Lumboischialgia: Causes And Symptoms Of Discomfort

What is lumboischialgia? Sciatic pain or lumbalgia, not a rare back condition in pregnancy. The cause of your back pain? Is it the sciatic nerve, the muscles, or the intervertebral discs? Problem solutions for back problems caused by the sciatic nerve.

Lumboischialgia, Lumbalgia, Sciatica – Back Pain Classified

There are many other terms for the term lumboischialgia. Not all of them are to be used synonymously. Lumboischialgia is not a disease, it is merely a symptom, a sign of disease. Lumbaralgia can be translated as back pain in the lumbar spine. Sciatica refers to involvement of the sciatic nerve, which carries back pain down the leg.

  • Sciatica: pain in the area supplied by the sciatic nerve (without back pain).
  • Lumbaralgia: pain in the area of the lumbar vertebrae (sciatic nerve need not be involved).
  • Sciatica syndrome: sciatica with additional symptoms, such as muscle weakness or sensory disturbances.
  • Lumbarradiculopathy: An irritation or damage to the nerve root or the lumbar spine.
  • Lumbago: sudden pain in the lumbar spine, of undetermined cause (also: lumbago).

To bring another term into play: Alumbosacral root irritation syndrome is usually a unilateral back pain that extends into the leg. If the pain radiates into the muscles of one side of the buttocks, medical science refers to it as lumboglutealgia.

Sciatic pain is caused by irritation (pressure or damage) to a nerve root of the sciatic nerve. The pain symptoms may be accompanied by numbness and tingling and may radiate into the foot.

The Sciatic Nerve: What You Should Know About It

It is the longest and largest nerve in our body. It is largely responsible for transmitting commands from the brain to the muscles of the legs and feet. Conversely, it picks up stimuli such as temperature, pressure, and pain in these areas. It reports a stimulus to the central nervous system so that we perceive it.

The sciatic nerve emerges from the spinal cord with its fibers on the right and left between the lumbar and sacral vertebrae (L4 to S3). From there it goes to its supply areas.

The exit points are called nerve roots. It continues on both sides through the buttocks to the knees. Here the nerve divides and supplies the front and back of the lower legs, into the feet.

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How Do You Recognize Lumboischialgia?

When a nerve root becomes damaged or irritated, back pain results. The pain continues into the supply areas (dermatomes) of the affected nerve fiber (sciatic pain).

In these areas, there is then pain, insensitivity, and even motor deficits, such as paralysis or loss of strength. The pain can extend from the back to the buttocks, thighs, knees, lower legs, heels, toes, and the soles of the feet. The same is true for any sensations of discomfort, such as numbness, tingling, or burning. Rarely, bladder emptying disorders also occur.

The pain usually occurs suddenly. Only one side is affected. The pain quality is described as electrifying, dull or throbbing. In most cases, the affected person instinctively adopts a protective posture, leaning sideways to the front.

Only with pain is it possible to bend forward with the upper body with the legs extended. Often, the discomfort subsides somewhat when walking.

Causes Of Lumboischialgia

Especially in the area of the sciatic nerve roots, in the lumbar and sacral vertebrae, the spine is very susceptible to disorders. This is due to the upright gait, for which this part of the spine has to do a lot.

A nerve root can be damaged or irritated by the following events.

  • Constriction at the exit hole due to a herniated disc, a bulging disc.
  • Narrowing at the exit hole due to wear and tear on the vertebrae, vertebral joints.
  • Pressure on the nerve due to space-occupying events (tumors, pregnancy).
  • Nerve inflammation, damage due to infections (herpes zoster) or other chronic diseases (diabetes, rheumatism).
  • Injuries in the area of the sciatic nerve.
  • Bad posture, malpositions.
  • Muscle tension.
  • tense piriformis muscle (muscle from the hip muscles).

Radiating Back Pain In Pregnancy, A Lumboischialgia?

