Drugs no solution for Sciatica pain: study

From 9news.com.au

People suffering from sciatica nerve pain spreading down their legs aren't necessarily any better off if they take a commonly prescribed painkiller, a study has found.
Researchers from the Sydney-based George Institute for Global Health gave 209 people with moderate-to-severe sciatica either the painkiller pregabalin or a placebo and found little difference between the relief they delivered.
Associate professor Christine Lin, who led the study, said the study was sparked by concerns that people with sciatica were being over-prescribed painkillers.

Sciatica is characterised by leg pain, including tingling, numbness or weakness, that radiates from the lower back and down the sciatic nerve that runs along the back of each leg.
People with lower back problems such as herniated discs or spinal stenosis can often have symptoms of sciatica.
Assoc prof Lin said the use of neuropathic pain medicines such as pregabalin had increased six fold in the past decade, while an estimated 200,000 to 400,000 Australians are thought to be affected by sciatica each year.
"But, until now there has been no high quality evidence to help patients and doctors know whether pregabalin works for treating sciatica," she said on Thursday.
"Our results have shown pregabalin treatment did not relieve the pain, but did cause side effects such as dizziness."
For the study, 108 people were given up to 600mg of pregabalin a day while the remaining 101 received a matching placebo.
After eight weeks, both sets of people reported similar levels of pain in their legs.
The results were also similar after 52 weeks.
However the people who took the pregabalin reported nearly twice as many adverse side effects, the most common being dizziness.
Despite the findings, almost two thirds of the patients in each group reported being extremely satisfied or satisfied with their treatment.
Assoc Prof Lin said two years after pregabalin was listed on the Pharmaceutical Benefits Scheme in 2013, prescriptions soared to higher-than-expected 2.4 million.
She said the most important thing people with sciatica could do is avoid bed rest and keep active.
"Unfortunately there are no drugs proven to work for people with sciatica and even epidural injections only provide a small benefit in the short term," Assoc prof Lin said.
"What we do know is that most people with sciatica do eventually recover with time."

http://www.9news.com.au/health/2017/03/23/08/05/drugs-no-solution-for-sciatica-pain-study

Sciatic Nerve Pain: Prevention, Stretches, and Exercises for Pain Relief

From belmarrahealth.com

Sciatica occurs when a person experiences feelings of numbness or tingling, which begins in the lower back region, through the buttocks, and runs down the leg—the sciatic nerve.
Nerve pain resulting from sciatica is a symptom related to an underlying condition that affects the sciatic nerve. Conditions that can lead to sciatica are a lumbar herniated disc, degenerative disc disease, and spinal stenosis.
Fortunately, physical therapy and exercises can help relieve sciatic nerve pain and improve the condition by increasing strength through stretching and aerobic techniques.

Sciatic nerve pain stretches

Sciatic nerve pain stretches aim to target the muscles that lead to pain. These muscles are often tight and inflexible, so stretching can loosen the tightness and minimize pain.
Stretching the hamstring is best for dealing with sciatic nerve pain, as the sciatic nerve runs through the hamstring—this is the area behind the quadriceps, underneath your buttocks.
Here are some examples of sciatic nerve pain stretches:
Towel hamstring stretch: Lay on your back with a towel wrapped around your thigh. With your leg up in the air and your hands grasping the towel, begin to straighten the knee until a stretch is felt at the back of the thigh. Hold the position for 10 seconds and gradually begin to increase the duration of the hold.
Wall hamstring stretch: Once again, lay on the floor with your buttocks up against a wall. With one leg stretched out in front and the other up against the wall, push the knee straight until a stretch is felt.
Hamstring stretch while sitting: Sit at the edge of a chair and have one leg straight out in front of you with your heel on the floor, toes pointing upward. Sit up straight while pushing your navel towards your thigh without actually leaning over. Hold the stretch for 30 seconds and repeat three times for each leg.
Pigeon pose: Lay with your back flat on the floor, then raise your right leg up to a right angle and interlock your fingers behind the thigh. Raise you left leg, resting your right ankle on its knee, and press that knee towards your head to stretch the tiny piriformis muscle. Lower both legs then repeat on the opposite side.
Knee to opposite shoulder: Begin by lying flat on your back with your feet flexed upwards. Lift your right leg, then link your fingers around your knee and pull it gently across your body towards the opposite shoulder. Hold the position for 30 seconds before returning to the starting position and repeat the movement with your left leg.
Sitting spinal stretch: Start by sitting on the ground with your legs extended in front of you and your feet flexed upwards. Bend your right knee and cross your leg over the left, planting your right foot flat on the outside of your left knee. Turn your upper body and place your left elbow to the outside of your right knee, helping to keep your body turned towards the right. Hold this pose for 30 seconds, then return to the starting position and repeat on the left side.
Standing hamstring stretch: Place your right foot on an elevated surface either at or below hip level and flex your foot so that your toes and leg are straight. Bend forward towards your foot and reach for your toes – the further you bend the deeper the stretch. Hold this position for 30 seconds, then switch legs.
Reclining Cow’s Face Pose: Lay face-up on your back and cross your left leg over your right. Raise both legs off the floor, flexing both feet, and reach for your outer ankles to hug your legs towards your stomach. Hold for 30 seconds, then switch sides and repeat.
Low Lunge: Begin in a regular lunge position with your right leg forward and your left knee on the ground. The top of your left foot should be flat on the ground. Lift your torso slowly and rest your hands on your right thigh, then lean your hips forward to stretch the left hip flexor. Hold this pose for 30 seconds, then repeat on the other side.

