Surgery best option for chronic sciatica pain, study says

From upi.com

Surgery can cut pain intensity by more than half among patients struggling with long-term sciatica, researchers report.
"Sciatica is the symptom of pain that radiates down the leg and is caused by compression of a nerve root in the spinal canal by a disc herniation," explained study author Dr. Chris Bailey. He's an associate professor of surgery with the Bone and Joint Institute at Western University in London, Ontario, Canada.

The U.S. National Institute of Neurological Disorders and Stroke notes that compression of the sciatic nerve -- which runs through the buttocks and down the back of the leg -- can cause a shock-like or burning sensation in the lower back. It can also trigger leg, foot and buttock pain and, in some cases, leg numbness and weakness. The condition is thought to account for roughly 5 percent to 10 percent of all lower back pain cases.
"Fortunately, in most cases sciatica will improve in weeks to a few months with non-operative care," Bailey said. "[But] our study looked at the group of patients that have persistent symptoms after that time."

Between 2010 and 2016, the investigators focused on treatment outcomes among 128 patients aged 18 to 60 who had already suffered sciatica pain for between four to 12 months.
Half were randomly assigned to undergo a discectomy, which entails the removal of tissue exerting pressure on the spinal cord or on a nerve root. Typically, the operation is a "simple" and "relatively low-risk" outpatient procedure, said Bailey, followed by a quick recovery.

The remaining patients were offered standard non-surgical care for six months. Care included an exercise regimen, painkillers, physiotherapy, function improvement training, and [for some] steroid injections for inflammation relief.

But after the study was over, roughly one-third in the non-surgical group had surgery anyway -- at 11 months out, on average -- the researchers said.

In the end, Bailey and his colleagues concluded "that surgery is superior to non-operative care for these patients with chronic symptoms."
Bailey acknowledged that prior research has often not identified a similar result. But he noted that "most previous research has focused on patients with a shorter course of symptoms. And because the natural history is very good for this group, the benefits of surgery are lost, as patients naturally improve with time."

By contrast, among chronic sciatica patients, "surgery [offered] a 70 percent greater likelihood of improvement six months afterward," he said.
Still, nine surgery patients had complications, one underwent repeated surgery, and patients in the non-surgery group who ultimately had surgery were more prone to complications, Bailey's team noted.

That thought was seconded by Dr. James Kang, professor of orthopaedic surgery at Harvard Medical School, and chairman of the department of orthopaedic surgery at Brigham and Women's Hospital in Boston.

Co-author of an accompanying editorial, Kang pointed out that one of the important things to think about when considering surgery "is that the longer the duration of the herniation and symptoms, the less likelihood of complete pain resolution."

For example, "I would state from experience that if patients have a chronic herniation up to and beyond 12 months, the potential benefit of surgery is significantly reduced if one is trying to get complete sciatica pain relief," he said.

It's also not always entirely clear which chronic sciatica patients stand to benefit the most from surgery. "There are several nuances to disc herniations," Kang said, "such as the herniated disc size, whether it is a free fragment versus contained, whether the nerve root has undergone some early damage in the three to four months that may be irreversible, as well as other factors."
So, there's no simple answer to the surgery versus non-surgery question, he noted.

"If the leg pain is great enough, patients will elect to have surgery if they have failed all other conservative treatments. It is as simple as that. And the earlier this decision is made beyond the three- to four-month mark, the better the chance of full recovery without complications," Kang said.
Bailey and his team published their findings in the March 19 issue of the New England Journal of Medicine.

https://www.upi.com/Health_News/2020/03/19/Surgery-best-option-for-chronic-sciatica-pain-study-says/5981584636741/

Dealing With Sciatica

From newsmax.com
By Dr. Brownstein

The sciatic nerve originates at the bottom of the spine, running out of the lower lumbar and sacral areas through the buttocks to the legs. Pain in the sciatic nerve is referred to as sciatica.

