This can be called sciatica (because of the occupancy of the nerve root or roots that form the sciatic nerve). Usually it is a consequence of moving the vertebrae disc of its bearing and consequently pressing on the nerve.
The nerve can be pressed by narrowing its bearing surrounding bone structures. It is called stenosis. This phenomenon should be assessed by a detailed neurological, neurophysiological and radiological examination. Despite the pain, patients fear of the examination and even more of the possible need for surgical treatment. This fear is not justified, because the surgical treatment of discus hernia is necessary only in a small number of patients, and those with difficulties and seriously disturbing health. Most of these patients are treated with other methods (painkillers, physical therapy).
Syndromes
The problems associated with discus hernia requiring urgent neurosurgical intervention are:
– Horse tail syndrome (Sy caudae equinae), which is a serious neurosurgical problem and occurs as a result of pressure from a pathological structure (usually discus hernia) on the bundle of nerve roots that originate in the spinal cord and they are very important for the functioning of the legs and other features. This condition can lead to loss of control of urination and the greater needs, weakness of the legs to their full stiffness, numbness of the seating region.
– Syndrome “lowered foot” – the sick cannot lift the foot, walking by pulling the toes along the ground. To raise the foot is forced to do so indirectly, by raising the knee and thigh, which is quite hard and clumsy. Management of motor vehicles in the usual way is disabled by failing to press the pedal.
Both situations are urgent neurosurgical diseases: these patients should be urgently addressed to neurological examination, possibly neurophysiological (if it can be done quickly and efficiently), to make appropriate radiological verification and treatment (surgical) in a neurosurgical facility. Best results are achieved if the cause of the disease is removed surgically in a time period of 24 to 48 hours. Surgery may be done after this period, but with modest results and a longer period of rehabilitation.
OTHER CONDITIONS
Other conditions that do not require a neurosurgical emergency surgery but should be carefully assessed to determine the method of treatment: a state with persistent pain along the foot / feet, which subsides despite adequate treatment with painkillers for a period of 6 to 12 weeks. The operation is achieved with pain relief and then the patient may be referred to a physical rehabilitation. Condition with progressive neurological deterioration over a period of time despite the measures taken for treatment. These include spinal stenosis (narrowing of the spinal canal), with signs of neurogenic intermittent claudicating (occurrence of cramps or weakness in the leg / feet, with ill have to change position or to stop and take a break).
In conclusion, if you appear in cross pain, which did not spread to the legs, no problems with muscle strength and control of large and small need to stay at home, avoid sitting, lie down on a flat surface and get moving as much as the pain allows. You can use some painkillers. If you do not calm down the pain, or if you have additional difficulties, contact the medical examination. And be sure, that the very disappearance of pain does not necessarily mean that the problem is solved. Sometimes the pain subsides, but leaves serious consequences: if you notice problems with the movement of the feet, muscle strength and / or control of the small and the greater need, it should immediately be assessed, diagnosed and treated in an appropriate neurosurgical facility.
