Discogenic radiculopathy L5 – S1, the most severe pathology of all vertebral pain syndromes. The main symptoms – a sharp, persistent pain that severely restricts the person’s movements. Half of all patients the disease lasts more than 6 weeks and is a cause of disability.
The reason
The main reason for severe pain – herniated disc, although in some cases there is compression of the roots due to diagnosed with spondylosis, or spondylosis. Also may be due to osteophytes, hypertrophy of ligaments, facets and other anatomical structures of the spine.
Persistent pain syndrome in most cases is associated not so much with the roots pinched nerve endings, as with the processes that run after the drive will move in the epidural space. And, finally, intense pain may occur due to an inflammatory process in the spine or in the spinal ganglia.
The result of all this is a long-term painful sensations in the lumbar-sacral region, which with great difficulty can succumb to the treatment with standard analgesic and anti-inflammatory drugs.
The clinical picture
The main symptom of lumbosacral radiculopathy is a strong pain attack, which does not abate throughout the day. Strongly expressed muscle-tonic syndrome, which may be accompanied by deformity of the spine according to the type of scoliosis.
In the diagnosis it is necessary to consider the violation of the sensitivity, not only tactile, but pain, temperature and vibration. Can be the reduction or even complete loss of tendon reflexes. Other symptoms may include hypotonia and weakness of the vertebral muscles, which are innervated by the affected nerves.
Conservative treatment
Discogenic radiculopathy L5 – S1 rootlets on the left, when properly selected treatment cured for several weeks. And only in particularly persistent uncomplicated pain syndrome and with a sharply limited capacity in the movements carried out surgery.
The literature describes cases of early surgical intervention with discogenic radiculopathy, which helped to overcome the pain almost immediately. However, after a couple of years after the operation, this method will not have any advantage over drug therapy and lowers the risk of developing chronic pain. At the same time, a later operational treatment efficiency is not inferior to the earlier.
As for conservative treatment, in most cases it is ineffective. It was found that epidural blockade with corticosteroids can bring temporary relief. Proved ineffective and the practice of prolonged bed rest, and a quick return to normal lifestyle leads to prevent the development of chronic pain syndrome.
Drugs
The treatment of discogenic radiculopathy based medication from the group of NSAIDs and muscle relaxants and painkillers. Additional methods include massage, medical gymnastics, manual therapy. But the effectiveness of these methods is limited and in most cases they do not allow to quickly arrest the pain
Good effect was achieved after application of gabapentin (tebantin). As for other drugs from this group, gabapentin belongs to the group of anticonvulsants, their effectiveness has not been studied and is not proven.
Complications
As any other pathology of discogenic radiculopathy L5 – S1 can have many unpleasant consequences. Among them the most dangerous can be considered paralysis of the lower limbs, leading to disability. Delayed treatment to professionals can be a cause of chronic sciatica in which any movement will cause severe pain.
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