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 neck and shoulder have a huge range of movement and thus they are more prone to injury. The ball and socket joint at the upper arm is the shoulder and both the neck and the shoulder are made up of soft tissues, muscles and ligaments. 

Reasons behind pain Injured rotator cuffs: 

Rotator cuffs are the tendons supporting the shoulder. If they are injured it might lead to a chronic loss of the range of movement. This is more commonly known as a frozen shoulder. 

Dislocation: Dislocated disc of the neck or shoulder due to an accident would cause severe pain in the affected area. 
Fractures: Fractured collarbone or the upper arm bone may result in chronic pain. 
Tendonitis: This occurs due to the over usage of the arms or neck or strains due to over exertion like in sports. 
An unstable shoulder joint: If there is instability in the ball and socket joint of the upper arm, chances of having a chronic pain is high. Others: Degenerative arthritis, herniated disc, and even heart attacks can be the other possible causes of chronic neck and shoulder pain. 
When to go to the doctor? 

When the patient experiences a pain due to a severe blow or injury, the neck pain radiates down the legs and arms, a feeling of numbness and tingling sensation, or has a stiff neck with fever or vomiting, it is essential to seek the advice of a Doctor. 

Diagnosis for shoulder and neck pain X-ray: 

The main form of diagnosing a pain is an x-ray. It helps to reveal diseases from arthritis, tumour, slipped disc, narrowing spinal cord, fractures and spinal cord instability. 

MRI: Magnetic Resonance Imaging or simply the MRI reveals the detail of nerve-related issues along with the problems in the ligaments and tendons. 
CT scan: There may be instances when the injuries are difficult to be diagnosed. And, in the case of a fracture, a CT Scan is advised for more details. It is also an alternative to MRI. 
ECG: An Electrocardiogram is a way of diagnosis if shoulder and neck pain continues along with chest pain or shortness of breath. If there is a risk of an individual having a heart attack, then an ECG is recommended. 
Electro Diagnosis: Electromyography referred to as EMG and Nerve Conduction Velocity (NCV) are used to diagnose pain in the arm, neck, shoulder followed by a numb feeling on the affected areas. 
Treatment for chronic shoulder and neck pain 
A simple sprain on the neck and shoulder would demand a rest for a few days along with pain medication. If the pain is due to muscle spasms application of dry or moist heat may provide relief. In the case of a swelling due to injuries, a cold ice pack 4 to 8 times a day will provide immense relief. Patients might be advised a cast or sling for the shoulder pain. The soft tissues in the neck and shoulder can be treated with pain relievers taken for a few days. Muscle relaxants are also prescribed depending on the severity of the pain. Local corticosteroid injections are helpful for shoulder arthritis. Platelet rich plasma injection is another modern treatment for arthritis or tendinopathy. In some situation, radio frequency procedures are very helpful. Exercises are very effective for both neck and shoulder pain movement. Surgery might be an option if nerve roots are affected.

Chronic Shoulder & Neck Pain - Ways It Can Be Diagnosed!

Lower back pain can be one of the most physically debilitating things that can affect you and limit your mobility. Even if the pain isn t that acute, it could still signal something deteriorating in your lower back. While oral medications, topical creams or sprays can help in reducing pain, there are other effective remedies you can try on your own. These will be handy when you have no medications at hand. One of these is the hot and cold therapy.

Heat therapy for lower back pain

Heat works well with lower back pain as it can dilate blood vessels and improve circulation within the tissue. This will help in circulation and also result in lowering the pain. Heat therapy will also loosen up other muscles in the area and help soothe sore areas which have been taking the burden along with the lower back muscles. Some of the techniques that can be applied are:

1. All day heat wraps: These are specially manufactured belts or wraps which wrap around your abdomen and keep tightness and pressure on your lower back as well as supplying heat.

2. Electric heating pads: These are mechanized heating pads which generate heat with electricity. You can place them under you back and then either sit or sleep with it positioned behind you. However, ensure that you don t keep these for too long as they could burn your skin.

3. Hot Compress with towels or hot water bags: Use a clean towel and heat it over a conductive surface and apply it on your lower back. You can also use hot water bags for the same purpose.

Cold therapy for lower back pain

Cold therapy uses the principle of constriction of blood vessels as well as slowing circulation. This will help numb the area and thus help relieve the pain. Some of the ways these can be administered are mentioned below.

1. Ice towel: In this method, soak a towel in ice cold water, wring it to dry it and then apply on your lower back. This will numb the pain without transferring the sting of the cold or damaging your skin.

2. Ice packs: Put about half a kg of ice in a plastic Ziploc bag and pour water over the ice to just about cover it. Push out the air out of the bag and then lock it. Use this ice pack with a towel to ensure that you back doesn't get wet.

3. Ice gel packs: These are ready made packs, which can be bought from medical stores and kept frozen to be used whenever you need it in order to relieve lower back pain.

Treating Lower Back Pain Using Hot and Cold Therapy

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

One part of the human body is essential for the efficient functioning of another. The hip joint provides support to your overall body weight while you are at ease or in motion. Suffering from medical problems pertaining to the hip can impede free movement; walking, running, stooping, sitting or even lying down will cause immense pain and discomfort in such a situation. While certain bodily disabilities come with old age and are in most cases unavoidable; some others can actually be controlled through physical exercise.

Take a look at a few stretches to improve your hip mobility:-

Stretch like a pigeon- this yoga loosens up muscle tension in and around a person's hip. Your right leg must be stretched behind while the upper part of your body bends over a folded left leg in front. Your head rests on your coupled hands. This stretch improves the shape of your hip as well.
Try to be an eagle for hip firmness- to align your body in the perfect eagle pose; you probably need to be a conjurer; that is the kind of flexibility the posture requires. Be a half chair making your hands intersect above your head while your left leg crosses the right one. The pressure is on your hip making it strong. Your body has to be in one single line.
Sit in the chair pose- crouching on your haunches with your torso inclined to the front is a good way to better hip mobility. This exercise also relieves you of back pain. It adds potency to the muscles of your upper thighs thus giving a well- rounded hip extra support.
Stoop in the downward doggy pose- the downward doggy pose helps you concentrate on the fullness of your hips. The back muscles are stretched and the problem of a small, rickety hip is dealt with through this yoga. Your legs should be erect at the knees and should be stretched apart depending upon the width of your hip. The rest of your body should bend in a forward arch while your spread hands touch the ground.
Try out the benefits of world's greatest stretch- world's greatest stretch involves a series of stretches that not only accentuates your hipline making your hip muscles adaptable to stress but also tones muscles in other parts of your body. It is a three- fold exercise. The second step is the most difficult where your body is balanced on a half folded right leg and you're required to touch the ground with your right elbow.

Tips to Improve Hip Mobility

Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

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