Sciatica and Physiotherapy

By Divya Singhal 

Sciatica is the pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the ankle. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and can radiate down below the knee. The sciatic nerve is the largest nerve in the body. The pain of sciatica is sometimes also referred to as sciatic nerve pain.
Well! If you have Sciatica, your:
Bottom
Back of your legs
Feet and toes
may feel:
Painful - the pain may be stabbing, burning or shooting
Tingling - like pins and needles
Numb
Weak

What causes sciatica?
The most common cause of sciatica is a bulging or ruptured disc (herniated disc) in the spine pressing against the nerve roots that lead to the sciatic nerve.
In rare cases, sciatica can also be caused by conditions that do not involve the spine, such as tumors or pregnancy.
Sciatica also can be a symptom of other conditions that affect the spine, such as narrowing of the spinal canal (spinal stenosis), bone spurs (small, bony growths that form along joints) caused by arthritis, or nerve root compression (pinched nerve) caused by injury.
Irritation of the nerve from adjacent bone, muscle, internal bleeding, infections in or around the lumbar spine, injury, and other causes.

What are the symptoms?
Symptoms of sciatica include pain that begins in your back or buttock and moves down your leg and may move into your foot. Weakness, tingling, or numbness in the leg may also occur.
Sitting, standing for a long time, and movements that may cause the spine to flex for a longer period of time(such as knee-to-chest exercises) may make symptoms worse.
Walking, lying down, and movements that extend the spine (such as press-ups) may relieve symptoms.

How is sciatica diagnosed?
Sciatica is diagnosed with a medical history and physical exam. Sometimes X-rays and other tests such as magnetic resonance imaging (MRI) are done to help find the cause of sciatica.

How is it treated?
In many cases, sciatica will improve and go away with time. Initial treatment usually focuses on medicines and Physiotherapy or Physical therapy to relieve pain. You can help relieve pain by
Incorporating a combination of strengthening, stretching exercises and aerobic conditioning are a central component of almost any sciatica treatment plan.
When patients engage in a regular program of gentle exercises, they can recover more quickly from sciatica pain and are less likely to have future episodes of pain.
It is very important that the patient is physically an active participant in therapy and can take responsibility in the treatment process.
One needs to get EXCLUSIVE exercise sessions from a physiotherapist.


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What is the Most Common Cause of Back Pain?

From checkbiotech.org

Being one of the most common reasons for absence from work, school and sometimes even doctor’s appointments, it may be uncomfortable and painful but not usually severe. Although it can affect people of any age, it is more common in people between 35 and 55 years of age. In the majority of cases the pain is not caused by anything serious, and with time gets better on its own. There are many options as to how to relieve the pain, but most of the time it just keeps coming back. The number one cause of back pain may be:
Strain: Strained muscles, ligaments, and a spasm. The things that can actually lead to this may be as a result of improperly lifting of anything, particularly heavy loads, or maybe as a result of an awkward or somewhat abrupt movement, or poor posture.

Spine Related Problems

Often, it occurs because something is not right in the way the spinal joints, muscles, discs, and nerves fit and move. The doctor can check to see if one has: a slipped disc (herniated disc), this disc is a soft (spongy) piece of cartilage that sits between vertebras. It separates the bony vertebra from one another, so they do not rub against each other. In case of a slipped disc, this soft piece of cartilage is no longer in place and has come off. This may be as a result of the wearing, tearing and shrinking of the disc. Often, it is due to aging or an accident.

Bulging Disc: although not as much as in a slipped disc, this bulge can press on a nerve and result in pain. It is usually asymptomatic and is only noticeable when it pushes on a nerve and instigates pain.

Spinal Stenosis: this is a usual case with people over 60 years of age, this occurs as a result of the narrowing of the spinal canal, which leads to the feeling of numbness in the legs and shoulders.

Degenerative Disc Disease: the spinal disc (shock absorbers) will shrink or tear as a result of old age, and causes the bones to rub against each other. This disc acts as a cushion, and with age, it wears out.

Arthritis: patients with osteoarthritis often experience problems in their joints. Especially the joints of the hips, lower back, knees, and In some cases, it can lead to the development of spinal stenosis, which is the term used to describe the narrowing of the space around the spinal cord.

Sciatica: this is a sharp and shooting pain that travels along the buttocks and down to the back of the leg, usually as a result of a bulging or herniated disk pressing on a nerve.

Wear and Tear of the Sacroiliac Joint: this is located exactly where the spine and pelvis meet each other. It does not move so much, but it is crucial in moving the weight of the upper body down to the lower body. The swelling and wearing away of this joint cartilage can occur after an injury, due to arthritis, infection, or in most cases even pregnancy.

Spondylolisthesis: A bone in the spine slides forward and moves out of place, more frequently in the lower back. The degenerative form of the condition is arthritis (discussed above), which makes the joints and ligaments weak in keeping the spine in place. It can make a disc to move forward over a vertebra.

