Sciatica pain can be mild to intense. Many with lumbar herniated disc and sciatica often wonder whether or not they require a surgery. Needless to say, it is never an easy decision. But the good news is that micro discectomy surgery has a higher rate of success when it comes to relieving sciatica pain. When compared to many other options, this one is relatively minimally invasive. It doesn t alter the structure of the spine permanently since it works by removing a small portion of the disc, which has herniated or extruded out of the disc.

When your sciatica pain stems from lumbar disc herniation, a small open surgery with the help of magnification is the prevalently opted surgical approach. On the other hand, a laminectomy is done when the bone or disc pinching the nerve root is required to be removed.

When should you consider undergoing surgery for sciatica?
Typically, neurosurgeons recommend considering surgery for sciatica in a host of situations which include the following:

Severe pain in the leg lingering for more than six weeks, which mainly affects one side of the leg or buttock
Intense pain in the low back and buttock, which continues through the course of the sciatic nerve andextends to the lower leg and even foot. This pain can be described as sharp and searing rather than a dull thud.
When pain has not alleviated even after non-surgical treatments that may include non-steroidal anti-inflammatory drugs (NSAIDs),oral steroids, injections, manual manipulations, and physical therapy
When the patient is not able to take part in the day to day activities due to intense lower back pain and the symptoms tend to become severe during movements like sneeze and cough.
When the symptoms are continuing to worsen, thereby indicating nerve damage, particularly when the progressive signs have their root in neurological issues
It is important to note here that surgical intervention may only be needed when the patient experiences progressive weakness in the lower portion of the body or sudden loss of bladder or bowel movement, which may stem from cauda equina syndrome. Two surgeries, namely lumbar laminectomy and microdiscectomy are performed on the basis of the cause as well as the duration of the sciatica pain.
In some cases, the symptoms are unique on the basis of the underlying causes of sciatica. For instance, trying to bend the body backward or walking a longer distance than normal may trigger unbearable symptoms. On the other hand, when the affected individual tries to bend the body forward, it can lead to symptoms stemming from the lumbar herniated disc.
In case sciatica occurs after an accident, injury or trauma, or if it happens in tandem with other symptoms, then it requires an immediate medical attention.
Thus, choosing to go for a surgery depends on several factors that only your doctor can assess and decide upon.

Sciatica - When Do You Have To Go For Surgery?

Osteoporosis is a skeletal disorder, which causes fragility of bones. In the absence of proper prevention and treatment modalities, osteoporosis can cause a painless progression and subsequent fractures. Such fractures (broken bones) mostly occur in the hip, spine, or wrist. As per several past data-driven studies conducted in the United States of America, 1.5 million new fractures are witnessed in people with osteoporosis every year. Of these, spine fractures are seen in 700,000; hip fractures in 300,000; wrist fractures in 250,000; and fractures of other bones in 250,000 people.

Possible Causes of Osteoporosis

Hormonal imbalances Pregnancy
Metabolic diseases Cancer
Age beyond 60-65 years
Symptoms of Osteoporosis-Induced Compression Fractures 
Significant upper or lower back pain
Changes in posture
Difficulty with breathing and digestion 
Decreased ability to walk 
An overall decrease in the quality of life Increased tendency for fracture of adjacent vertebrae
Treatment

Compression fractures are usually managed with pain medications; narcotic pain medicines are administered for a few months until the pain decreases. Also, few available medications are known to increase the bone density. It is hoped that by building the bone density, future fractures can be prevented. Another method is immobilization of the spine with a brace that helps decrease pain from a broken vertebra; however, such braces are helpful only for the fractures of the lower back.

Role of Kyphoplasty in the Management of Osteoporosis

Kyphoplasty is a procedure that involves a new technology whereby an osteoporotic compression fracture can be treated with relief in pain, restoration of the lost bone height, and immediate stabilization of the fracture with the injection of bone cement. 

How is kyphoplasty done?

The procedure is carried out via two A  incisions on each side of the affected vertebra. The technique utilizes X-ray equipment to place working tools into the collapsed vertebra. This step is followed by an insertion of an inflatable bone tamp or expander into the fractured vertebra on each side, after which, the balloons are slowly inflated, lifting up the fractured portion of the vertebra to a more normal height. The balloons are then deflated, and cement is slowly injected. Excellent restoration of fractures, which are less than 4-6 months old and better than 90% success at reducing pain associated with the broken vertebra, is seen with kyphoplasty. 

Which patients can benefit from kyphoplasty? 

