The sciatic nerve is the longest nerve in the human body. It runs from the lower back, through the buttocks, your hamstrings and into the lower leg. Sciatica means pain in the leg, numbness or any kind of weakness in the lower back. There can be many reasons for a leg pain such as an injury to the leg or it can be due to the main nerve which travels in the lower back. Many times, it is not diagnosed properly and hence it will take a lot of time to respond to the treatment or in some cases, it may not respond at all. 

Symptoms of Sciatica: 

You will experience pain in the lower back only on one side of the body. 
The pain continues from the lower back to the sciatic nerve. 
Rarely, you will see the pain on both sides of the body or buttocks. 
The pain is very sharp. 
In some cases, the patient may experience a needles or pins sensation in the leg and in some cases, it is weakness or numbness in the lower back. 
The pain gets so severe that you will not be able to walk or even stand. 
If you have lower back pain combined with leg pain, then lower back pain is not going to be as severe as the leg pain. With the help of the symptoms, your doctor will be able to diagnose sciatica but in order to know the exact cause and origin of this pain, you will have to undergo other tests and examinations. 
Physiotherapy for Sciatica: 
There are many surgical treatments available for sciatica, but it is always good to go for non-surgical treatments. So you can opt for physiotherapy. You will be able to see better and long lasting results with this treatment. As it involves a thorough assessment of it on which the treatment protocol is laid. 

Physiotherapy involves four phases: 

Pain relief 
Restoration of normal flexibility 
Restoration of full functionality 
Prevention of recurrence 
In sciatica, it is due to unbearable pain, you seek treatment. So that has to be treated initially. When you can see that the pain is under control, then the physiotherapist will start working on the range of motion for your joints. The muscle tension will be reduced and muscle strength will be improved. In the third stage, your physiotherapist will start working on restoring the normal function of your body, especially your legs and your lower back. In the last stage, the physiotherapist will help you with some exercises that will stop its recurrence. Usually, sciatica will return after some time but taking a little care at the early stage can prevent it.

Physiotherapy For Sciatica - Why Is It The Best Treatment Option?

Scoliosis is the abnormal twisting and curvature of the spine. It is usually first noticed by a change in appearance of the back. There are several types of scoliosis based on the cause and age when the curve develops; the majority of patients have no known cause.

Typical signs include:
1. Visibly curved spine
2. One shoulder being higher than the other
3. One shoulder or hip being more prominent than the other
4. Clothes not hanging properly
5. A prominent ribcage
6. A difference in leg lengths

Back pain is common in adults with scoliosis. Young people with scoliosis may also experience some discomfort, but it's less likely to be severe. Seeking medical advice If you or your child has signs of scoliosis, make an appointment to see your spine specialist. They can examine your back and can refer you for an X-ray for confirmation. If you or your child are diagnosed with scoliosis, it is important to see a scoliosis specialist to talk about treatment options.

What causes scoliosis?
In around eight out of every 10 cases, a cause for scoliosis is not found. This is known as idiopathic scoliosis. A small number of cases are caused by other medical conditions, including:
1. Congenital scoliosis: Caused by birth defects.
2. Neuromuscular scoliosis: Common conditions are
- cerebral palsy
- a condition associated with brain damage
- muscular dystrophy
- a genetic condition that causes muscle weakness
- marfan syndrome
- a disorder of the connective tissues
3. Idiopathic Scoliosis: What causes idiopathic scoliosis is still unknown.
4. Adult scoliosis: In adults, age related changes in the discs and joints of the spine and a reduction in bone density may cause scoliosis. Adults can also experience worsening over time of previously undiagnosed or untreated scoliosis.

