Rehabilitation in people with sciatica

The article is professionally consulted by Master, Specialist Doctor I Nguyen Thi Thanh Binh - Rehabilitation Doctor - Department of General Surgery - Vinmec Danang International General Hospital.

The sciatic nerve is the largest nerve in the body, originating from the L5-S1 lumbar vertebrae, going down the buttocks, back of the thighs, calves, shins, and feet. Sciatica occurs when the sciatic nerve is damaged by inflammation or by being squeezed or compressed. Sciatica patients are mostly elderly, people with long-standing diabetes and obese people.
The cause of sciatica is mainly due to disc herniation, disc protrusion and direct pressure on the sciatic nerve. In addition, other causes can be mentioned such as: degenerative arthritis that causes irritation or pressure on the sciatic nerve; compression by tumor, muscle, infection, bleeding from trauma, narrowing of the spinal canal,...
Symptoms of sciatica include: pain along the path of the sciatic nerve from the lower back to the lower back. buttock, thigh, lower leg, and possibly foot, pain is often continuous or intermittent, lessens with rest, increases with movement, when bending over, when sitting for a long time, dull or severe pain, Pain may be accompanied by a burning sensation, numbness, fatigue, or muscle weakness from the lower back down the buttocks and down the back of the lower leg, usually on one leg. In severe cases, the patient has difficulty walking, even unable to walk.

The disease affects working capacity, making patients limited in daily activities, gradually causing muscle atrophy, even leading to disability.
Treatment of sciatica is the most important diagnosis and treatment according to the cause, in which conservative medical treatment measures are highly effective when combined with physical therapy and rehabilitation. rehabilitation to relieve pain and maintain mobility, and to prevent complications from pain and reduced mobility. Surgical intervention is indicated when conservative treatment measures are unsuccessful or in cases of spinal cord injury, spondylolisthesis causing instability, severe herniated disc, severe spinal stenosis, trunk tumor. vertebrae or myeloma with nerve root compression...
Regular rehabilitation treatment and exercise help relax, reduce pain effectively, can prolong time, limit the progression of the disease. .

Rehabilitation methods for sciatic nerve pain patients can use include hot compress, infrared irradiation, laser, short wave, ultrasound, magnetic field, electro-acupuncture, spinal stretching machine, massage massage... These ways will promote maximum effectiveness if the patient is combined with medical treatment methods.
Specifically:
Absolute rest in case of severe pain, should lie on a hard bed, avoid lying in a hammock or rocking chair, avoid strong movements such as sudden turns, running, crouching. Apply heat or cold to the painful area, cold first for 48 to 72 hours and then start applying heat. Heat therapy has the effect of reducing pain, antispasmodic, vasodilating, enhancing nutrient metabolism, and enhancing circulation. Heat therapy includes: Infrared, short wave, ultrasound. Note not to use in case of acute infection. The electrical treatment methods: pulsed electricity, electrolysis, TENS current, interference current have the effect of stimulating neuromuscular, analgesia, enhancing metabolism which are very effective for patients with sciatica.

Massage techniques, soft tissue mobility in the affected lumbar region and leg. These techniques have the effect of increasing circulation, nutrient metabolism and excretion, regulating pathological processes, relaxing muscles and deep joints, and effectively reducing pain. Spine stretching: can be done manually in the acute stage or by stretching machine in the subacute and chronic stages, applied 1-2 times a day, 15-20 minutes each time. This is a method to help stretch the distance between the 2 vertebrae thereby reducing pressure on the disc, stretching the ligament system around the joint, reducing pressure on the sciatic nerve, thus effectively reducing pain. Indicated in cases of spinal degeneration, disc herniation. Spinal extension machine was born to bring many effects to patients to help reduce pain, act on the right mechanism, prolong the disease progression time. Some exercises at home to support sciatica treatment:

Movement 1 (Figure 1): This simple posture stretches the spine and reduces pressure. Do the following: the patient lies on his back on a flat surface, slowly bend his knees to his chest, hold his knees with both hands, his back is straight. Hold this position for 30 seconds, then stretch your legs and repeat.
Movement 2 (Figure 2): The patient kneels and puts his hands on the exercise mat, his right hand is raised straight forward, combined with his right leg stretched back, hold for 10 seconds, then switch sides.
Exercise 3 (Figure 3): The patient lies on his back, bends his hips, bends his knees, feet still touching the ground, elbows on the mat, lifts his chest and neck back, holding back whenever it feels difficult. take a break. Repeatedly.
Movement 4 (Figure 4): The patient lies on his back, bends his hips, bends his knees, feet still touching the ground, presses his back on the exercise mat, hold for 10 seconds. Repeatedly.
Movement 5 (Figure 5): The patient lies on his back, hands down, placed next to each other and under the buttocks, legs propped up, knees bent, heels close to the buttocks, breathing maximally. The effect of this movement is to exercise and exercise the muscles of the lumbar region.
Movement 6 (Figure 6): The patient kneels and puts his hands on the mat, arching his back like a cat's back, hold for 10 seconds, then lower his back, repeat 15 times.
Sciatica needs to be treated early to avoid serious complications that affect quality of life. You should choose treatment at reputable hospitals with modern medical equipment to achieve the best effect.
Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.