Especially during pregnancy, almost every second woman complains of pain in the lower back. Fortunately, it is rarely due to damage or irritation of one of the sciatic nerve roots.

In fact, medicine does not yet have any demonstrable causes to offer for this. However, the following circumstances are considered possible as reasons for deep-seated back pain during pregnancy.

  • Unilateral weight gain, thus shifting the body’s center of gravity forward.
  • Loose ligament structures (due to hormonal changes) in the lower trunk area lead to instability and muscle tension.
  • Backwater of venous blood presses on the sciatic nerve.
  • Direct pressure from the uterus on the tissues around the sciatic nerve.

In the vast majority of cases, it is not lumboischialgia when pregnant women complain of radiating lower back pain. It appears to be a temporary irritation of sciatica, due to one or more of the above causes.

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Lumboischialgia, Course And Chances Of Cure

It usually begins with an acute, sharp painful stimulus that immediately extends to the lower extremities. Depending on the cause, the pain can last from a few days (muscle tension) to several months (herniated disc).

The pain occurs in intervals. They depend on the type of movement. Everything should be aimed at restoring the nerve. To do this, the cause of the irritation must be identified and eliminated as soon as possible.

Suspicion Of Lumboischialgia, What To Do?

How can you tell if it is lumboischialgia? If you don’t want to go to the doctor right away, you can first do two simple tests for yourself. One is the already mentioned prevention with stretched knees .

There is a justified suspicion if the pain worsens. Or the other way around: In the supine position, have someone lift the affected leg while it is stretched out.

If there is pain in the back and leg from 45 degrees, it could be lumboischialgia. This test is also performed in the doctor’s office and is called the Lasègue test.

Radiating Back Pain, When To See A Doctor?

If, in addition to sciatic pain, you notice weakness and paralysis in your leg, or bladder emptying problems, you should see your doctor immediately. Of course, even if the pain is very severe.

Or if they cannot be alleviated with the usual measures. Especially during pregnancy, it is better to seek medical advice on the measures you can safely take.

You can also check for yourself whether bad posture or muscle tension is causing the pain. A common bad posture is the hollow back. To check it, stand straight sideways in front of a mirror.

If your shoulders are on a vertical line, behind your buttocks, you probably have a hollow back. Observe whether your weight rests mainly on your heels. This is another indication.

Of course, there are many other postural problems and possibilities of tension-irritating sciatica. Physiotherapists have an eye for this. They can give you specific exercises to work off these bad postures.

Suspected Lumboischialgia, What Does The Doctor Do?

In an orthopedic practice, the first step is to try to rule out serious diseases of the spine. For this purpose, an interview and a physical examination take place.

If there is evidence of sciatic nerve involvement, nerve stretch tests, such as the Lasègue sign mentioned earlier and the Bragard sign, can provide further reassurance. In the Bragard test, the foot on the stretched leg is also tilted toward the dorsum of the foot (dorsiflexion).

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If this results in pain in the leg or buttocks, this is referred to as a positive sign. This is another indication of irritation of a sciatic nerve root.

Reflex tests (patellar tendon reflex, adductor reflex, Achilles tendon reflex) also point to possible sciatic involvement if the reaction is weakened. Only when the suspicion of a specific event at a sciatic nerve root has been substantiated are patients referred for X-rays or magnetic resonance imaging.

As a rule, the complaints have then already existed for several weeks. They can no longer be controlled with conservative therapies.

What Are The Conservative Therapies For Lumboischialgia?

Rest and bed rest were yesterday. Experts have long agreed that exercise is the best therapy for back pain. Rest to relieve sciatic pain should only be used for the short term. Once serious disease and damage have been ruled out, the first priority is to eliminate the pain. After that, the back muscles are strengthened with exercises and incorrect postures are corrected.

Conservative therapy involves first treating the pain with painkillers, anti-inflammatories and muscle relaxants. Physically, heat applications such as baths, wraps, packs or radiation help.

