ЕФЕКТИВНОСТ НА КОНВЕНЦИОНАЛНАТА И КОМПЛЕМЕНТАРНАТА МЕДИЦИНА ВО ЛЕКУВАЊЕ НА ПАЦИЕНТИ СО ЛУМБОИШИЈАЛГИЈА
EFFECTIVENESS OF CONVENTIONAL AND COMPLEMENTARY MEDICINE IN THE TREATMENT OF PATIENTS WITH LUMBOISCHIALGIA

Summary/Abstract: Sciatica is a syndrome characterized by pain symptoms along the sciatic nerve (n. ischiadicus) and is part of the lumbosacral nerve plexus. According to statistics, sciatica is the cause of 65% of cases of damage and loss of symptoms in the peripheral nervous system. Sciatica has a rich etiology. The reasons can be local and general reasons. Local causes of sciatica include osteochondrosis (spondylosis) or discopathy, which is essentially a dystrophic process with the formation of osteophytes. As a consequence, a disc herniation may occur, which will affect the 4th and 5th lumbar vertebrae or the 5th lumbar and 1st sacral vertebrae, pressing the roots of the spinal nerves that exit there. The diagnosis of "sciatica" is made after taking a thorough history and monitoring a complex of symptoms. The condition flows with combined sensory disorders, dysfunction, impaired reflex function (dysreflexia), weakened or increased muscle tone. Sciatica occurs with symptoms of acute pain along the sciatic nerve. In the syndrome, spontaneous pain is most often manifested, which extends to the back of the thigh and goes down to the big toe. If the process affects the sciatic nerve trunk or sacral roots, the leg is flexed at the hip and externally rotated. When the lumbar roots are primarily affected, the leg is flexed and internally rotated. The degree of damage is checked by coughing, which increases pain when the process has affected only the roots of the spinal nerves. To make a diagnosis of "sciatica", it is necessary to examine the nerve trunks. When bending the head forward, pain is felt in the lower back - Neri's symptom. Another way to prove sciatica is Bonnet's symptom - when bringing the hip to the midline of the body, pain is felt when the damage is in the sciatic nerve. When abducting the thigh from the midline, pain is felt as a result of damage to the femoral nerve (n. femoralis). Symptoms of impaired functionality are observed in sciatica. Decreased sensitivity to pain, temperature and touch is noted. A common symptom of the syndrome is a dizzy gait due to permanent paresis of the foot of the affected limb and reduced muscle tone of the the calf. Differential diagnosis sciatica can be compared to other diseases. Such an example is inflammation of the hip joint (coxitis), inflammation of the sacroiliac joint, isolated neuritis of the femoral nerve. According to new studies for the treatment of sciatica, exercises performed under the supervision of a physical therapist are used. The goal is to maximize muscle movement, increase circulation and blood supply to the area, and refresh the tissues. In case of a severe pain syndrome, it is recommended that the patient rests completely, lying on a hard bed in an antalgic position in which no pain is felt. Anti-inflammatory drugs, analgesics and muscle relaxants are recommended. In cases of unbearable pain, cortisone preparations are also used. Sometimes a local anesthetic is also applied - 1% lidocaine solution.. After calming down the severe pain syndrome, therapeutic massages and gymnastics are recommended. Research methods: The research was conducted at the Recreation Center at the University "Goce Delchev", Shtip, and at the Clinical Hospital - Shtip, in the departments of Physical Therapy and Kinesitherapy. The research included 18 patients diagnosed with lumbo-sciatica in the spine, of which 10 patients were male and 8 patients were female. The patients were divided into two groups: Control and Experimental. In the patients of the Control group, drug therapy, Physical Therapy and Rehabilitation and Kinesitherapy were applied. In the patients of the Experimental group, in addition to the above, complementary methods from the field of traditional Chinese medicine were also included. Results: The results show that Cupping therapy causes local tissue decongestion in the affected area and pain reduction. Discussion: Cupping therapy is a complementary decongestion technique from the field of traditional Chinese medicine. It is generally indicated for the treatment of lower back pain. Conclusion: Treatment with Capintherapy allows for local decongestion of the affected painful area, increased blood circulation, influx of fresh blood, and removal of toxins.

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