Symptom lasega with osteochondrosis and other diseases: what is it?

Lasega symptom: the causes of the appearance. Treatment of diseases accompanied by a symptom of Lasega

Lasegh's symptom in neurology was discovered by a French doctor and was subsequently named after him.

Even in the middle of the XIX century, the doctor noted: if the patient, lying on his back, raises his straightened leg, in lumbar part of the body there is a sharp pain that immediately passes when a person bends limb.

Causes of appearance

Often, because of problems with the sciatic nerve, Lacega appears a symptom that accompanies the pinch or neuritis of this part of the CNS.

This nerve is the largest in the human body, it is formed from branches branching from the spinal cord - the lumbar and sacral. It consists of two types of nerves: tibial and fibular.

If they are excessively stretched, jammed or injured, the person feels strong pain when he is trying to lift his straight leg in a lying position.

When the patient lies in a relaxed state, he does not feel pain, since the sciatic nerve is idle at this time.

But when he begins to lift the limb, the nerve is immediately stretched, causing painful sensations.

Three degrees of the syndrome

It is not necessary to be a doctor to determine Lacega's symptom: it can be found at home, after a simple procedure. But it's better to turn to a professional who will do it as high as possible.

Diagnosis is as follows: the doctor asks the patient to lie down on the couch and move his limb. The higher the leg rises, the more pronounced the symptom is.

The peak of pain usually occurs during the period when the limb is at an angle of 60º with respect to the surface.

Doctors at the same time distinguish three degrees of Lasega's syndrome:

• The first - the pain occurs only in the position of the foot at an angle of 60º.
• The second - acute painful sensations are characteristic at rise of a limb in 45º.
• Third - the patient can maximally raise his leg only by 30 °.

It is clear that the latter degree is characteristic of a more serious disease than the first. At the same time, the doctor is obliged to interrupt the diagnosis immediately, as soon as the patient is hurt. Otherwise, a person may have nerve fibers and, as a consequence, paralysis of the sciatic nerve.

Basic views

Medicine identifies three types of symptoms:

1. Positive symptom of Lasega. Occurs gradually when the leg is raised, but when it bends in the knee and hip joint disappears. Can talk about squeezing the sacral and lumbar roots, which often occurs with osteochondrosis and radiculitis.
2. Negative. When the limb is bent, the pain does not disappear. Physicians say that in this case it can be caused by the pathology of this part of the body. The patient is referred for an additional examination to find out the real causes of pain. By the way, they often have a psychological character: they are observed in hysterical women, depressed people.
3. Pseudo-positive symptom. It is found when the muscles of the back of the thigh are very weak. Usually this is observed in elderly patients. In this situation, an orthopedic consultation is required.

Depending on the variety, the patient is prescribed appropriate therapy.

Osteochondrosis

This is one of the most common causes of pain. Symptom Lasega in osteochondrosis is characterized by acute pain, which spreads over the entire surface of the thigh.

Its range is wide: from the buttocks to the very feet. In such cases, the patient is prescribed medication.

Treatment of osteochondrosis involves taking medications that belong to four groups:

• Medicines that are based on vitamin D. It improves the absorption of calcium. Contraindication: the increased content of this element in the patient's blood. Side effects are the formation of kidney stones.
• Preparations, whose action is aimed at reducing the release of calcium from the bones and reducing pain. For example, "Alosteen" and "Calcitrine." In rare cases, the body reacts negatively to their reception: nausea, vomiting, and hypertension develop.
• Therapy aimed at treating osteoporosis. It includes such drugs as "Bivalos "Fosamax "Bonviva". They block the process of bone resorption.
• Female hormones are estrogens. Among their functions is the prevention of increased brittle bones. The most popular are "Proginova "Klimonorm" or "Estron".

In addition to medicines, the patient is prescribed exercise therapy and other necessary procedures.

Radiculitis

The causes of the appearance of Laseg's symptom originate from this disease.

