Afterward, leg raises can cause leg pain

Lumboischialgia


Lumboischialgia (also known as root irritation syndrome) is back pain that is transmitted to the leg and can be traced back to nerve root irritation. Lumboischialgia is characterized by burning or stabbing back pain in the lumbar spine, which is transmitted to the leg via the sciatic nerves and causes pain, sensory disturbances or paralysis there. In most cases, the disease is caused by a herniated disc in the lumbar spine.

Definition: what is lumbar sciatica?

The term lumbar sciatica is made up of the words lumbalgia and sciatica. Isolated back pain in the lumbar spine area is referred to as lumbar pain. Sciatica is leg pain that is caused by an isolated irritation of the sciatic nerve (sciatic nerve).

A lumbar sciatica is therefore Back pain that is based on nerve root irritation and radiates or is passed on to the leg via the sciatic nerves. The disease is therefore also known as back leg pain. Since the symptoms of lumbar pain, sciatica and lumbar sciatica cannot always be clearly differentiated from one another and the transitions between the various symptoms are fluid, these three terms are often used synonymously.

How does lumbar sciatica express itself?

Lumboischialgia manifests itself through burning or stabbing pain in the lower backthat radiate into the leg along the buttocks, hips and back thigh. For this reason, lumbar sciatica not only causes severe back pain in the lumbar spine that is typical of lumbar pain, but also Pain and numbness in the leg. In addition, lumbar sciatica can also be a Muscle weakness and paralysis in the leg entail.

How does lumbar sciatica develop?

The lumbar spine is the starting point for lumbar sciatica. From here the pain radiates through the buttocks and the back of the thigh into the leg. The lumbar spine consists of a total of five vertebrae and, as the lower part of the spine, has to carry a large proportion of the body's weight. The lumbar vertebrae are therefore one of the vertebrae that are subjected to the most stress and therefore have an increased risk of signs of wear and tear, diseases and damage.

 

 

In the lumbar spine, the lower spinal cord nerves unite to form the sciatic nerve (sciatic nerve), the largest nerve in the human body. This extends from the lumbar spine over the back of the thigh to the hollow of the knee. It will come in the lumbar spine area to a Nerve irritation, the pain in lumbar sciatica is therefore passed on to the leg via the sciatic nerves.

Causes of Lumboischialgia

Lumboischialgia can have various causes. By far most common cause represents the Herniated disc in the lumbar spine But other diseases and pathological changes in the lumbar spine can also Back and leg pain cause. These include, for example, cysts or tumors on the vertebral joints or inflammation of the nerve roots.

Lumboischialgia caused by a herniated disc in the lumbar spine

In most cases, lumbar sciatica is caused by a herniated disc (disc prolapse) or a bulging disc (protrusion) on the lumbar spine. The intervertebral disc either protrudes completely (herniated disc) or bulges only slightly into the spinal canal (protruding disc). Such protruding or bulging of the intervertebral disc occurs most frequently between the lumbar vertebrae (LWK) 4 and 5 or between the lumbar vertebrae (LWK) 5 and the sacral vertebrae (SWK) 1.

As a result of a herniated disc or a protruding disc, the nerves in the spinal canal are compressed to a greater or lesser extent. This leads to the typical lower back pain. These radiate along the sciatic nerve via the buttocks and the back of the thigh into the leg and cause pain and sensitivity disorders there.

Other causes of lumbar sciatica

In addition to a herniated disc in the lumbar spine, the following diseases and pathological changes in the lumbar or sacrum vertebrae can result in lumbar sciatica:

  • Nerve root inflammation and inflammation of the sciatic nerve
  • wear-related narrowing where the nerves emerge from the lumbar spine
  • Signs of wear and tear on the lumbar spine
  • Cysts on the vertebral joints
  • Ossification of vertebral ligaments
  • Blockages of the vertebral bodies, for example due to bone tumors or bony outgrowths (osteophytes)
  • Inflammation and abscesses of the surrounding tissue
  • Circulatory disorders
  • Bad posture

Symptoms of lumbar sciatica

Lumboischialgia manifests itself through various symptoms that can last between a week and six months, depending on the severity and severity of the disease. The Main symptom are burning or stabbing back pain in the lumbar spine areathat radiate down the buttocks and the back of the thigh down to the leg. In addition, lumbar sciatica typically goes with severely limited mobility of the spine through to stiffening as well Sensory disturbances or even Paralysis in the leg hand in hand.

