Sciatica - lumboischialgia

Diseases painful conditions of the spine

MECHANICALLY CAUSED BACK PAIN AND / OR LUMBOSICHIALGIA

Symptoms

Lumboischialgia (sciatica) - a strong, sharp pain in the lower back that spreads to the leg through the gluteal region, sometimes all the way to the toes. Antalgic body position - the torso bends spontaneously and without the voluntary control of the person to the side and forward to reduce the pressure on the root n. ischiadicus. Tingling, weakness, poor control of leg movement, poor foot support. Paressis n.peroneus - foot paresis is also possible (dropped foot) - weakness of the lower leg muscles, and impaired and / or limited foot function.

Cause

Most often, incorrect and inappropriate lifting of the load, rotation of the hull associated with bending or straightening of the hull. Degenerative changes of the vertebrae and discs (degenerative disc disease, ossification of the spine)

Goals of therapy

Treat the cause of the problem, i.e. disc damage and root irritation n. ischiadicus. Reduce and / or eliminate low back and leg pain, and eliminate any neurological symptoms (tingling in the leg, changes in sensation, weakness of the lower leg and feet). Improving the function of the lumbar spine, and thus the function of the entire locomotor system. Reduce the pressure inside the spine and repair the damaged disc between the two vertebrae as well as the vertebrae themselves. Reduction and / or elimination of mechanical and other irritation of the spinal nerve root and consequent reduction and / or complete elimination of symptoms of lumboischialgia (sciatica)

Therapy

Non-operative decompression therapy of the spine (DTK) - stretching of the lumbar spine. Resting in the unloaded Williams position: lying on your back with your legs raised on a rise or lying on your side with your legs bent and a pillow in between. Electrotherapy, infrared light therapy , manual therapy as needed.

Efficiency

It depends on timely intervention. Acute phase 4 - 6 weeks - conducting decompression therapy of the spine as soon as possible after the injury - a prerequisite for faster and better recovery, better long-term health. Subacute and chronic phase 1 - 2 months and more from the onset of the injury - the later onset of DTK therapy increases the likelihood of longer recovery, ie more therapy.

Performance

80% or more of patients treated with non-surgical spinal decompression therapy achieve cure or relief of discomfort. Only in about 10% of cases, DTK cannot help because the injury is of such a nature (eg sequestered (broken) disc) that surgery is really necessary.

Prejudices

FALSE - claims by some medical circles that stretching the spine, in a fresh (acute) disc injury between the vertebrae can cause the injury to worsen.

TRUE - like any medicine, stretching the spine, if properly dosed and measured, can only benefit the patient.

Application of non-operative DTK after spine surgery

After surgery, 30-40% of patients have certain problems, then it no longer makes sense to do DTK because it has been shown to give poor results. Therefore, DTK only makes sense before surgery or immediately after surgery, which is not yet applied in Croatian health care.