In addition to him, the patient also has other symptoms: Neri - the connection between the flexion of the head and lower back pain, Bahretev-Fierstein - the affected limb begins to ache while raising a healthy leg. The patient is prescribed such medicines:

1. Nonsteroid drugs that have anti-inflammatory and analgesic effects: Ketoprofen, Diclofenac, Flurbiprofen, Indomethacin, etc. They help to quickly eliminate the main symptom of radiculitis - pain.
2. The muscle relaxants arrest spasms of skeletal muscles. Despite many side effects, they are able to eliminate the squeezing of nerve fibers. For example, "Tubokurarin "Doksakuriy "Rapakuroniy". By the way, they are prescribed for the treatment of osteoporosis.

In addition, to eliminate Lasega symptom with radiculitis, the patient is prescribed narcotic analgesics. But this is only in critical cases, when the pain is simply unbearable and not removed by other medications. The patient is also recommended to drink antidepressants and vitamins.

Prevention

To prevent Lacega symptom, as well as the development of dangerous diseases associated with it, it is possible to carry out preventive measures.

They also protect a person from osteochondrosis and radiculitis. And even if the patient is already sick, they serve as an excellent supplement to drug therapy.

Among them are the following procedures:

• Gymnastics. If physical loads are given at least half an hour a day, you can achieve an increase in bone mass by 5%.
• Massage. It improves blood circulation in muscles.
• Sunbathing. Ensure the intake of vitamin D in the body, without which the absorption of calcium would be impossible.

It is also recommended to abandon bad habits, which since ancient times are faithful companions of numerous diseases. And also learn how to eat right.

Refusal of fatty, smoked, fried, canned food will only benefit the body.

If in addition to balance the use of proteins, fats, carbohydrates and enrich the diet with vitamins, fiber and other useful substances, you can achieve full-fledged health, good physical fitness, youth and beauty.

A source: http://.ru/article/207732/lasega-simptom-prichinyi-poyavleniya-lechenie-zabolevaniy-soprovojdayuschihsya-simptomom-lasega

Lumbar osteochondrosis - causes, symptoms, treatment

is considered one of the most common diseases among the pathology of the spinal column. Many people at the age of about 30 years are already familiar with back pain.

And among the elderly, almost everyone suffers such a disease.

At the same time, the overwhelming majority of cases are due to lumbar osteochondrosis, since this department experiences the greatest burden in the daily and labor activity of a person.

The mechanism of development

The disease has a degenerative-dystrophic character and is mediated by disturbances in the structure of connective tissue of the intervertebral discs, joints, ligaments, vertebrae. There is destruction of the nucleus and fibrous capsule of the disc, then the process extends to the bone and cartilaginous tissue.

In the conditions of constant loads on the bodies of the vertebrae, bone tissue grows in them - this is how osteophytes form.

Causes

Osteochondrosis of the lumbar region arises under the influence of various unfavorable factors.

As a rule, there is a combination of etiological factors - then the development of the disease is most pronounced.

The disease has a multifactorial nature, and the most important cause of pathology will be a detailed examination.

The most common etiological factors in the development of osteochondrosis include:

• Prolonged strain on the spine.
• Overweight and obesity.
• Classes in heavy sports, carrying loads.
• Injuries of the spinal column.
• Flat feet, violations of posture.
• Endocrine and metabolic pathology.
• Heredity.

If it was previously thought that the appearance of osteochondrosis of the lower back is a characteristic feature of older people, in modern conditions cases of illness in young people are increasingly being recorded. This is to a certain extent can contribute to violations of the regime of the day and nutrition, chronic stress, an incorrect position of the back when working at the table.

Often there is an underestimation of the importance of the problem - discomfort in the spine is not given due attention, and a visit to the doctor is postponed indefinitely or is not planned at all. In this case, the disease becomes more and more neglected and difficult to treat. It must be remembered that the appearance of the first signs of the disease should be a stimulus to medical examination.

Symptoms

Lumbar osteochondrosis is characterized by manifestations, the emergence of which is mediated by disturbances in various structures of the spinal column. The disease affects not only meniscuses, bone formations and ligaments, but also provokes damage to the roots of the spinal cord and vessels.