Back pain

Typical of lumbar sciatica Back pain in the lumbar spine area can radiate through the buttocks and the back of the thigh to the lower leg and foot. How far and how much the pain extends into the leg depends on the strength of the nerve root irritation in the lumbar spine: the stronger the nerve root irritation, the further the pain in lumbar sciatica is transmitted along the sciatic nerve into the leg. If the nerve roots in the lower back are very irritated, this leads to Leg pain radiating down to the foot. If the nerve roots are less strongly irritated, the leg pain breaks off in the thigh or lower leg area.

The type and severity of pain ranges from mild lower back pain that radiates into the buttocks, to more severe back pain that radiates into one leg or both legs, or down to the lower leg. Extreme pain, which those affected describe as stabbing and burning, is also possible. The pain is often triggered and exacerbated by movements such as bending or lifting the leg or turning the body. In the case of very severe lumbar sciatica, the Pain even at rest when standing, sitting or lying down occur.

 

 

Limited mobility

Anyone who suffers from lumbar sciatica is severely restricted in their ability to move. Because of the pain, the muscles around the spine reflexively cramp in lumbar sciatica. This leads to muscle tension in the lower back and a Curvature and stiffness of the spine. As a result, it is not possible for those affected to bend over, turn their upper body or stand upright. In addition, because of the pain, those affected often take a sideways curved posture.

Emotional disorders and neurological failures

In the case of lumbar sciatica, sensory disturbances and neurological deficits often occur in the painful regions. This is what happens in these areas, for example Numbness, tingle and a limited ability to feel up to and including insensitivity. This can sometimes be accompanied by muscle weakness and paralysis in the legs. In addition, lumbar sciatica can also lead to a Impairment of the bladder and bowel function to lead.


Diagnosis of lumbar sciatica

Lumboischialgia can usually be diagnosed very easily by taking a medical history (anamnesis), the typical symptoms and a thorough physical examination. Further diagnostic procedures, such as magnetic resonance imaging (MRT) or computed tomography (CT), can be used to additionally secure the diagnosis and determine the exact causes of the symptoms.

Anamnesis (taking the medical history)

In order to find out more about the medical history and the exact complaints of the person concerned, the attending physician introduces the patient Anamnesis interview. During this interview, the doctor asks, among other things, whether the patient has had back problems in the past, since when the pain has existed, where exactly it occurs and how severe it is. He also asks whether there are additional movement restrictions in the spine as well as sensory disorders, muscle weakness or paralysis in the legs. If the patient reports the typical back leg pain, this already indicates the presence of lumboischialgia.

Physical examination

In order to confirm the suspected diagnosis of lumbar sciatica, the attending physician first conducts a thorough physical examination. This includes in particular the so-called Lasegue test. The patient is supine on a treatment couch. The affected leg, in which the pain occurs, is then slowly raised by the doctor without any action on the part of the patient. The leg is extended while the hip joint is slightly bent.

If there is lumbar sciatica, lifting the leg at an early stage leads to a significant increase in pain, as the sciatic nerve is stretched and the nerve root is additionally irritated. One speaks of the sign after Lasegue. The pain becomes even worse when the toe of the raised leg is pulled towards the patient (so-called Bragard test), this also indicates lumbar sciatica.

In addition to the Lasegue test and the Bragard test, the physical examination also includes:

  • a review of the reflexes in the lower extremities,
  • an examination of toe and heel gait and one-legged stance as well
  • an examination of motor control and nerve conduction velocity.

Imaging procedures

If lumbar sciatica cannot be clearly diagnosed in the course of the anamnesis and physical examination, additional imaging methods such as magnetic resonance imaging (MRI) can be used Computed tomography (CT) and myelography can be performed. With a Magnetic resonance imaging (MRI) the nerve roots in the spinal cord and possibly a herniated disc can be made visible. At a Myelography a contrast agent is injected into the intervertebral space and then an X-ray is taken. In addition to these imaging diagnostic procedures, examinations can also be carried out in which the conduction of electricity through the nerve tissue is checked.

Treatment of lumbar sciatica

Lumboischialgia is usually initially treated conservatively as part of symptomatic therapy. Such symptomatic therapy aims to treat the symptoms, i.e. a Relief of pain and numbness in the back and leg, rather than eliminating the cause. A causal therapy, in which, for example, a herniated disc is treated surgically, usually only takes place when the symptomatic therapy with conservative treatment methods no longer works.

Various conservative treatment approaches are available for symptomatic therapy. This includes in particular the medical therapy, step positioning, physiotherapy and back training. In around 90 percent of cases, the back leg pain typical of lumbar sciatica disappears within six weeks with the help of bed rest and painkillers.

