Lumbago and Sciatica
Lumbago is a sudden strong lumbar pain, which is mostly caused by a jerky movement, rotation, bending, rising, or heavy lifting while squatting. Like in a reflex the individual touches the source of pain. The person cannot get up or even sometimes falls down. He requires assist to pull himself up.
Reduction in pain can be achieved in the step position. The patient lays on his back with a cushioned box or chair under his calves so that his legs are raised at right angle.
The condition can persist for several days or weeks and will fade away gradually. The cause of this pain attack is a protrusion of a disc, which exerts pressure on a nerve leaving the spinal canal. In the disc protrusion the outermost layers of the annulus (the membrane surrounding the disc) are still intact, but annulus's innermost layers are weakened and possibly torn, thus weakening the annulus as a whole.
A disc protrusion does not mean that the disc itself has "slipped". This is not possible as it is fixed by fibers to the vertebral body. The longitudinal muscles of the back are now contracted, as a reaction to the pain.
If there is relief of symptoms by changing posture, warmth and bed rest one can assume that the protruded disc went back to its old shape and the nerve is not permanently damaged. As in many such cases, degenerative changes already exist and it can be predicted that the attack will repeated. In these cases a orthopedic specialist should be consulted.
More complicated is a lumbago, where there is a disc prolapsed (herniated / ruptured) into the spinal canal. The individual cannot derive from the degree of pain, if it was a protrusion lumbago or a more complicated prolapsed lumbago. If sensation disturbances are present, or if paralysis is present, or if there is a loss of bladder control, an orthopedic specialist should be consulted or called immediately. If symptoms are very severe, a hospital with a orthopedic or neurosurgical department is the best solution. The possibility of immediate disc surgery is very real.
Warning: Self administration of strong pain medication can conceal complications and prevent their early diagnosis.
Sciatica is defined as the inflammation of a certain part of the sciatic nerve. The sciatic nerve is a connection of several nerves, which exit the lower lumbar spine and the upper nerves of the sacral bone. Here the prolapsed disc contacts one of the nerve roots, which form the sciatic nerve. The result are strong pain radiating down to the toes.