Reflex Syndromes

The main types of reflex syndromes for osteochondrosis of the lumbosacral spine are lumbago and lumbargia. They occur when the disease worsens, are provoked by physical activity and are caused by muscle spasms:

1. Lumbago is a sharp sharp and deep pain in the lumbar region, appearing in the form of lumbago. The patient wants to take a pose that would reduce the degree of pain. Tension of the near-vertebral muscles, a symptom of Lasega, will be determined. There are no signs of a neurological deficit.
2. Lumbalia is defined as chronic, aching and monotonous pain, arising gradually and increasing with exercise. The soreness of the spinous processes, muscles, ligaments and intervertebral joints of the lower back is characteristic. Movement in this department is limited, and sensitivity is preserved.

As a rule, reflex syndromes appear first, their appearance in the early stages of the disease should be regarded as the need to begin treatment. Otherwise, manifestations will only worsen, and the extent of the lesion will increase.

Compression syndromes

Osteochondrosis of the lumbar spine is accompanied by a decrease in the height of the intervertebral disc and the formation of bone osteophytes, which is responsible for the compression of nerve fibers. The pain in this case is burning, cutting character.

Disturbs the weakness of the quadriceps and tibial muscles is reduced, maybe their hypotrophy, is expressed by Laceg's symptom. The most common lesion is the first sacral root, when the pain radiates into the buttock and spreads outside the thigh, lower leg, and foot.

Vegetative-vascular syndromes

When the nerve roots are squeezed, there is a violation of their circulation.

Radiculohexia in patients with low back osteochondrosis is characterized by gross neurologic manifestations in the lower extremities.

What rootlets are affected can be determined by the localization of sensory and motor disorders.

There will be violations of trophic skin in the form of dryness, chilliness, peeling, hair loss.

Exacerbation of osteochondrosis of the lumbar region must be stopped with drugs in time, because in the later stages pareses and paralysis, which naturally lead to a loss of functional ability and disability.

Symptom Lasega

In many cases, the osteochondrosis of the lower back during a medical examination is marked by a symptom of Lasega.

It is characterized by pain arising from the tension of the root of the sciatic nerve. You can check it - slowly raise your straight leg, lying on your back.

The Laceg symptom must be interpreted correctly, since different variants are possible:

• With a slow lifting of the legs, the Lacega symptom reaches a maximum degree of expression at an angle of 60 degrees.
• If there is a disc herniation, Lacega's positive symptom also appears with a smaller angle of hip lift.
• Possible false positive reactions in people with reduced flexibility, when the pain is due to muscle tension.
• Check the symptom of Laseg carefully, without applying significant effort, as with sudden movements may tear the rootlet.
• When carrying out local anesthesia, there is no protective reflex, so you need to be careful when flexing your straight leg - Laceg's sign will be false-negative and there is a risk of over-stretching the nerve.

Check the symptom Lasega can be entrusted only to the doctor, the onset of pain should be a signal to stop the study.

Stages of osteochondrosis

If at the beginning of the disease the symptomatology is rather scarce, then with the progression of pathology more serious violations are added. In this case, the development of osteochondrosis of the lumbar spine occurs in several stages:

• The first degree is characterized by changes in the nucleus of the intervertebral disc. Reflex syndromes are noted.
• The second degree proceeds with the destruction of the fibrous capsule of the disc. Compression syndromes join the clinic.
• The third degree develops after the formation of a herniated disc. The root compression syndromes and vegetative-vascular manifestations predominate, and the instability of individual vertebral segments arises.
• 4-th degree is characterized by adherence of arthrosis of intervertebral joints, ligament injury.

To treat lumbar osteochondrosis is necessary at the initial stages of its development, since in the future changes become irreversible, which conservative methods will eliminate complicated.

Treatment

The therapy of the lumbar osteochondrosis should be complex, including methods of multidirectional influence on the structure of the spinal column.

Given the progressive nature of the degenerative process, it is necessary to make maximum use of the possibilities of conservative treatment, and in some cases to prefer surgery.

Completely cure the disease in many cases will be impossible, but to save the patient from painful manifestations and stop the progression of pathology - the goal is quite achievable. To do this, use:

1. Drug treatment.
2. Physiotherapy.
3. Curative gymnastics, massage.
4. Operative treatment.

What methods to use in a particular case - can be determined after a medical examination and examination.

Medication correction

The use of medicines for osteochondrosis of the lumbar region is the most effective method of eliminating exacerbation. Taking medications should be done against the backdrop of eliminating the load on the spine, in severe cases, recommended bed rest.