Diagnosing scoliosis
Scoliosis can usually be diagnosed after a physical examination of the spine, ribs, hips and shoulders. You may be asked to bend forward to see if any areas are particularly prominent. For example, one of your shoulders may be higher than the other or there may be a bulge in your back. Scans The specialist will take an X-ray to confirm the diagnosis of scoliosis.The X-ray images will also help determine the shape, direction, location and angle of the curve. The medical name for the angle the spine curves is known as the Cobb angle.In some cases, scans such as a magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan may also be recommended. Treating scoliosis in children If your child has scoliosis, their treatment will depend on their age and how severe it is. The main treatment options are:
- observation
- casting
- bracing
- surgery

Observation treatment is not always necessary for very young children because their condition often corrects itself as they grow. However, if the curve does not correct itself, it can reduce the space for the internal organs to develop in, so careful monitoring by a specialist is important. Casting in some cases affecting young children, the spine may need to be guided during growth in an attempt to correct the curve.

In a child aged under two years of age, this can sometimes be achieved by using a cast. A cast is an external brace to the trunk made out of a lightweight combination of plaster and modern casting materials. The cast is worn constantly and cannot be removed, but is changed regularly to allow for growth and remodelling. Bracing If the curve of your child's spine is getting worse, your specialist may recommend they wear a back brace while they are growing.

A brace cannot cure scoliosis or correct the curve, but it may stop the curve from getting worse. If a brace is used, it will need to be carefully fitted to your child's spine. Braces are often made of rigid plastic, although flexible braces are sometimes available. In general, modern back braces are designed so they are difficult to see under loose fitting clothing. It's usually recommended that the brace is worn for 23 hours a day, and is only removed for baths and showers.

However, it should be removed during contact sports and swimming. Regular exercise is important for children wearing a brace.The brace will usually have to be worn for as long as your child's body is still growing. For most children, this will mean they can stop wearing it when they are around 16 or 17 years old. Surgery is recommended, if your child scoliosis is severe and in case, other treatments have been unsuccessful, corrective surgery may be recommended. They type of surgery will depend on your child's age.

Surgery in children for younger children, generally those under the age of 8 to 9, an operation may be carried out to insert growing rods. These rods aim to allow for continued controlled growth of the spine while partially correcting the scoliosis. After surgery to insert the rods, your child will need to return to their specialist every 4 to 6 months to have the rods lengthened to keep up with the child's growth. In some cases, rods that can be lengthened using external magnets during an outpatient appointment may be used.

Surgery in teenagers and young adults operation where the spine is straightened using metal rods attached with screws, hooks, and/or wires, and bone grafts are used to fuse the spine in place. This metalwork will usually be left in place permanently, unless they cause any problems. After the operation, most children can return to school after a few weeks and can play sports after a few months. Possible complications of scoliosis Physical complications of scoliosis are rare, although serious problems can develop if it's left untreated.

Emotional issues having a visibly curved spine or wearing a back brace may cause problems related to body image Lung and heart problems In particularly severe cases of scoliosis the rib cage can be pushed against the heart and lungs, causing breathing problems and making it difficult for the heart to pump blood around the body. Nerve compression In some cases of scoliosis, particularly those affecting adults, the bones in the spine compress nearby.

All About Scoliosis

Total Hip Replacement is also known as Total Hip Arthroplasty, in which the damaged cartilage and bones in the hip area are removed and replaced with prosthetic components. On the other hand, Total Knee Replacement, also known as Total Knee Arthroplasty or resurfacing, involves replacing the bone surface of the knee area. 

Causes of Hip and Knee Pain 

Arthritis is the most common cause of chronic hip and knee pain or disability. Other causes include: 

  Avascular necrosis or Osteonecrosis is a condition where there is an inadequate supply of blood to the femoral head due to a hip injury. The inadequate supply of blood may cause the bone surface to collapse and this can result in arthritis. 

  Rheumatoid Arthritis is the most common inflammatory Arthritis. In this condition, the synovial membrane surrounding the joint begins to thicken and become inflamed. This results in cartilage loss, stiffness, and pain. 

  Osteoarthritis is the type of arthritis, usually related to old age but can occur among young people too. The cartilage cushioning the hip and knee bones becomes soft and gradually wears off. The bones eventually start rubbing against each other which causes stiffness and pain in the knee and hip area. 