Sciatica is a common problem. I see patients who suffer from sciatic nerve pain on a near-daily basis. Many experience pain along the entire trajectory of the sciatic nerve, ending in the ankle or foot. The pain from sciatica is asymmetrical; it presents on either the left or the right side of the body, never on both sides.

The most common cause of sciatica is spinal stenosis — the narrowing of the lumbar or sacral spinal canal, which pinches the sciatic nerve.

Degenerative disc disease — in which the lower lumbar discs collapse on one another and pinch the sciatic nerve — is another common cause of sciatica.

Other reasons for sciatic nerve pain include injury, inactivity, and muscle spasms that cause a pinching of the nerve.

I’ve found spinal manipulation very helpful for patients with sciatica. This is particularly true for those suffering from acute sciatica, but it can even be helpful for those with chronic, long-term sciatica.

Oftentimes, one adjustment of the lower spine is all that is needed to free up the sciatic nerve. But in other patients, it’s not that easy.

Chiropractors have extensive training in spinal manipulation. A good chiropractor can be essential for helping a person overcome sciatica. But like other physicians, not all chiropractors have the same skill sets. As with all professions, there are good chiropractors and not-so-good chiropractors.

Osteopaths are also trained in spinal manipulation techniques, but few osteopaths use osteopathic manipulation treatment (OMT) in their practices.

Once again, if you need spinal manipulation, it is important to find an osteopathic physician who regularly performs OMT in his or her practice. I work closely with skilled osteopaths who help my patients with musculoskeletal problems.

I’ve found that the root cause of sciatica is often simple dehydration. The discs that line the spine are very sensitive to a person’s hydration status. Many sciatica patients can resolve their pain just by rehydrating with water.

In fact, one of the best initial treatments for any type of back pain is to drink water. Hydration also helps in cases of herniated discs, injuries, and spondylolisthesis.

https://www.newsmax.com/health/dr-brownstein/chiropractor-sciatica-back-pain/2020/03/18/id/958881/

Senior Living: Helping older adults identify and treat sciatica

From presstelegram.com

By Dr. Jason Koh, D.O.
Contributing writer

For many older adults, aches and pains may seem like a natural part of aging.
According to the National Centre for Biotechnology Information, lower back pain is one of the major disabling health conditions among adults age 60 or older.

Older adults are at risk of developing chronic lower back pain given their age-related changes in their body. Older adults are the second most common age group to visit physicians for lower back pain. Sciatica is one of the lower back pain issues that impacts seniors. 

Sciatica is best described as a sharp, stabbing discomfort that radiates down the leg or foot. Older adults experiencing sciatica may feel burning sensations comparable to electric jolts. The pain can begin in the nerve roots of the lower back and travel down to the buttocks, back of the thigh, lower leg and into the foot. 

Many older adults and their caregivers may be unfamiliar with sciatica. This may cause people to live with the pain for long periods of time. Common indicators of sciatica for older adults include:

• Tingling, numbness or lack of sensation known as paresthesia
• Difficulty walking due to “foot drop” or difficulty lifting the foot
• Burning sensations traveling to or from the lower extremities

Fortunately, sciatica symptoms usually resolve on their own within 3 weeks. In some cases, the symptoms may persist. The pain that sciatica generates can worsen if left untreated. Sciatica problems that go untreated can lead to lasting damage over time. Issues that can arise include nerve damage, loss of feeling and even loss of bladder control. 

