What is the sign of sciatic pain

Sciatica: When the sciatic nerve is offended

Last Updated on: 22nd September 2020, 12:40 pm

Just bend down abruptly once or lift a heavy load - and you're there: radiating from the lower back to the leg, stabbing, burning painsthat make it impossible to stand upright and turn every movement into torture. Most common causes of such SciaticaPopularly known as sciatica, are muscle tension and disc lesions. We'll tell you what best to do about it if the sciatic nerve leads to hellish pain.

Table of Contents

The sciatic nerve - what is it actually?

The Sciatic nerve alias Nervus ischiadicus (lat: ischiadicus = concerning the ischium) is the longest nerve in the body. Humans have two pieces of this thick nerve - a right and a left. The sciatic nerve arises from the spinal cord between the fourth lumbar vertebra and the second sacral vertebra, i.e. at about hip height, and runs in the direction of the buttocks on the same side, then on the back of the thigh up to the knee.

Above the knee, it divides into the peroneal nerve (fibularis) and the tibial nerve. Branches of these two thinner nerves run down the lower leg down to the toes. What are the tasks of the nerve? It transmits sensations from the leg to the spinal cord and movement intentions of the brain via the spinal cord to the leg muscles.

When the sciatic nerve is causing pain

The long path over which the nerve, often simply called sciatica, extends, makes it understandable that complaints are often not limited to the back when it is "offended", e.g. B. injured or - for example due to a herniated disc - is pinched. Various causes lead to sciatic pain, which, if they are limited to the course of the nerve, are also referred to as sciatica, sciatica, radicular lower back pain or, in common parlance - just like the nerve - mostly simply referred to as sciatica.

If the pain radiates to the lumbar spine, the correct term is lumbar sciatica (combination of lumbago and sciatic pain, also: lumbago-sciatica syndrome). In contrast to pain only in the lumbar spine, which is called lumbar syndrome or lumbar spine syndrome.

This is a generic term for acute low back pain, also known as lumbago, also popularly known as lumbago. And chronic low back pain, also known as lumbar pain. Often the different terms are not exactly differentiated and used synonymously for pain that falls within the supply area of ​​the sciatic nerve.

Causes of sciatica: herniated disc & co

Sciatic pain is mostly to blameTension the Back musclesVertebral blockages orDisc problems. The wear and tear of the lower intervertebral discs that occurs in the course of life promotes sciatica. This is especially true when pressure is added, for example by lifting a heavy load, because then one or more intervertebral discs protrude and trigger acute pain. Since one or - more rarely - several of these intervertebral discs usually slide away laterally in the case of a protrusion or a herniated disc (prolapse), the pain almost always only radiates into one leg. On the side towards which the intervertebral disc (s) has / have slipped.

Sometimes a completely natural state also ensures like one pregnancy for sciatica. Because then there is a shift in the body's center of gravity. The gluteal muscles, which are additionally stressed as a result, can trigger pain. In addition, the child's weight presses into the pelvis and thus on the sciatic nerve, which can also cause pain.

An increased risk of acute sciatica appears to have very large, physically strenuous (e.g. lifting loads) or very people under stress as well as smokers. The pain and other complaints are promoted by unfavorable postures such as long sitting in a bent position or frequent overstretching of the spine.

Inflamed or pinched sciatic nerve

Draw occasionally Inflammation (e.g. abscess in the spinal canal), Infections (e.g. Lyme disease, shingles), Tumors or their daughter tumors (metastases), Strains, Circulatory disorders or Bleeding in the spinal canal, Accidents or Operations responsible as the cause of sciatica. Also can

  • Vertebral fractures (e.g. in the context of osteoporosis),
  • a Spinal stenosis (Narrowing of the spinal canal),
  • Spondylarthrosis (degenerative changes in the vertebral joints) or
  • a Spondyolisthesis (Vortex sliding, displacement of individual vortices against each other)

squeeze the sciatic nerve and cause pain or other symptoms. Or there is a so-called Piriformis Syndrome in front. This occurs when the sciatic nerve is compressed at its exit point from the pelvis under the gluteal muscles to the thigh by shortening and thus thickening the piriformis muscle (extractor and extensor).

Symptoms - this is how an offended sciatic nerve feels

The sciatic pain is mostly called stabbing and burning and shooting in, at times as like an electric shock, but sometimes also as dull-piercing described. Sciatica can - depending on the cause - be so severe that every movement is perceived as a punishment. But it can also be quite mild.

If the pain in the leg is limited to a section such as the back of the thigh and lower leg or the outside of the foot, this indicates irritation of one or more nerve roots (root irritation syndrome, lumbar radiculopathy, "radicular pain").

Pain that is less easy to isolate and usually only extends to the knee is not due to a bruised sciatica, but rather to muscle tension or misalignments such as an oblique position of the pelvic sacrum ("pseudoradicular pain").

