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/