Ischialgia Etiology and Clinical Manifestations

        Ischialgia is pain felt along the leg. Judging from the sense of the word, then ischialgia is pain felt along N.ischiadicus. So ischialgia defined as pain felt along the nerve and subsequent ischiadicus along the legs. Ischialgia is a condition where the nerves Ischiadicus, which innervate butt to foot pinched area, in that case, which is pinched nerves Ischiadicus right side. This can happen due to some disease processes such as physical trauma, chemical, and electrical, infections, metabolic problems, and autoimmune. Ischialgia increase in frequency along with the many activities undertaken.

Etiology
Ischialgia arising from stimulated sensory fibers, which are derived ischiadicus nerve posterior root L4, L5, S1, S2, S3 .
Ischialgia Causes can be divided into :
1 . Ischialgia discogenic , usually occurs in patients with herniated nucleus pulposus (HNP) .
2 . Ischialgia mechanical divided into :
        - Spondiloarthrosis defermans .
        - Spondilolistetic .
        - Tumor caud .
        - Metastatic carcinoma in the lumbosacral vertebrae corpus .
        - Corpus lumbosacral fracture .
      - Pelvic fractures, inflammation or neoplasm on the tools in the pelvic cavity, causing pressure on the lumbosacral plexus.
3 . Ischailgia non- mechanical ( medical ) consist of:
       - Radiculitis tuberculosis
       - Radiculitis luetika
       - Adhesion in the subarachnoidal space
       - Injecting drugs in nerve ischiadicus
       - Neuropathy arthritic , diabetic and other neuropathies .

        The cause of the pinched nerve there are several factors, which include: contraction / inflammation of the muscles of the buttocks area , the presence or absence perkapuran spinal condition called herniation nucleus pulposus (HNP). To find out the exact cause of the physical examination should be done carefully by a physician , if necessary additional screening radiology / X-ray of the spine .



Clinical manifestations
      Which must be considered in the anamnesis, among others :
1. Locations pain, how long, first pain, type of pain (slashing, pressing, etc.), radiation of pain, pain intensity, fixed to the waist, precipitating factors, and factors that aggravate pain
2. Activities that cause elevation of pressure within the subarachnoid such as coughing, sneezing and straining memprivakasi terasanya ischialgia discogenic
3 . Factors trauma almost always be found except in the process of neoplasm or infection

      Sciatica or ischialgia usually on only one side. Which can cause taste like needles, Nagging pain , or pain as shot. Perceived likelihood stiffness in the legs. Walking, running, climbing stairs, and straighten the legs aggravate the pain, which is relieved by bending your back or sitting .
 
The symptoms are often caused by Ischialgia are :
a. Lower back pain
b. Pain the butt area
c. Numbness / blistering on the lower back
d. Pain radiating or as a sense of shock, which is in the area feel the buttocks radiating to the thigh, calf and even up the legs, depending on where the pinched nerve section.
e. Pain is often inflicted after excessive activity , especially much crouching or standing and walking a lot.
f. The pain also often provoked due to heavy lifting.
g. If left then over time will lead to lower limb weakness / lower limbs accompanied by the diminution of the muscles of the lower leg.
h. Can be symptoms tingling or numbness.
i. In severe cases can arise in muscle weakness and loss of patellar tendon reflexes and Achilles  .
j. When the conus or cauda equina may occur defecation disorders, urinary and sexual function. This situation is a neurological gravity that require surgery to prevent permanent damage function .
k . Pain worse with coughing, sneezing, lifting

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