Other causes

• Lifestyle: most back pains are as a result of the things one does while carrying out daily activities. Some of this things include; lifting heavy loads; slouching on the work or school desk; lack of exercise; overweight; always on high heels; driving for too long without a break; overstretching; standing or bending for a long time; to much tension on a muscle; even smoking.
• Emotions: Do not underestimate the power of feelings in terms of causing pain. Stress can bring about muscle tension in the back, while depression and anxiety may make the pain feel worse than it is.
• Cauda Equina Syndrome: the caudal equine is a spinal nerve roots bundle; it arises from the lower portion of the spinal cord. People with cauda equina syndrome feel a rather dull pain in the area of the lower back and upper buttocks, as well as an absence of feeling in the buttocks (numbness), genitals and thighs. Sometimes one may also experience bowel and bladder dysfunction.
• Abnormal Curvature of the Spine: if the spine curves in an unusual manner the patient is more likely to experience continuous back pain. An example is scoliosis which is a condition characterized by the one-sided deviation of the spine to one side.
• Tumors: although this occurs in rare cases, one has the possibility to get a tumor in the back. They are often spread by cancer that started somewhere else in the body. Less-common causes include Kidney stones; an infection; Endometriosis (a build-up of tissue, usually uterine tissue, outside the uterus); Osteomyelitis (an infection in the bones and spinal disc); Fibromyalgia (a condition that causes a muscle pain that spreads).

The back is a complex structure that is made up of muscles, tendons, ligaments, bones, and intervertebral discs. A problem in any of the anatomical structures that make up the spine can lead to pain. The spine is divided into four areas: cervical (the neck area), thoracic (the upper back area), lumbar (the lower back area), and the sacral part.
Back pain can be classified into two, acute back pain and chronic back pain, based on their nature, depending on how long the patient’s symptoms last, the pain can be short-lived symptoms (less than three months), are also classified as acute pain. Conversely, symptoms that last longer than three months are automatically classified a chronic back pain. The symptoms of spine pain can also range from mild to severe, intermittent or constant. In addition to the physical pain, patients may also experience psychological symptoms like depression that are often linked to the back pain. The symptoms that accompany back pain can be so severe for some people that it inevitably affects the quality of life they live, which can be quite disturbing.

http://checkbiotech.org/common-cause-back-pain/

The Rundown on Sciatica

By Brennan McMahon

What is Sciatica?
Sciatica is a condition that is not a disease or sickness in itself, but rather is a symptom of an underlying problem.
Major enervation of the legs, buttocks and lower back are by the sciatic nerve, which is the largest single nerve in the body. It originates from a nerve cluster in the spinal cord that combines in the lower back to run through the buttocks and send branches of nerve endings all through the lower limbs, down to the toes.
When the sciatic nerve is compromised in any way, the resulting pain affects all of the muscles connected to it, causing a radiating pain that originates in the lower back and radiates down the leg to the foot.

Causes and Symptoms
The major cause of sciatica is from a lumbar disc herniation, which is when there is a rupture of the disc supporting the lumbar vertebrae in the lower spine. This can cause the disc to press on the sciatic nerve.

Other causes may include:

• Slipped disc (called isthmic spondylolisthesis) where one vertebrae can slip forward over another due to a small fracture or stress to the disc.
• Spinal and disc degeneration due to age is normal, but it can be severe in some individuals. This can be due to genetics, a lifetime of medication, lack of exercise, or have no cause at all. The degenerated disc and bones can pinch the nerve and cause sciatic pain.
• Arthritis due to age, which may cause spinal stenosis (enlargement of the disc and soft tissue surrounding the disc) and attendant pain due to pressure on the nerve.

Other less common causes are built-up trauma to the leg over time (like with athletes), tumors, infections that affect the lumbar spine, internal bleeding around the sciatic nerve and bone interference in the path of the nerve (like with a fracture or shift), causing irritation and pain.

The symptoms of sciatica are mostly pain related and include:

• Radiating pain that affects the leg and foot.
• Lack of sensation and difficulty in movement of the lower limbs.
• Sharp pain when standing or trying to walk, which gets worse on sitting down.
• Neurological symptoms like progressive loss of sensation in the leg and lack of bowel and bladder control, which are signs of a more serious underlying condition.

Treatment Options

Most times, sciatic pain is not serious enough to warrant a hospital visit, and it goes away after a matter of weeks. However, the pain can become all-consuming for some patients, and they will seek relief. Treatment for sciatica is mostly non-surgical, aiming at reducing and eliminating the pain it causes.

Therapy

• Steroid injections can be given directly into the affected lumbar area to reduce inflammation and pain relief. The effects can be short-lived, but it helps the patient to be able to focus on their daily lives and also take part in other therapy options like exercise.
• Massage can help to increase circulation, release endorphins that cancel out pain, and relax the muscles that may be contributing to the pinched nerve. It is a recommended alternative treatment for sciatica, however short-lived the effects.
• Acupuncture is an approved method of pain relief, not just for sciatica but for other pain-causing conditions too. It would be prudent to employ the services of a registered practitioner.
• Some special exercises can help with lumbar spine alignment and pain relief. Stretching and aerobic exercises are recommended to the patient, with a regimen than can last weeks or months.

Surgery

When sciatic nerve impairment gets so serious that the patient is losing sensation in the lower limbs, or cannot move at all, then surgery might be needed to immediately free the sciatic nerve and prevent permanent nerve injury.
Keep in mind that sciatica surgery is a last resort, only recommended after all other less invasive options have been exhausted.

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