hi and pleased to answer you
The common vertebral sciatica sometimes begins with
low back pain (
lumbar pain) for a few days, then the attack starts with a sharp pain, increased by effort, cough, sneezing and defecation.
This pain follows a well determined path according to whether it is the 5th lumbar root or the 1st sacral root that is irritated:
• Lumbosciatic L5: lumbar pain extends on the outside of the thigh and leg, crosses the back of the foot and wins the big toe;
• Lumbosciatic S1: lumbar pain extends on the buttock, the posterior face of the thigh and leg, and passing through the sole of the foot, reaches the 5th toe;
• Sometimes the pain is truncated and stops at the buttocks or thighs; At other times, it is replaced by curious and disagreeable cutaneous sensations (dysaesthesia).
The spine is painful and stiff to mobilization. There is contracture of the muscles surrounding the spine (para-vertebral muscles) and sometimes the sciatic pain appears by pressing the contracted muscles (sign of the bell). The sign of Lasègue is looking for the patient lying on his back: the doctor raises the painful leg which must remain taut, which puts the
sciatic nerve in tension: a violent pain slows down the continuation of the movement from a certain angle. The physician notes a decrease or loss of sensitivity in the skin area of the affected root. The achillian reflex is diminished or abolished in S1 sciaticae.
The physician is always looking for genito-sphincteric disturbances (imperious urges,
erectile dysfunction) or a weakness of the lower limbs (sensations of stepping from the knees to the walking), which are harmful signs.
The lumbosciatic disc herniation is a benign condition whose natural evolution is usually in a variable time to healing. It generally lasts between 3 and 6 months. The aim of the treatment, above all medical, is only to hasten the cure. It combines rest at the beginning, analgesics and anti-inflammatories. In the aftermath of the crisis,
physiotherapy allows you to shake your back and educate the patient (gestures and positions to avoid, how to lift a load ...).
In some cases,
surgical treatment is urgently needed.
I advise you to consult a
rheumatologist.
best wishes