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Sciatic Pain PDF

Sciatica is pain that radiates from the lower back down the leg along the sciatic nerve. It is usually caused by a herniated disc or other condition that compresses the sciatic nerve. Symptoms include pain, numbness, tingling or weakness in the leg. Most cases resolve within 6 weeks with rest, heat/cold therapy and over-the-counter pain medications. If pain persists, treatments may include physical therapy, steroid injections, or surgery as a last resort. Dr. Weil recommends trying acupuncture, bodywork, yoga or osteopathic manipulation before more invasive options.

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174 views1 page

Sciatic Pain PDF

Sciatica is pain that radiates from the lower back down the leg along the sciatic nerve. It is usually caused by a herniated disc or other condition that compresses the sciatic nerve. Symptoms include pain, numbness, tingling or weakness in the leg. Most cases resolve within 6 weeks with rest, heat/cold therapy and over-the-counter pain medications. If pain persists, treatments may include physical therapy, steroid injections, or surgery as a last resort. Dr. Weil recommends trying acupuncture, bodywork, yoga or osteopathic manipulation before more invasive options.

Uploaded by

hiren_mistry55
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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11/10/2016

WhatisSciatica?SciaticPainExplained|Dr.Weil

BACKPAIN

Sciatica
Whatissciatica?
Sciaticaispaininthelowerbackorhipthatradiatesdownintothebuttockandbackofthelegalongthesciaticnerve,oftentothefoot.Sciaticpainisthe
resultofapinchedorinflamedsciaticnerveandcanoccurfollowinganinjury,muscularstrainorherniated("slipped")vertebraldiscthatpressesonthe
nerve.Fortunately,sciaticausuallygoesawayonitsownwithinafewweeks.

Whatarethesymptomsofsciatica?
Thepainofsciaticacantakeanumberofformsitmayfeellikeacrampintheleg,mayworsenwhenyousit,sneezeorcough,andmayshowupas
numbness,burning,tingling,anelectricalshockoraspinsandneedlesalongtheleg.Muscleweaknesscanoccureitherduetopainorpressureonthe
nerve.Lossofbowelorbladdercontrolisararebutseriouscomplicationthatrequiresemergencytreatment.
Only10to25percentofallcaseslastmorethansixweeksand80to90percentofallpeoplewithsciaticarecover,intime,withoutsurgery.

Whatarethecausesofsciatica?
Thetwosciaticnervesarethelongestnervesinthebody,runningfromthelowerspinalcorddownthebuttockandhip,andcontinuingdownthebackofeachlegtothefoot.Each
carriesnervesignalsformotorcontrolofseveralmusclesofthelowerlegaswellassensationtothebacksofthethighs,calvesandfeet.
Anythingthatcompressesasciaticnerveforprolongedperiodsoftimecancausesciatica.Sometimesthisistheresultofherniationinadiscofthelowerback.Agerelatedchangesto
thespinecausedeteriorationtotheshockabsorbingpadsofcartilagethatseparatethebackbones(vertebrae)fromeachother.Thesepadscreatespacebetweenthebones,allowing
aplaceforthenervestotravelastheyleavethespinalcord.Ifthesediscsrupture,theirinnergelatinoussubstancecanseepoutandpushagainstthenerves.Degenerativearthritis
canalsocauseanarrowingofthespacebetweenvertebraeorcauseonevertebratoslipforwardontoanother.Thiscanpincharootofthesciaticnerve,andcausesimilarsymptoms.
Traumafromacaraccidentorblowtothespinecaninjurethesciaticnervedirectly,ascanmuscularstrainsofthelargelowerbackmusclesandspasmsofthepiriformismusclethat
runsdirectlyoverthenerve.Asthesemusclesbecometightorgointospasm,theycancreatearopeliketensionthatirritatesthenerve.Tumorsofthespine,spinalcord,orthenerve
itselfarerarecausesofchronicsciaticpain.
Inadditiontogettingolder,beinginajobthatrequiresconstanttwisting,heavyliftingordrivingcanmakeonemorepronetosciatica.Theconstantsittingthatoccursasaresultofa
deskjoborbeingoverlysedentarycanalsoputexcesspressureonthelowerbackandlegs.Andfinallythosewithdiabeteshaveanincreasedriskofsciaticaduetothedamagethat
occurstoperipheralnerveswhenbloodsugarsareabnormallyhigh.

