Lumbosacral radiculitis symptoms and treatment

For the defeat of the lumbosacral region, a typical chronic course with regular relapses of varying intensity and duration is typical.

The main clinical symptom of radiculitis is pain. It can be felt in the lumbar region and sacrum, in the gluteus muscle and give to the leg, often depriving the patient of the ability to walk. Discomfort is greatly enhanced by turning the body, trying to reach the chest with the chin, straining the muscles of the abdomen, sneezing and coughing.

Other symptoms of radiculitis:

  • limitation of mobility;
  • tingling in the toes;
  • violation of sensitivity;
  • reduction of the hyoid fold on the side of inflammation.

Depending on the location of the destruction of the discs, symptoms of lumbosacral radiculitis can be localized in different zones: in the lumbar region, buttocks, thighs, or along the entire length of the leg.

The defeat of the nerve fibers of the sacral segment, called sciatica, is manifested by sharp pain along the sciatic plexus – from the buttock in the center of the back of the thigh through the calf muscle to the heel. Lumbosacral radiculopathy in this case is accompanied by a sensation of “goose bumps” in the limbs, numbness of the skin, and cooling of the legs.

With damage to the nerves of the spinal cord, pain is noted over the entire surface of the thigh, inability to bend the big toe or foot, backache. External postural disorders also develop: scoliosis in the affected area, decreased physiological bending in the lumbar region, and the appearance of kyphosis.

Signs of radiculitis appear equally in both men and women. The acute period lasts no more than 14 days, sometimes longer. Then the symptoms gradually fade away until the next relapse.

There are four main forms of lumbosacral radiculopathy, which differ among themselves in the affected area:

    sciatica of the lumbar region in combination with the inflammatory process in the ep >

Depending on the intensity and nature of the pain, the following types of lumbosacral radiculitis are distinguished:

  • lumbar ischialgia – gradually increasing pain radiates to the buttock and lower limb;
  • sciatica lumbago – discomfort occurs in the lower back;
  • sciatica – the pain is sharp with concomitant burning sensation, gives in the leg.

Symptom complex can occur both in one limb, and in two at the same time.

Which doctor treats lumbar sciatica?

Radiculitis is treated by a neurologist or neurologist. If there are no such specialists at your local clinic, you should contact your GP.

Since an attack of radiculitis often completely immobilizes a person, he needs the support of those who are nearby before going to a medical institution or the arrival of a doctor.

First aid for radiculitis of the lumbar includes:

  • immobilization of the spine with a corset, bandage or tight bandage;
  • laying the victim in a horizontal position with slightly raised limbs;
  • anesthesia with Orthofen, Diclofenac tablet.

The back of a person in a horizontal position should not bend. For this patient with an acute attack of radiculitis, they are placed on a board, plywood, or simply on the floor.

Diagnostics

As a rule, the symptoms characteristic of radiculitis allow you to immediately determine the cause of the pain. To confirm the diagnosis, the patient is prescribed hardware research methods:

During the diagnosis, lumbosacral radiculitis must be differentiated with a neoplasm of the spinal cord, meningomyelitis, and spinal blood flow disorder.

Treatment

How to treat sciatica? All therapeutic measures are carried out only by a doctor. In combination with painkillers, exercise therapy, physiotherapy, and exhaustion are used. The latter technique is very effective for lumbosacral disorders and quickly relieves pain.

The independent use of various methods of non-traditional practice and warming procedures for radiculitis is undesirable, since discomfort can be caused not by pinching of the nerve processes, but by other diseases in which heat is prohibited.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Medicinal products

The most effective method of stopping an attack of radiculitis is medication. The following basic medicines are most often prescribed to patients:

  • muscle relaxants – Sirdalud, Baksolan, Midokalm;
  • NSAIDs in tablets – Ortofen, Ibuprofen, Diclofenac;
  • injections of B vitamins – Combilipen, Neurobion, Trigamma, Milgamma;
  • painkillers and anti-inflammatory ointments – Indomethacin, Nise, Diclofenac, Apizartron, Finalgon, Viprosal.

With the infectious nature of the lesion, treatment of lumbosacral radiculitis is supplemented with iv administration of urotropin or antibiotics. With very severe pain in the affected areas, blockades are performed. As anesthetics, Trimecaine, Lidocaine, Novocaine are used.

To prescribe medications for radiculitis, you must consult your doctor. Most of the drugs considered have a large number of limitations and adverse reactions, so it is not recommended to use them on their own.

Physiotherapy

How to cure lumbar sciatica with physiotherapeutic methods? In the subacute period, UFD is often used along the sciatic nerve and electrophoresis with anesthetics, salicylates, lithium.

In the acute stage of radiculitis, ultrasound in pulsed mode with analgesics, sodium chloride and hydrogen sulfide baths helps well. The diadynamic currents are also well established. Such procedures perfectly complement the medical effect and significantly alleviate the patient’s condition.

Operative intervention

If conservative treatment of lumbosacral radiculitis does not work, the patient may be offered surgical intervention. The operation is assigned in the following cases:

  • dysfunction of the pelvic sphincters;
  • movement disorders;
  • deterioration in the quality of cerebrospinal fluid;
  • pain syndrome that cannot be corrected for 2-3 months.

Typically, the symptoms considered in the complex are indications for surgery.

Complications

In the absence of treatment, lumbar sciatica often leads to a decrease in the central channel of the spine, compression of the spinal cord and a deterioration in blood flow. Similar pathological conditions can result in spinal infarction and paralysis of the lower extremities.

Prevention

To prevent the development of radiculopathy of the lumbosacral spine, it is necessary to adhere to the following simple recommendations:

  • avoid sudden movements, as well as weighted postures, twisting the spinal column;
  • regularly load the muscles of the pelvic girdle, abdominals and lower back to create a strong muscle corset;
  • sleep on orthopedic or hard mattress;
  • during work and study, take the correct posture;
  • lift weights only from a semi-squat;
  • boost immunity.

