Saturday, 11 May 2024

Why is my sciatica not going away?

From medicalnewstoday.com

Sciatica is a type of nerve pain that radiates down the back into the hip and leg, usually because of a herniated disk. It often goes away in a few weeks, but can become chronic.

Compression, inflammation, and irritation of the sciatic nerve can cause sciatica. The sciatic nerve runs from the lower back to the feet.

This article reviews what sciatica is, what causes it, and how to treat it.


Does sciatica go away?

Sciatica typically goes away within 4-6 weeks, even without medical intervention.

Lifestyle changes, such as eating a healthful diet and maintaining moderate activity levels, can help to stop sciatic recurring.

Sciatica that lasts more than 3 months or that goes away and comes back may be chronic.

Chronic sciatica is a long-term condition that can cause ongoing pain. It is more difficult to treat than acute (short-term) sciatica, but several remedies can offer relief.

The most common cause is a herniated disk in the lower spine.

Another risk factor is spinal stenosis, which causes the spinal column to narrow.

Herniated disk

Doctors do not know why some cases of sciatica become chronic.

Many acute and chronic cases happen because of a herniated disk. In most cases, herniated disks improve on their own within a few weeks. When they do not, this may cause chronic pain.

People with herniated disks often remember a specific injury that triggered the pain. An injury does not mean that the pain will be chronic.

However, people with a herniated disk from an injury may develop the same injury again, especially if they continue repeating the movements that led to it.

Inflammation

Inflammatory conditions can trap spinal nerves, causing sciatic pain.

People with chronic inflammatory conditions, such as rheumatoid arthritis, may notice that their sciatica flares when their condition worsens.

Treating the underlying condition may help treat sciatica.

Infection

An infection in or around the spine can cause an abscessTrusted Source, which is a swollen and infected mass. This abscess can trap spinal nerves, causing sciatica and, sometimes, other symptoms.

Spinal mass or cancer

Any massTrusted Source in or near the spine may trap spinal nerves, causing sciatic pain.

Some masses are cancerous, others are not, such as an epidural hematoma. An epidural hematoma is an accumulation of blood in the epidural space. The epidural space is an area between the vertebrae and their surrounding membranes.

It is important that people with sciatica see a doctor to rule out potentially dangerous conditions such as cancer, especially when sciatica does not go away.

Spinal stenosis

As a person ages, the normal wear and tear on their spine can cause spinal stenosis. In spinal stenosis, wear and tear, or inflammation cause a narrowing of the spinal canal. This is the small space in the center of the spine that carries the spinal cord and nerve.

A narrowing of this canal can put pressure on the spinal cord and nerves, causing nerve pain throughout the body.

Lifestyle issues

Several lifestyle factors may increase the risk of sciatic pain or extend the healing time.

People with these risk factors may find that sciatica becomes chronic or recurs. Risk factors for sciatica include:

  • little physical activity and prolonged sitting
  • having overweight or obesity
  • smoking

As sciatica often follows an injury, people may also find that the symptoms do not improve if they continue the activity that caused the original injury.

Tuberculosis

Sacroiliac joint tuberculosis, which doctors call tuberculous sacroiliitis, is a rare form of tuberculosis (TB), a lung infection.

It happens when the infection creates an abscess that spreads to the sacroiliac joint in the pelvis and lower spine. A person may also have symptoms of TB, such as breathing problems or coughing.

TB is a very rare causeTrusted Source of sciatica, but if symptoms persist and a person has a history of exposure to TB, testing is important.

Spinal misalignment

When the spine is not properly aligned, such as when a person has scoliosis or another chronic condition, it can put pressure on the space between the vertebrae.

This pressure may cause herniated disks. It can also compress the sciatic nerve, causing nerve pain. Depending on the cause, a person may need surgery, physical therapy, or other treatments.

Sciatica can and does come back, especially when a person has a chronic medical condition.

People who do not make lifestyle changes to prevent more sciatic pain may also redevelop symptoms. However, for most people, sciatica heals on its own within a month or two.

                                                                               Oscar Wong/Getty Images

  • Aerobic exercise promotes fitness and can help a person reach and maintain moderate body weight.
  • Stretch the hip flexors by standing straight in front of a chair. Bend the knee to a 90-degree angle and put the foot on the chair. Lean forward to stretch for 30 seconds.
  • Kneel with the buttocks resting on the heels, then put the chest to the ground with the arms elevated straight above the head and flat on the ground. Hold for 30 seconds.
  • Lie on the back and bring the knees to the chest. Hold for 30 seconds. Some people find additional relief by rocking from side to side in this position.
  • Lie on the back, with the knees bent and the feet flat on the floor. Lift alternating legs, as if marching, for 30–60 seconds.

Discover more of the best exercises for sciatica here.

The most common symptoms of sciatica include:

  • electrical sensations along the side of one leg
  • pain that radiates from the lower back to the hip and down the leg
  • intense leg cramps
  • pain when walking or moving
  • numbness in the legs, hips, or lower back
  • pain when sneezing or coughing

Sciatica usually goes away on its own, with or without treatment.

A doctor can diagnose the cause of sciatica and may prescribe treatment to speed healing.

However, sciatica is not a medical emergency, and it is fine to wait to see whether the symptoms resolve before visiting a doctor.