As soon as possible, there are parallel instructions for adapted physiotherapeutic exercises. Alternative methods can also do a lot in an accompanying way. If you have access to it, try taping (kinesiotherapy), acupuncture or chirotherapy.

When Is Surgery Necessary For Lumboischialgia?

Surgical therapy for sciatica/lumboischialgia is performed for radicular and complicated causes. These include:

  • Injuries to the bones, ligaments, joints.
  • Herniated disc.
  • Tumor diseases.

In medicine, the so-called red flag symptoms are considered a clue. For example, if in addition to the sciatic pain there are also bladder or bowel emptying disorders (cauda equina syndrome) or paralysis of the leg.

Sciatic Pain, Lumboischialgia: Therapy During Pregnancy

In case of back pain or sciatic pain, the doctor will definitely try to treat without medication and with adapted physiotherapeutic measures. In most cases, applications that relax the muscles help.

These can be heat applications, massages or exercises from progressive muscle relaxation according to Jacobson. Strengthening the back muscles is part of the therapy program, as is learning back-friendly behaviors in everyday life.

Especially in the case of lumbalgia with involvement of sciatica during pregnancy, alternative methods from acupuncture or kinesiology can also provide effective support.

What Can You Do Yourself Against Sciatica?

Without question, the best thing to do is to avoid lumboischialgia in the first place. The preventive measures consist in strengthening the back muscles, recognizing and correcting bad posture in time.

Preventing Back Problems And Sciatic Pain

Yes, it has to do with exercise. The only sure way to support and protect your spine is to have well-developed back muscles. At the latest when you plan to have a child, you should start regular back training.

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This will save you a lot of suffering during pregnancy. A pregnancy gymnastics course is a must

150 muscles ensure a strong backbone. That’s why it’s important not to just train on the fly. One-sided or incorrect training can have the opposite effect. Do you have frequent back problems? Then have an individual training program drawn up for the time before and during pregnancy. Health insurance companies also have information about back-friendly behavior and back-strengthening exercises available for their customers.

Continuity is important. Once you have your back program, exercise a little every day. This will do more good than exercising for two hours once a week. Some exercises can also be integrated into your daily routine without having to make a big effort.

Pay attention to an adequate level of nutrients during pregnancy. Even if there seems to be no direct connection between nutrition and lumboischialgia: Only a well-supplied body forms healthy bones and muscle structures and is able to cope with the additional stress of pregnancy.

Alleviating Measures

Is it then nevertheless happened, the sciatica hurts and no more movement goes? Here are a few tips to soothe the acute pain of sciatica or the pain of lumboischialgia.

When the pain shoots in, lie down and elevate your legs. Preferably with a 90 degree angle at the knees (stepped bed position). This relieves the sciatica and provides immediate relief from the acute pain.

Bed rest for longer than two days is not recommended. Use every minute in which the pain is bearable for movement or light exercises. Of course, if you are not pregnant, you can use painkillers to give yourself a little more room to move. For sciatic pain or lumbalgia during pregnancy, warming ointments, baths or packs can provide relief.

Important: If the sciatic pain does not subside after two to three days with these remedies, you should definitely consult a doctor. The aim is to rule out serious damage to the spine. In an emergency, they can also prescribe painkillers that will not harm you or your unborn child.

Especially for pregnant women, it is not beneficial to lie down for too long. Keep moving! Particularly gentle forms of exercise are aqua gymnastics and stretching exercises for the muscles. Draughts and psychological stress have a negative effect on the muscles.

Avoid negative stress situations and keep warm. Only when you are relaxed inside can your muscles relax completely.

Sources

https://www.aerztezeitung.de/Medizin/Lumboischialgie-kann-auch-neuropathisch-sein-382360.html

https://link.springer.com/chapter/10.1007/978-3-7091-3925-7_25

https://krankenkassen.net/gesetzliche-krankenversicherung/leistungen-der-gkv-allgemein/prophylaxe-kurse-rueckenschule.html

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