For muscle training, swimming (on the back or breaststroke) and skiing are perfect. During classes, course intake of vitamin C and chondroprotectors is recommended.

The lumbosacral form of radiculitis is characterized by a long course and constant relapses. In order to cure the pathology completely, it is necessary to diagnose it as soon as possible and follow all the doctor’s instructions exactly.

Lumbosacral radiculitis

Lumbosacral radiculitis is a clinical symptom complex due to degenerative-dystrophic changes and secondary inflammation of the spinal roots in the lumbar and sacral spine. It is manifested by variable pain syndromes: lumbalgia, lumbago and lumbar ischialgia. Diagnosis is based on complaints, results of examination and palpation of the lumbar region, the presence of positive symptoms of Laseg, Neri, Ankylosing spondylitis and typical trigger points, spinal radiography data. Therapy is carried out with anti-inflammatory, analgesic, vitamin, vasoactive pharmaceuticals and physiotherapy.

Overview

Lumbosacral radiculitis is the most common form of radiculitis. The second place after him belongs to cervical radiculitis. Mostly people after 35 years of age fall ill, the peak incidence falls on the age period of 40-50 years. Lumbosacral sciatica is associated with inadequate static-dynamic loads on the spine and takes first place among the causes of temporary disability in connection with damage to the peripheral nervous system. Those who are most susceptible to the disease are people who, due to their professional activities, are forced to lift weights, be in an inclined position or sit for a long time, i.e. agricultural workers, loaders, welders, builders, drivers, etc. Lumbosacral sciatica differs as as a rule, prolonged relapsing course with relapses from 1 time in 2-3 years to several times a year. Due to the widespread prevalence of radiculitis of lumbosacral localization, the issues of its effective treatment are topical issues of modern neurology, vertebrology and manual therapy.

Causes of lumbosacral radiculitis

According to generally accepted notions, the pathogenetic basis of radiculitis is made up of degenerative-dystrophic processes (osteochondrosis, spondylarthrosis, lumbar spondylosis) occurring in the spinal column. The main factors contributing to the development of these processes are physical inactivity, metabolic disorders (obesity, diabetes mellitus), spinal injuries (fracture of the lumbar spine, spinal injury), excessive static or dynamic load on the spinal column, abnormalities in the development of the spine or posture disturbances to curvature of the spine with the formation of scoliosis or lumbar hyperlordosis.

As a result of degenerative processes in the intervertebral discs, the height of the latter decreases, the ligamentous apparatus is weakened, additional load is placed on the muscles that hold the spine. Muscular overstrain leads to pain. In addition, sprawling osteophytes can irritate nerve roots emerging from the spine, also provoking a pain syndrome. Painful irritation, in turn, causes a spasm of the vertebral vessels of the lumbar spine. In conditions of poor blood supply and venous stasis, secondary inflammation occurs. Lumbosacral radiculitis can provoke intervertebral hernia of the lumbar spine. At first, the symptoms of radiculitis are caused by the irritating effect of the intervertebral hernia on the spinal root. As the hernia increases, it squeezes the spine, causing a violation of its functions.

The triggers that provoke exacerbation of radiculitis of the lumbosacral localization include: weight lifting, a sharp turn or tilt in the lower back, hypothermia, general infectious diseases (SARS, flu, bronchitis), prolonged static load on the lower back (for example, truckers), intoxication . Perhaps a combined effect of these factors.

Symptoms of the lumbosacral radiculitis

There are 3 main clinical syndromes: lumbalgia, lumbago and lumbar ischialgia. Lumbalgia is a subacute lower back pain that is dull and prolonged. Strengthening of lumbalgia is facilitated by lowering the body and turning the body, prolonged walking, standing, and sitting. Pain decreases in a horizontal position when removing the load from the spine. Lumbago – acute sharp pain in the lower back, described by patients as “backache”. It occurs suddenly, usually when lifting heavy, turning or tilting the body. Often forces the patient to “freeze” in a certain position, since any movements cause sharp pain. Lumbar ischialgia is said to be when back pain radiates to one or both legs and is accompanied by paresthesia, numbness and vegetative-trophic changes in the affected limb.

Each of the clinical syndromes is characterized by varying objective changes recorded by a neurologist or vertebrologist during the initial examination. First of all, attention is drawn to the arbitrary restriction of mobility in the lumbar spine and the patient’s analgesic posture. When examining the lower back, there may be a skew of the body to the healthy side, a tonic contraction of the long muscles of the back. Palpation of the muscles is tense and painful.

There are a number of trigger points, pressure on which causes pain. The main clinical use was given to the Gar points and the Ballé points. The first include a point in the sacroiliac joint, points above the spinous and transverse processes of the IV-V lumbar vertebrae, a point above the posterior-upper spine of the ilium. The second are represented by paravertebral points of the lumbar, sacral-gluteal, femoral, popliteal, as well as points on the lower leg and foot. The occurrence of pain when clicking on the points of the gluteal region and legs is characteristic of lumboischialgia and is not observed with lumbago and lumbalgia. Also for lumbar ischialgia, the distribution of pain along the nerves distally from the place of pressure is typical.

In the acute period, lumbosacral radiculitis is also characterized by the presence of a number of specific symptoms. There is an increase in lower back pain when coughing and sneezing (Dejerine symptom), smoothness of the sublingual folds (Bonnet symptom), involuntary bending of the leg on the affected side when the patient sits down from a supine position (ankylosing spondylitis), lower back pain when lifting the straight leg in position lying on your back (Laseg symptom), increased pain with a sharp bend of the head forward (Neri symptom).