If suddenly and violently a pulling or tearing pain occurs, which radiates into the leg, is aggravated by pressing or coughing, maybe accompanied by numbness or "pins and needles" in parts of the leg, paralysis of individual muscle groups or even a bladder or rectal evacuation disorder, a herniated disc is probably the cause.

Danger! In the majority of cases, the pain disappears within fewer days to a maximum of six weeks by itself again. If you stay longer, it is advisable to consult a doctor to get to the bottom of the cause. Likewise, if symptoms like Numbness, tingling, decreased strength or paralysis occur.

Which Doctor For Sciatic Nerve Pain?

When it comes to nerve pain, the neurologist is always the right contact. The anamnese (Collection of the medical history) including determination of the symptoms follows a neurological examination including examination of the reflexes on the leg, which serves to reveal any bad posture, loss of sensitivity or symptoms of paralysis.

Possibly supplemented by a Electroneurogram (ENG; measurement of nerve conduction velocity) or Electromyogram (EMG; measurement of the electrical voltage in a muscle) with which the doctor can determine the location of the nerve damage more precisely. In any case, the so-called is checked Lasègue sign, triggering severe stretching pain in the buttocks and thighs. By bending the extended leg in the hip joint. With a flat and relaxed supine position, slowly passively through 90 °.

The Lasègue sign is considered positive (= indication of a nerve entrapment, for example in the case of a herniated disc) if a flexion of about 45 is not possible due to pain in the leg, buttocks or back.

Methods of diagnosing sciatic pain

Often are too imaging procedures (X-rays, CT, MRI) required, for example, to detect vertebral or intervertebral disc lesions as well as local inflammations (e.g. abscesses) as the cause of the pain.

If inflammations, infections or tumors are the causes of the pain, the diagnosis can be made on the basis of Blood tests put. There may also be a Lumbar puncture, in which liquor ("nerve fluid", cerebral fluid) is removed from the spinal canal with a hollow needle and examined microscopically and chemically.

Sciatic Nerve Pain - Treatment

Sciatic nerve exercises

So-called physiotherapy helps with sciatic pain caused by muscle tension. Above all, exercises that specifically build and strengthen the lower back muscles. Or - in the acute phase - passive movements performed by a physiotherapist. Likewise, stretching maneuvers in this region such as changing to the supine position, grasp the right and then the left knee with your hands and carefully pull towards the sternum.

If the roughest phase is over, it is advisable to go easy on the back and the Sports that strengthen the core muscles such as Pilates, Nordic walking, hiking, cross-country skiing, dancing, yoga, Qigong, Powerplate, water aerobics, canoeing or backstroke swimming. Consistently and slowly increasing the load.

Three exercises that will relieve the pain

  1. Step positioning for pain:Here's the first one Step storage to mention: lie flat with your back on a firm surface, possibly place a warm towel or a hot water bottle under your back, place your lower legs at a 90 ° angle on an elevation (e.g. low chair, edge of bed, suitcase) and and exhale. The better oxygen supply achieved in this way causes tension to be released more quickly.
  2. Tighten your knees for sciatic pain:Another exercise is called Tighten your knees: Lie flat with your back on a firm surface, with your feet on the ground, bend your legs. As pain-free as possible, pull your right knee towards your right shoulder with your arms and stay there for about 30 seconds. Then do the same procedure with your left knee. Repeat the exercise three times for each side. Finally, pull both knees close to you and hold this position for 30 seconds.
  3. Put your knees on your side for sciatic pain:Another exercise is Lay your knees on your side: Lie flat on your back on a firm surface and cross your hands behind your head. Bend your knees, roll carefully to the right side until you feel a slight stretch in the lumbar spine area and stay there for 30 seconds. Then: change sides.

Medication and surgery for sciatic nerve pain

Pain reliever and anti-inflammatory drugs form the second pillar in the treatment of sciatic pain in addition to movement. However, they should be used with caution and, if possible, only for a short time, as they carry the risk of side effects. Often, over-the-counter pain relievers are sufficient. Otherwise the doctor has to prescribe some. Or inject a local anesthetic or glucocorticoid ("cortisone") into the spinal canal or near the affected nerve roots.

In any case, the aim of treatment is to eliminate the symptoms and, if possible, also their causes. And quickly, in order to prevent the back pain from becoming chronic, serious damage to the sciatica and poor posture that worsen the pain.

Only in Extreme case, for example in the case of therapy-resistant sciatic pain caused by a herniated disc Cauda equina syndrome (Damage to the lower nerve roots lying in the spinal canal and pulling backwards) and increasing motor impairments (reduced strength, paralysis), can lead to this Surgery necessary become.

Osteopathy sciatica

In theOsteopathy, tension is released and blocked joints are loosened by gentle pressure and counter pressure. Here you will find a selection of excellent sciatica osteopaths:

Johanna Hocher - Osteopathy Vienna

Johanna Hocher is an osteopath and physiotherapist im Therapy center Rosensteingasse in Vienna. In addition to osteopathy, Ms. Hocher also devotes herself to coaching, physiotherapy & psychotherapy and Reiki.

