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On the anatomical plan, the pains sciaticas correspond to a compression of the previous root, motor car, of the nerve sciatica. The pains are generally typical and the most often isolated. Most sciatalgies of the sportsman is benign and only justifies rest, accompanied by a simple treatment analgesic and anti-inflammatory. More of the half of the sciaticas heal spontaneously, in an average of 4 to 5 months. In some cases the important lesions with rupture of the intervertebral disk or the hernias discales provoking lasting pains can force however, to a surgical gesture. The main exam is the scanner, that measures the extent of the damages very precisely. The medical treatmentThe symptom pain is in first line: the analgesics are efficient, that it was about the anti-inflammatory and décontracturants or of the analgesics class III (morphine and derivative of the opium). The infiltrations of corticoides are frequently a balance conclusive, all as the mechanical techniques, used jointly. Lumbar Contention, chiropractic and tractions are efficient in close to 70% of the cases. The former dogma of the absolute rest is discussed currently by the specialists. it seems acquirement that a certain liberty of movement, with resumption very prudent of the activities, don't change the prognosis of the sciatica. The surgeryIt is only in case of failure of the medical treatment and aggravation of the symptoms that a surgical gesture will be considered. Traction is indeed useless for the hernias of the lumbar region. The objective is to relieve the compression of the nervous root quickly. For it, one can either: - To destroy the core hernie by a chemical substance. It is the nucleolyse to the chymopapaine. its indications must be weighed carefully. The technique is sure with 75% of good results and drag the recovery in some weeks;
- To extract the fragment of disk making hernia surgically. It is the method that gives the best results:Â close to 100%. it asks for a perfect technicality;
- To eliminate the bothersome disk fragment by percutaneous way. The method knew its improvement in the beginning of the years 90. its results are comparable to those of the nucleolyse.
The indications of the different techniques will be weighed and will clearly be exposed to the patient. The extreme casesWhen the sciatica accompanies or is prolonged by signs of paralysis of the lower members, the emergency is before all surgical. Only the surgery can heal those shapes of sciatica. The continuations of the treatment of the sciaticaThe post-operative rehabilitation will be an essential time of the recovery.it must be progressive and sufficiently prolonged. The resumption of the physical activities is possible, in a selective manner, thanks to activities as the swimming. it must be her also very progressive and made under strict medical control until complete funding. In any case, the patience imposes itself:Â it is only at the end of some months that the recovery of a sciatica by hernia discale can be affirmed. Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â 2009-04-27
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