x`?kzlh (Sciatica) ,d ckr O;kf/k] vk;qoSfnd erkuqlkj dkj.k funku o fpfdRlkA

x`?kzlh ,d ,slh O;kf/k gS] tks vR;f/kd d’Vnk;d ,oa dfBukbZ Bhd gksrh gS] vkSj nh?kZdky rd izHkkfor djrh gSA x`?kzlh izk;% e/;e o o`)koLFkk esa gksrh gSA x`?kzlh esa osnuk fLQdizns”k vFkkZr dej ls izkjaHk gksdj Øe”k% dVh ds fiNys Hkkx m:]tkuq,-tU?kk rFkk iSj rd tkus okyh fof”k’V izdkj dh osnuk dks x`?kzlh dgrs gSA

          fLQdiwokZ dVh i`’Bks:tkuqtÏkian Øekr~A

          x`?kzlh LrHHk :dksnSx`Zgfr LiUnrseqg%AA

          okrk}kr dQkRRknzk xkSjokjkspdkfUUkrkA

      p-fp- 28

x`?kzlh jksx esa loZizFke furEc blds ckn dVh] i`’B m: izns”k] tkuq tU?kk vkSj iSj esa Øe”k% tdMkgV osnuk lqbZ pqHkksus lh osnuk gksrh gS] vkSj ckj&2 bu izns”kksa esa Linzu gqvk djrk gSA x`?kzlh jksx esa ;g y{k.k dqfir ok;q ls gksrk gSA ;fn bl jksx esa okr o dQ dk  izdksi gks rks rnzk] “kjhj esa Hkkjhiu vkSj Hkkstu esa v:fp ds lkFk&lkFk mi;qZDr y{k.k gksrs gSA

        vk;qosZn erkuqlkj x`?kzlh d.Mjk dh O;kf/k gSA

  vkpk;Z lqJqr us x`?kzlh dks fuEu rjhds ls of.kZr fd;k gSA

      ikf’.kZ izR;kxq­ayhauka rq d.Mjk;kfuykfnZrkA

     lDFku% Ks;a fux`gh;kn~ x`?kzlh frfg lk Le`rkAA

l-fu

vFkkZr ,Mh rFkk izR;sd iknkMafy;ksa dh d.Mjk esa tc okr ls izdqfir gksrh gS rFkk Vkax ds ladksp foLrkj dks jksd nsrh gS] rc bls x`?kzlh jksx dgrs gSA

pw¡fd ;g d.Mjk dh O;kf/k gS] vr% lqJqr us blesa fljkos/k fpfdRlk crkbZ gSA

izdkj& 2 izdkj

      ¼1½ okrt x`?kzlh

      ¼2½ okr dQt x`?kzlh

vk/kqfud erkuqlkj ¼1½ Higher Sciatica

                         ¼2½ Lower Sciatica

dkj.k&

      vk/kqfud erkuqlkj&

¼1½ Lumber Spinal Stensis (narrowing the Spinal canal in the lowerback)

¼2½ Degenrative disc discase

¼3½ Spondy lolisthesis (A condition in which on rertelra slits forwards over another,

¼4½ Pregnancy

¼5½ Spinal disc herniation

¼6½ Spinal Stenosis

¼7½ Pirifarmis emdrome

¼8½ Tumour im Pining on the Spinal cord or the naerne roots.

¼9½ cauda egwna eyndrome

x`?kzlh eq[; :Ik ls Lumber ------- Nerver L₃, L₄, L₅ and Sacral Nerva S₁, S₂ or S₃ ds Nerve Root esa ncko iM+us ls ;k Sciatic Nerve ij dgha Hkh ncko (Comperssion) iM+us ij gksrk gSA

& fdlh izdkj dk vk?kkr gksuk

- Aneurgsm of the hypogastric artery

vk;qosZn erkuqlkj&

     vk;qosZn esa x`?kzlh dks okr o okr dQ ls mRiUUk ekuk gSA rFkk “kq) 80 okr fodkjksa esa Hkh bldh x.kuk dh gSA

¼1½ okr izdksid funku] vkgkj o fogkj dk lsou djukA

¼2½ e`nq “k¸;k ;k vlu ij lksuk

¼3½ cSBs jguk ;k lka;dy vf/kd pyuk

lEizkfIr&

      Loizdksid dkj.kks ls izdqfir okr vFkok okr dQ dVh i`’B m:] tkuq tU?kk vkSj iSj esa “kwy mRiUUk djrk gS] rc x`?kzlh jksx dh mRifRRk gksrh gSA

x`?kzlh esa izdqfir okr d.Mjk esa tkdj bl jksx dks mRiUUk djrk gSA

Sciatica Nerve fLQ~d izns”k (Glutialrgg) ls fudyrh gS] rFkk mldh “kk[kk,a iSjks rd tkrh gS] vr% osnuk Hkh fLQ~d izns”k ls izkjaHk gksdj Øe”k% iSj rd tkrh gSA

ijh{kk& (How to make diagnosis)-

1-   The most applicd diagnostic test is the straight leg rise (SLR test) to Prodace L ase Geu’s sign

