Institute for Sports Medicine Frankfurt Main

Witch shot (Ischialgia, backache)

1. Risk kinds of sport:

- Golf, tennis, muscle sports, track and field athletics
- all kinds of sport, with which falls are possible

2. Function:

Movement of the trunk, connection to the basin and concomitantly to the hips and to the lower extremity by the lumbar spine.
Injury mechanism:
- Falls of any kind
- Impacts or footsteps in the backs
- Lifting heavy articles
- Fast moving the torso into a endgradige position (lift)
Injury:
- Muscle spanning with swelling of the musculature or irritation of nerves by pressure (tissue swelling, blockings) apart from the center line of the lumbar spine

3. Symptoms:

- sudden or creeping beginning possible
- painful movement restriction of the torso
- Already attitude up to the stuckness
- pain like breaking through in the back
- Pain radiant emittance in one or both legs
- Tingling/swarming feeling in the legs and/or feet
- Weakness feeling in the legs
- Foot jack or foot countersink weakness
- Problems with blisters - and/or emptying of intestine
- Pain when coughing, sneezing or pressing
- Pain with movement one or both legs
- Muscle spannings in the back
- Border pain
- Pain in hip or knee
- Pain in the kidney camp
- Pain in the hypogastric region
Other pain causes:
- Bony injury of the Lendenwirbelsäule
- invertebral disk incident or invertebral disk degeneration
- Wear or instability within the range of the lumbar spine
- Restricting spinal canal
- Blockings sacroiliac joints
- Inflammations or getting jammed nerves
- Bruise of the lumbar spine
- Illnesses of the hip joints
- Border breaks
- Urological or gynaecological illnesses
- other internal illnesses
- Muscle injuries
- Illnesses and injuries within the range of the bony basin ring
- Leg length difference

4. First measures:

- Indulgence
- Warmth
- Stage storage

5. Diagnostics:

A physician should be visited, in order to exclude a being present from heavy damages in each case.
- Roentgen of the lumbar spine, if necessary also the basin
- clinical investigation of the lumbar spineand the basin
- neurological investigation with examination of the muscle and reflex status
- if necessary computer tomography
- if necessary nuclear spin tomography

6. Therapy: Caution! Frequently lengthily!!!!!

a) Conservative therapy
- muscle-relaxing medicines
- Chirotherapie
- analgetic and decongestant working medicines
- Physiotherapy (under expert guidance and self-exercises after arrangement with the therapist)
- with strong pain injections at the points of pain or nerve roots
- with german types immobilizing in the corset, if necessary operational therapy necessarily
- insert supply
b) Operational therapy
- with invertebral disk incidents with neurological losses operational therapy
- with german types immobilizing in the corset, if necessary operational therapy necessarily

7. Physiotherapy:

- Manual therapy
- Stabilization
- Massage
- Heat's application
- Back school
- Interference current treatment
- Hydrotherapy
- Strengthening the musculature

8. Prevention:

- sufficient warming up
- Preservation of a good torso muscle corset
- Paying attention to correct attitude with going, standing, seats, stretchers and lifting, as well as with the practice of the sport
- Avoidance of superelevated body weight
- Back school
- Optimal attitude of the sport equipment (e.g. bicycle)

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