Treatment of sciatica in a sanatorium

Sciatica

Sciatica is one of those conditions that people often delay seeing a neurologist for. We tend to ask ourselves — should we really be concerned if the pain attacks occur only two or three times a year? This leads to a dangerous misconception — that it's possible to live with this condition peacefully and for a long time. However, over time, the disease progresses and completely dominates the patient’s life, bringing along a range of unpleasant consequences.

Sciatica (from the Greek "Ishia" – hip) is nothing other than the inflammation of the longest nerve in our body — the sciatic nerve. Other names for this condition include lumbosacral radiculitis and sciatic neuritis. Sciatica develops as a result of damage to the nerve roots of the lumbar-sacral spine.

In most cases, sciatica is accompanied by pain radiating from the lower back down the back of the thigh. In other words, the pain runs along the entire length of the nerve, starting from the lower part of the back where the lumbar nerve roots are located, then passing through the gluteal region and along the nerve endings of the lower limb.

Causes of Sciatica

One of the most common causes of sciatica is a herniated intervertebral disc that compresses the nerve. Sciatica can also be triggered by simple cold exposure.

In general, there are many causes that lead to sciatic nerve inflammation. These include:

• Changes in the shape of the vertebrae causing damage to nerve endings;
• Injuries (including birth-related);
• Irritation of the nerve by adjacent muscles, bones, or tumors;
• Internal bleeding;
• Infections (including flu, rheumatism, tuberculosis);
• Constipation;
• Arthritis;
• Diabetes;
• Gynecological diseases.

Among the rarer but possible causes are: abscess, blood clot, tumor, Lyme disease, fibromyalgia, pelvic infections, Reiter's syndrome.

Let’s take a closer look at some of the main causes:

• Herniated intervertebral disc — sciatica occurs and progresses due to compression or irritation of the nerve root by a deformed intervertebral disc.
• Spinal stenosis — a pathological condition associated with narrowing of the spinal canal, which houses the spinal cord and nerve roots. It most commonly affects people over 60 years old and is related to enlargement of the facet joints, increased pressure on the nerve roots passing through the intervertebral foramina. As a result, the nerve becomes compressed, leading to pain and all the accompanying symptoms characteristic of sciatic nerve neuropathy.
• Osteochondrosis — a degenerative disease of the spine that leads to changes in intervertebral discs, their bulging and flattening, and formation of bone spurs. These bony outgrowths compress and irritate the nerve roots.
• Spondylolisthesis — displacement of one vertebra relative to another. As spondylolisthesis develops, the nerve roots forming the sciatic nerve become pinched or compressed.
• Dysfunction of the sacroiliac joint — pain arises due to irritation of the joint, which causes irritation of the lumbosacral nerve roots.

Symptoms

The clinical symptoms of sciatica are just as varied as its causes. The pain itself — whether it’s sharp, burning, stabbing ("electrical shocks"), numbness, tingling — can vary in intensity and nature. In some cases, pain is localized only in the lower back; in others, it spreads along the entire length of the sciatic nerve — from the fingertips to the buttocks. There may even be no direct pain in the lumbar spine, but very uncomfortable sensations in the buttock, thigh, foot, or calf, and sometimes in the toes.

Typically, sciatica affects only one leg, though in some cases patients may feel pain in both legs. Pain can "travel" — appearing in the lower back, then moving to the buttock, and further down the leg to the knee, foot, and even reaching the toes. Various combinations of pain sensations are possible, even without any discomfort in the lower back. The most important thing to understand from the first alarming signs is that the disease will not resolve on its own — and will only get worse over time. In advanced stages, the attacks are so painful that the patient cannot bend, turn, stand, or sit. Sometimes, even lying down does not bring relief.

Diagnosis and Treatment of Sciatica

Diagnosis of sciatica is based on patient history and physical examination. Typical symptoms significantly simplify diagnosis, although some require specific testing methods. X-rays, MRI, CT scans, and electromyography can provide valuable insights into the underlying cause of sciatica.

Once the cause has been identified and the diagnosis made, the next question arises: which treatment method will be most effective in this particular case? Here, opinions may differ, since there are many options, and some contradict each other. Regardless of the cause, a general recommendation is to stop or minimize physical activity. This helps reduce the irritation of the nerve roots. Warming the lower back during an acute flare-up is strictly prohibited, as it may cause swelling and prolong the recovery period. At the first sign of the disease, you should immediately consult a neurologist.

Prompt medical attention significantly increases treatment effectiveness and accelerates recovery. The most effective approach to treating sciatica involves a comprehensive therapy plan using methods such as:

• Acupuncture;
• Vacuum therapy;
• Gentle manual therapy.

Treatment of sciatica, lumbago, spondylosis, and other musculoskeletal disorders at our sanatorium usually shows positive results within the first few days. On average, the duration of treatment for sciatica, depending on the stage of the disease, is about two weeks.