Diagnosis of lumbosacral radiculitis

As a rule, the above clinical symptoms allow the doctor to diagnose lumbosacral radiculitis. Electromyography or electroneuromyography makes it possible to confirm the level of damage to the neuromuscular system. Radiography of the spine is necessarily performed in 2 projections. Often, it reveals signs of osteochondrosis, subluxation of the vertebrae, curvature of the spine, anomalies of its development (lumbarization, sacralization, etc.).

A necessary point is the exclusion of such serious causes of lumbar ischialgia and lumbalgia as tumors of the spinal cord and spine, spinal cord disturbances, intervertebral hernia, meningomyelitis. The doctor should be alerted by a pronounced radicular syndrome, which occurs with sensitive and motor disorders, which is difficult to treat. If there is evidence, patients are given an MRI of the spine, if it is impossible to perform it, CT. MRI makes it possible to diagnose a hernia, tumor, inflammatory changes in the spinal substance; determine the size of the lesion, the stage of development of the hernia; evaluate the degree of compression of the spinal canal.

Treatment of lumbosacral radiculitis

Therapeutic tactics are based on the relief of pain and all its components (inflammatory, muscle-tonic, compression component). Comprehensive pharmacotherapy consists of the appointment of anti-inflammatory and analgesic drugs (amidopyrine + butadion, metamizole sodium, diclofenac, nimesulide, etc.), muscle relaxants (tolperisone hydrochloride, baclofen), vitamins gr. In (thiamine, pyridoxine, cyanocobalamin), improving local blood circulation funds (nicotine to-you). In case of intense pain, therapeutic paravertebral blockade with the introduction of glucocorticosteroids is advisable. Local application of ultraviolet radiation, electrophoresis, UHF, magnetotherapy has anti-inflammatory and analgesic effects. Reflexology can be used to relieve pain.

Effective means to eliminate or stop the degenerative processes occurring in the spine do not yet exist. A certain effect is noted with the use of chondroprotectors (glucosamine, chondroitin sulfate, extract from marine fish, etc.). In order to eliminate subluxation of the vertebrae and to increase the intervertebral space, manual or traction therapy can be performed. In case of an intervertebral hernia causing a pain-resistant syndrome or compression of the root with loss of its function, surgical removal of a hernia with a disk is possible (diskectomy, microdisectomy).

After the acute period subsides, in which rest is recommended for patients, they gradually start physical therapy exercises in combination with myofascial massage of the lumbosacral spine and physiotherapy. Regular gymnastics strengthens the muscles of the spine and lower back, which avoids further relapses. Patients are also recommended swimming, water and mud therapy.

Prediction and prevention of lumbosacral radiculitis

In most cases, lumbosacral radiculitis responds well to therapy. The acute period can be stopped within 5-7 days. The question of subsequent relapses depends on how it is possible to eliminate the factors that provoke them (overload, weight lifting, overweight, etc.), as well as on the patient’s recommendations on regular exercise therapy, visiting the pool, and periodic massage courses.

Prevention of lumbosacral radiculitis is reduced to the observance of an adequate mode of work, avoiding the lifting of excessive weights and other loads on the spine, maintaining an active lifestyle, rational nutrition, timely correction of metabolic disorders, etc.

The manifestation and treatment of lumbosacral radiculitis

A frequent reason to see a doctor is back pain (dorsalgia), especially in the lumbosacral region. The mechanism of its development may be different. If pain occurs due to pinching or inflammation of the roots of the spinal nerves, this condition is called radiculitis or radiculopathy.

The vertebrae are massive in the lumbosacral region, the intervertebral discs between them have a lower height than in the overlying regions. It is on this area that the maximum load falls during turns, tilts of the body, improper lifting of the load. All this leads to frequent damage to the lumbar vertebrae, discs and nerve roots that extend between adjacent vertebrae.

Causes

Radiculitis can lead to:

The most common cause of root impairment in the lumbar region is degenerative changes in the vertebrae and intervertebral discs (osteochondrosis).

In this case, the disk becomes less elastic, low, and is no longer held between adjacent vertebrae due to the destruction of the outer shell. There are protrusion (protrusion) or loss of disc structures (hernias). They squeeze and push out the nerve root, leading to tension, inflammation, ischemia of this formation. Discogenic sciatica occurs.

On the vertebrae themselves, bone spikes, antennae, and proliferation of marginal sites are formed. All this narrows and deforms the holes for the roots to exit, and with movements, outgrowths injure the roots. Such sciatica is compression.

Injury of the root occurs acutely after an unsuccessful turn, jump, sharp extension in the lower back, weight lifting, with a spasm of the lumbar paravertebral muscles against a background of prolonged uncomfortable body position, sometimes against stress.

Inflammations and tumors give a picture of the subacute development of radiculitis, usually the same provoking moments are present.

Manifestations of radiculitis

Radiculitis is primarily a pain syndrome. The pain is one-sided, severe. Because of it, the body tilts in the opposite direction (to expand the distance between the vertebrae), movements in the lumbar region are sharply limited. The pain can give in the buttock, thigh, down to the popliteal fossa.

The muscles in the lower back are strained, the gait is limping, sparing the affected side. Acute pain only in the lumbar region (by the type of lumbago) is called lumbago. If she appeared while torso, sometimes a person can not straighten up.

There are neurological manifestations – symptoms of tension of Laseg, Neri, etc., changes in tendon reflexes, skin sensitivity and muscle strength. Sometimes there are moderate signs of inflammation – fever, malaise.

The acute form of infringement of the root can go into a chronic course, in this case, neurological signs will increase with a decrease in strength in the legs and muscle atrophy will begin.

Radiculitis leads to temporary disability and requires complex treatment.

Principles of treatment

Directions of exposure in the treatment of acute stage of radiculitis:

In the early days of the disease, you can not give physical activity to the affected area. Therefore, exercise therapy is permissible only after a decrease in the severity of the process, in the recovery and rehabilitation period. Moreover, it is necessary primarily for the correction of pathological settings and complexes of movements, strengthening the muscle paravertebral corset, that is, for the prevention of repetition of the roots.

