The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

The backbone (spine) has smooth movement with smooth intervertebral disks. However, this fluid movement can be limited due to arthritis, which can happen due to many reasons   genetic to age to injury to infection to tumors. The lower back has two sets of spinal disks   sacral and iliac. This sacroiliac region has an elastic vertebral tissue. This could be gradually replaced with hard bone, which can cause fusion between the disks. Such a condition is known as ankylosing spondylitis (fusing disk spaces), which is a type of arthritis.

The typical symptoms of ankylosing spondylitis (AS) are morning pain and stiffness in the low back and upper buttocks, which gradually decrease as the day goes by. The symptoms usually start and continue to gradually worsen over a period of 3 to 6 months. In severe cases, there could be spinal fractures, but in most cases, pain, stiffness and reduced movement are the main complaints.

Why homeopathy for AS (Ankylosing spondylitis)?

Major benefits of homeopathy could be summarized as under:

It addresses altered immune system, treating the roots of this autoimmune disease.

It helps in pain control without side effects.

It aims at disease control.

It is absolutely safe even if used for a long time.

Homeopathic medicines are prescribed on the basis of individual case evaluation by taking into account patient s genetic, immunological and psychological parameters. It is safe and effective as a long-term therapy. It reduces pain, improves mobility and most importantly, controls the disease. It has no adverse effects.

Homeopathy helps AS patients by acting on the immune system, which is usually overactive in these people. Depending on the presenting symptoms, the doctor will prescribe a customized regimen for the patient.

Rhus Tox: This is the first medicine of choice when the patient experiences sacral/lumbar area pain that is worse at rest, with sitting, or after a period of inactivity. The pain radiates down the legs to the foot. Walking or any other activity/motion provides relief from the pain.

Aesculus: This is indicated in patients who have extremely painful and stiff low back and hips. The pain is a constant ache and there is discomfort with trying to rise from a seat, stooping, and walking, where greater effort is required. There is a feeling that the legs would give way, adding to resistance while walking.

Kalmia: This is used in patients where the back pain and stiffness are accompanied by a warm, numb, and prickly sensation. Low back pain and neck pain is associated with a burning sensation. The pain appears in sudden bursts in the early parts of the night and travels down the arm or up into the scapula.

Kali Carb: This is indicated where there is extreme weakness along with AS symptoms of pain and stiffness in the lumbosacral back area. The patient feels like he is going through a paralytic attack and must lie down to rest. This is a feeling similar to a broken back, and can extend up into the neck or down to the legs. The symptoms are more severe in the early morning hours. Changing positions in the bed worsens the pain.

If you or someone else is suffering from AS symptoms, give homeopathy a try.

Homeopathy Treatment For Ankylosing Spondylitis

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?

The main purpose behind physiotherapy is reducing lower back pain and increasing muscle and bone function, so that such instances are avoided in the future. Physiotherapy is the first line of defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope of performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).

A physical therapy program for back pain usually has two components:

Passive physical therapy to help reduce the patient's pain to a more manageable level

Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

Heat/ice packs

TENS units

Iontophoresis

Ultrasound

Active Physical Therapy - Back Pain Exercises

In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.

Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.

One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps.

Physiotherapy for Back Pain

Muscle contusion is a condition that is characterized by bruising in the muscles. It generally tends to occur in athletes who play a lot of contact sports. Repetitive blows in any part of the body may cause damage to the underlying muscle tissues. These blows may lead to internal bleeding, resulting in blood clot formation. The most common site where it occurs are the quadriceps.


The various causes of this condition are:
1. Direct repetitive blows to a part of the muscle in contact sports such as football
2. If you fall on a hard surface 
3. It may also occur if the muscle comes in contact real hard with sports equipments like soccer balls

The symptoms of a muscle contusion are:
1. You may experience swelling of the muscle
2. Excessive pain
3. Decrease in range of motion in the concerned body part
4. It may lead to leaking of blood vessels
5. You may also experience hematoma where a lump is formed over the affected spot
6. Symptoms of broken bones, dislocations and fractures may also occur

Complications
This disorder may also lead to various complications such as compartment syndrome, which leads to compression of blood vessels resulting in pain. 

Treatment
The basic treatment for this condition is the rice protocol which is rest, ice, compression and elevation. You should rest the muscle, then apply ice to the affected area to reduce the pain. You can also take nsaids (non steroidal anti-inflammatory drugs) to reduce the pain. In severe cases, the doctor may drain the lump surgically.


It is advisable to not return to your normal sports routine in order to allow the muscle to recover. If you carry on with your regular routine, it may result in further complications like the formation of scar tissue. You may undergo various stretching exercises to relieve the pain and make a gradual return to your normal sporting activities.