  Post-Traumatic Arthritis can follow a severe hip and knee fracture or injury. 

  Some children with hip disease or problem, even after treatment, can develop into arthritis later. This may be caused by uneven or unusual growth of hip which affects the joint surfaces. 

Knee Replacement Procedure 

  Bone Preparation: The surface of impaired cartilage at the end of the tibia and femur are separated besides a small extent of the underlying bone. 

  Locating the Metal Implants: The removed bone and cartilage are substituted by metal implants creating the joint surface. These metal pieces may either be press-fit or cemented into the bone. 

  Resurfacing the Patella: The undersurface of the kneecap or Patella is cropped and reformed with a plastic button. This process is variable depending upon the condition. 

  Inserting a Spacer: To form a smooth gliding surface, a plastic spacer of medical-grade is positioned between the metal components. 

Hip Replacement Procedure 

  Metal stem replaces the damaged femoral head and positioned into the femur s hollow center. 

  On the upper portion of the stem, a ceramic or metal ball is planted. This ball acts as a substitute for the damaged/detached femoral head. 

  The damaged Acetabulum or cartilage surface of the socket is discarded and supplanted by a metal socket. Cement or screws are used to sustain the socket in place. 

  A spacer, either metallic, plastic or ceramic is placed between the socket and the new ball for a smooth gliding surface. 

Take Away 

Knee and Hip Replacement are taken as the last option for the patient. The surgery and its outcome vary depending upon various factors. One should consult the doctor before undergoing for the Hip and Knee Replacement Surgery.

Primary Knee & Hip Replacement - Know More About Them!

Exercises for Sciatica
Sciatica is often distinguished not as a medical condition but as a set of symptoms that underlie a more serious medical concern such as a slipped disc, degeneration of the spine or the lumbar region etc.
It is important to note the symptoms of Sciatica, as these are quite distinct -
1.Constant pain in one of the buttocks or leg (rarely are both legs affected)
2.The pain worsens on sitting
3.The pain is often described as a sharp & searing pain similar to a burning sensation
4.The pain is often accompanied by a heaviness or numbness that makes movement difficult
5.Shifting of postures (sitting to standing and back to sitting) becomes painful and laborious
An alternative to surgery would be to supplement the oral medication with certain specific exercises.
Reflexology, Acupuncture and Chiropractic manipulation are all considered effective to alleviate the pain to a large extent.
Patients are often encouraged to partake in daily exercise routine, incorporating strengthening and stretching exercises.
The strengthening exercises target the core or abdominal muscles along with the back muscles to provide more support to the back.
The stretching exercises will help to “loosen up” the surrounding muscle groups such as the hamstrings, which then allow for more blood and oxygen circulation alleviating the pain and giving the immune system a much needed boost.
When patients engage in a regular programme of gentle stretching and strengthening exercises, they can recover quickly (in comparison to those who do not exercise) from the flare ups and over time the painful episodes are known to reduce significantly, both in frequency as well as intensity.
Ancient holistic practices such Yoga and Tai-chi are often considered the best form of exercises for the afflicted because of the balanced and slow but controlled movements that complement the ‘breath’ rather than causing further exertion to the already fragile bone density.
It is recommended that expert advice be sought and the exercises should be undertaken only under trained supervision. Please do not attempt to “experiment” with Yoga or Tai-Chi on your own, as improper or wrong posture could lead to irreparable damage to the spine. 


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 Exercises for Sciatica To Keep It Under Check

The movement between bones and muscles is possible due to the fluid filled sacs that enable smooth gliding of the bones. When there is an inflammation of these sacs, condition known as bursitis results, leading to friction, reduced movement, painful movement, discomfort, and irritation.

Some of the common causes of bursitis include age, which brings along reduced elasticity of the tendons and ligaments.  Additionally, sudden injury to the bursa area, repetitive stress, overuse of the ligaments or tendons, incorrect posture, and improper exercise can all lead to bursitis.