In chronic radiculitis, therapy during an exacerbation is carried out as well as lumbago treatment. But later, measures will necessarily be included to reduce the constant compression of the spine.

Treatment may include:

Preference is given to conservative methods of treatment, while drugs from different pharmacological groups and various non-drug methods are simultaneously used.

The operation is indicated in the absence of the effect of complex conservative treatment for 1,5 months, with a rapid increase in weakness in the leg and with the addition of a malfunction of the bladder and sphincter of the rectum. This can be endoscopic discectomy (removal of the disc), laminectomy (removal of the part of the vertebra that infringes the root).

Medicines for radiculitis

In acute radiculitis and with an exacerbation of the chronic process, different drugs are used. These include:

A combination of various means is used. This has a multifaceted effect and reduces the period of acute pain. With an infectious nature, it is necessary to affect the pathogen, for which, given the etiology, antibiotics, vaccines or serums are prescribed.

Reducing the intensity of pain is necessary not only for subjective improvement of well-being, but also for therapeutic purposes. Pain causes protective muscle tension. Prolonged tonic tension leads to tissue edema and compression of adjacent structures, including nerve roots.

Pain can be reduced by blocking pain receptors, limiting the number of nerve impulses going to the central nervous system, reducing the severity of inflammatory reactions and edema. Preference is given to agents with several mechanisms of action.

NSAIDs are a first-line drug in the treatment of radiculitis, reducing the production of inflammatory mediators and reducing tissue edema. Thus, they have both a painkiller and a healing effect. These include Diclofenac, Ibuprofen, Naproxen, Ketoprofen, Arkoxia, Movalis, Voltaren and many others. Some of them are available not only in tablet form, but also in the form of solutions for injection, ointments and gels for external use over the focus of inflammation and damage.

In the treatment of NSAIDs, it is necessary to observe the daily and age dosage, to control the picture of the KLA and the condition of the gastrointestinal tract. Drugs in this group can cause damage to the mucous membrane of the stomach and duodenum (up to ulcers), immunoallergic damage to the liver, tendency to bleeding. The presence in the history of aspirin-dependent bronchial asthma, gastric ulcer limit the use of these funds.

Of the painkillers used Ketonal, Ketanov. They have a fairly fast and powerful effect. With severe pain, narcotic analgesics are prescribed for a short time.

Given the severity of pain with radiculitis, therapeutic blockades are widely used with the use of analgesics, steroids with the addition of vitamins. A strictly dosed mixture of Novocaine (Lidocaine), a corticosteroid and one of the B vitamins (Thiamine B1 or Cyancobalamin B12) is administered.

The use of blockades allows you to reduce or stop the pain very quickly, often even during the procedure. At the same time, the drugs enter the affected area, acting directly on the root. Nerve impulses are blocked, swelling is relieved, blood supply improves due to vasodilation.

Medications for blockages can be administered:

With radiculitis, muscle relaxants are also recommended (Midokalm, Metocarbomil, the combined drug Skutamil). They allow you to reduce reflex muscle spasm, relaxing skeletal muscles and without affecting internal organs. They are contraindicated in myasthenia gravis, a pronounced slowdown in the rhythm of the heart.

To improve blood supply and tissue nutrition, vascular preparations – Eufillin, Pentoxifylline (Trental) can be prescribed. In acute condition, they are usually administered intravenously. Contraindications are cardiac arrhythmias and severe liver dysfunction.

With the development of peripheral paresis, Prozerin, Dibazole are used to help restore motor function.

Widely used products for application to the skin. They come in 3 types:

The use of non-steroidal agents in ointments gives a lesser effect, but reduces the risk of side effects compared with pills and injections.

The treatment of radiculitis is the use of various drugs, complemented by a wide range of non-drug measures.

Non-drug treatment

Maintenance of rest of the affected area is the most important condition. This reduces the risk of infringement of neighboring roots, helps to cope with muscle spasm and reduce pain. Attempts to “develop” the lower back are unacceptable; in the acute period, various exercises are contraindicated. On the first day, half-bed mode is optimal, sleep on an even semi-rigid base with a shield placed over the mattress, restriction of movements and support for the back with a removable corset. The rise from the bed should be carried out without twisting movements of the torso, only by turning the whole body.

On the first day, local cooling often relieves pain with the help of wrapped ice bags or camphor skin lubricants. Subsequently, warming and wearing special belts made of wool (sheep, dog, camel) are recommended.

A doctor may be prescribed traction own weight. To do this, the bed shield is lifted so that the head end becomes 30-40º higher. The rings worn through the armpits fix the upper body, and the weight of the body stretches the intervertebral spaces, reducing pressure on the roots.

Manual therapy is permissible with compression radiculitis. If the infringement is of a discogenic nature, then only individual methods are used. And in the case of a disk hernia, it is completely advisable not to use this treatment method in an acute condition.

Physiotherapy is allowed to be used on the first day. It can be:

Using electrophoresis, you can enter anti-inflammatory, anesthetic and trace elements (lithium, copper). And in the subacute stage, they additionally use electrophoresis therapeutic mud, mud applications, therapeutic baths.

Massage is carried out after a decrease in the severity of pain, soon exercise therapy joins it under the supervision of a doctor and instructor. Initial exercises are carried out in bed, and subsequently the amount of load increases.

The treatment of radiculitis should be intensive and comprehensive, using various drugs, ointments, non-drug methods. In the rehabilitation period, it is necessary to continue therapy to restore nerve conduction along the spine, increase range of motion, strengthen muscles and prevent re-infringement.

