Fizio Aktiv
22. May 2019.

What is sciatica?

Sciatica is a type of neuralgia, ie. pain occurring in the area of nerve innervation. These are pains that occur due to pressure on the sciatic nerve at the place where it comes out of the spinal cord, ie on one or more of the five spinal nerve roots that together build this nerve. It is important to note that sciatica means a set of symptoms and not a diagnosis that explains the cause of the nerve pain itself. Therefore, it is important to know the cause of the disease that is accompanied by sciatica symptoms, so that we can act on the very cause of the problem and, by eliminating it, eliminate the sciatica itself. Symptoms such as pain, tingling, and muscle weakness will vary in intensity, prevalence, and presence. This indirectly helps us diagnose the problem.



How does sciatica occur?

Išijas lečenjeThe sciatic nerve is the largest nerve in the body, it is the largest in size, and it has the largest path of spread. Considering these facts, it is logical that the chances for problems of this nerve in relation to the others are the greatest, which has been proven as a percentage.

It is estimated that 80% of cases of sciatica are caused by problems related to the spine. It can be:

  1. Spondylolisthesis change of position of one vertebra in relation to the other, more precisely sliding of the vertebra and its movement out of the bearing. The consequence of this is that when the vertebrae move, there is physical contact with nerve structures, which causes pressure and inflammation of the nerves or spinal cord.

Diagnosis is achieved by X-ray.

  1. Spinal stenosis Spinal stenosis, or compression within the spinal canal, causes a narrowing of the space in which the spinal cord, cauda equina, and sciatic nerve roots are located.

It is best diagnosed by magnetic resonance imaging.

  1. Degenerative damage to the intervertebral disc- Causes damage to the disc wall which, when loosened or cracked, causes the disc walls to swell and bulge on it, pressing and irritating the enrv, or leaking the contents of the disc that presses on the nerve and causes sciatica.

It is best diagnosed by magnetic resonance imaging.

  1. Injuries- vertebral fractures, crushing of surrounding tissue, injuries to muscles, ligaments, swelling, hematomas can cause pressure and inflammation of the sciatic nerve .

Diagnosed by ultrasound, X-ray, as well as magnetic resonance imaging, depends on the injury.

  1. Osteophytes – bony outgrowths which, by their position, can press on the sciatic nerve and give symptoms of lumbosciatica.

Diagnosed by X-ray.

  1. Pregnancy- Enlarged uterus, fetus, amniotic fluid, can cause pressure on nerve roots or sciatic nerve and give symptoms of lumbosciatica. Altered hormonal activity can also alter the contents of the intervertebral discs, which can be more susceptible to damage and lead to sciatica.

Diagnosed by magnetic resonance imaging.

  1. Piriformis syndrome- is a specific situation in which a muscle called the piriformis presses on the sciatic nerve. The reason for this is the very small physical distance of the muscle in relation to the nerve, and the spasm of this muscle can cause sciatica. According to research, in 17% of people, some or all of the sciatic nerve passes through the muscle, which creates very favorable conditions for the occurrence of this syndrome.

It is diagnosed by a clinical examination, and the diagnosis is completed by ultrasound.


The symptom that definitely dominates sciatica is pain . The severity of the pain can vary from insignificantly mild to severe. It can occur in the form of mild fatigue, dull pain or tingling, all the way to severe pain that limits or prevents daily activities. The pain usually occurs on one side, which depends on the cause of the pain. The prevalence of pain begins in the back, in some cases it stays there and sometimes it can spread all the way to the feet. Pain occurs in characteristic regions, which are determined by parts of the skin or dermatomes that innervate different nerve roots. If the pain spreads to the lower leg, ie it does not spread below the knee, there is a suspicion that it is pain that does not originate from the pressure on the nerves or the spine, but that the problem is in the hip. The pain intensifies after standing, sitting, at night after an active day, after sneezing, coughing, laughing, vomiting.

Important accompanying symptoms, in addition to pain, are numbness, paraesthesia and muscle weakness. Numbness can spread all the way to the feet, ie to the toes, in the form of tingling, tingling, needle stings. Muscle weakness is a more serious sign that the nerve compression is great and in that case more invasive methods are needed.

