What injections are given for a pinched sciatic nerve?

Neuralgia refers to severe shooting pain that occurs due to a damaged or irritated nerve. Neuralgia can affect any part of the body, causing mild to severe pain. Certain medications and surgical procedures can effectively treat neuralgia.

Severe neuralgia can affect a person's ability to perform everyday tasks and can affect their quality of life.

Neuralgia has many possible causes, including:

• infections such as shingles, Lyme disease, or HIV
• pressure on bone nerves, blood vessels or tumors
• other medical conditions such as kidney disease or diabetes
• aging

This article examines the different types of neuralgia, their symptoms, and available treatment options.

general information

There are 12 pairs of intercostal nerves in the human body. They originate from the roots of the thoracic spinal cord and cover the entire chest, adjacent to the peritoneum, muscles, skin and mammary glands. The individual fibers of each nerve are responsible for tissue sensitivity, motor function and regulation of the functioning of all structures. Accordingly, damage or inflammation in any area can radiate pain to a variety of parts of the body.

The sensations can imitate diseases of internal organs: myocardial infarction, angina pectoris, pancreatitis, gastritis, cholecystitis, etc. In some cases, only a doctor can accurately determine the nature of the pain after a full examination. That is why it is important to seek help promptly if chest pain occurs.

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Symptoms of a pinched nerve

The main symptom of a pinched sciatic nerve is pain. When bending the torso, the patient feels pain in the lower back, which spreads to the thigh, reaches the popliteal cap and ends in the foot. Symptoms of a pinched sciatic nerve also include impaired motor activity, loss of sensation in areas of the body where the nerve runs, as well as decreased pelvic function. You can simply check whether the sciatic nerve is pinched. The patient needs to lie on his back, stretch his legs forward. Then you need to raise one leg without bending it. If there is pain when lifting, the sciatic nerve is pinched.

Forms

There is no special classification of the disease. There are several separate forms depending on the mechanism of occurrence:

• radicular: associated with irritation of the spinal cord roots at the point of their exit from the spinal column;
• reflex: associated with overstrain of muscle fibers at the site of the nerve passage.

There is also a classification of neuralgia depending on:

• causes: primary (associated with damage or inflammation of the nerve itself) and secondary (due to other diseases);
• localization: unilateral and bilateral;
• course of the disease: acute and chronic.

Blockade

If the pain cannot be eliminated using traditional methods, they resort to the blockade procedure. This is a short-term drug blocking of one link in the mechanism of pain development . The blockade is carried out by introducing the necessary medicine into a certain point of the body.

The procedure has one goal - to effectively and quickly relieve pain. Usually one injection is enough to eliminate it, but sometimes a course of up to 15 injections is given with a break of several days.

Indications

Compared to other conservative treatments, blockade has many advantages:

• Fast and successful result.
• The possibility of repeating the blockade if a new exacerbation occurs.
• The risk of adverse reactions is minimal if proper technique is followed.
• In addition to pain relief, this procedure has antispasmodic and anti-inflammatory effects.
• The blockade relieves swelling of the nerve roots if they are inflamed.

But it should be noted that the procedure can be done no more than 4 times a year.

Contraindications

Unfortunately, there are also restrictions on the blockade:

• Increased bleeding, i.e. hemophilia or thrombocytopenia.
• Infectious skin diseases.
• Sensitivity to medications used.
• The patient's serious condition.
• Heart pathologies.
• Myasthenia.
• Mental illness.
• Hypotension.
• Epilepsy seizures.
• Lactation period and pregnancy.
• Childhood.
• Severe liver diseases.

There is no need to hide the fact that complications happen. But if the procedure is carried out under sterile conditions and by an experienced doctor, then the risk of consequences is significantly reduced.

How is the procedure performed?

To carry out an intercostal blockade, the patient lies on his healthy side. First, intradermal infiltration is made with a thin needle, it is called the “novocaine nodule.” Then a thick needle is passed through this area to the lower edge of the rib. The needle is then inserted under the edge of the rib.

Pay attention to how the nerve block is performed

10 ml of a special solution is injected into the painful area of ​​the intercostal space . If the blockade is done in the area of ​​the posterior ribs, then the integrity of the vessels must be monitored.

Medicines for blockades

Depending on the medicine used, there are types of blockades:

1. Single-component, containing one drug.
2. Two-component, when two medications are used.
3. Multicomponent, from 3 or more products.

Local anesthetics. These drugs are used for all blockades. They block nerve impulses and turn off sensation at the injection site.

Most often, lidocaine and novocaine are used for blockade. Representatives of these anesthetics:

• Novocaine.
• Lidocaine.
• Bulivakain (merkain).

The drug, dosage and concentration are selected only by the attending physician.