Causes and Symptoms of Muscle Contusion

People who suffer from arthritis are more likely to experience osteoarthritis symptoms. The intensity of the feeling of knee pain in winter is often linked to barometric pressure. In winter, there is a reduction in the pressure exerted by the air around us. This drop in pressure can cause the tissues around the joints to swell resulting in increased pain. The other possible cause of knee pain in winter can be explained from the influence of heat. Fluid in tissues becomes more viscous during winter. As a result of this increased viscosity, the elasticity of the muscles decreases, resulting in winter aches and pains. 
Some scientists believe that the higher pain intensity in winter is to be more of a psychological thing. Seasonal affective disorder is more during winter, and people suffering from mental depression seem to sense more pain during winter as the weather restricts outdoor activities. Improper intake of food also causes knee pain in winter due to undigested material. Even though winter arthritis is uncomfortable, the following tips help to make the joints work better and make you withstand the season easier.

Tips to Manage Joint Pain in Winters

Physical activity in winter can reduce winter aches and pains and enhance overall health benefits. Low impact activities like aerobics, swimming in a heated pool, weight training, and riding a stationary bicycle can reduce stiffness, increase the blood flow, and support the knees. Thus, winter arthritis can be well managed by doing exercises.
Diet also plays a vital role. Eating a balanced diet that comprised of low saturated fat, lean proteins, more fiber, and refined carbs helps to improve body functions during the winter. Drinking water throughout the day helps to reduce winter aches and pains. It is essential to consume easily digestible foods like vegetables. Consuming vegetables like carrots and cucumbers that have diuretic properties can help to eliminate waste products from the body.
Vitamin D deficiency may worsen osteoarthritis. It is necessary to take a supplement vitamin D or ensure to make your diet is vitamin-D rich. Fish oil is a potent source of omega 3 fatty acids. Increase your intake of milk, a rich source of protein and calcium that help to strengthen the bones. Exposing the body to sunlight help to obtain vitamin D.
Non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen can be used to reduce inflammation and pain. Injecting a viscous substance can decrease the friction of the bones and ease the condition.
Home Remedies for Knee Pain in Winters

Wrap the inflamed knees with blanched cabbage leaves. This can cool down inflamed knees.  Aloe vera also helps to reduce inflammation.
Comfrey (symphytum officinale) can act as an anti-inflammatory agent. Create a compress using mashed root or comfrey tea soaked bandages can also be used to reduce inflammation.
Applying an ice-pack can help to reduce swelling and alleviate winter aches and pains. While applying ice-pack, ensure to cover the entire knee. Applying a bag of frozen peas to the area also works well. While using ice or heat therapy, make sure to do them carefully as over agressive and over doing it, can cause problems. 
Steam therapy also helps to reduce pain in your knees. Soak your knee in a steaming hot water for 15 minutes. Applying hot water bag also can relieve knee pain in winter effectively.
Winter aches and pains all over the body can be relieved by administrating massage therapy by a professional.
Avoid applying strain or pressure on your knees. Take adequate amount of rest to reduce pain and swelling.
These are basic guidelines to help you. Contact your doctor for further management.

Tips For Managing Joint Pain in Winter

Breaking a bone no matter how small is painful. This pain is caused both by the actual break in the bone and the damage to surrounding muscles, ligaments, nerves and other soft tissue. There are three stages of pain caused by a fracture:

Acute Pain: Pain that occurs immediately after a bone is fractured
Sub-Acute Pain: Pain experienced while the one and soft tissues heal
Chronic Pain: Pain experienced after the fracture has healed
Any kind of fracture can cause these types of pain. However, it is not essential for everyone who has had a fracture to experience all the three kinds of pain. Many people experience pain only when the fracture occurs but in few cases, a person may break a bone and not realize it. Each type of pain needs to be dealt with in a different way.

Acute Pain: Acute pain reduces as the fracture heals. For this, the fractured bone must be reset in place and held together with a splint, brace or cast so as to immobilize it. In some cases, surgery may also be needed. Over the counter pain medication is often prescribed to help deal with this type of pain. The patient is also advised to rest the broken bone and avoid certain types of movement that could worsen the break. A broken bone takes a minimum of 6 to 8 weeks to heal. However, in cases of other conditions such as osteoporosis, this time period could be much longer.
Sub-Acute Pain: As the injury heals, the sub-acute pain experienced reduces. Immobilizing a broken bone to help it heal causes the muscles and soft tissues around it to stiffen and weaken thus triggering this type of pain. Physical therapy can be very helpful in dealing with this type of pain. Along with strengthening the muscles and reducing stiffness, physical therapy also helps reduce inflammation and scar tissue. Physical therapy can be provided in many ways including exercises, electrical stimulation, ultrasounds, massage etc. It is important to remember that at this stage of treatment, the more the affected limb is used, the faster it will heal. However, it is advisable to avoid putting too much pressure on the bone.
Chronic Pain: Some people may experience pain for several months and even years after a fracture has healed. This is usually caused by nerve damage or the development of scar tissue. Underlying conditions such as arthritis could also trigger this type of pain. Management of chronic pain varies from individual to individual. Treatment usually takes the form of medication, exercises and physical therapy. It is important not to avoid this type of pain and consult a doctor to ensure that it is not being caused by any other condition.

Fracture Pain - How To Deal With It?

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