Therapy | Pinched nerve in the bottom

Therapy

The therapy for a pinched nerve in the buttocks is initially aimed at relieving the pain. Rest and bed rest are recommended. It often also helps to elevate the affected leg.

Painkillers such as paracetamol or ibuprofen can also be taken. Ointments such as Voltaren or Doc ointment are also helpful. If there is severe muscle tension in the back, muscle-relaxing medication is occasionally injected.

If the acute pain symptoms are contained, physical therapy or physiotherapy should be performed. Initially, this treatment aims to relax the muscles through massages and heat applications. However, effective treatment of entrapment can only be achieved through movement training.Therefore, exercises are performed that strengthen the lower back muscles in particular.

If the nerve becomes entrapped due to structural changes (e.g. herniated disc, narrowing of the spinal canal), surgery may become necessary. However, this is rarely the case. Surgery is also performed when severe symptoms such as a bladder voiding disorder occur, or the pain cannot be adequately treated. In the case of causes such as malignant tumors in the spine, cancer therapy must be carried out. This usually consists of surgery, chemotherapy and radiotherapy.

Duration

The entrapment symptoms usually last for one to two months. The duration is primarily based on the time the sciatic nerve needs to regenerate once the cause of the incarceration has been removed. Since the cause is often too weak back muscles or poor posture, the duration of the complaints depends largely on how regularly affected persons perform their exercise therapy. Even a recurrence of the symptoms can only be consistently prevented by permanently strengthening the back muscles. Those who do not perform the exercises, on the other hand, have to expect a significantly prolonged course of the pain up to its chronification.

Diagnosis

The diagnosis of a trapped nerve in the buttocks initially consists of various clinical tests. In the so-called Laségue test and the Bragard test, the sciatic nerve is stretched in a targeted manner. If the nerve is pinched at one point, sudden shooting pain occurs.

Motor tests such as the toe or heel gait can provide indications of motor failure. The reflexes of the patellar tendon (patellar reflex) and the Achilles tendon (at the foot) are also tested. If the tests are positive, imaging such as MRT or CT can be performed.