2-   MRI

3-   CT-Scan

4-   X-Ray L.S. (Lumbosacral Spine)

SLR Test- jksxh dks ihB ds cy mRRkku lqykdj iSjks dks lh/kk QSykdj] fQj jksxh dks vius iSjks dks vkleku dh vksj mBkus dks dgrs gS] ;fn jksxh iSj ugha mBk ikrk ;k de mBk ikrk gS] tc mlls T;knk mBkus dh dksf”k”k djrk gS] rks osnuk gksrh gS ¼4½ 30⁰ to 70⁰  SLR Test the gS rks Sciatica gks ldrk gSA

y{k.k&

1-    iSjks esa tdM+kgV

2-    osnuk

3-    lqbZ pqHkksus tslk nnZ vkSj QM+du

4-    ihM+k dk izlkj dej ds ihNs ls “kq: gksdj mDr tkuq tgka vkSj iSjk rd tkrk gSA bu LFkkuksa ij LrC/krk vkSj Linzu Hkh gksrk gSA

vk/kqfud erkuqlkj

1-   Pain in the rear or leg that is worse when sitting.

2-   Burning or tingling down the leg.

3-   A constant Pain on one Side of the rear.

4-   A Shooting Oain that makes it difficult to sleep

Sciatica useally affects only one side og the Lower body often the pain wxtends from the lower back all the way through the back of thigh and down through the leg

Dee pending on where sciatic Nerve is affected the pain may also extend to the foot.

fpfdRlk lw=&

1-    pjd vuqlkj xqYQ lfU/k esa d.Mjk ok fljk ds chp esa fljkos/k o vfXudeZ djuk pkfg,A ;fn x`?kzlh esa okr dQ dk vuqca/k gS] rks vfXudeZ djuk pkfg,A rFkk lkFk gh vuqoklu rFkk ^^vUrj d.MjkxqQafljk oLR;fXudeZ paA fu:g cfLr iz;ksxA                                              p-fu- 28

x`?kzlh esa jDreks{k.k dSls dke djrk gS] bldk fopkj djus ij irk pyrk gS] fd d.Mjk dk fuekZ.k jDr ls gksrk gS] vkSj x`?kzlh esa okr d.Mjk esa vkfJr gksdj osnuk mRiUUk djrk gSA

^^jlkr~LrU;afL=;k jDrvl`tk d.Mjkfljk**

vr% jDreks{k.k ls uohu d.Mjk dk fuekZ.k gksrk gS vkSj dqfir ok;q dk vuqykseu gks tkrk gS vkSj osnuk esa deh vkrh gSA

vkpk;Z lqJqr us rks tkuq ds Åij ;k uhps 4 vaxqy izns”k esa fljkos/k djuk pkfg,A

vkpk;Z okxHkVV~ us x`?kzlh dks fo”okph ds leku gh ekuk gS vUrj dsoy bruk gS] fd fo”okph gkFk esa gksrh gS vkSj x`?kzlh iSj esa gksrh gSA

2-    ckyqdk Losn djuk pkfg, vkSj vH;ax+ gYds gkFkksa lsA

3-    m’.k miukg ck/kuk pkfg,A

4-    jksxh dks Hard bed esa lqykuk pkfg,A

5-    vuqoklu o fu:g cfLr dk ckjh&ckjh ls iz;ksxA

6-    ,j.MrSy iku

7-    yk”kqu {khj dk iz;ksx

Hkko izdk”k ds vuqlkj&

1-    x`?kzlh jksx esa ihfM+r euq’; dks vPNh rjg ls fojspu o oeu djkuk pkfg,A vkejfgr o nhIrkfXu le> dj LusgofLr nsuh pkfg,A tc rd Å/oZ”kqf) ¼oeu½ ugha djk;k tkrk rc rd HkLe esa gou ds leku Lusg fujFkZd tkrk gSA

x`?kzL;kRRkZ jua lH;x~ jsds.k oeusu okA

KkRok fujkxa nhIrkfXu ofLrfHk% leqikpjsrAA

uknks ofLrfcf/ka dq;kZ?kkonw/oZ u “kq);frA

Lusgks fujFkZd% l L;knHkLeU;so gqra;FkkA

Hkko izdk”k fp- 24

2-    izkr% dky ,j.MrSy dks xksew= ds lkFk ,d ekl rd ihus ls x`?kzlh rFkk mlxzg u;j gks tkrk gSA