For the prevention of lumbosacral radiculitis, the workload should be optimized, avoiding twisting, sharp extension of the body, prolonged stay in an uncomfortable position. If it is necessary to lift weights, the main load should lie on the muscles of the thigh, and not on the lower back, that is, it is necessary to lift the load from a semi-squat with a vertical body position. A comfortable ambient temperature without damp and drafts is also needed.

How to recognize the symptoms of lumbosacral radiculitis?

Lumbosacral sciatica has specific symptoms, drug treatment will be effective at the initial stage. In an advanced case, surgery is inevitable. Only a doctor can prescribe a high-quality and effective treatment that will stop the progression of the pathology and minimize the occurrence of relapses.

What it is?

Radiculitis of the lumbosacral spine is a complex of symptoms that is manifested by degenerative-dystrophic changes, with the addition of secondary inflammation of the spinal roots in the region of the lumbar and sacral zone of the spinal column.

Causes

The causes of lumbosacral radiculitis are mass. These include:

  • injuries of the vertebrae in the corresponding area;
  • arthritis;
  • the presence of osteophytes;
  • advanced osteochondrosis;
  • the effect of drafts and hypothermia;
  • systematic significant load on the spine;
  • passive lifestyle;
  • excessive body weight;
  • pregnancy;
  • poor nutrition;
  • colds;
  • sciatica;
  • regular stress;
  • immune and endocrine disorders;
  • deformities of the vertebrae of a congenital nature;
  • the presence of neoplasms;
  • heredity, etc.

Types and types

Lumbosacral radiculitis is classified relative to the manifestation of pain.

  1. Sciatica. In this case, the pain is increasing, there is an irradiation in the legs and buttock.
  2. Sciatica. The pains are sharp, reminiscent of a jerk. Tingling and burning sensations are also felt. Irradiation in the shins, thighs and buttocks.
  3. Lumbago. The pain is concentrated in the lower back. Appears with displacement of the vertebra, hypertonicity of the lumbar muscles and hernia.

If you look from the side of the anatomical manifestation of lumbosacral radiculitis, then there is a division into:

  1. Myeloradiculitis. It is characterized by infringement of roots. There are changes in the cerebrospinal fluid and tendon reflexes of the legs. Myeloradiculopathy of the lumbosacral spine begins with soreness in the back, usually patients do not pay attention to it. At the final stage, if left untreated, numerous complications and the inability to move independently can develop.
  2. Myeloradiculitis. This is an infectious disease. The spinal cord suffers.
  3. Radiculoneuritis. The spinal cord and roots are totally damaged.
  4. Radiculoganglionitis. Infectious disease. The nodes and nerve roots suffer.

Symptoms and signs

Symptoms of radiculopathy of the lumbosacral spine are manifested in the form of:

  1. Pain syndrome. Soreness is quite diverse. It can be present not only in the affected area, but also given to the lower extremities, buttocks. She is aching, shooting, sharp, dull, temporary or permanent. It is especially clearly felt at night, during coughing, sneezing, with motor activity.
  2. Impaired sensitivity. With lumbosacral radiculitis, the lower back and legs may become numb, there is a burning sensation and tingling sensation.
  3. Muscle weakness. The muscles of the hips, buttocks, legs are weakened. Over time, even muscle atrophy can develop.

To all of the above symptoms, pallor of the skin of the face, increased work of the sweat glands, and fast fatigue are added.

Diagnostics

To determine the diagnosis, the doctor must initially talk with the patient. Complaints are heard, inspection is carried out.

  1. Electroneuromyography or electromyography. The result will indicate how affected the nerves and muscles are.
  2. X-ray examination (two projections). Here, various changes that are found in the spinal column will be revealed: deformations, congenital anomalies, subluxations, osteochondrosis, etc.
  3. Magnetic resonance imaging and computed tomography. These methods will detect neoplasms, determine their size and degree.

Treatment

Treatment for radiculitis of the lumbosacral is complex. May be conservative and radical. Conservative therapy includes:

  • taking medicines;
  • performance of special physiotherapy exercises;
  • visiting a physiotherapy room;
  • massage therapy.

Medication

A medication prescribed by a doctor is prescribed for lumbosacral radiculitis. Medications can be taken orally or applied directly to the lesion locally. it

  • Painkillers and anti-inflammatory drugs. Preparations in the form of:
  1. Nimesulide;
  2. Diclofenac;
  3. Metamizole sodium;
  4. Amidopyrine;
  5. Butadion and others
  • Muscle relaxants:
  1. Baclofen;
  2. Tolperisone hydrochloride.
  • Vitamins (group B):
  1. Pyridoxine;
  2. Thiamine;
  3. Cyanocobalamin.

If severe debilitating pain occurs, blockages may be prescribed. Painkillers, anti-inflammatory drugs, glucocorticosteroids will be introduced at the site of the lesion.

The use of chondroprotectors (for example, Chondra drug) is also practiced.

Physiotherapy will help speed up the healing process:

operations

If the radicular syndrome of the sacro-lumbar spine for three months does not go away, the attending physician will offer the patient to think about a radical method.

Also, surgery for lumbosacral radiculitis is indicated for:

  • degenerative changes in the vertebrae;
  • significant problems with motor activity;
  • neurological disorders.

There is surgery in which only the intervertebral disc is removed, which compresses the sciatic nerve. This is called a small open type operation. If spinal stenosis is detected, a laminectomy is advisable. In this case, the bone near which the pinched nerve root is located is removed.

Folk methods

There are a large number of traditional medicine recipes that can be used to treat radiculitis in the lumbosacral spine. It is extremely undesirable to use them without consulting a doctor, as they are effective only at the initial stage. In the future, self-medication will only lead to complications.

Discogenic radiculopathy of the lumbosacral spine may be the reason for the use of various medicinal herbs.

