Lumbosciatica or sciatica, is a condition that manifests with pain in the lumbar spine, caused by irritation or compression of the sciatic nerve, pain that irradiates in the buttock muscles and on the posterior part of the lower limb (on the route of the sciatic nerve). The pain may also be accompanied by numbness, tingling and/or weakness in parts of the lower limb or leg. In rare situations, you may feel a burning sensation but not descending below the knees

It’s the longest and thickest nerve in the body, at its thickest point having the size of the width of the thumb. It originates in the lumbar spine, the nerve roots leaving the spinal cord at the level of the L4 vertebra and descending on the posterior part of the lower limb. In the popliteal fossa (behind the knee), it branches into 2 nerves, namely:

• The tibial nerve that moves on the posterior part of the calf and leg
• The common peroneal nerve, which moves to the anterior and lateral parts of the calf and leg.

The sciatic nerve is responsible for the sensory and motor functions of the parts of the body on its route.

The intervertebral discs are structures of fibrocartilaginous nature placed between two vertebrae. They are essential for the movement of the spine and act as a ligament, tying a vertebra to the next, but especially have a role in the absorption of shocks significantly diminishing the impact between the vertebrae. The discs are round and flat, with a thickness between 9-11 mm and consist of two components, a fibrous ring and a pulpy nucleus. When the pulposus nucleus moves between the vertebrae, it presses on the sciatic nerve. The intervertebral disc can also swell and press on the sciatic nerve causing numbness and pain on its innervation route.

It represents a slip of a vertebra, most often forward, from the lower one, and thus pinching the sciatic nerve or narrows the spine canal.

It’s a condition in which the sciatic nerve is trapped around the piriform muscle. Normally, the sciatic nerve has its trajectory under the piriform muscle, but in 16% of the population, the trajectory of the sciatic nerve is through the pyriform muscle, thus being prone to the appearance of sciatica.

A cyst or tumor that occupies the space around the nerve (a situation much less common)

First of all, the cause that determines must be identified, because in some situations the lumbosciatic is a manifestation /a symptom of another disease.
The necessary therapeutic measures are:

Avoid activities that cause or accentuate pain.

The resumption of these activities is done gradually.

Drug treatment with anti-inflammatories helps reduce pain and inflammation. It’s recommended for short periods of time, 7-14 days maximum.

In the first 2-3 days from the onset of pain, ice is applied locally, to reduce inflammation, in sessions of 5-10 minutes, 3-5 times a day. Always put a thin towel between the ice and the area on which it is applied.

Heat is applied locally, on the painful area, in several sessions per day of 10-20 minutes each, especially if there is associated and muscle contracture to the decontraction and relaxation of the muscles.

Physical therapy combined with manual therapy is the essential element of the recovery program. Through specific exercise programs and light stretching exercises, the following are pursued:

➢ increasing the flexibility of the spine and reducing the pressure on the nerves and discs
➢ toning the abdominal and lumbar paravertebral muscles
➢ increasing joint mobility
➢ preventing relapses and/or other injuries.

The nervous pain felt further away from the lumbar area, more precisely at the level of the buttock muscles, the posterior muscles of the thigh and calf, requires light exercises to stretch these muscles.

If the treatment methods listed above do not sufficiently help reduce pain and inflammation, it is possible that the sciatic nerve is severely pinched, a situation in which, following an MRI, an injection/infiltration can be made in the lumbar spine to reduce the inflammation of the sciatic nerve roots.

Full recovery can take up to 12 weeks. in several sessions per day of 10-20 minutes.

➢ The sitting position is not maintained for more than 20 minutes without taking a short break

➢ Avoid, as much as possible, the movements of twisting and/or bending the back (bending in front)

➢ Lifting objects is done by bending the knees, keeping the back straight. Avoid lifting weights for 6 weeks from the onset of pain.

➢ Physical exercise will be introduced into your daily routine. Cycling or swimming are sports that are beneficial for the back. Running instead, can cause compression of the sciatic nerve and aggravate the condition.