lumboischialgia

What is lumboischialgie?

Lumboischialgie refers to pain that emanate from the lower back and radiate to the lower extremity. Typically, the pain affects only one side (only one leg). In addition to the pain further complaints are possible (sensation of discomfort etc.).

The lumboischialgie is to be distinguished from a sciatica (sciatica): The latter is caused by an isolated irritation of the sciatic nerve. In contrast, in a lumboischialgie additional nerves are affected in addition to the sciatic nerve. These are nerves that leave the spinal cord at the level of the lumbar spine:

Among other things, these lumbar nerves with their motor parts provide for hip flexion and knee extension as well as for the function of the gluteal muscles. The sensory components of these nerves transmit touch, temperature and pain stimuli from the lower back as well as from the front of the legs to the central nervous system.

Lumboischialgie: symptoms

When a nerve root is irritated or damaged, the symptoms appear in the areas supplied by the nerve root. Thus, each nerve root can be assigned to certain skin areas that provide it. These are called dermatomes:

• First Lumbar Nerve Root (L1): Low back pain that radiates forward into the groin.
• L2: Low back pain radiating to the front of the thigh and running below the groin.
• L3: Low back pain radiating to the front of the thigh and pulling from the top to the inside above the knee.
• L4: Low back pain radiating to the front of the thigh and slanting over the knee from the top to the inside of the lower leg.
• L5: Low back pain that runs along the outside of the thigh and radiates to the front of the lower leg to the foot.

If numbness or other abnormal sensations occur, these also run in the described dermatomes.

In addition, lumboischialgie may cause muscle weakness. For example, those affected may have difficulty climbing stairs or may no longer be able to stand on one leg (the affected leg). Often they are also unable to stand on their toes or heels.

In addition, the doctor can often detect weakened or extinguished reflexes. This affects either the patellar tendon reflex, Achilles tendon reflex or adductor reflex.

Lumboischialgie: investigations

In conversation with the patient, the doctor first becomes To raise medical history (Anamnese). Among other things, he gives a detailed account of the symptoms, asks how long they have existed, and whether they have changed over the course of time.

After that follows one physical examination, For example, the doctor checks the mobility of the joints, the strength of the muscles and the reflexes in the affected leg.

In case of long-lasting discomfort or acute severe symptoms such as paralysis or disturbances of urinary and bowel contingency are also Imaging studies necessary. The most frequently used are computed tomography (CT) and magnetic resonance imaging (MRI). With these methods, for example, a herniated disc or vertebral fracture can be identified as the cause of lumboischialgie.

Lumboischialgie: causes

The most common cause of lumboischialgie is a disc prolapse, The gelatinous core of the disc breaks through the fiber ring to the outside. He can press on a nerve root and cause discomfort.

But also Vertebral fractures (by accident or osteoporosis) or wear-related (degenerative) changes to the vertebral joints can narrow the nerve roots.

Other causes of lumboischialgia or similar complaints may be:

• Inflammations such. As a spondylodiscitis (inflammation of the intervertebral disc and the adjacent vertebral body), Lyme disease or abscesses
• Kidney stones
• Masses that are on the nerves like ovarian cysts or abdominal aortic aneurysm

Lumboischialgie: therapy

If no signs of paralysis or incontinence occur, lumboischialgia is preferably treated conservatively: the doctor usually prescribes pain therapy and physiotherapy to the patient. An effective pain therapy is very important to prevent the symptoms from becoming chronic.

If an infection is the cause of lumboischialgia, the doctor may prescribe antibiotics (against bacteria) or antivirals (against viruses).

If the conservative lumboischialgie therapy brings no relief or paralysis or other neurological deficits occur, surgery is considered. Various techniques are used. For example, in a herniated disc, the emergent nucleus of the disc can be removed, which presses on the nerve root (nucleotomy). An acute one lumboischialgia with disturbance of the urinary and stool continences is reason for an emergency operation!