sciatica(redirected from extraspinal sciatica)
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sciatica(sīăt`ĭkə), severe pain in the leg along the sciatic nerve and its branches. It may be caused by injury or pressure to the base of the nerve in the lower back, or by metabolic, toxic, or infectious disease. Treatment is for the underlying condition; measures for the relief of pain include bed rest, immobilization of the leg, heat, and sedation.
ischialgia, lumbosacral radiculitis, a disease of the roots of the lumbosacral section of the spinal cord and, mainly, of the sciatic nerve (nervus ischiadicus).
The causes of sciatica are the same as those of radiculitides. Because of the great length of the sciatic nerve and its close connection with many surrounding formations, such as the organs of the lesser pelvis (the uterus and its appendages, the urinary bladder, the rectum, the membranes of the spinal cord, the spinal column), diseases of the sciatic nerve occur with great frequency. They occur both as primary, with the influence of some injurious factor (chilling, infection) directly on the nerve, and as associated with involvement of the nerve with diseases of the surrounding organs. Examination reveals characteristic pain points, tension symptoms (the extremities in a position in which the nerve is taut and there is acute pain, such as in the forced adduction of a raised leg or bending of the head toward the chest in a recumbent position with the legs straightened), loss of sensitivity in certain areas of the skin (according to the type of nerve root), and autonomic and trophic disturbances.
In the acute stage of sciatica, treatment involves rest (lying on a hard bed), ultraviolet irradiation of the painful area, diady-namic currents, analgesics, and novocain blocks; later, ionization with novocain and potassium iodide, diathermy, ultrahigh-fre-quency therapy, massage, therapeutic exercise, and vitamins Bi and B12 are prescribed. Surgery is recommended in severe, protracted cases of sciatica that are the result of affection of the intervertebral disks or a dislocated disk.
REFERENCESGuber-Grits, D. S. Zabolevaniia poiasnichno-kresttsovogo otdela perifericheskoi nervnoi sistemy. Moscow, 1960.
Shamburov, D. A. Ishias, 2nd ed. Moscow, 1954.
Shustin, V. A. Diskogennyi poiasnichno-kresttsovyi radikulit: Klinika, diagnostika, lechenie. Leningrad, 1966.
V. A. KARLOV