At home, you can do:

  1. Warming the affected area with compresses based on mustard, horseradish, garlic, black radish.
  2. Applying aloe gruel, compresses on tincture of oregano, survivor, water pepper, heather, butterbur, marshmallow and balsam perfectly relieve inflammation.
  3. Compresses from black elderberry, amphibian mountaineer, butterbur and valerian have a sedative effect.
  4. Anesthetize herbs in the form of cinquefoil, medicinal sweet clover, adonis, and autumn colchicum.
  5. Decongestant effect in buttercup anemone, rough cornflower, jaundice. Knotweed, Umbrella Pear.
  6. Honey, bee bread, clay, sea salt justifies itself. Based on these products, compresses are made. With salt – baths.

An exercise

Spondylogenic radiculopathy of the lumbosacral spine and other forms of radiculitis are treated with exercise therapy. The complexes are selected by the doctor. It is important that the load increases gradually. Before class, a warm-up is initially carried out. Exercises are performed slowly, without sudden movements, twisting.

The complexes presented below will relieve pain in the corresponding area with lumbosacral radiculitis.

Complex 1

  1. Lie on your back. Bend the right leg, lift the left so that it can be wrapped around the arm. Pull to the head. So hold on for about ten seconds. Then relax. Perform at least 6 times.
  2. Do not change the starting position. Bend both legs at the knee joints. Press one limb to the stomach and hold for 8-12 seconds. Alternately with each leg 5 times.
  3. Get on your knees, rest your palms. One leg goes back. So alternately, about 10 times.
  4. Stand up. Lean to the table, lean yourself and tilt your head back, bend a little. Take a starting position and repeat the exercise. At least 6 reps.

Complex 2

  1. Lie on your back. Hands lie along the torso. Make a Bike.
  2. The starting position is the same. Complete the Bridge.
  3. Stay on your back. Raise your legs above the floor, make crosses – “Scissors”.
  4. Get on all fours. Bend down, hold for 12 seconds. Relax – Kitty.

Recovery Prognosis

Lumbosacral radiculitis is treated well. It is important to start treatment in a timely manner. Rehabilitation is also important. The acute phase can be avoided in a week. If you eliminate all the factors that give a load on the sacrum and lower back, then relapse can be minimized.

Complications

If you start radiculitis of the lumbosacral, then there will be a loss of sensitivity of the lower extremities. Constant pain in the affected area will be debilitating. It will be difficult to bend down, stand up or sit down. Over time, there will be problems with movement. A person will begin to limp, fall, disability is ensured.

Prevention

In order to prevent lumbosacral radiculitis should:

  • minimize all physical activity;
  • normalize weight;
  • move more;
  • do sport;
  • eat right and balanced;
  • timely treat all diseases.
  • monitor metabolism.

Conclusion

Lumbosacral sciatica is treated conservatively. In case of complications, surgical treatment takes place. In the Internet resources you can find a rich list of literature on this topic.

Lumbosacral radiculitis: symptoms and treatment

Sciatica is a disease in which compression or inflammation of the nerve endings occurs. In this case, the patient feels severe pain in the area of ​​the affected nerve, numbness and sharp weakness in the muscles. There are several varieties of this disease, but one of the most common is lumbosacral radiculitis.

Causes of lumbosacral radiculitis

The prevalence of this type of disease is due to the fact that it is the lumbosacral spine that accounts for the greatest load. It was previously believed that lumbar radiculitis appears as a result of an infectious lesion. Now, experts have come to a consensus that this disease is a direct consequence of the development of osteochondrosis and occurs due to degenerative processes in the tissues of the intervertebral discs.

If the intervertebral discs do not receive the required amount of nutrients, their structure begins to change – the fibrous ring (the outer part of the vertebra) is compacted, dries and cracks. With the development of the degenerative process, protrusion of the internal structures of the vertebrae occurs, which leads to the formation of protrusions and intervertebral hernias. At the same time, the distance between the vertebral discs is reduced, and the ligamentous apparatus is also weakened.

The main factors provoking the appearance of lumbosacral radiculitis are:

  • spinal injury;
  • hypothermia;
  • neoplasms in the peripheral nervous system;
  • arthritis, arthrosis;
  • advanced age – over the years, the elasticity of the cartilaginous discs is lost;
  • inflammatory processes in tissues that are located near the spinal column;
  • degenerative and dystrophic changes;
  • sedentary lifestyle;
  • autoimmune diseases;
  • diseases of internal organs;
  • salt deposits;
  • bone growths;
  • increased load on the spine;
  • genetic predisposition.

An attack of lumbosacral radiculitis can occur under certain external or internal conditions. These include: physical stress, intoxication, viral disease, sudden movement of the body.

Symptoms of lumbar radiculitis

The first and main symptom of lumbosacral radiculitis is severe pain, the intensity of which depends on the degree of damage to nerve fibers. Most often, a pain attack can be triggered by a sharp physical exertion. The pain is aggravated by coughing, tension of the abdominal muscles, sneezing, body movements, lifting weights and other loads on the lumbar region. It becomes difficult for a person to tilt the body, bend his toes, his mobility is deteriorating.

The localization of pain depends on the level of damage to the vertebrae. A pain symptom can occur not only in the lower back, but also in the buttocks, thighs, calf muscles or lower leg. An attack of radiculitis lasts about two weeks and can be characterized by the following specific signs:

  • Symptom Lasega. It is characterized by pain in the gluteal, lumbar region, as well as on the back surface of the leg, which intensifies when lying on your back or when lifting a straightened leg.
  • Symptom Bonn. In the affected area, under the buttock, a crease is straightened.
  • Symptom of ankylosing spondylitis. When rising from a prone position to a sitting position, a reflex bend of the leg occurs.
  • Symptom Neri. It is characterized by an increase in pain during the inclination of the head forward.
  • Symptom Dejerine. It manifests itself as an increase in pain when sneezing or coughing.