Various dosage forms are used: injections, tablets, ointments. The proven effectiveness of such groups of drugs:

• Analgesics and anti-inflammatory drugs.
• B vitamins.
• Muscle relaxants.
• Diuretics.
• Preparations with a sedative effect.
• Chondroprotectors.

During the period of exacerbation, the most commonly used drugs are those that relieve pain, muscle spasm, restoration of nervous trophism, elimination of inflammation and normalization of the general emotional background. The use of tablets and ointments may be inadequate, so they are mostly used in injections.

To normalize the state of nerve tissue necessarily use the vitamins of group B. The injections with their contents can be painful, so sometimes they add lidocaine.

After elimination of an exacerbation it is possible to apply preparations in the form of ointment, rubbing them into the lower back. Their effect will support and prolong the effect of injections.

The arsenal of modern ointments is quite wide, it includes:

1. Anti-inflammatory.
2. Painkillers with a warming effect.
3. Ointments of complex action.
4. Homeopathic remedies.
5. Ointments with chondroprotectors.
6. Ointments for massage.

Prescribe medicines for osteochondrosis of the waist can only be a doctor - he will recommend the most effective drugs, their dosage and the course of admission.

Physiotherapy

Eliminate the aggravation of osteochondrosis of the waist will help physioprocedures. They have an additional analgesic effect, reduce inflammation, improve blood circulation and relieve muscle spasms. The following methods are used:

• Electrophoresis preparations.
• Magnetotherapy.
• Laser treatment.
• UHF-therapy.
• Reflexotherapy.

Massage and physiotherapy exercises

Great value in the treatment of lumbar chondrosis is given to gymnastics and massage. They are an integral component of therapy for vertebral column diseases.

There are complexes of exercises LFK for various departments, including lumbar.

Their regular execution will allow to restore movements in the spine, to strengthen its flexibility and resistance to static loads, which will make it much more effective to treat the disease.

Massage is given a separate place for osteochondrosis. Its use in the early stages of the disease gives significant results. Apply such techniques:

1. Classical massage.
2. Vacuum-roller massage.
3. Acupressure.

A good effect is given by the combination of massage with the methods of manual therapy, when certain movements are eliminated subluxation of intervertebral joints, manifestations of instability, muscle spasm is removed and pressure on nervous roots. The use of such techniques is possible in a subacute period, against the background of taking supportive drugs. You can entrust the carrying out of the massage only to an experienced specialist.

Operative treatment

Operation with osteochondrosis of the lower back is sometimes the only way to treat pathology of a pronounced degree.

If conservative methods fail to achieve the expected analgesic effect, in the case of a pronounced disc herniation, persistent compression paresis, complications of the disease (caudal syndrome), surgical methods.

Also, various mini-invasive decompression techniques, disk nucleoplasty and prosthetics are used.

Although modern techniques and do not allow to cure osteochondrosis completely, but to minimize its manifestations and stop progression can be quite effective.

A source: http://MedOtvet.com/osteochondrosis/poyasnichnyi-osteohondroz-prichiny-simptomy-lechenie.html

Symptom of Lacega's tension: application and evaluation of the syndrome in neurology

Sometimes it is very difficult to diagnose a neurological disease correctly. This is due to the fact that most patients are not able to objectively assess the pain, and exaggerate the scale of the symptoms.

With prolonged soreness, a situation may occur in which a person is unable to correctly interpret pain, and in rare cases, it may be completely ignored. You can identify an objective picture of neurological diseases of the spine with the help of tension symptoms.

Symptoms of tension

Symptoms of tension are signs of neurological diseases of the spine, which are accompanied by muscle spasms or other causes that cause difficulties in the movement and stretching of the nervous roots. The symptom of tension can indicate degenerative changes in the spine and osteochondrosis. The provocation of passive movements causes severe pain.

In neurology, there are 7 symptoms of tension:

• Dejerine;
• tripod;
• landing;
• Wasserman-Matskevich;
• Bonner;
• Neri;
• Lasega.

Lasega's test

For the first time a symptom was discovered by the French neurologist Laceg in the middle of the 19th century.