Patients with a recent vertebral compression fracture due to osteoporosis 
Patients with fractures which are less than 4 months old
Patients with fractures who are on chronic prednisone or steroids 
Complications from this procedure have been primarily related to patients who have been on blood thinner medications. 
Potential complications also include cement leaking out of the vertebra and into inappropriate areas. 

Kyphoplasty In The Management Of Osteporosis!

Hereditary Angioedema is a rare skin related disorder and as the name suggests it is also a genetically inherited condition. This condition mainly afflicts the throat, abdomen and the limbs of the patient, with a certain kind of swelling. This swelling can become fatal if not treated on time. Here is everything you need to know about the condition and its treatment.

Causes: A rare genetic mutation of the SERPING1 gene can cause this condition. Usually, this gene is known to produce C1 esterase inhibitor, which is a kind of blood protein. This blood protein is an important element of one s immune system and is usually involved in the biochemical reactions that control the body s response to inflammation causing elements. This is done when the blood protein produces a hormone known as Bradykinin. If this blood protein does not function in a normal manner, then there is excessive production of this hormone, which leads to swelling and inflammation.

Type One: There are various types of Hereditary Angioedema that can affect various parts of the body. Type one is one of the most common kinds and can be found on the face, hands, abdomen, throat, as well as feet and genitals of the patient. The severity and frequency of attacks cannot really be predicted and the patient may suffer from attacks throughout his or her life. The best way to treat this type of Hereditary Angioedema is with the help of antihistamine drugs and prednisone which can fight allergic attacks.

Type Two: This kind of Hereditary Angioedema has the same symptoms as type one and is caused by a malfunction of the C1 inhibitor, rather than the Bradykinin hormone as one can see in type one. This condition can also be treated with anti-allergy drugs.

Type Three: This is very rare kind of Hereditary Angioedema. In fact, medical science is yet to find a conclusive body of knowledge that can point to the exact causes and symptoms of this condition. Coagulation is one of the main causes recognised so far. This condition is much more common in women than it is in men, and it usually shows up as facial swelling.

Timely Treatment: While there is no cure for this condition, one can prevent a flare up of the symptoms by taking C1 inhibitors and Bradykinin receptors as well as enzyme inhibitors. It is important to get early treatment for the symptoms and to have constant access to a hospital and its emergency unit. One should also keep track of attacks and symptoms and get regular check-ups done by a doctor to detect the earliest signs of the same to avoid fatalities.

What is Hereditary Angioedema and How Can it be Treated?

Spinal surgery becomes inevitable when back pain cannot be managed with medications and/or exercise. This is a major decision and requires planning for many things before, during, and after the surgery.

Before a spinal surgery- This preparation will help in smooth recovery, especially if you do not have a full-time caretaker.

Discontinue pain killers: Discontinue pain killers at least 10 to 14 days before surgery. These are blood thinners and can prolong bleeding during the surgery.

Prepare for blood loss: Most people experience some blood loss, but not excessive.

Use a toilet seat raiser: Sitting and getting up from the toilet seat may be difficult. The seat raiser is used to increase the height, making this movement easy.

Enable easy access to common items: Before heading for the surgery, keep things which are commonly used within easy reach. This will help reduce movement and avoid searching (especially if someone else is going to be doing it).

Stock it up: Cooking may not be feasible during the initial postop period, and so it is advisable to stock up food items (ready to eats, fruits, soups, etc.) which will come in handy.

Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used.

Caregiving: It is always advisable to have someone stay over with you during the initial postop days. They could help with regular household chores, cooking, etc.

Lifestyle changes: Ensure you eat well in the days before surgery, quit smoking, quit/use moderate amounts of alcohol, and exercise as advised by your surgeon.

After Surgery- Post surgery, there will be some pain and limitation of movement. It is important to understand that adherence to post-op instructions will improve the success rate of the surgery. Also, recovery time for spine surgery is slightly longer and affects overall quality of life, so psychological preparation is required.

Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail

Rehab: The surgeon will recommend physical therapy and rehab exercises which need to be followed. Complete recovery may take anywhere between 3 to 12 months. During this time, care should be taken to avoid repeat injury.

Support: Adequate back support should be provided using lumbar support and ergonomic chairs, and the right posture should be maintained. Ensure there is no undue strain on the back muscles.

Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain.

Smoking and alcohol should be completely stopped, as healing can be hampered.

With some preparation, spinal surgery can be sailed through smoothly.

What To Expect Before and After Spine Surgery?