If sciatica was formed due to osteochondrosis, external changes in the body can be observed: curvature of the spine, protrusion of the vertebrae, straightening of lordosis in the lumbar spine, curvature of the spine in the direction opposite to the affected one. With the infectious nature of radiculitis, pain can only intensify when the body is tilted forward, while physical activity does not cause an increase in symptoms. When the inflammatory processes subside, the pain quickly disappears.

Diagnosis of the disease

At the first sign of radiculitis, you should definitely contact a qualified specialist. Lumbosacral sciatica, the treatment of which was not carried out in a timely manner, can lead to the development of serious complications, which will be extremely difficult to eliminate in the future. Diagnosis of lumbosacral radiculitis includes the following examination methods:

  • the study of the anamnesis, symptoms of the disease;
  • external examination of the patient for signs of curvature of the spine;
  • laboratory tests of blood and urine;
  • radiography;
  • Computed tomography, MRI.

These diagnostic procedures can accurately determine the cause of the disease, the degree of damage to the vertebrae and the localization of degenerative processes.

About the treatment of lumbar radiculitis

Treatment of lumbosacral radiculitis is determined by many factors: the degree of development of the disease, symptoms, the presence of complications and others. At first, it is recommended that strict bed rest be observed to exclude additional trauma to the vertebrae and stop the development of inflammatory processes.

It is advisable for the patient to sleep on a hard bed, ideally, use a special orthopedic mattress. Lumbar loading should be minimized. Often prescribed to wear special corsets for several hours a day. The basis for the treatment of lumbar radiculitis is drug therapy.

Medication

Non-steroidal anti-inflammatory drugs are most effective in this disease. Their action is to stop the inflammatory process, reduce pain symptoms, relieve swelling. Taking such drugs is allowed strictly in agreement with the attending physician, since they have many contraindications and can have a negative effect on the mucous membranes of the digestive tract.

During an exacerbation, the following drugs are prescribed: Diclofenac, Indomethacin, Ibuprofen, Ortofen. When the inflammation decreases and the pain decreases, it will be possible to switch to ointments that have a milder effect: Apizartron, Voltaren, Nise, Camphocine, Diclofenac-gel, Finalgon.

Creams and ointments based on natural ingredients – Zhivokost, ointments with snake venom (Viprosal, Alvipsal, Vipratoks), ointments with bee venom (Virapin, Apizartron, Mellivenon) can have a beneficial effect. These creams, due to their irritating effect, increase blood circulation in the area of ​​the affected vertebrae. It should be borne in mind that any medicinal creams have a number of contraindications, therefore, it is required to consult a doctor before starting their use.

For very severe pain, blockages and injections are prescribed. They do not treat the disease itself, but only temporarily relieve symptoms. To relieve the pain symptom, painkillers and muscle relaxants are used: Midokalm, Lidocaine, Meloxicam, Siralud, Novocaine, Trimecaine. As in the case of ointments and anti-inflammatory drugs, injections have a number of negative effects, so their use should be single.

To restore cartilage tissue and prevent the development of the disease, chondroprotectors are used: Arthron Flex, Alflutop, Hyaluron, Rumalon, Honda, Noltrex, Toad Stone, Structum, Teraflex, Fermatron, Chondroitin sulfate and others. In addition, sedatives and vitamin complexes may be required to saturate damaged vertebrae with nutrients.

Physiotherapy for lumbar radiculitis

Physiotherapeutic treatment can sometimes have an even more beneficial effect than taking medication. The main physiotherapeutic procedures for lumbosacral radiculitis include:

  1. Ultraviolet irradiation, which is carried out on the lumbar region and in the legs, along the length of the affected nerves. It is prescribed in the subacute stage, when inflammatory processes are reduced and pain symptoms are not so pronounced.
  2. Electrophoresis, in combination with drugs – dicain, phenol, adrenaline, virapine ointment. If radiculitis is of an infectious origin, lithium and copper solutions are used, as well as salicitals. Electrophoresis with therapeutic mud has a good effect.
  3. Ultrasound therapy using a mixture of painkillers (analgesics). Ultrasound treatment can be continuous or pulsed, depending on the form of the disease. If the radiculitis is infectious, ultrasound is prescribed together with calcium chloride and hydrogen sulfide baths.
  4. The use of diadynamic currents. In this case, electrodes are placed in the areas of the affected nerve endings, which cause activation of the nerves affected by the disease.

If sciatica was triggered by osteochondrosis, spinal traction may be indicated. Spend it on the bed with a slight lift at the head. The duration of classes is usually 10 minutes, the frequency is 2-3 times a day.

Physiotherapy

For the treatment of radiculitis, special therapeutic physical education (LFK) is necessarily used. It can be prescribed as a prophylaxis of exacerbations. The goal of therapeutic exercises is to reduce the load on the affected area of ​​the spine. In the acute phase of the disease, one should not engage in medical exercises.

The load during exercise therapy should increase gradually. Before starting the exercises, it is necessary to do a light workout to prepare and warm the muscles. All exercises must be performed carefully and slowly, without sudden movements, twisting and turning the body. If you experience pain, you need to reduce the intensity of the classes, or stop the exercises. Treatment of chronic radiculitis always includes therapeutic exercises. A specific set of exercises is determined by the doctor based on the form and stage of the disease.

Lumbar sciatica: symptoms, how to treat lumbosacral sciatica

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  • How lumbar sciatica develops
  • Symptoms of Lumbar Radiculitis
  • What is dangerous lumbar sciatica
  • Diagnostics
  • Treatment of lumbar radiculitis
  • Causes of Lumbar Radiculitis
  • Stages of Lumbar Sciatica
  • Prevention

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How lumbar sciatica develops

The lumbar spine consists of 5 vertebrae. Between them are elastic “pads” – intervertebral discs. 8 pairs of spinal nerves depart from the intervertebral discs.