He conducted an experiment in which he discovered a sharp pain in the patient when he lifted an even foot in a recumbent position, after bending the knee or hip joint, painful sensations stop instantly.

Soreness when raising the lower limb in the forward position is due to the stretching of the sciatic nerve, while the pain reaction can only cause the stress of one nerve root. The pain reaction arises because the roots of the nerve in the intervertebral foramen are squashed when exposed to excessive tension.

Normally, stretching the nerve within the physiological process can not cause it to overstrain, and movement in the intervertebral foramen is smooth, the spine easily slides over it without unnecessary compression. Painful sensations can arise because the nerve fibers of the sciatic nerve can not elongate naturally, this may be due to its pinching or overexertion.

The sciatic nerve is the largest nerve in the human body and positive Lasega syndrome can indicate a number of diseases throughout its extent. Doctors use the symptom of tension to make an accurate diagnosis of diseases of the lumbosacral spine.

How to check

The test for Lasega's symptom can be performed only by a neuropathologist. Indications for the study may be the patient's complaints about discomfort in the lumbar region, gluteus muscles, hip and thigh muscles during movement.

Discomfort can manifest as limited movement, the appearance of pain or numbness in the area of ​​passage of the sciatic nerve. Perhaps the manifestation of pain on only one side, this indicates a unilateral defeat.

For the procedure, the patient is placed on his back on a firm, stable surface. In the lying position, the patient does not experience unpleasant sensations, the nerve roots are completely relaxed and do not cause pain.

The symptom of Lasega's tension is considered negative if the subject does not experience pain when raising an even limb. Positive can be considered a symptom in the case when the subject feels pain when raising his leg, after it is bent at the knee joint, the pain abruptly disappears.

False positive symptom is most often observed in the elderly, he speaks of a weak muscle tone, and is not associated with overstretch of the sciatic nerve.

Key points of the study:

• The extremity should rise very smoothly, it is forbidden to bend the leg sharply, this can cause serious damage to the sciatic nerve.
• The study should be discontinued immediately after the onset of the pain symptom.
• The procedure can not be administered to patients under the influence of anesthetics or anesthesia. The result of such a study can not be reliable, and the absence of a pain protective mechanism can cause a rupture of nerve fibers.
• When receiving a positive test for Lacega's symptom, the patient should be referred for additional studies of the lumbosacral spine.

Causes of the syndrome

The main reason for the positive result in the Lasega symptom test is the intervertebral hernia.

The mechanism of the onset of the symptom is related to the fact that the tissues supporting the intervertebral disc in their physiological position, damaged, stretched and the disc can be displaced towards the spinal cord channel.

In the canal, the disc can exert pressure on the roots of the sciatic nerve; in the relaxed state, the patient does not experience pain, but with tension, the nerve must round the body of the intervertebral disc, this causes it to stretch over a large length, and he does not is capable. Thus the painful sensations arise in the field of a loin. The detection of such a symptom requires an additional X-ray examination to clarify the diagnosis.

The appearance of soreness during the test in the gluteal muscles can testify to the osteochondrosis of the lumbosacral section.

Diseases accompanied by a symptom of Lasega:

1. osteochondrosis;
2. neoplasms in the region of passage of the sciatic nerve;
3. the appearance of an intervertebral hernia and disc displacement;
4. damage to the sciatic nerve;
5. compression of the nerve root with muscles around the buttocks;
6. compression of the distal vertebral column;
7. accumulation of mineral salts in the ligaments in the region of the spine.

Evaluation of the results

The appearance of soreness when raising a foot at an angle of 60 degrees can not be indicative of positive symptom of Lasega, this is due to the fact that at this angle the nerve reaches its maximum stretching.

Bending of the limb at an angle of 40-60 degrees also causes maximum stretching of the nerve, The pain may not be associated with the symptom of tension, but speak of the ultimate achievement length of the nerve.

Only bending the leg at an angle of up to 30 degrees indicates the true symptom of Lasega.

The manifestation of Lasega's syndrome may indicate the development of certain diseases of the lower spine, but is not a prerequisite for establishing a definitive diagnosis. To accurately determine the disease, methods are used to identify other symptoms of tension, fluoroscopy and MRI.

