From the point of view of modern medicine, radiculitis is not an independent disease, but is a symptom complex that indicates the presence of an effect on spinal nerve roots.
Typical signs of radiculitis are a violation of sensitivity, pain, muscle weakness, spreading along the course of the affected nerve.
The most common and dangerous form is lumbosacral radiculitis, which develops against the backdrop of pathological changes in the intervertebral discs, joints or ligaments of the spine. In the absence of appropriate treatment, acute radiculitis becomes chronic.
Violations of innervation in lumbar radiculitis lead to disorders of the pelvic organs. The main danger of sciatica lies in the fact that a progressive underlying disease can lead to atrophy of the muscles of the lower limbs up to a complete loss of mobility.
Content
- 1Causes of lumbar radiculitis
- 2Symptoms and Diagnosis
- 3Treatment with sciatica sciatica
Causes of lumbar radiculitis
In most cases, the cause of lumbar radiculitis is the manifestation of osteochondrosis.
According to statistics, 95% of patients with lumbar sciatica are diagnosed with certain manifestations of osteochondrosis.Radiculitis manifests itself against the background of other diseases and pathological conditions, among which:
- viral infections;
- spondylitis of different etiologies;
- myositis;
- dislocations, fractures and dislocations of the lumbar spine;
- curvature of the spine;
- Bechterew's disease;
- rheumatoid arthritis;
- tumor processes.
The most common cause of radiculitis is the intervertebral hernia.Hernias are formed as a result of degenerative-dystrophic changes in the structure of intervertebral discs. As the connective tissue is destroyed, the disks are deformed, protrusions are formed (protrusions of the disk nucleus) and a hernia is formed.
The hernia presses on the roots of the spinal nerves, causing inflammation and pain. This species of radiculitis is calleddiscogenic radiculopathy of the lumbosacral spine.
Irritation of the roots of the spinal nerves is not always associated with the pathologies of the intervertebral discs, it can point to stenosis of the spinal canal or foraminal canals, as well as the presence of osteophytes - pathological bony outgrowths vertebrae.
Symptoms and Diagnosis
Manifestations of radiculitis can be triggered by chronic stress, hypothermia, Radiculopathy occurs as a complication of infectious diseases, as well as against the background of endocrine and exchange disorders.
When examining the patient, a spasm of long dorsal muscles, a discoloration of the color and temperature of the skin in the affected area, painfulness when pressing on the spinous processes are revealed.
Radiculitis is accompanied by increased sweating, depending on the degree of severity and form disease can change the sensitivity of the skin along the affected nerve until its full losses.
Symptoms of acute radiculitis:
- When moving from a lying position to a sitting position, the leg on the affected side involuntarily bends (Bekhterev's symptom).
- On the side of the lesion, the gluteal fold is smoothed.
- The pain is aggravated by sharp head inclinations, coughing, sneezing and attempts (symptoms of Nerl and Dejerian).
- When the leg is lifted from the side of the lesion, the pain sharply increases (a symptom of Legas).
- Unnatural posture and gait of the patient: the person keeps the body in a position in which the pain is felt the least.
In addition to the listed symptoms with radiculitis, there may be pain in the lower abdomen, difficulty and soreness during urination, during intercourse. Some patients have erectile dysfunction.
Localization and features of manifestations of radiculitis are distinguished:
- lumbago (lumbalgia);
- sciatica (ischialgia);
- sciatica.
Lumbalia, in the people - a backache, is manifested by a sharp pain at the bottom of the back, which occurs immediately during or after exercise. A pain attack can last from a few minutes to several days.
Ischialgiaarises from the defeat of the sciatic nerve. For ischialgia is characterized by the spread of pain in the buttock and lower along the back side of the thigh along the affected nerve. In severe cases, the pain extends to the foot, including the toes, combined with muscle weakness, loss of skin sensitivity. The pain is described as shooting, burning, the intensity varies from slight discomfort to unbearable suffering, in which patients can not lie, sit, stand, move.
Manifestationslumboschialgiaremind lumbago and sciatica at the same time. The pain radiates into the leg, spreading over the buttock and back of the thigh, and usually does not affect the foot. It is described as stinging or aching.
Preliminary diagnosis is established on the basis of a survey and external examination of the patient, the results of clinical tests.To identify pathologies of the spine, localization and the nature of the damage to the roots, the patient is referred for additional examinations: radiography, computer or magnetic resonance imaging. In some cases it is recommended to perform electromyographic examination.
Treatment with sciatica sciatica
Treatment of lumbosacral radiculitis is aimed at normalization of metabolic processes in the affected nerve, removal of muscle spasm and pain sensations, as well as general strengthening of the body. Treatment of radiculitis is in addition to the treatment of the underlying disease that caused the manifestations of radiculopathy.
The most effective is the combination of drug treatment with physiotherapy and a sparing diet.In some cases, the doctor may additionally recommend some folk remedies, the use of which does not contradict modern approaches to the treatment of radiculitis.
Than to treat a radiculitis in an acute phase? In the acute phase of radiculitis, the doctor usually prescribesDiclofenac injectionor similar preparations,Tol'personorMidokalm, Mukosatand complex preparationsvitamins of group B.
As the patient's condition improves, injectable forms of drugs can be replaced with tablets. In some cases, external pain relievers and agents are also prescribed to promote the regeneration of tissues in the form of ointments, gels or patches.
In severe cases, the patient is prescribed a novocaine blockade with the introduction of Relanium, Euphyllinum, Hydrocortisone. Injections are made in the muscle areas above the zone of injury, in bone tissue, the joint cavity or periarticular tissues, in especially severe cases - epidural.
The most effective procedures for lumbar radiculitis are:
- acupuncture;
- magnetotherapy;
- physiotherapy;
- massage;
- electrophoresis with hydrocortisone and lidocaine.
In medical practice, physiotherapy procedures combine among themselves, in particular, massage can be prescribed in conjunction with ИРТ or magnetotherapy. Also, special exercises will help you in the fight against sciatica in the lumbar region, which the doctor will help to choose.
It is highly undesirable to engage in self-medication, as the lumbosacral radiculitis is prone to transition to chronic form, it often indicates the presence of more serious diseases and can lead to severe complications. With pain in the lower back, you should see a doctor and undergo an appropriate course of treatment under the supervision of specialists.