It is important to receive prompt treatment if sciatica symptoms are present. Older adults experiencing the following symptoms should seek medical attention:

     New or sudden bladder issues

Urinary retention or difficulty urinating

Fever associated with back pain

Bowel or bladder incontinence

Constipation

New or sudden weakness in the lower extremities

Loss of sensation in the groin region

A typical diagnosis of sciatica includes a medical history check, physical examination and possible MRI imaging to determine the localization and severity. Often the wear and tear of our bones and discs over time can lead to injury later in life. Common causes of sciatica include:

• Injury to the spinal nerve of the lower back
• Compression of the spinal nerve due to a herniated disk
• Disk degeneration
• Severe arthritis of the back
• Strenuous body mechanics such as improper lifting, twisting and bending
• Obesity
• Prolonged sitting with poor posture
• Muscle degeneration due to age
• Lack of exercise
• Poor nutrition

Sciatica is typically treated with conservative treatment options including physical therapy, medications or injections. Your physician may also recommend at-home treatment options, including:

      Lumbar and postural education by a trained physical therapist

Cold packs and heat pads

Sleeping with a pillow between the knees

Light to moderate physical exercise

Physical therapy is a treatment option for seniors experiencing sciatica. Secondary options include physical therapy and exercise under a physician’s supervision.

Treatment options for older adults may involve medication such as anti-inflammatories and muscle relaxers for nerve related pain or epidural steroid injections. These injections may help with pain by alleviating inflammation around the spinal nerve. X-ray guidance is used to direct the needle to the location of where the nerve root is affected. 

Surgery may be recommended when there is evidence of nerve injury, or sciatica symptoms are so frequent or chronic that the quality of life is greatly reduced or debilitating. It is best to work with a physician to determine if surgery is the right option for treatment.

Engaging in preventative practices are essential to reduce risk for sciatica:

• Exercising regularly
• Proper nutrition
• Maintaining a healthy bodyweight
• Engaging in proper body mechanics such as lifting and bending correctly
• Avoiding prolonged sitting by getting up every 30-45 minutes for short walks 

Caregivers may help their loved ones with pain relief by providing supportive care, basic assistance for the mobility impaired and helping with physical therapy during alternate at-home sessions when a physical therapist is not present. 

https://www.presstelegram.com/2020/03/15/senior-living-helping-older-adults-identify-and-treat-sciatica/

Tips on Relieving Pain Caused By Sciatica

From runnerstribe.com

Sciatica is known as the irritation incurred by the sciatic nerve due to excessive pressure. This nerve originates from the lower spine and travels through the pelvis and buttocks. Sciatica is more commonly experienced by older people, particularly when it is caused by a ruptured disc. However, there are also pregnant women, as well as seemingly fit and healthy individuals who may also experience sciatica. As such, Here are some tips on how to relieve the pain caused by this condition:

Medication

Perhaps the most common pain relief method for sciatica is through medication. There are oral medications, and there are also topical solutions that act as relaxants to ease muscle spasms. While some over the counter drugs work, prescription medicines are usually more effective.

Stretches

Another way to ease the pain brought about by sciatica is by performing certain stretches and exercises. According to Dr. Justin Dean, the medical expert behind Dean's Sports Therapy, a proper stretch will allow you to mobilize the sciatic nerve being pinched. Thus, you can try the reclining pigeon pose, which is a common yoga pose that works to open the hips, or the sitting pigeon pose which proves to be easier to execute even when you are in pain. You can also do a sitting spinal stretch to create space in your spine to relieve the pressure on your pinched nerve.

Massage

There are several forms of massage that can be beneficial to alleviate the pain you are feeling because of sciatica such as deep tissue massage or trigger point massage. This is because getting a massage can release endorphins, which are your body’s natural pain killers. A massage can also improve your blood circulation, as well as soothe your sore muscles, which all aids in alleviating your pain.

Mind-Body Techniques

Some people use their minds to overpower the pain they are feeling and this is known as mind-body techniques. You can practice deep-breathing exercises, meditation, or even guided imagery to be able to work on the power of your mind to control your body. Even cognitive behavioural therapy can help in relaxing your muscles and giving you a certain sense of control over the pain you are feeling.

Nutrition

You can also reduce muscle inflammation through your nutrition. Opt to eat more whole grains, as well as natural foods such as fresh produce over processed foods high in preservatives. You can also take supplements to help build the micronutrients that your body needs typically because you may not be able to acquire some of the vitamins and minerals you need through food alone.