With metabolic disorders in the spine, the intervertebral discs become thinner, become brittle, their height decreases. Under load on the lower back, the discs may not withstand and crack. In this case, the semi-fluid core of the intervertebral disc enters the spinal canal and compresses the nerve roots. There is lumbosacral radiculitis.

Another cause of compression of the nerve roots is osteophytes. These are bone growths on the vertebrae. They form when the height of the intervertebral discs decreases. Osteophytes pinch the nerve roots, causing lower back pain.

Symptoms of Lumbar Radiculitis

The following symptoms of lumbosacral radiculitis are distinguished:

  • sharp burning pain in the lower back;
  • pain is given to the thigh and buttocks, aggravated by coughing, sneezing, movement, physical activity, change of position, at night;
  • fever, chills;
  • lower abdominal pain;
  • strong tension and stiffness of the muscles of the back and legs;
  • pain along the outer edge of the entire leg to the toes of the foot.

During an attack of lumbar radiculitis, a person hardly stands or sits, looking for a position in which pain is not felt. In advanced cases, the patient atrophies the muscles of the hips, lower leg, buttocks.

What is dangerous lumbar sciatica

The disease quickly becomes chronic. In this case, any careless movement, infection, hypothermia or stress provokes an attack of radiculitis.

Often, lumbosacral sciatica leads to sciatica – inflammation of the sciatic nerve. Then a severe pain in the leg joins the back pain. Walking is almost impossible.

It is dangerous when diseases progress that lead to lumbar radiculitis. With simultaneous compression of the nerve roots and blood vessels, spinal cord ischemia may appear. With infectious damage to the spinal membrane, neuritis and myelitis occur.

Intervertebral hernia in the lumbar region without treatment leads to paralysis of the legs and feet, disrupts the functions of the pelvic organs.

Feedback on treatment

I would like to say a big thank you to Alexander Chukaev. Half a year has already passed after the treatment, but I still constantly think about how good it is that I got to him! I came to see him in despair. At that time, I was 25 years old and was severely limp due to pain in the inner thigh for 1,5 years. I could not only engage in some kind of active activities (running, any outdoor games in nature, etc.), but also just walk normally. I visited 5 doctors before him, including the clinic, 122 medical units, where I got to the head of the department of traumatology, and 3 paid clinics. I went through all the examinations (MRI, ultrasound, x-ray) and NOBODY could tell me what was the matter. Everyone agreed: “this is not a joint.” Everyone wrote some recommendations, but there was nothing concrete. I had a course of magnetotherapy, injected a blockade, prescribed ointments, but nothing gave even a short-term effect. Alexander immediately determined the diagnosis, explained everything in great detail and showed in the pictures, answered all my silly questions, prescribed a treatment that was constantly monitored, and after 2 months I was able to walk without limping! Now for all questions only to him :)

Diagnostics

If the back pain is accompanied by a burning sensation and does not go away for several days, immediately consult a specialist. The doctor of our clinic in St. Petersburg will interview you and conduct an examination. He will make an accurate diagnosis using a comprehensive examination. We use the following diagnostic methods:

Treatment of lumbar radiculitis

The disease responds well to treatment at the initial stage. The doctors of our clinic treat lumbar sciatica with conservative methods. Conservative treatment relieves lower back pain and heals the body.

The doctor prescribes an individual course of treatment for the patient, taking into account the stage of the disease, age, gender and characteristics of the body. Treatment of lumbosacral radiculitis will take from 3 to 6 weeks. The patient undergoes procedures 2-3 times a week. Low back pain will pass through a 1-2 visit to the clinic. The course of treatment is composed of the following procedures:

Treatment of lumbar radiculitis in the Health Workshop in St. Petersburg relieves lower back pain, swelling and muscle cramps. Procedures improve blood circulation and metabolism, relieve compression and inflammation of the nerve roots, and cure lumbar sciatica. The patient feels a surge of strength, his immunity strengthens.

After the course, our doctors will give recommendations on what to do regularly so that the disease does not return. The patient can visit the doctor for free for a year after the end of treatment.

Causes of Lumbar Radiculitis

The following diseases cause lumbar sciatica:

  • osteochondrosis;
  • intervertebral hernia of the lumbar;
  • spondylitis – inflammation of the spine in the lumbar;
  • viral infections;
  • problems in the genitourinary system;
  • inflammation of the muscles of the lumbar spine;
  • spinal injury in the lumbar;
  • rheumatoid arthritis;
  • ankylosing spondylitis;
  • scoliosis, lumbar lordosis;
  • spinal stenosis;
  • spondylosis;
  • piriformis syndrome.

The disease often occurs in overweight people or endocrine diseases – hypothyroidism, diabetes mellitus. Lumbosacral radiculitis affects bodybuilders and weightlifters, loaders, cleaners, workshop workers. The disease often appears after hypothermia.

Stages of Lumbar Sciatica

Lumbar radiculitis has two stages:

  1. Acute, or neurological. It occurs when squeezing the nerve roots. A person has severe back pain, tension in the muscles, increased sensitivity of the lower back.
  2. Chronic The disease causes prolonged aching back pain. Sensitivity of legs and lower back decreases, muscles atrophy.

Prevention

For the prevention of lumbosacral radiculitis, we recommend:

  • engage in walking, swimming, dancing;
  • sleep on an elastic orthopedic mattress;
  • regularly go to the sauna;
  • during sedentary work, take a break every 1-2 hours and warm up: tilts with the body in different directions, smooth rotation of the head;
  • when working at a computer, keep your head and back straight, lean on the back of the chair;
  • limit the use of fried, oily and spicy foods;
  • give up cigarettes and alcoholic beverages, drink less coffee and strong tea;
  • eat more fruits and vegetables – they should be 2/3 of the diet.

Egorov Vladimir Leonidovich,
neurologist
Leading Specialist, Health Workshop
Date of publication:
November 22.03.2018,
Update Date:
November 2.10.2019,

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

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