It is advisable to see a doctor if:

  • sciatic pain interferes with daily functioning
  • sciatica goes away and then comes back
  • the pain is unbearable or gets steadily worse

Although the outlook for most people with sciatica is good, those with chronic sciatica face a longer and more complicated recovery. The majority of sciatica cases resolve within 4-6 weeksTrusted Source without medical intervention.

2020 study found that surgery for herniated disks that cause sciatica offered better results than conservative treatments, such as exercise. However, the trial was small, and the researchers only recruited participants from a single treatment center. Researchers also noted that a person’s outlook is typically better the earlier surgery occurs.

However, some studiesTrusted Source show that occupations involving strenuous back movements, depression, and poor socioeconomic situations can increase the risk of recurrent, or chronic sciatica.

Sciatica can be intensely painful, although most people do not have to live with it long term.

It is common for sciatica to last for several weeks. If weeks turn into months, however, this may indicate that it is time to seek a diagnosis and explore other treatment options.

https://www.medicalnewstoday.com/articles/why-is-my-sciatica-not-going-away

Thursday, 9 May 2024

Doctor explains why sciatica is so painful at night with top tips on how to improve it

From msn.com

A doctor has explained why the pain from sciatica can be worse at night and how to improve it.

Sciatica is a condition that gives you severe pain in your lower back and legs, and it can stop you from getting a good night's sleep. Dr Tony Nalda, who runs the Scoliosis Reduction Center, has explained why the pain from sciatica can feel worse at night and what you can do to help it.

Sciatica is a medical problem that happens when something else in your body rubs or presses on your sciatic nerve. It can be caused by things like back injuries, spondylolisthesis, spinal stenosis, and slipped discs - which is a common cause, reports Bristol Live.

What are the signs of it?

Dr Nalda said: "The most common symptom of sciatica is shooting pains in your hips and legs. You may also experience weakness or numbness, or find it hard to move your legs. Some people have tingling or stabbing pains in their legs and thighs, or increased discomfort when they sit down."

                                                      There can be many causes of the condition         © Getty Images/iStockphoto

Why does it hurt more at night?

People have fewer things to distract them at night, which makes the pain feel worse because it's all they can think about. Dr Nalda said: "Also, lying down for extended periods increases pressure on the sciatic nerve.' Finally, the lack of movement at night can cause the muscles around the sciatic nerve to stiffen."

What can you do about it?

Dr Nalda has these tips to help reduce your sciatica pain:

  • Sleep on your back or side, not your front. Sleeping on your front doesn't support your spine properly, and it can make the nerve irritation worse.
  • Use special pillows to help your body and sleep on a mattress that's not too soft.
  • Try stretching before bed and when you wake up to make your body more bendy and get your blood moving.
  • Use cold things to bring down swelling and warm things like a nice bath to relax your muscles and help with the soreness.
  • If the pain is really bad, talk to your pharmacist or doctor about stronger medicine.
  • Keep moving gently all day, and try not to stay sitting or lying down for too long.
  • If it hurts on one side of your body, don't lie on that side. Try the other side instead.

Dr Nalda said: "A medical specialist may recommend physiotherapy, painkilling injections, or even surgery. If you act wisely, you can lessen the pain and improve your quality of life."

https://www.msn.com/en-gb/health/other/doctor-explains-why-sciatica-is-so-painful-at-night-with-top-tips-on-how-to-improve-it/ar-BB1kNiDD?ocid=msedgdhp&pc=HCTS&cvid=23d953a48fb74ede8a80763f5dcfd03c&ei=17 

How Should I Lay With Sciatica? A Review By Doctors

From msn.com

Expert opinion from Robert H. Shmerling

M.D. Senior Faculty Editor, Harvard Health Publishing · 30 years of experience · USA

There is no single correct position recommended for people with sciatica. For many, finding a comfortable position is a matter of trial and error. To some extent, the cause of sciatica may affect which positions are most comfortable. For example, side-sleeping may be better for someone with sciatica due to lumbar spinal stenosis while back sleeping may feel better for the person with disc disease. And, of course, no matter what position you start with, people tend to move around during sleep so choosing a single position for sleep is often impossible. 

That said, many experts make the following general recommendations: Place a pillow under the knees and/or lower legs when lying on your back. Put a pillow between the knees if lying on your side. Try curling up in the foetal position. Use pillows to keep the head and upper back tilted forward a bit or sit in a reclining chair that allows a forward bend to the back. Stick with what works. If stomach sleeping is more comfortable, don’t feel compelled to follow advice about other positions, especially if the other positions cause more pain. If finding a comfortable position is challenging, work with a physical therapist who can help you identify and maintain positions that reduce pain when you lie down.

Expert opinion from Ipsa Arora

MD (Internal Medicine) · 5 years of experience · USA

Lie flat on your back, with your heels and buttocks in touch with the bed, and your knees slightly bent towards the ceiling. To provide support, place a cushion between your bed and your knees. Gradually add more cushions until you achieve a comfortable knee posture. It is fairly unusual to experience no alleviation after a few days. Continue to try different sleeping positions until you discover one that helps you to sleep through the night.

Expert opinion from Piyush Puri

MBBS · 1 years of experience · India

Start with a good spinal alignment. When you lie down, ensure your head, shoulder and hips are in straight line. Try using a small pillow below your neck and head but not your shoulder. Try sleeping on the side, especially if you sleep on the side opposite of where it hurts. Putting a pillow between your knees can make side sleeping even more comfortable.

https://www.msn.com/en-ae/health/medical/how-should-i-lay-with-sciatica-a-review-by-doctors/ar-BB1lYxs7