Sciatica Exercises

Exercising for sciatica nerve pain has been found to be more effective than simply staying in bed. Strengthening and low aerobic exercises should be your go-to, as they offer the most relief from sciatica nerve pain.
Strengthening exercises should work to strengthen the spinal column and the supporting muscles, tendons, and ligaments. This includes targeting the lower back, abdomen, glutes, and hip muscles.
Low aerobic exercises consist of walking, swimming, and pool therapies. They aim to increase fluid and nutrient exchange in order to promote a healthy environment for healing. Furthermore, low aerobic exercises work as a natural painkiller, as exercise has been shown to help alleviate pain by increasing endorphins in the body.
Speak to your physical therapist or trainer with regards to appropriate exercises to help strengthen your muscles in order to reduce sciatica nerve pain.

http://www.belmarrahealth.com/sciatic-nerve-pain-prevention-stretches-exercises-pain-relief/

Temporary Versus Long-Lasting Pins and Needles

From news-medical.net

The common phenomenon of ‘pins and needles’ sensation (or paresthesia) caused by abnormally functioning nerves is described best as tingling and prickling feelings in one or more limbs. It may be intense enough to be uncomfortable or even painful, depending on the underlying etiology. In common parlance, the nerve is said to have fallen asleep.
Pins and needles may be temporary or permanent.

Temporary paresthesia

Temporary causes of pins and needles include lying or leaning against a hard surface in some position which puts prolonged pressure on a limb. This cuts off sufficient blood flow and shuts down the stream of nerve impulses. In such cases, merely changing a position restores normal function to the nerve and the sensation disappears. At first the limb feels numb and unusually heavy, but this is rapidly replaced by the onset of a fierce prickling. This is caused by random abnormal firing of sensory impulses by the recovering nerve cells to the brain and spinal cord.
Kneeling on a hard surface, or just wearing socks or shoes which are so tight as to put pressure on the nerves running near the bones of the foot, can also bring about temporary pins and needles in the lower limbs. The quickest and only remedy is to take off the pressure and allow the nerve to regain its normal metabolic activity. Nerves consume much oxygen, so a normal blood supply is crucial. Once blood flow reduces, anaerobic metabolism takes over, bringing about the creation of metabolites which result in shutting down cell activity for some time.
Raynaud’s disease is another condition in which the limbs develop pins and needles. In this case, the blood supply to the tips of the fingers or toes is cut off severely by cold external temperatures, or (in a few cases) by anxiety or stressful circumstances. This leads to impaired nerve transmission.
Hyperventilation is yet another cause of temporary pins and needles. In this case the acid-base balance in the body is upset by the excessive voiding of carbon dioxide through the breath, leading to an imbalance in the levels of various ions in the blood. This is responsible, in turn, for abnormal nerve conduction, which results in pins and needles.

Long-lasting pins and needles

When pins and needles occur very frequently or last a long time, other more serious causes should be ruled out. These primarily include neuropathies or diseases of the nerves, which may be due to nerve trauma, nerve toxicity or nerve disease.
One of the most common causes of nerve damage in modern times is diabetes mellitus, in which high blood glucose levels produce toxic results on nerve cells. Also, some toxic agents may “poison” the nerves, leading to chronic pins and needles. They include lead, radiation, and alcohol abuse. Furthermore, certain drug may cause persistent pins and needles, most notably chemotherapeutic agents, anticonvulsants, certain antibiotics, as well as drugs used to treat HIV infection.
Again, many nerve entrapment syndromes present with pins and needles among other symptoms, including ulnar nerve compression, cervical spondylitis, sciatica due to compression of the sciatic nerve in the pelvis or thigh, or carpal tunnel syndrome. In all these conditions, a major sensory nerve is compressed when it passes through a confined space which is shared by other structures, one or more of which is inflamed.
Other causes of nerve damage include:

• Damage to the central or peripheral nervous system, such as a stroke or multiple sclerosis
• Malnutrition such as vitamin B12 deficiency, where a vitamin that is crucial to nerve integrity is missing or deficient
• Pernicious anemia in which vitamin B12 is deficient because of a congenital error of metabolism
• Nerve damage due to overuse, infection or injury
• Hypothyroidism, which is also associated with nerve compression due to edema of many structures, and is also therefore a cause of pins and needles

http://www.news-medical.net/health/Temporary-Versus-Long-Lasting-Pins-and-Needles.aspx