x`?kzlh O;kf/k esa mi;ksxh dqN izeq[k fpfdRlk ;ksx&

1-    ;ksxjkt xqXxqy

2-    Lkehj iUUkx jl

3-    o`grokr fpUrkef.k ;ksx

4-    J`xaHkLe

5-    vfXurq.MhoVh

6-    egkukjk;.k rSy

7-    egkfo’kxHkZ rSy ¼vkekoLFkk esa½

8-    ckrxatkdq”k jl

9-    ,dkxaohj jl

10-  vej lqUnjh oVh

11-  fo’kfrUnqd oVh

12-  vkjksX; of/kZuh oVh

13-  egkekft’Bkfn ?ku oVh

14-  egkjkLukfn d’kk;

15-  n”kewy fj’V

16-  n”kewy DokFk

17-  egk;ksxjkt xqXxqy

18-  v”oxa/kk pq.kZ

19-  “rkojh pw.kZ

20-  izoky fi’Vh

21-  ;ksx ofLr Øe

22-  Lkgpj rSy vH;ax o ofLr ekuk

23-  Ckyk rSy

24-  jkLuk xqXxqy

25-  iF;kfn xqXxqy

26-  jkLuklIrd DokFk

27-  ikfjtkr d’kk;

ikf’.kZ”kwy ;k iknry”kwy (Heal pain) dk dkj.k funku ok fpfdRlk vk;qosZfnd erkuqlkjA

ikf’.kZ “kwy ;k ikn ry”kwy (Heal pain) ftls vke Hkk’kk esa ,M+h esa nnZ gksuk dgrs gS] ,d cgqr gh lkekU; leL;k gS] ftlds cgqrk;r ejht fpfdRlk vH;kl ds nkSjku feyrs gSA rFkk cnyrs ifjos”k [kkuiku esa cnyko ds dkj.k c<+rs gh tk jgs gSaA vr% tkus dSls mRiUUk gksrh gS] ;g O;kf/kA

vk/kqfud erkuqlkj Calcaneal Spur, Planter fasitis Calcaneal burscitis, Achilles Tendinitis and Concaneal bonefracture vkfn dqN chekfj; gS] ftuesa ikf’.kZ izns”k ;k Hepl Regionesa ;k lehiLFk izns”kksa esa osnuk gksrh gSA ikf’.kZ dks Calcanial bone tks dh iSj dh Heal Region dh gÏh gS] dks dgrs gSA

vkpk;Z lqJqr us xqYQlfU/k ds uhps nksuksa iSjks esa dwpZf”kj eeZ dh fLFkfr crkbZ gS] ftl ij vk?kkr ls :tk ¼osnuk pain½ “kksQ (Swelling) y{k.k mRiUUk gksrs gSA dwpZf”kj ,d :tkdj eeZ gS] ftlesa iz/kku y{k.k :tk (pain) gksuk eq[; gSA

      xqYQlU/ksj/k mHk;r% dwpZf”kjks uke

     r= :tk”kksQkSA

lq-“kk- 6

ikf’.kZ “kwy dh rqyuk eq[; :Ik ls ge (Calaneal spur) ls djrs gSA ;k Plonter fascitis ls blesa yxkrkj Bone ds ruko esa jgus ds dkj.k vk;qosZn erkuqlkj ;g ,d izdkj dh okr O;kf/k gS] ijUrq blesa jDr vkSj fiRRk dk Hkh lalxZ gks ldrk gSA

ikf’.kZ”kwy dh lEizkfIr 4 izdkj ls cu ldrh gSA

1-    nq’V jDrfiRRk tU;

2-    nq’V fiRRk tU;

3-    nq’V vketU;

4-    nq’V okr tU;

dkj.k vk/kqfud erkuqlkj&

1-   Standing for Prolonsed Period on nard Sqrfaces

2-   Improper footoere

3-   Distant ranner sach a athletes.

4-   Obesity.

5-   Tight calf muscle.

6-   Flat feet (Structural deformity)

eq[; y{k.k& Calcomeal spur

1-   Pain-especially while walking, jogging or running morningtime more

2-   Swelling over heal

3-   Numb ness

4-   Tingling

Planter fasciitis-

1-   When Plantar fasciitis occurs, the pain is tipically sharp.

2-   Usually unilateral (70% of (ases)

3-   Numbner

4-   Tingling

5-   Swelling

6-   Lkksdj mBus ds ckn iSj j[kus ij nnZ (pain)lcls T;knk gksrk gS] tks pyus fQjus ls de gksrk tkrk gSA