Read More

A source: http://neurodoc.ru/diagnostika/simptomy/natyazheniya-lasega.html

Positive symptom of Lasega. Symptoms of Lasega, Neri in Neurology:

Pain syndrome in the lumbar region - a fairly common phenomenon. The reason for it can be quite a variety of conditions. Pain sensations in the lumbar region are recorded in the case of the following pathologies:

• vertebrogenic and discogenic lesions of nerve roots;
• renal colic;
• pancreas diseases;
• pathological changes in the bone tissue of the vertebrae.

Establishing the cause of pain syndrome, diagnosing lesions of nerve roots and clarifying the degree of severity diseases are helped by the symptoms described by various authors, indicating a pathology from the side of the spinal disc segment.

The most frequently studied phenomenon, which has diagnostic significance, and also plays a role in determining the patient's ability to work, is Lasega's symptom.

What it is

Lasegh's symptom in neurology is one of the most well-known and most frequently verified signs of neural trunk damage during exacerbation of the osteochondrosis of the spine.

On the positive symptom Lasega speak in the case of pain in the lumbar region and along the trunk of the sciatic nerve in the patient lying on the back while flexing the thigh.

The mechanism of occurrence

In a normal state in a healthy person, the nerve root is freely located in the intervertebral foramen, not stretching and not causing pain when flexing the thigh (with the exception of some discomfort at an extreme degree bending).

Stretching of the nerve root becomes more or less painful when it is infringed in the intervertebral foramen, as well as in the case of tension due to the convexity of the herniated intervertebral disc. In these situations, any tension with a slow rise of the lower limb will be painful.

Lasega's positive symptom is said to occur when soreness occurs when the hip is raised by less than 60 degrees.

This situation can arise even when examining a healthy person who leads a sedentary lifestyle or who is characterized by reduced flexibility.

How is Laceg's symptom caused?

The symptom is manifested when the leg is unbent at the patient lying on the back with the bent position of the thigh. The study should be conducted carefully, without making sharp movements, since pain with a positive Lasega symptom can have a high intensity.

Lasega's symptom is positive if there is pain in the lumbar region, along the back of the thigh and the lower leg of the corresponding side. Soreness, as a rule, is localized on the side of the affected nerve root.

For example, Lacega's symptom on the right is caused by the right leg bending.

• The first phase of Laseg's symptom: the occurrence or appearance of pain in a patient lying on the back when trying to bend or flex the elongated leg in the hip joint.
• The second phase of Lasega's symptom: if in the subsequent leg, without straightening in the hip joint, bend in the knee, then the pain syndrome either disappears or its intensity drastically decreases.

Important point: it is not allowed to cause a symptom of Lasega's tension after using anesthesia, since a protective pain reflex in such conditions is significantly reduced; In this case, manipulation can lead to axon breakdown and cause motor damage (up to paresis).

False positive Lasega symptom

Normally, in persons with reduced flexibility, as well as leading sedentary lifestyle, when flexing the hip in the supine position on the back, soreness is often noted in the region of the posterior surface of the thigh. It is caused by stretching the muscles of the posterior thigh group. This is the false-positive Lasega symptom, which is not a sign of pathology of the rootlet.

Interpretation of Lasega's symptom

In the presence of a pathological process localized in the region of the nerve root, tenderness can appear when the thigh is bent at different angles (10, 15, 20, 30 degrees). The level at which the Lacega symptom arises allows one to judge the severity of the patient's condition and is of great importance for diagnosing the stage of the disease.

In order to monitor the dynamics of clinical manifestations of radicular lesion, it is advisable to indicate, when fixing the results of the examination, the approximate angle at which the patient achieves morbidity (an example of such a record: Lacega's symptom on the right is positive, 30 degrees). This will make it possible in the future, with repeated examinations, to compare the current result with the previous one and to make a judgment on the dynamics of the patient's state according to the results of comparison. In particular, an increase in the angle between the plane on which the patient lies and his thigh will speak of a gradual improvement in the patient's condition.

When there is a positive Lasega symptom

In neurology, this phenomenon belongs to the group of so-called tension symptoms; from the name it is visible, that the formation of this diagnostic sign is related to the tension and tension of the nervous the trunk.