Corticosteroids. Strong anti-inflammatory agents that eliminate pain and swelling. For better effect, combine with local anesthetics.

Use:

• Hydrocortisone.
• Dexamethasone.
• Diprospan.
• Kenalog.

Other drugs. These are additional means that are used in multicomponent blockades. They cannot eliminate the pain on their own.

Usually used:

• Vitamins belonging to group B.
• Thrombolysin.
• Lidaza.
• Voltaren.
• Rumalon.

For intercostal neuralgia, the blockade is very effective and quickly relieves pain. But we should not forget that this is a serious procedure and cannot be neglected. If you violate the execution technique, it will lead to serious consequences. .

Video: “Basic prevention of intercostal neuralgia”

Causes

The list of main causes of intercostal neuralgia includes:

• degenerative-dystrophic diseases of the spine: osteochondrosis, arthrosis, hernias and protrusions of discs, etc.;
• uneven or excessive load on the spine and back muscles (due to carrying heavy objects, poor posture, etc.);
• spinal column deformities (primarily scoliosis);
• diseases of the nervous system, in particular multiple sclerosis;
• infectious lesions: tuberculosis, herpes zoster, influenza;
• injuries of the spine and chest, surgical interventions in this area;
• tumors in the ribs, sternum, spinal column;
• taking certain medications;
• increased load on the respiratory muscles and abdominal muscles;
• increased intra-abdominal pressure, including during pregnancy.

In addition, intercostal neuralgia can occur secondary to other diseases, for example, pleurisy, pathology of the digestive system, kidney disease, thyrotoxicosis, and immunodeficiency states. Adolescents during the period of active skeletal growth may also experience similar symptoms.

What is a pinched sciatic nerve?

The sciatic nerve is the largest in the human nervous system. The sciatic nerve originates in the pelvic area. Passes through the sciatic foramen, through the buttock, and descends to the popliteal cap. Its functions include supplying all the muscles of the lower extremities with nerve impulses, thanks to which movement occurs - a person can walk, run, jump, and so on. Accordingly, when the sciatic nerve is pinched and inflamed, a person experiences problems with movement, and also feels pain that starts from the lower back and goes down to the foot. A pinched nerve is a compression of the nerve that interferes with the normal flow of nerve impulses to organs and tissues. Another name for this disease is sciatica.

Symptoms

The main symptom of intercostal neuralgia is severe pain in the chest along the nerve. As a rule, it occurs suddenly and resembles an electric shock, gradually spreading along the ribs. The nature of the sensations can be different: shooting, pulsating, constant, burning or dull.

Deep breathing, turning the head or body, bending, pressing or simply touching the chest causes a pronounced increase in pain. In addition, characteristic signs of neuralgia are:

• persistence of pain at night;
• the ability to determine the epicenter of pain;
• redness or paleness of the skin in the affected area;
• a feeling of tingling, crawling or, conversely, numbness along the affected nerve;
• slight muscle twitching in the affected area.

As a rule, during an attack of neuralgia, a person tries to lie or sit motionless in a position in which the pain becomes slightly less.

If the cause of the pain syndrome is herpes zoster, first redness appears on the skin along the affected nerve, then numerous blisters that burst, forming crusts. After recovery, increased pigmentation remains in this area for some time.

Differences from myocardial infarction

Chest pain, especially on the left, can be a consequence not only of intercostal neuralgia, but also of more serious problems. The most dangerous is myocardial infarction. This condition requires emergency medical attention. The characteristic differences in pain are:

• occurrence against the background of physical, less often psycho-emotional stress;
• spread to the left arm, shoulder, left half of the neck and lower jaw;
• no changes when turning the body, bending, pressing on the sore area;
• decreased intensity when taking nitroglycerin and its analogues.

A heart attack is often accompanied by cold, sticky sweat, pale skin, dizziness, and fear of death.

It is important to remember that the signs of a cardiovascular accident and intercostal neuralgia are not always so radically different. An accurate diagnosis can only be made by a doctor.

What is intercostal neuralgia?

The cause of the disease is pinching or irritation of the nerve endings passing between the ribs . Intercostal neuralgia begins to manifest itself as severe pain, which intensifies with sudden movements, coughing and even deep breathing.

Intercostal neuralgia manifests itself as acute pain with sudden movement, coughing and breathing

The pathology is considered serious, with a lot of negative consequences. Therefore, timely diagnosis and adequate therapy are necessary, which should be carried out by a qualified specialist. This can be explained by the fact that the disease resembles other diseases in its symptoms.

The manifestation of intercostal neuralgia can easily be confused with renal colic or cardiac pathology . The disease is not considered dangerous, but since the background of development is serious pathologies, the risk of complications is very high. To prevent this from happening, it is recommended to immediately consult a doctor who will prescribe a set of procedures. Intercostal neuralgia is successfully eliminated and even treatment at home is allowed, naturally, with the permission of a doctor.