Whatistheconventionaltreatmentforsciatica?
Formostpeople,sciaticpainrespondswelltosimplemeasures,includinghotandcoldpacks,stretchingexercisesandtheuseofoverthecounter(OTC)painmedicationssuchasnon
steroidalantiinflammatories(NSAIDS)likeibubrofen.Insomeinstances,doctorswillprescribeanNSAIDalongwithamusclerelaxanttotreattensionandmusclespasm.Narcotics
maybegiventodealwithpoorlycontrolledsciaticpain,althoughtheycanbecomeaddictivewhenprescribedforlongperiodsoftime.Chronicsciaticpainlongerthan23months
canbetreatedwithnarcoticpainpatchesortheuseoftricyclicantidepressantsandanticonvulsantdrugs,whichworkbyblockingpainmessagestothebrainorbyenhancingthebodys
ownproductionofendorphins.Thesemedicationscanhavesideeffectswhichincludeconstipation,drymouth,weightgain,bladderproblems,blurredvisionanddizziness.
Mostconventionaldoctorsrecommendphysicaltherapywithstretchingexercisesassoonasthepainbeginstodiminish.Youoftencanbeginthisrehabilitationbytakingshortwalks
evenbeforestartingphysicaltherapy.Rehabilitationtypicallyincludesexercisestohelpcorrectposture,improveflexibility,andstrengthenlowerbackandlegmuscles.Massage
therapy,ultrasound,andothertechniquesareoftenincludedinatherapysession,whichtypicallylastsonehour.
Whenconservativemeasuresdontalleviatepainwithinafewmonths,anepiduralsteroidinjectionornerveblockmaybeconsidered.Typically,asteroidisgivenalongwithanumbing
agentsometimesunderXrayguidanceintotheareaofsuspiciousnerveirritationwiththehopethatitwillsuppressinflammationandhelprelievesciaticpain.Thesetypesof
proceduresarestillunderinvestigationastohoweffectivetheyare.Someresearchhasfoundthatcorticosteroidscanprovideshorttermsymptomreliefhowever,datadoesntseemto
confirmitslongtermusefulness.Inaddition,becauseofthesideeffectssteroidscanhave,thenumberofinjectionsyoucanreceiveislimitedusuallynomorethanthreeinoneyear.
Surgerytocorrectaherniateddiscisusuallyreservedfortimeswhenthecompressednervecausessignificantweakness,bowelorbladderincontinence,orwhenpaingets
progressivelyworseordoesntimprovewithothertherapies.Mostcurrentsurgicaloptionsinvolvealumbarlaminectomywithdiskectomy,wheretheherniatedportionofthediscis
removed,relievingthecompressionandretainingasmuchnormaldiscanatomyaspossible.Sometimesasurgeonwillperformthisoperationthroughasmallincisionwhilelooking
throughamicroscope(microdiskectomy).Fusionofvertebraeforsciaticaisrarelydone.Successratesofstandarddiskectomyversusmicrodiskectomyareaboutequal,although
sometimespaincontrolandrecoverytimecanbebetterwiththelesserinterventionofmiscrosurgery.

WhattherapiesdoesDr.Weilrecommendforsciatica?
Regardingsurgerytoremovepartorallofaherniateddisk,Dr.Weilrecommendsconsideringitonlyif,afterthreemonthsoftreatment,youstillhavedisablinglegpain.Luckily,thatis
rarelythecase.
Iftheproblemismuscular,specificstretchesthatcanrelaxthepiraformismusclearefrequentlybeneficialandcanbringimmediaterelief.
AnyonewithchroniclowbackpainshouldreviewtherecommendationsinthatsectionandconsiderthebookswrittenbyDr.JohnSarno.
Thebesttherapyisprevention.Maintainidealweight,engageinregularphysicalactivityseveraltimesaweek,andavoidprolongedsittingasmuchaspossible.Also,carryingalarge
walletinthehippocketofpantscansometimescauseoraggravatesciaticaremoveunnecessaryitemsand/orfindalternativewaystotransportyourmoney,identificationandother
essentials.Ifyouarediagnosedwithsciatica,Dr.Weilrecommendsthesetreatmentoptions:
Acupuncture:TheNationalInstitutesofHealthrecognizesacupunctureasanacceptablealternativetoconventionaltherapiesforlowbackpain.Lookforanacupuncturist
accreditedbytheAmericanAssociationofOrientalMedicineortheAmericanAcademyofMedicalAcupuncture.
Bodywork:BoththeAlexanderTechniqueandtheTragerApproachcanhelpovercomebackpain.TheTragerApproachincludestablework(apractitionergentlyrocksand
lengthensyourbodytoreleasetension)followedbyamovementlessonforcontinuedselfcare.TheAlexanderTechniquecanhelprelievepainandpreventrecurrencesby
correctingpoorpostureandteachingproperpatternsofmovement.
TherapeuticYoga:Yogacanhelprelievepainandprotectagainstrecurrencesbystrengtheningyourback.Italsocanbalancenervousfunctioning,promoteflexibilityand
neutralizestress,allofwhichcontributetobackpain.(Therapeuticyogamayoffermorebenefitsthanphysicaltherapy.)
OsteopathicManipulation:Thissystemofmanipulationofthemusculoskeletalsystemcanbeahighlyeffectivetreatmentandusuallyrequiresonlyafewvisitstoaqualified
practitioner.

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