1. The most frequent case, when there is a positive Lasega symptom - with osteochondrosis. Inflammation in the nerve root region leads to its compression and tension. Other symptoms of this group (Neri, Bechterew) will also be positive.
2. Acute discogenic lumbalgia. This condition occurs when the fibrous ring is torn, leading to protrusion of the intervertebral disc in the spinal disc-segment. The cause of this violation can serve as an awkward movement in the lumbar spine, a sharp rise in severity. Clinically acute discogenic lumbagia manifests itself by sharp pain in the lumbar region, often causing the patient to "freeze" in the position in which he was caught by a pain syndrome. The duration of the pain attack is from half an hour to several hours. When diagnosing an important role play the symptoms of Matskevich and Lasega, a symptom of the "board" (the impossibility of flexion in the lumbar region).
3. Subacute discogenic lumbalgia. The reason is a prolonged physical load in an uncomfortable position for the patient (often in a bent state). In contrast to the acute condition, sublingual lumbagia is characterized by delayed development of pain syndrome.

Other diagnostic signs accompanying the Lasega symptom

1. Neri - the emergence of soreness in the lumbar region in the flexural position of the head.
2. Symptom Matskevich - pain in the groin and the anterior surface of the thigh when flexing the tibia of the patient in a supine position.
3. Symptom Dejerine - increased pain when coughing or sneezing.
4. Bekhterev's symptom (in a number of sources it is mentioned as a cross symptom of Lasega) - when a lying patient is seated, the leg on the side of the lesion of the nerve root bends at the knee joint. If this leg is straightened, the healthy one will bend. In cases where a positive symptom of Lasega is registered, Bechterew's symptom is usually also positive.
5. The phenomenon of Lerrey is a marked increase in soreness in the lumbar region in the case of a sharp transition from a recumbent position to a sitting position, which is almost always a symptom associated with Lasega.

Tactics in detecting the positive phenomenon of Lasega

The symptom speaks of the acute course of the disease. A patient who has this symptom identified is disabled (for at least 10 days).

• The first step is the removal of the pain syndrome (the optimal use of NSAIDs, with severe pain can be applied drug blockade).
• The patient should provide bed rest for the time of existence of acute pain syndrome (this is especially important in cases of integrity of the fibrous ring).
• An integrated approach is required: the treatment regimen includes NSAIDs, muscle relaxants, physiotherapy, as it exits the exacerbation - exercise therapy.
• In order to avoid relapse, a patient with discogenic disorders can be shown in situations associated with a load on the lumbar spine, wearing a lumbosacral corset.

A source: https://www.syl.ru/article/308063/polojitelnyiy-simptom-lasega-simptomyi-lasega-neri-v-nevrologii

Symptom Lasega for the diagnosis of pathology in the lower back

Lasega's symptom is a test used in neurology when examining a patient with suspicion of diseases of the nervous system or the lumbosacral spine.

When a pathology occurs in a specific area of ​​the spine, the body reacts with muscle spasms and blocks, resulting in jammed nerve roots.

Identify such areas is an important task for doctors for correct diagnosis and further treatment.

A test is based on the protective tension that arises in the buttock area, the muscular tissues of the waist and the posterior surface of the thighs, as a result of the tension of the sciatic nerve or spine emerging from it.

In neurological practice, this diagnostic procedure is considered effective and helps to identify patient such diseases as osteochondrosis, sciatica, sciatica, intervertebral a hernia.

The essence of the method is based on the manifestation of spasmodic contractions of the skeletal musculature of the back region that arise when the nerve roots are jammed by muscles or vertebrae.

Often a symptom of Lasega is called "symptom of tension Since it is with the tension of the sciatic nerve that the patient experiences acute acute pain.

In this case, the test is considered positive.

Ernest Charles Laseg (1816-1883). French doctor, neuropathologist and psychiatrist, professor of medicine. Described the symptom of the appearance of pain in the lower back and along the sciatic nerve when flexing in the hip joint of the straightened leg.

The symptom was named after the scientist's death.

The sciatic nerve is the largest and consists of fibers emerging from the roots of the nerves, starting from the lumbar spinal cord.

