Medical history (history of illness) represents an important component in the diagnosis of sciatica/lumboischialgia. Family history Social history What is your occupation? Current medical history/systemic history (somatic and psychological complaints). Where is the pain localized? How long have you had back pain? How severe is the pain? How did the pain start? Suddenly starting after … Sciatica, Lumboischialgia: Medical History
Cardiovascular (I00-I99). Vertebral artery dissection (dissection = splitting/intersecting). Musculoskeletal system and connective tissue (M00-M99). Acute ligament or muscle pain in the spine. Acute reversible joint dysfunction – blockage of a joint that resolves spontaneously Autoimmune diseases such as ankylosing spondylitis – chronic disease of the spine. Disc prolapse (herniated disc) Disc protrusion (bulging intervertebral disc) … Sciatica, Lumboischialgia: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by sciatica/lumboischialgia: Psyche – Nervous System (F00-F99; G00-G99). Paralysis (see below ischiadic nerve – nerve branches and supply areas). Sensory disturbances (see below). Strong psychological stress Dissatisfaction Musculoskeletal system and connective tissue (M00-M99) Chronic back pain Radicular pain – pain due to … Sciatica, Lumboischialgia: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, gentle posture; asymmetries? (pelvic obliquity (= leg length difference … Sciatica, Lumboischialgia: Examination
2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Inflammatory parameter – CRP (C-reactive protein).
Therapeutic target To relieve pain and thus increase range of motion Therapy recommendations Analgesia (pain relief) according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, also antiphlogistics / drugs that inhibit inflammatory processes (ie, non-steroidal anti-inflammatory … Sciatica, Lumboischialgia: Drug Therapy
Diagnosis is usually made on the basis of history and physical examination. Optional medical device diagnostics-depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics-for differential diagnosis. X-rays of the affected spinal segments, in two planes – if fractures (bone fractures) are suspected, etc.; if spondylolisthesis (spondylolisthesis) is suspected … Sciatica, Lumboischialgia: Diagnostic Tests
Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for supportive therapy: Omega-3 fatty acid docosahexaenoic acid. Omega-3 fatty acid eicosapentaenoic acid The above vital substance recommendations were created with the help of medical experts. All statements are supported by scientific studies with high levels of evidence. For a … Sciatica, Lumboischialgia: Micronutrient Therapy
Surgical therapy for sciatica/lumboischialgia is performed for radicular and complicated causes. These include: Tumor disease Injuries to the bones and/or joints and ligaments Nucleus pulposus prolapse (herniated disc); surgical therapy see below disc damage (discopathy). Further notes Spinal cord stimulation (SCS). The procedure: This is a minimally invasive procedure. An electrode is implanted in the … Sciatica, Lumboischialgia: Surgical Therapy
To prevent sciatica/lumboischialgia, attention must be paid to reducing individual risk factors. Behavioral risk factors Postural deformities Overweight (BMI ≥ 25; obesity). Medication Glucocorticoids (medications for inflammation and when the immune system is overactive – for example, in allergic reactions), these can lead to osteoporosis-related fractures with long-term therapy, resulting in back pain (three months … Sciatica, Lumboischialgia: Prevention
The following symptoms and complaints may indicate sciatica/lumboischialgia: Pain in the buttocks Pain radiating into the leg → lumboischialgia (root irritation syndrome in which pain occurs in the lumbar spine and in the supply area of the sciatic nerve, see below). Pain in the groin area Gentle posture Movement restriction Tension and the hardening of … Sciatica, Lumboischialgia: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Sciatica is a pain condition in the supply area of the sciatic nerve, usually caused by irritation of the nerve roots. If there is concomitant pain in the lumbar spine (LS), the condition is referred to as lumboischialgia. The cause of sciatica/lumboischialgia is usually a herniated disc (lat. Prolapsus nuclei pulposi, … Sciatica, Lumboischialgia: Causes