Video: “What is intercostal neuralgia and how to diagnose it”

Diagnostics

Intercostal neuralgia, regardless of the severity of the pain syndrome and its location, requires a full diagnosis. The following examinations will help distinguish it from other pathologies:

• questioning and medical history: identifying the nature of the sensations, the conditions of their occurrence, the duration of the attack, concomitant diseases;
• examination and palpation: the doctor evaluates the appearance of the skin, checks the reaction to movements, pressing, turning, bending, assesses the severity of reflexes;
• laboratory diagnostics: general and biochemical blood tests, general urine tests: allows to identify signs of damage to the heart muscle (tests for troponins, CPK), inflammation, renal pathology, gastrointestinal diseases, etc.; the exact set of tests depends on the location of the source of pain;
• ECG, ultrasound of the heart: allow you to identify or exclude cardiovascular pathology;
• X-ray, CT or MRI of the thoracic spine: helps to identify osteochondrosis, osteoporosis, tumors, hernias and protrusions of intervertebral discs, etc.;
• Chest x-ray: allows you to assess the condition of the lung tissue and identify signs of tumors;
• Ultrasound of the kidneys, abdominal organs (excludes relevant pathology);
• FGDS to exclude pathologies of the esophagus, stomach, duodenum;
• myelography, contrast discography, electrospondylography to assess the condition of the spine, intervertebral discs, spinal cord and its roots.

If necessary, consultations with narrow specialists and additional examinations are prescribed.

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Treatment

Intercostal neuralgia requires complex and often long-term treatment, including medication, physiotherapy, massage, etc.

Drug therapy

In the acute phase of the disease, therapy is aimed at relieving pain and improving the patient's condition. Depending on the specific clinical situation, the following are prescribed:

• non-steroidal anti-inflammatory drugs (NSAIDs): products based on diclofenac, nimesulide, ibuprofen, meloxicam and their derivatives; used in tablet, injection and local (creams, ointments, patches) form;
• analgesics: analgin and products based on it; like NSAIDs, they relieve pain;
• muscle relaxants to eliminate muscle spasms: mydocalm, etc.;
• group vitamins: milgamma, neuromultivitis, etc.; necessary to restore normal functioning of nerve fibers;
• sedatives to reduce the psycho-emotional component of pain and improve sleep.

If necessary, the following may additionally be prescribed:

• anticonvulsants: inhibit the passage of pain impulses;
• antidepressants to relieve tension;
• antihistamines and diuretics: relieve tissue swelling, especially relevant for pinched nerve roots;
• antiviral drugs for herpes zoster;
• glucocorticosteroids for persistent pain and severe inflammation that cannot be relieved by milder means.

Physiotherapy and exercise therapy

Physiotherapeutic procedures are prescribed after the acute pain subsides. Help speed up recovery:

• UHF;
• reflexology;
• magnetic therapy;
• electrophoresis;
• laser treatment;
• paraffin applications;
• mud therapy.

These procedures help improve blood circulation and metabolism in the affected area and accelerate the regeneration of nerve tissue.

Physical therapy exercises are prescribed after complete recovery. The main goal of gymnastics is to unload the back muscles. The complex is developed individually. The first classes should be carried out under the supervision of a specialist; in the future, home exercises are allowed.

Other treatments

Since very often the cause of intercostal neuralgia is pathology of the spine and spinal cord, the following are often used as additional methods of influence:

• acupuncture;
• manual therapy;
• therapeutic massage, including the use of warming agents;
• Shiatsu massage (acupressure);
• osteopathy;
• underwater traction and other techniques.

Like all medical procedures, these techniques are used only in a clinical setting and are carried out by specialists with medical education and the appropriate certificate.

What injections are given for a pinched sciatic nerve?

The doctor should tell you what injections can be given if the sciatic nerve is pinched. Self-medication for such a disease is unacceptable. In addition, the injections must be administered by an experienced and trained person. For example, this could be a treatment room nurse. Also, if the patient’s movement is difficult or causes him pain, injections can be given at home, but a specialist can also be invited for this.

Novocaine, Lidocaine

When the pain torments the patient, does not allow him to move normally, and does not go away even after a long rest, the doctor may decide to prescribe a novocaine or lidocaine blockade (anesthetic injection). The injection is placed at a certain point on the buttocks. The analgesic effect occurs quickly. Lidocaine has a greater effect. After administration of this drug, the pain subsides faster. Lidocaine is also less toxic than novocaine. There is a wide list of contraindications for such blockades:

• allergies to drugs;
• bradycardia (low heart rate);
• severe liver failure;
• pregnancy;
• arterial hypotension;
• myasthenia gravis;
• and others.