Fibromyalgia is a condition that causes chronic pain in muscles, soft tissues, tendons, and joints. For some, it can also cause memory problems, fatigue, mood swings and lethargy. Fibromyalgia is not a disease but a syndrome. The same can be effectively managed through wellness, medicine, massage and alternative medicine. This condition is more observed in women than man. Luckily through, this condition is not life threatening and does not damage muscle and joints.

What are the symptoms?
The most common symptom of Fibromyalgia is the pain. The experience of pain can be burning, deep, shooting or ache at regular intervals. Tender points around the soft tissue can be visible. This worsens at night. Some common indications of this condition include less sleep, headaches, depression, fatigue and other cognitive issues. With proper care the symptoms do improve, it, however, is a long-term condition and chances are that the pain might return in the long run.

How does massage help?

Massage can prove to be extremely beneficial for this lot. Research indicates that massages such as Shiatsu, myofascial release and Swedish improve the condition for better. Mentioned below are few benefits that have been observed in patients of different age group:
An evening session with a massage therapist will help a patient to get sound sleep at night. This ensures that the body rejuvenates and repairs during the sleep. The patient feels more energetic than ever before.
Massage improved muscle tonicity: Massage helps to improve the lethargic muscle aid strength and vitality to the body. It is essential to include more petrissage strokes during the massage session to accomplish the goal.
Massage helps a great deal to improve mental clarity. A healthy, relaxing massage session can relieve mental stress, gives clarity to thinking and resolves the cognitive issues that a person is facing.
A person suffering from Fibromyalgia can get relief from headache with proper massaging. Massage greatly improves the flow of blood to the brain and the spinal cord region thereby, ensuring that headache is greatly reduced. Relief from headache can improve the overall health of a patient.
Massage can reduce the level of depression and anxiety faced by a person suffering from fibromyalgia. Depression and anxiety leads to hormonal fluctuations leading to appetite, mood swings, constant irritation etc. A regular massage session can restore the body homeostasis thereby keeping the body condition normal.
Regular massage session will improve the overall pain level of the patient and give a chance to the muscle to gain extra strength. With proper care and therapy, it is entirely possible to cure the condition for good. 
However, it is also necessary to continue with the session. Giving up massage therapy after temporary relief won t serve the purpose for long-term pain relief.


Fibromyalgia Pain - Can Massage Help Reduce It?

Facial paralysis is a loss of facial movement because of nerve damage. Your facial muscles may seem to hang or may become distinctly weak. It can happen on one or both sides of the face. Usual reasons for facial paralysis include:

Infection or swelling of the facial nerve
Head injury
Head or neck tumor
Stroke
Facial paralysis can increase all of a sudden or happen slowly over a span of months (mostly if one has a head or neck tumor). Based upon the cause, the loss of movement may keep going for a short or a long period of time. However, physiotherapy can prove to be very beneficial. Here is how:

1. Electrical stimulation: A few specialists suggest utilizing electrical stimulation and biofeedback as technique for physiotherapy for facial paralysis, yet different specialists believe that it does help in recovery. Talk with your specialist or advisor about whether electrical stimulation is ideal for you. Electrical stimulation uses little amounts of electricity to relieve the muscles in your face. This causes your muscles to jerk as though electrical signals from your brain reacted to them. During this time, your face is most incapacitated, which might be the main cause for you to enact these facial muscles.

2. Manual massage: Face rub can be performed in conjunction with other treatment choices. It is possible to enhance mental relief. Massage methods on the face include:

Effleurage
Finger or thumb massage
Tapping
Stroking
3. Kabat rehabilitation: Kabat recovery is a sort of engine control restoration procedure. During Kabat, specialists increase the compression of the weakened muscle by applying a global stretch and then massaging the solid segment. They encourage movement by verbal info and manual contact. While performing Kabat, there are namely three phases - the upper (temple and eyes), intermediate (nose), and lower (mouth). Before Kabat, ice compression needs to be performed to the particular regions, with a specific end goal to build its contractile power.

4. Icing: Ice helps in decreasing the aggravation surrounding the facial nerve, which might be in charge of the loss of nerve movement or conduction leading to facial paralysis. You can either use an ice pack or any cold compressor.

5. Facial exercises: These include doing essential activities with the distinctive muscle surrounding your face. In case you consult a specialist or physical advisor for your facial paralysis, he or she will suggest particular exercises for your level and stage of paralysis. If not, have a go at flexing the different muscles in your face through and through. Frown, raise your eyebrows, gradually flicker your eyes, and proceed down to your jaw.

Facial Paralysis - How Can Physiotherapy Help You Get Better?

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