Contact:Johanna Hocher, 1170 Vienna

Physical Therapy Center Graz-Nord

TheTherapy center Graz-Nord primarily deals with symptoms such as back pain, poor posture, restricted mobility and pain after accidents or operations. In addition to osteopathy, spinal exercises are also offered here.

Contact:Therapy Center Graz, 8020 Graz

Brenda Stys - Linz

The Montessori teacher Brenda Stys is a physiotherapist and Osteopath in Linz. She treats back pain emanating from sciatica just as competently as, for example, neck pain.

Contact: Brenda Stys, 4040 Linz

What else can help against sciatic nerve pain?

In addition to physiotherapy, other physiotherapeutic methods also help with sciatica, alternative medical approaches as well as some Home remedies such as:

  • a Fascia therapy, fascia training to relieve back pain caused by tension. By detaching stuck connective tissue fibers from one another.
  • Massages against muscle tension, for example with anti-inflammatory eucalyptus or rosemary oil, which relieves tension and promotes blood circulation. It seems advisable to first test the substance on a small area of ​​skin for compatibility, because essential oils can cause an allergic reaction in sensitive people. Or with heated stones placed on the backbone or pain-inducing trigger points (hot stone massage).
  • Reflexology massages.
  • the Rolfing, a massage with fingers, elbows and ankles, which corrects postural defects, or the Dorn method, straightening joints with gentle pressure.
  • the Jin Shin Jyutsu alias (healing) currents, which after an examination of the energy flows by laying on of hands on special energy points harmonizes the energy flows in the body.
  • the Wheals, a technique of injecting a local anesthetic under the skin.
  • the Cupping with glass suction bellsthat are placed on reflex zones on the back. A negative pressure is created in these by heating or air suction, which stimulates the blood circulation and the lymphatic drainage.
  • TENS stimulation current treatments (transcutaneous electrical nerve stimulation).
  • Soft laser, whose light pulses alleviate back pain by stimulating cell renewal.
  • Cold treatments with gel or ice packs (10 to 15 degrees Celsius) to block the transmission of pain, usually effective in the acute phase.
  • Heat applications to promote blood circulation and thus muscle relaxation in the event of prolonged pain. In the form of infrared radiation (red light lamp), a thermophore (hot water bottle), heated or cherry stone pillows, heat plasters from the pharmacy, warm bath tubs with rosemary or lavender bath additives, mud and mud packs, wraps, e.g. with chamomile extract, anti-inflammatory and decongestant Arnica or a pulp made from ground fenugreek seeds.

Complementary medicine against sciatica

Alternative medical approaches as well as some home remedies also support the healing process. Such as

  • acupuncture, in which needle sticks activate the self-healing powers at selected points.
  • the Traditional Chinese medicinethat uses different drugs (e.g. specially mixed herbal teas) against back pain.
  • the homeopathythat uses certain substances depending on the form and side effects of the back pain.
  • Schuessler salts
  • Bach flowers
  • tea or capsules with the extract of the devil's claw.

Which makes the discomfort worse

The bed rest that used to be prescribed for lumbago is now only used in exceptional cases. We now know that moderate exercise is much more likely to relieve pain and other symptoms. Also to be avoided in case of back pain

  • standing or sitting for long periods of time
  • heavy loads, d. H. Pack less in your handbag, instead of carrying heavy shopping bags, it is better to run errands several times or - ideally - get help.
  • lapse into restraint: it is recommended for back pain for a maximum of two days. It is more promising to loosen up the tense muscles through gentle movement.

Preventing sciatic pain - is that possible?

Regular exercise is considered the best prevention against sciatic pain. Above all, targeted exercises for a strong back, such asbe taught in a back school, because only well-trained, strengthened back muscles are able to support the spine so that sciatica does not develop. For example, in the supine position, lift both knees off the floor at a right angle, so that the lumbar spine is pressed against the mat. Then slowly and carefully let both legs drift first to the left and then to the right until they touch the floor at the side of the mat.

A back school also teaches rules of conduct for a back-friendly behavior. Such as B. Lift heavy objects not from your back, but from your knees with your back straight and arms bent. By crouching slightly and wearing them close to your body.

Exercise helps relieve sciatic pain

Speaking of loads: even and straight Obesity, which primarily stresses the spine, encourages the development of lumbago & Co. and should therefore be reduced. Counterproductive, uninterrupted sitting that promotes pain can be alleviated by taking regular breaks that are used to exercise. But also through movements while sitting such as a conscious change between a "cat hump" and an upright, but not stiff, therefore more favorable sitting posture for the back ("Dynamic sitting").

You should also make sure that the Workplace designed to be back-friendly (e.g. adapting the office chair to the body size, height-adjustable desk) so that no muscle tension and bad posture arise. Also high quality sleeping mattresses do their part in preventing pain in the area of ​​the sciatica.

You can find the best neurologists in your state here:

Gabriela Gerstweiler