements in the knee. The gait changes, lameness develops.
3. Compression of the spinal roots at the level of the 5th lumbar vertebra (L5) causes pain on the outer surface of the thigh and lower leg, the inner part of the foot with damage to the big toe. Paresthesias in the area of ​​the foot and weakening of the muscle strength of the lower limb are revealed, which makes it difficult to support and motor function of the affected leg.

Pain sensations decrease or completely stop when lying on the healthy side of the body.

To prescribe effective treatment, an etiological disease of the spine is identified, which caused the appearance of radicular syndrome. Recommend instrumental examination methods that reveal the specifics and severity of the pathological process, clarify its localization:

• radiography in direct and lateral projection - determines violations of the bone tissue of the spine, indirectly indicates narrowing of the intervertebral discs and infringement of the nerve roots;
• Magnetic resonance imaging(MRI) - a more accurate and expensive diagnostic method, provides information about the state of not only the vertebrae, but also the intervertebral discs, blood vessels, nerves, muscles, ligaments, spinal cord;
• myelography - reveals the state of the spinal cord and nerve roots with the help of a contrast agent introduced into the subarachnoid space, followed by fluoroscopy.

Correct diagnosis contributes to the appointment of adequate therapy, which prevents the development of complications and the formation of disability.

Medical tactics

Treatment of radiculopathy is aimed at eliminating the pain syndrome, reducing inflammation and swelling of the neurovascular bundle. After stopping the acute process, the therapy of the etiological disease is continued to prevent the progression of the pathology. Patients are prescribed bed rest on a hard, flat surface, which prevents spinal deformity and additional injury to soft tissues. Fried, salty, spicy, fatty foods are excluded from the diet. The diet is enriched with fresh vegetables, fruits, herbs, cereals and dairy products. For effective treatment, you should stop smoking and taking alcoholic beverages.

Conservative therapy for radicular syndrome includes:

• analgesics to relieve pain - baralgin, ketorol in solutions for intramuscular injections;
• non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammatory response in the affected area, eliminate swelling and pain syndrome - movalis, diclofenac, nimesulide for the first 5 days through intramuscular injections, then in tablet form for a course of 10-14 days;
• lubrication of the lower back with anti-inflammatory and locally irritating ointments - capsikam, diklak-gel, finalgon;
• novocaine blockade with the addition of lidocaine, antibiotics, glucocorticoids for quick relief of pain;
• muscle relaxants to relax spasmodic muscles in the area of ​​nerve compression, which has an analgesic effect, improves blood flow to tissues, reduces congestive processes - sirdalud, mydocalm;
• vitamin complexes based on drugs B 1, B 6, B 12 in order to normalize metabolic processes and trophic nerve roots, improve the conduction of nerve impulses, regenerate damaged tissues - milgamma, neuromultivit in injections or tablets;
• physiotherapy after the acute pain syndrome subsides to activate metabolism, normalize muscle tone, improve blood flow - magnetotherapy, UHF, electrophoresis, radon baths;
• physical therapy to restore the anatomically correct position of the spinal column and strengthen the muscular frame of the back;
• massage, acupuncture, reflexology - to strengthen the muscles of the back, normalize blood circulation, improve nutrition of the spine.

In a severe course of the disease, persistent symptoms develop that are not amenable to conservative methods of therapy. In such cases, resort to surgical treatment.

Indications for surgical intervention include chronic pain syndrome, impaired motor activity (paresis, paralysis), pathology of the pelvic organs with urinary and fecal incontinence.

Massage and manual therapy are prescribed for the prevention of radiculopathy

Preference is given to minimally invasive methods, which are characterized by less damaging effects on healthy tissues and a short recovery period. In case of lumbar osteochondrosis complicated by protrusion, hernia, proliferation of osteophytes, nucleoplasty, microdiscectomy, removal of damaged spinal tissues with replacement with implants are prescribed.

Prevention

To prevent radiculopathy, it is necessary to consult a doctor in a timely manner when the first alarming symptoms from the spinal column occur. Infringement of the spinal root occurs against the background of the chronic course of the disease, an untimely diagnosed and treated pathological process. You should adhere to a balanced diet, give up addictions, engage in physical education, monitor the maintenance of normal body weight. It is important to sleep on a firm mattress and wear comfortable shoes with low heels. It is necessary to avoid engaging in heavy physical labor associated with an axial load on the spine. It is useful to take courses of therapeutic back massage twice a year.

Complexes of therapeutic exercises are prescribed during the recovery period of the disease

To prevent exacerbation of radiculopathy in osteochondrosis, you can perform a set of exercises daily to strengthen the lumbar spine:

• lying on your back with arms extended along the body and straight legs, contract the abdominal muscles 10-15 times;
• the starting position is the same, lift the upper half of the body off the floor, stay in this position for as long as possible and return to the previous position, the number of repetitions is 10-12 times;
• lying on your back, bend your knees and lay to the right of the body, at the same time point your head and chest to the left side, perform springy movements 6-8 times, and then do the same exercise, changing the sides of the head and legs;
• sit on the floor, stretch one leg, and bend the other at the knee joint and take it to the side, lean towards the straight leg and try to clasp the foot with your hands, change legs and repeat the exercise 5-6 times;
• in a position on all fours, alternately arch your back up and bend down until you feel a pleasant warmth in the lower back. Repeat the exercise 8-10 times.

If possible, hang on the horizontal bar several times a day for 10-15 minutes. Do a morning workout for all muscle groups before you start active motor activity.

Radicular syndrome in the lumbar region causes intense pain, impairs the sensitivity and motor ability of the limbs, disrupts pelvic functions and contributes to the appearance of sexual impotence. This significantly reduces the quality of life and can lead to disability. To prevent pathology, it is necessary to consult a doctor in a timely manner and undergo a comprehensive treatment of diseases of the spinal column.