The appearance of pain with its tension serves as an indicator of pathology, since the nerve has limitations to stretching.

A healthy person will not feel discomfort when he is stretched, a patient with problems of the lumbosacral spine will to experience pain, because apart from the usual tension, the nerve will have to be stretched additionally, for example, skirting the intervertebral a hernia. Therefore, when raising a straightened leg in a certain position, the patient complains of pain. It is important to consider that painful sensations should appear not only in the leg itself, but also in the lumbar region.

1. Most often the symptom of Lasega testifies to the presence of osteochondrosis. The patient in this case is concerned about the pain in the buttock, which can grab the back of the thigh and reach the lower leg, as well as the external surface of the foot.
2. The second most frequent disease, which can be diagnosed with a test, is the sciatica of the lumbosacral section.
3. Often the test gives a positive result in infectious pathologies of the spinal cord.

The positive test result by Lasega's method is a convincing reason for sending the patient to the comprehensive diagnostic complex.

What is the basis of the test?

The mechanism of Lasega's symptom is based on the anatomical structure of the body.

• • The roots of the spinal nerves pass through the holes between the vertebrae in the lumbar region. Their length before the transition to nerve fibers is 12 mm. When the patient lies, the nerves are in a relaxed position.
  • When lifting a leg with a straightened knee, the nerve begins to stretch. Infringement of the root of the nerve provokes pain syndrome. If the pain is felt on the back of the thigh, the symptom is considered false positive.
  • The correct result is the appearance of pain when lifting the limb to 40-60 degrees. After lifting the leg above 60 degrees, the examination is not valid, since stretching the sciatic nerve for a longer length does not allow its size. A positive result of Laceg's symptom may appear when the leg is raised by 10-30 degrees.
  • It should be noted that the physiological stretching of the sciatic nerve is permissible at a load of not more than 3 kg. If pathology is present, the continuation of the procedure can lead to rupture of neural connections and paralysis. Therefore, the test is stopped at the first painful sensations.

If the patient is under general anesthesia, the test is prohibited because:

1. first, it is impossible to judge the outcome of the procedure, since the patient can not react to it;
2. secondly, there is a risk of rupture of neural connections.

Self-diagnosis at home using the Lacega test is unacceptable. Despite the apparent simplicity of the procedure, only a qualified neurologist is able to accurately assess the patient's reaction and take into account all the nuances of the test.

• The patient is lying on the couch. Further, the test is continued depending on the patient's condition. A person can lift his knee straight in the knee. If for any reason he can not do this, the patient's leg is picked up by the doctor.
• Movement should be slow, without jerks. Lifting the limb continues until painful sensations appear on the back of the thigh. This serves as a signal for the end of the procedure.
• A positive test is considered if the pain begins when the limb is raised 30-40 degrees above the horizontal surface of the couch on which the person lies during the test. Pain must pass when the doctor gradually begins to flex the limb of the patient in the knee and hip joints. It is also possible to numb the dermal surface of the front of the thigh during the test.
• In this case, we are most likely talking about osteochondrosis and squeezing the 5 lumbar or 1 sacral roots.
• The appearance of pain when the limb is raised by 70 degrees indicates the presence of pathology, unrelated to the jamming of the nerve roots. Most often later, the defeat of the femoral muscle is diagnosed.
• When the pain after flexing the limb in the knee and hip joint does not pass, Laseg's symptom is recognized as negative. Discomfort and pain in this case are caused by joint disease. Therefore, more complete diagnosis and consultation with an orthopedic surgeon is needed.
• The test can be confirmed by lifting the leg to the limit with the subsequent rapid bending of the ankle. Pain must spread throughout the limb.

Sometimes the pain in the leg can be psychogenic, which is often observed in women with diagnosed hysteria. In this case, there is no relationship between the change in the position of the limb and the patient's condition.

It is impossible to diagnose on the basis of one test of Laseg, since each person has an individual threshold of sensitivity and carries pain differently.

Therefore, for the reliability of the examination, the Lacega test is combined with other diagnostic procedures, for example, the symptom of Bechterew-Fierstein and the Neri symptom.

A source: http://pomogispine.com/bolit-v/poyasnichno-kresttsovyj-otdel/lasega.html