The most commonly affected parts are the elbows, shoulders, hips, knees, and ankles. The dull, aching pain that ensues is accompanied by stiffness. Movement can worsen this pain.  The area can be red, hot, and swollen indicating infection. Whatever the area affected, some of the common ways to manage bursitis pain are listed below.

1. Rest - As soon as bursitis is identified, the area must be rested. As noted, in most cases, repetitive stress and injury is the most common cause, and resting the area really helps.

2. Ice only - If bursitis is happening for the first time, then an ice pack alone should help reduce the pain in 1 to 2 days.

3. Ice and moist heat - If it is happening repeatedly, then alternating moist heat and ice for 15 minutes each will help.  This can be done two to three times a day. 

4. Anti-inflammatories: In most cases, if rest and topical therapy are not working, then the regular anti-inflammatory agents may be given. 

5. Physical Therapy - In some cases, mild exercises can help reduce inflammation and pain. 

6. DMSO (dimethyl sulfoxide) - This clear, colorless, oily liquid is made from wood pulp and helps in reducing the inflammation caused by bursitis. A 70% DMSO mixture can be applied with cotton on the affected area 3 times a day for 3 days, then 2 times a day for the next 3 days, and then 1 time a day for the next 3 days.  If there is no improvement in the first 3 days, it needs to be discontinued.

7. Foods to remove calcium deposits - In a number of cases, bursitis that is present for months or years is worsened due to the calcium deposits. Foods like apple cider vinegar can help dissolve the calcium deposits that could have formed in the bursa.

8. Steroids: Local injections of corticosteroids may be necessary in some cases. Though inflammation can be curtailed with this, there is always the fear of hampered immunity and altered sugar levels.

9. Surgical drainage - In very rare cases, the bursa may need to be surgically drained.
Bursitis is a very common issue and can be managed easily as well. Consult your doctor and avoid medicating on your own.

Ways to Treat Bursitis

In Ayuveda, muscle cramp is known as  khalli vaata . Vyaana vaata it is a biological force that is responsible for regulating the functioning of your voluntary muscles. In case of a muscle cramp, the vyaana vaata gets impaired. Metabolic wastes are harmful toxins that tend to get accumulated in your system if not flushed out of your body and deposited between your muscle tissues and nerve-endings. This toxic waste is known as 'aama' in Ayurveda and it is known be a prominent cause of cramps. Besides aama, vata dosha is also responsible for muscles cramps.

Ayurveda provides a number of remedies to treat the problem of muscle cramps. The following are some of the most effective remedies to relief the discomfort of muscle cramps:
1. Drink warm milk to get instant relief from abdominal cramps. The alkaline properties of milk help to pacify the acidic condition in stomach that results in cramps. It is also a rich source of calcium which is known to aid in the relaxation of troubled muscles.
2. Physical activity including stretching exercise is effective in reducing the acute pain of leg cramps.
3. Garlic compound which is also called as 'Lagsunadivati' is helpful in relaxing muscles and it is also known to calm the  vata dosha  that aids in relieving muscle cramps.
4. Do warm up exercises and stretching exercises to lessen the risk of developing a muscle cramp during your workout session
5. Increase the intake of foods that are rich in minerals, calcium, potassium and magnesium as it is known to reduce the chances of muscle cramps.
6. Massage the painful region with 'prasarini taila' or 'mahanarayana taila' to relax the strained muscle.
7. Apply ice pack on the strained muscle to reduce the swelling and pain of the muscle.
8. Sinhanaada guggulu is well known to provide instant relief from muscle cramp. It has medicinal properties which have a mild laxative effect. It eases the problem of abdominal cramps and lessens the discomfort associated with it.
9. In case of extreme pain, 'Lakshmivilaas rasa',  Prataapa lankeswara rasa , are among the most effective Ayurvedic medications which are known to provide relief in case of chronic muscle cramps.

Muscle Cramps - How to Treat them Effectively through Ayurveda

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