Drug treatment of lumbar sciatica

Drug therapy for lumbar sciatica is aimed at relieving back leg pain, inhibiting possible inflammation of the nerve roots and sciatic nerves, and relaxing the cramped back muscles. Among other things, they are used anti-inflammatory and analgesic drugs such as ibuprofen, paracetamol or the so-called non-steroidal anti-inflammatory drugs, or NSAIDs for short. Furthermore, the so-called Muscle relaxants used to relax the back muscles. These drugs can either be taken in the form of tablets or injected by the doctor in the form of a syringe.

Step positioning to relieve pain

The so-called step positioning is a helpful immediate measure to alleviate the acute pain in the back leg in lumbar sciatica. The patient either lies down in Lie on your side with your legs bent at right angles or in Lie on your back with your lower legs on a chair on the ground. This step position and the bent legs relieve the sciatic nerve, the lower back and the back muscles and so temporarily relieve the pain of lumbar sciatica.

Physiotherapy and back training

With the help of physiotherapy and back training, both acute pain can be alleviated and a recurrence of lumbar sciatica can be prevented. The goal of physiotherapy and back training is on the one hand to calm the irritated sciatic nerve. On the other hand, the overloaded tendons and muscles in the lumbar spine should be strengthened and strengthened. This is done with targeted Physiotherapy stretching and tensioning exercises the back, abdominal, trunk and pelvic floor muscles. In addition, as part of physiotherapy and back training, those affected learn how to behave in a back-friendly manner in everyday life, for example when sitting and lifting.

Surgical treatment as part of spinal surgery

If a lumbar sciatica cannot be adequately treated with the mentioned conservative therapeutic measures, a surgical intervention must be considered. This is especially the case if the lumbar sciatica was caused by a herniated disc in the lumbar spine. The operative measures that are then used include endoscopic disc surgery and minimally invasive spinal surgery.

Further treatment measures for lumbar sciatica

Other possible therapy methods that can be used for back leg pain include:

  • gentle massages and warm baths
  • acupuncture
  • Local infiltration of local anesthetics and cortisone to the affected nerve roots as part of the so-called periradicular therapy (PRT)
  • Electrotherapy with various types of current for anti-inflammatory and pain relief

Cure prospects for lumbar sciatica

With a lumbar sciatica usually exist good chance of recovery. If it is consistently treated with pain reliever and anti-inflammatory medication, temporary rest and bed rest, step positioning, physiotherapy and back training, the typical back leg pain will disappear in around 90 percent of cases within six weeks again.

However, back problems such as lumbar sciatica are common recurring. In order to prevent the recurrence of back leg pain, those affected should therefore undertake targeted and regular back muscle training as part of back training and physiotherapy after the symptoms have subsided. Regular exercise and sporting activities as well as a healthy lifestyle also help prevent lumbar sciatica from occurring again. This is especially true for people who have an office job or who are overweight.

If the lumbar sciatica is based on a herniated disc in the lumbar spine or another more serious cause, a disc surgery is often necessary. In this case, recovery may be delayed. In general, however, the chances of recovery are also to be classified as good here.

Prevention of lumbar sciatica

In addition to a healthy lifestyle with healthy eating and Sufficient relaxation breaks in everyday and professional life all measures taken by the Strengthening and relieving the back serve. This includes in particular

  • regular physical activity and exercise,
  • back-friendly behavior, for example through healthy sitting conditions and sitting breaks during office work and
  • avoiding abrupt rotational movements and lifting heavy loads as well
  • an effective back muscle training.

Back muscle training as part of the back school

With the help of back muscle training, the back muscles are strengthened and strengthened in the long term.This relieves and supports the spine and thus prevents renewed lumbar sciatica. Back muscle training can take place, among other things, as part of back training or physiotherapy. On the one hand, those affected learn in the back school and in physiotherapy back-friendly behavior and back-friendly movement sequences. For this purpose, they are trained, for example, in how to avoid heavy loads on one side, how to sit in the correct position at the desk and how to pick up objects from a crouch with a straight back. On the other hand, those affected carry out targeted back training and physiotherapy under professional guidance Stretching and tension exercises to strengthen and strengthen the back, abdominal, trunk and pelvic floor muscles and to prevent lumboischialgia from occurring again.

Healthy diet to prevent lumbar sciatica

A healthy diet helps prevent disc breakdown, which can lead to lumbar sciatica. The dietary rules that those affected should adhere to include, among other things, that they should avoid wheat and meat from fattening animals and instead eat more fish, spelled, millet and fresh vegetables.