ANPING HUALUN PHYSIOTHERAPY

Sciatica Pain Relief Patch

    Sciatica is sciatic nerve route and distribution of regional pain syndrome.The vast majority of cases of sciatica is secondary to local and surrounding structure of sciatic nerve lesion to the stimulation of sciatic nerve damage and oppression, called secondary sciatica;A series of primary, i.e., sciatic nerve inflammation.


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Sciatica 

Sciatica is sciatic nerve route and distribution of regional pain syndrome.The vast majority of cases of sciatica is secondary to local and surrounding structure of sciatic nerve lesion to the stimulation of sciatic nerve damage and oppression, called secondary sciatica;A series of primary, i.e., sciatic nerve inflammation.


The cause of

A variety of causes.The vast majority of patients with sciatica is secondary to local and surrounding structure of sciatic nerve lesion to the stimulation of sciatic nerve damage and oppression, called secondary sciatica;A series of primary, i.e., sciatic nerve inflammation.


Clinical manifestations of

1. General symptoms

(1) the pain is mostly limited to sciatic nerve distribution area, the back of the thigh, calf posterolateral and feet, pain of the patients can show the unique position;Landing on lumbar flexion, knees and toes.Such as pathological changes in nerve root, spinal canal pressure increases the pain worse (cough, push).

(2) the degree of muscle loss can be due to the etiology, pathological changes and damage degree of different difference is very big, can have all or part of the sciatic nerve muscle weakness or paralysis.

(3) with or without sciatic notch in sciatic nerve stem of tenderness.

(4) have sciatic nerve pull), and their allelic Lasegue character positive, this often exists in parallel with the severity of the pain.Local anesthesia sciatic nerve root or nerve trunk this sign can disappear.

(5) the Achilles tendon reflex drops or disappear, knee reflex can be increased due to the stimulus.

(6) of sciatic nerve area can feel drops or disappear, including external ankle vibration sense of loss, can also feel light barrier.

2. The sciatic nerve inflammation

Often associated with various types of infection and systemic disease, such as upper respiratory tract infection.Because of the sciatic nerve is relatively shallow, be affected with damp be affected with damp and cold easily occurs when the sciatic nerve inflammation, should pay attention to systemic disease occurs when the sciatic nerve inflammation such as concurrent presence of collagen vascular diseases and diabetes mellitus.

Most of them are unilateral sciatica, without waist and back pain;Pain is persistent, commonly can also as onset, vertebral canal pressure increases when the symptom is aggravating, also along the sciatic nerve path radiation.Sciatic nerve trunk tenderness obviously, calf tenderness;Pain and muscle weakness are not parallel, in pain, and muscle weakness is not obvious, more acute pain due to determine motor function is difficult, can check out the foot drop, calf, pretibial muscle atrophy;Achilles tendon reflex decrease or disappear, but Achilles tendon reflex can be normal, normal knee jerk, shallow feeling obstacle is obvious.

3. Secondary sciatica

(1) lumbar disc is the most common causes of sciatica, multiple in lumbar 4 ~ 5 and waist 5 ~ s1, about one-third of the cases had a history of acute waist injury, between 20 to 40 years old, most patients clinical characteristic is for weeks, months of low back pain, sciatica and then on one side of the lower limbs.Physical examination, besides has the general symptoms of sciatica is back muscle strain, lumbar restricted movement, scoliosis, the spine tenderness of the lesion site.

(2) the lumbar osseous arthritis found in more than 40 years old, subacute chronic onset, there are many long-term waist TongShi, sit long stand up hard, standing for a long time to sit down is difficult, clinical can be characterized by one side or both sides of the symptoms of sciatica, and the waist.

(3) the lumbosacral vertebral congenital malformations lumbar sacral, sacral vertebra waist, recessive spina bifida, which, besides can be performance sciatica often enuresis history, physical examination often have foot deformity, lumbar di ministry skin abnormalities, such as in the rear of the anus small concave, the centerline of the lumbosacral region of small hemangioma, the objective and accurate instructions often vertebral plate parts that haven't healed.

(4) the sacroiliac common for rheumatoid arthritis, tuberculosis lesions, the joint capsule with seepage destruction when stimulus waist 4 ~ 5 nerve trunk, some patients may have symptoms of sciatica.


Check

1. The imaging examination

Has the important status, including lumbosacral vertebral, sacroiliac joint X-ray film, spinal MRI and spinal angiography and CT, besides clinical pelvic physical diagnosis to do pelvic CT or MRI.

2. Electrophysiological examination

1) vertebral side muscle EMG can help identify the root sciatica and distal lesions.(2) the short head of the biceps femoris muscle EMG can help identify the lateral sciatic nerve with total mental derangement.(3) patients with pelvic or femur fracture difficult to routine checkups, EMG can assist in evaluation of neural function.(4) femoral nerve and sural total of motor nerve conduction velocity and F wave there may be exceptions, sciatic nerve conduction velocity is difficult to stimulate proximal to the lesions.

3. The other

Application of corticosteroids or bureau hemp drug injection piriformis, if pain relief is helpful in diagnosing piriformis syndrome.


The differential diagnosis

Should be paid attention to and the strain of lumbar muscles, hip fibrous tissue inflammation, such as the hips and thighs pain diseases that differentiates, these are local pain, no feeling dysfunction, decreased muscle strength, and with hyporeflexia neurological signs.


Treatment

By first response to treatment, and pay attention to symptomatic treatment, all sciatica should stay in bed, sleep hard bed.Application of vitamin B group, the pain treatment, temporarily not physical therapy before the cause is unknown. 

Also you can use self-heating pain relieving patch


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