Trigamma, Milgamma, Neurobion

Milgamma is a medicine that contains a number of B vitamins. It also contains benfotiamine, which has high bioavailability and tends to accumulate in cells and tissues. Pyridoxine present in the composition activates metabolic processes and helps to quickly restore muscle performance. Milgamma's injection helps to quickly relieve pain, as well as eliminate the cause of pinching.

Another drug that contains a complex of B vitamins is Trigamma. Neurotropic B vitamins contained in Trigamma have a positive effect on inflammatory and degenerative diseases of the nerves and musculoskeletal system.

Neurobion is another drug that includes a complex of B vitamins. Its pharmacological properties are similar to those of the above drugs. These drugs, unfortunately, are not a 100% guarantee of recovery. On the contrary, in about 50% of cases they cause side effects. The prescription of these injections should be made after a detailed examination, identification of contraindications and assessment of possible risks and expected benefits.

Dexamethasone, Methylprednisolone, Prednisone

If the sciatic nerve is pinched, steroidal anti-inflammatory drugs may be prescribed. This may be Dexamethasone, Methylprednisolone or Prednisone. The main active ingredient of these drugs is cortisol (a biologically active glucocorticoid hormone of steroid nature). Injections of these drugs help not only eliminate pain, but also relieve swelling of nerve fibers. However, such injections cannot be given for more than 5-6 days - side effects may occur (weight gain, mental disorders, glucose intolerance, and others).

Diclofenac, Voltaren, Dikloberl, Ortofen

Non-steroidal anti-inflammatory drugs are also used in the treatment of pinched sciatic nerve. The most common are Diclofenac, Voltaren, Dikloberl, Ortofen. The active substance of these drugs is diclofenac (a derivative of phenylacetic acid). After injections with the listed drugs, the pain goes away quickly, but this effect does not last long. There are also a number of side effects - nausea, vomiting, liver failure, urticaria, hearing loss, heart failure, decreased visual acuity and much more.

Complications

Complications of intercostal neuralgia occur quite rarely, however, in severe cases, without appropriate treatment, the patient may encounter the following problems:

• severe spasm of the respiratory muscles, limiting inhalation and exhalation;
• inability to get out of bed due to significant increase in pain;
• excessive pain syndrome that is not relieved by conventional analgesics and NSAIDs;
• heart rhythm disturbances due to muscle spasms and nerve pathology;
• decreased leg mobility.

In addition, complications can be caused by attempts to be treated outside the clinic. Abscesses and cellulitis after acupuncture, paralysis and decreased sensitivity after manual therapy are not a complete list of problems. That is why you should not treat intercostal neuralgia either independently or with the help of dubious specialists.

Prevention

Prevention of intercostal neuralgia is mainly general measures aimed at strengthening the muscle frame and improving the health of the body. Neurologists recommend:

• lead an active lifestyle, play sports at an amateur level;
• minimize hypothermia and colds;
• watch your posture;
• avoid lifting heavy objects;
• maintain a high level of immunity;
• eat a balanced diet, if necessary, take additional vitamins, especially group B;
• treat chronic diseases in a timely manner;
• avoid stress, get proper rest and ensure yourself at least 8 hours of sleep every night.

Following these simple rules will significantly reduce the risk of developing intercostal neuralgia.

Treatment at the Energy of Health clinic

Doctors at the Energy of Health clinic will always come to the aid of patients with intercostal neuralgia. We offer each client:

• a full examination with consultations with specialists for an accurate diagnosis;
• individual selection of treatment regimen;
• services of a qualified chiropractor;
• own exercise therapy room for the most effective and safe exercises;
• modern methods of physiotherapy;
• massotherapy;
• drug blockades for severe pain syndrome.

Regular observation by a neurologist after the acute period of the disease has subsided will help prevent recurrent attacks.

Advantages of the clinic

In the neurology department of the Energy of Health clinic, every patient receives the highest level of specialists and modern equipment for diagnosing and treating diseases. We take an integrated approach to therapy and use not only medications, but also physiotherapy, exercise therapy and massage.

Treatment is prescribed only after a thorough examination and is monitored by a specialist until the patients fully recover. Adequate prices, convenient location, private parking - we do everything for the convenience of our clients.

If intercostal neuralgia interferes with living, walking and moving, do not delay treatment. Sign up for the Health Energy clinic and get rid of pain.

When is injection therapy prescribed?

It must be said that injections for a pinched sciatic nerve are not prescribed immediately. That is, when the first signs of the disease appear, neurologists

(provided that the patient took care of his health and came to the appointment after the first symptoms of the pathology) they begin therapy with painkillers, anti-inflammatory drugs, and also prescribe massage courses and physiotherapeutic procedures. If a positive effect cannot be achieved for some time, the pain does not go away, but becomes stronger and occurs more often, the question of prescribing injections arises.