In conclusion, there are several means on how sciatica can be treated, as well as on how the pain it causes can be alleviated. However, what may prove to be effective for one person and ineffective for another person. Thus, it is important to try which of the pain relief methods would alleviate the pain you are feeling, and in doing so, never give up on finding the answer to your needs.

https://www.runnerstribe.com/news/tips-on-relieving-pain-caused-by-sciatic/

6 Most Common Causes of Sciatic Nerve Pain

From lifesly.com

Sciatic nerve pain or Sciatica can be so excruciating that you would feel like lying on the couch forever. It originates from the lower back and goes down to the pelvic area with changing intensity as it can range from a mild ache to a burning sensation to sharp pain. It usually affects only one side of the body and, in most cases, can be treated by doing stretches for sciatica pain or by applying CBD topicals.

But, this condition can take a more serious turn if the affected person has pre-existing conditions like weak legs and bowel issues. We have listed here six most common causes of Sciatica so that you are equipped to prevent the situation rather than facing it when it happens.

Job Description

There are some occupations that are more likely to cause you sciatic nerve pains as they involve activities like heavy lifting, harmful work postures, and extensive loading, which have a high likelihood of straining sciatic nerve. As a result, workers end up tearing their discs and suffer from herniation.

Sciatica can occur even in people who have a sedentary work routine that involves sitting on hard surfaces for long hours. Therefore, employers must facilitate their employees to take regular breaks to stretch their bodies, and employees must make sure that their sitting posture is right and is not compressing the sciatic nerves.

Obesity

Obesity is an unhealthy accumulation of fat on a person’s body that is extremely harmful for health. Obesity is not only a disease in itself, but it also is a high-risk factor for various other medical conditions like osteoarthritis, type-2 diabetes, knee pain, and sciatic nerve pain. Excessive weight puts a tremendous amount of strain on the vertebrae and increases the risk of a herniated disc, which in turn causes sciatic nerve pain.

Age

Every organ, muscle, tissue, and bone of our bodies age with time and as a result, create multiple health conditions of severity. For example, the discs in our back degenerate with time and are more likely to get herniated and result in sciatic nerve pain, which is why most of the people suffer from sciatica when they reach old age.

Diabetes

Diabetes is a condition in which the body is incapable of producing enough insulin to deal with the levels of blood sugar and as a result, damages various systems of the body. Not only does it cause conditions like heart attacks, strokes, and hyperosmolar hyperglycaemic state, but it also damages the nerves in the lower back and cause sciatic nerve pain.

Spondylolisthesis

Spondylolisthesis is a condition where a person experiences displacement or slippage from its original position, and is now non-congruent to the other vertebrae. Its pain intensity and ramifications is dependent on the direction and extent of displacement. Overall, Spondylolisthesis can lead to conditions like stiff hamstrings, erect back, kyphotic posture, and sciatic nerve pain.

Piriformis syndrome

Usually, the sciatic nerve goes below the piriformis muscle, but in some people, it goes through the muscle. As a result, if the muscle suffers any trauma or compression, it can cause sciatic nerve pain and limited mobility.

Now that you understand the various causes of sciatic nerve pains, look for ways to prevent it from happening and progress towards a world of health!

The post 6 Most Common Causes of Sciatic Nerve Pain appeared first on NYK Daily.

https://lifesly.com/6-most-common-causes-of-sciatic-nerve-pain/

Effective sciatica pain relieving exercises and stretches

From thehealthsite.com

Some of the common symptoms of sciatica include a backache, hip pain, difficulty in standing up, tingling sensation in the legs, etc. Thus, here we have mentioned a few exercises for pain sciatica relief.

The nerve pain that is generated from the lower back and extends to the back of the feet and the legs is known as sciatica. It is caused due to the irritation of the largest nerve in your body (sciatic nerve). Some of the common symptoms of sciatica include a backache, hip pain, difficulty in standing up, tingling sensation in the legs, weakness and numbness of the lower back, legs and hips, etc. Thus, here in this article we have mentioned some effective exercises and stretches to get relief from sciatica pain.