Išijas simptomi


How to cure sciatica?

A complete treatment plan absolutely depends on an accurate diagnosis of the cause of sciatica as a symptom. Depending on that, the treatment is based on simple stretching exercises and the application of some medications, all the way to surgery.

In essence, in the acute phase, while the pain is strong, it is advisable to rest for a short time within a few days, not more than 5 days. There is no evidence that rest greatly affects recovery or that movement is reduced, even more so, from our experience, patients who have just normalized their activities have recovered faster. To normalize activities means to perform daily activities, but in the right way with respect for protective positions, as well as in a certain intensity. The essence is that a person should not stop with activities, but to reduce them to some extent, and as we said, follow the rules and restrictions. It is forbidden to stand for a long time as well as to walk for a long time (the term “long” means from person to person the moment when the problems intensify), lifting loads heavier than 5 kg, sudden movements, spinal twisting movements, while spinal rotation movement is strictly forbidden. associated with flexion. If the symptoms are severe, you can take medication (some analgesics, antirheumatics, sedatives, muscle relaxants or a combination of some drugs from these groups). Manipulation and mobilization techniques are being done, where expelling air with an audible “CLICK” and adjusting the correct position of the facet joints causes immediate relief of symptoms.

When the pain subsides, if the pain subsides, the disease enters the subacute phase, where other symptoms are alleviated, and the person is more mobile and active. You should not relax too much and overdo the activities so as not to return the problem and pain. In this phase, exercises are given in addition to all normal activities. The exercises are specially tailored to each person, depending on the case by our expert team.

Physical therapy is also included, in the form of all its modalities:

Depending on the cause, the use of orthotic aids in the form of lumbar corsets is recommended, with the aim of relieving the pressure on the discs and nerve roots, and at the same time relaxing the muscles, which gives support to the body to start the healing process.

In our office we work, and in this case we recommend innovative therapies such as SALUS-TALENT and INDIBA-ACTIVE CELL, therapies with incredible ability to reduce inflammation, which is common in sciatica, strong analgesic effect, muscle relaxant effect, which is especially painful because it is mostly one side of the back muscles in spasm. The effects of enhancing tissue regeneration, at the cellular level by activating the natural mechanisms of the cell, are most important in tissue recovery.

50% of people get cured in the first 6 weeks, while 90% get cured after 3 months. The remaining 10% mostly need surgery, because these are difficult cases that cannot be solved with physical therapy. Sciatica decompression surgery is indicated if the pain does not decrease for 3 months in addition to all therapies, if there is a progressive weakening of the muscles, if there is a disorder of sexual functions or control of urination.

LET YOUR CHOICE FOR SOLVING THE PROBLEM BE WITH US! ACCURATE DIAGNOSIS AND EFFECTIVE THERAPY ARE THE ONLY WAY TO SOLVING THE PROBLEM, THE WAY WE ARE GUIDED TO. Using modern methods of physical therapy techniques such as manipulation and mobilization of joints, orthotic devices FOR BACK PAIN, MODERN APPLIANCES LIKE SALUS-TALENT, INDIBA-ACTIVE CELL AND possess experienced and knowledgeable physical therapist who WILL CHOOSE THE RIGHT PROGRAM KINEZITERAPIJSKI suited for you.

Electromagnet of high magnetic induction which has an excellent analgesic effect on the joints, dispersion effect on the swelling, so it has proven to be extremely effective in spinal pain problems such as spondylosis, dysarthrosis, lumbago, lumbosciatica, … This magnet is the first electromagnet to be used. it is dosed individually according to the patient’s feeling, so that unlike standard magnets, the patient can feel from mild vibrations to very strong muscle contractions with the therapy on this magnet. The analgesic effect, ie the effect of reducing pain, is felt very quickly, sometimes even after the first treatment.

This is an extremely pleasant therapy for the patient. It is done in the form of a massage while the free electrode is in the therapist’s hand. It has the best effect on soft tissues such as muscles, tendons, ligaments, … It has shown itself perfectly in reducing muscle spasm, ie. muscle relaxation, elimination of swelling, and has the fastest analgesic

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