What is Lumbosacral Plexitis?
Plexitis is the name of a group of diseases that arise as a result of damage to the nerve plexuses. The reasons may be different. Plexitis of the lumbosacral and other types is characterized by a violation of the vegetative-trophic, motor and sensory system of a person.
Lumbar plexitis is a disease that causes pain in the thighs and buttocks. Lumbosacral plexitis is also recognized by pain in the sacral region. Pain gives in leg. Sacrum is a bone located at the base of the spinal column. The lower part of the sacrum is connected to the coccyx. With lumbosacral plexitis, sweating disorders occur, legs swelling is observed. The walking process is difficult, it is also difficult to stand in one place.
The lumbosacral plexus is formed from the anterior branches and spinal nerves. Plexitis usually does not affect the entire plexus. Most often, the femur, sciatic and obturator nerves are affected. Plexitis is caused by infection, intoxication of the body, diseases of the abdominal cavity and pelvic organs. There is also a possibility of occurrence during pregnancy, pathological birth, etc.
Causes of Lumbosacral Plexitis
Plexitis can occur due to injuries, swelling, or compression of broken or displaced bones. There is also plexitis of an infectious nature – it develops with flu, tuberculosis, brucellosis and other similar diseases. The next type of plexitis is allergic. It occurs as a reaction to the vaccine administered.
Also, lumbosacral plexitis can be caused by intoxication, namely, it occurs after poisoning with substances, for example, lead, alcohol, arsenic, etc.
Pathogenesis during Lumbosacral Plexitis
Lumbar plexitis causes pain and sensitivity disorders in the gluteal, femoral areas, on the outer surface of the lower leg. Pain points occur in the groin, along the inner and front surfaces of the thigh. For this disease, the symptoms of Wasserman and Neri are characteristic. Loss or decrease of the knee reflex is quite common. The thigh bends worse, the adduct function and extension of the lower leg are impaired. Atrophy of the muscles of the anterior, thigh and gluteal muscles is fixed.
Sacral plexitis is characterized by a characteristic pain syndrome, impaired motor functions, sensitivity disorders, vegetative-vascular disorders in the area of communication of the sciatic nerve with the central nervous system, as well as in the area of the upper and lower gluteal nerves, posterior cutaneous nerve of the thigh.
Pain from the lumbosacral region extends along the thigh, lower leg, and also on the buttock. In the same areas, sensitivity is disturbed. In the vast majority of cases, a symptom of Lassg is detected. Atrophy of the posterior muscles of the thigh and lower leg occurs. Paresis of extensors and flexors of the foot and fingers develops. Achilles reflex falls out.
Symptoms of Lumbosacral Plexitis
Lumbosacral plexitis is recognized by the following symptoms:
- pallor and coldness (cold to the touch) of the skin of the legs;
- swelling of the soft tissues of the leg;
- fragility of nails on toes;
- weakness of the leg muscles – up to the complete impossibility of its active movement;
- decreased sensitivity of the skin of the legs;
- severe pain in the lumbar region and in the leg (in the thigh, lower leg, foot), which intensify with active or passive movement in this limb.
Diagnosis of Lumbosacral Plexitis
To make a diagnosis, a medical history and analysis of the patient’s complaints are required. The doctor clarifies:
– does the person suffer from diabetes mellitus (a disease that manifests itself in periodic or constant rises in blood glucose, which negatively affects the metabolism and blood supply to all body tissues), does it suffer from gout (a disease that manifests itself in an increased level of uric acid in the body, which is negative affects the tissue);
– whether the person was vaccinated before the onset of pain, whether there were surgeries, fixation of the leg with plaster, whether there were injuries to the coccyx, spine, sacrum, lower back;
– How long have such complaints appeared (pain or weakness in the legs, thinning of the nails on the legs, etc.).
Next, conduct a neurological examination. Doctors evaluate the strength of the muscles of the legs, the condition of the skin and nails, also evaluate reflexes (can be reduced with lumbosacral plexitis) and muscle tone (decreased with plexitis).
A blood test is often prescribed to confirm the diagnosis. Inflammation can reveal leukocytosis – an increased number of white blood cells in the blood, as well as an increased ESR (sedimentation rate of red blood cells), especially if plexitis is of an infectious nature.
The method of electroneuromyography makes it possible to assess the speed of an impulse along nerve fibers and to identify signs of damage to nerves or nerve plexuses.
Computed tomography (CT) and magnetic resonance imaging (MRI) help check the lower back and abdomen if lumbosacral plexitis is suspected. These methods allow a layer-by-layer study of the structure of the abdomen and lower back in order to identify changes that lead to an unsolution of the plexus function (trauma, edema, tumor).
Sometimes, a neurosurgeon should be contacted to make a diagnosis.
Treatment of Lumbosacral Plexitis
Treatment should be comprehensive, it depends on the causes that led to the disease of lumbosacral plexitis. If plexitis is infectious, anti-inflammatory therapy is needed. Surgical methods are relevant if an arterial lesion (aneurysm) occurs with the course of the disease or a neoplasm grows that leads to plexitis.
To treat this disease, medications such as analgesics, novocaine blockade are used. Novocaine helps reduce pain, and also improves trophic tissue. Physiotherapeutic and reflexotherapy methods are often used, including UHF, paraffin therapy, electrophoresis, muscle electrostimulation, and mud therapy.
When the acute manifestation of symptoms disappears, massage therapy and exercise therapy are used. Chronic lumbosacral plexitis is treated in sanatoriums of a specialized type.
Prevention of Lumbosacral Plexitis
To prevent plexitis (not only lumbar or sacral, but also other types), it is necessary to remove factors that contribute to metabolic disturbances in the body and a disturbance in the blood supply to peripheral nervous system tissues. Infectious diseases and chronic diseases need to be treated, not “triggered,” because they can have complications – not only plexitis, but also other diseases.
For the prevention of plexitis, it is necessary to do gymnastics, to harden the body, to fully relax, observing the sleep regimen. You need a healthy diet (which includes fruits, vitamins and vegetables), dosed physical activity, refusal of alcohol and smoking. These items are included in the concept of a healthy lifestyle, which helps to avoid not only plexitis, but also other diseases associated with impaired functioning of organs and organ systems.