Seated Pigeon Pose
Step 1: Flex your knees and sit on a mat.
Step 2: Lean back and support your upper body and diagonally behind you place your fingertips on the mat.
Step 3: Lift your right leg and place it on your left knee.
Step 4: Make sure your right ankle is on top of your left knee.
Step 5: Gently move your left leg from left to right.
Step 6: Before switching legs do this 10 times.
Step 7: Practise 3 sets of 10 reps on each side.

Shell Stretch
Step 1: Start with kneeling down position and sit on your heels. Place your palms close to your knees and keep your toes pointed out.
Step 2: Lean forward and bring your chest close to your knees. Step 3: Keep your back straight, and look at the mat.
Step 4: Push your upper back up toward the ceiling.
Step 5: Hold this pose for 10 seconds.
Step 6: Practise 5 sets of 10 seconds hold.

Seated Crossover Hamstring Stretch
Step 1: Sit on a mat with your legs extended forward.
Step 2: Cross your right leg over the outside of your left leg.
Step 3: Place your right foot close to your left knee.
Step 4: Wrap your left hand around the outside of your back, and place your right hand on your left side.
Step 5: Bend and bring your head close to the right knee.
Step 6: Hold this pose for 10 seconds.
Step 7: Repeat on the other side.
Step 8: Practise 3 sets of 10 seconds hold on each side.

https://www.thehealthsite.com/fitness/effective-sciatica-pain-relieving-exercises-and-stretches-kd0918-611812/

Today health tips: Regular practice of yoga can help you get rid of back pain

From thehealthsite.com

Yoga is a great form of exercise that can boost your overall fitness and health. Today, health tips from us brings you a few asanas to help you deal with back pain.

Back pain is a common problem today. Long hours in front of a computer, bad posture and lack of exercise contribute to this condition. Though earlier, it was commonly seen in elderly people, it is now quite common in the younger generation too. Today, health tips from us will tell you how you can deal with your back pain. You can do this easily by adopting the practice of yoga. This ancient Indian mind-body therapy is a great way of dealing with many simple and chronic health conditions. And, back pain is one of them. Follow our health tips of the day and start practicing yoga every day. You will notice your back pain disappearing in no time. As part of our health tips today, we bring you a few yoga asanas that can help you find relief.

Cat-cow pose

This asana gently stretches your torso, shoulders and neck. It is a good start to getting rid of your back pain.
Directions: Get on the floor on all four. Your wrists must be underneath your shoulders and your knees below your hips. Inhale deeply and look up. At the same time, let your stomach drop down toward the mat. Exhale and tuck your chin into your chest. Bring your navel in toward your spine and arch your back. Repeat this movement for 60 seconds.

Downward-facing dog

This pose gives you relief from back pain and sciatica. It also makes your back strong.
Directions: Get on the floor on all four. Your wrists must be underneath your shoulders and your knees below your hips. Put your weight on your hands and keep your toes properly planted on the ground. Now lift your knees and push your buttocks towards the ceiling. Maintains a slight bend in your knees and try to lengthen your spine and tailbone. Your heels must be off the ground. Your head must be in line with your upper arms. Hold this pose for 60 seconds.

Cobra pose

This is a gentle asana that stretches your abdomen, chest and shoulders. It makes your spine strong and relieves sciatica pain.
Directions: Lie down on your stomach. Keep your hands under your shoulders and your fingers facing forward. Draw your arms in tightly to your chest. Putting pressure on your hands, slowly lift your head, chest, and shoulders off the ground. Bend your elbows a little and let your head drop back. This will put more pressure on your back.  to deepen the pose. Exhale while releasing the pose.

https://www.thehealthsite.com/fitness/yoga/today-health-tips-regular-practice-of-yoga-can-help-you-get-rid-of-back-pain-730609/