Sciatica is probably one of those things which is vaguely familiar but a person is not fully aware of it. The sciatic nerve is one which is part of the spine and then spreads out over the legs. When this nerve gets pinched, it leads to sciatica, or pain of the sciatic nerve, which is tremendous! But, then, what exactly is a person to do in order to reduce the pain caused on account of sciatica?


The best answer for this is not medication, though it does have its uses, but rather, exercises which help the situation improve and reduce the risk of the person going mad due to the pain! One of the simplest exercises that a person can start with is known quite commonly as the knee to shoulder exercise. All that one needs to do is to lie down on the back and then, raise one knee and pull it across the body, with hands wrapped around it, so that it touches the opposite shoulder. This position of the knee touching the shoulder is to be held for about half a minute. About 3 repetitions need to be done and the same with the other side.


While it is important in the effort to relieve pain due to sciatica, it is equally important not to push oneself beyond natural limits, especially initially as this can cause injury. After all, more pain is the last thing which a person with sciatica is likely to want!


Since it is important to keep in mind the fact that consistency is one of the key secrets to reducing the sciatic pain, it is worth keeping in mind the standing hamstring stretch. What this exercise can boast of is the fact that it is one which can be done nearly anywhere. Also, it is pretty simple, too!


To do the standing hamstring stretch, one leg needs to be kept on an elevated surface which is not as high as the level of the hip. It is important to keep in mind that the leg is to be kept straight. The torso needs to then be bent towards the elevated leg. This process should be done slowly and again, maintained for about half a minute.


The sitting pose is useful to remember, as well. Sitting on the floor, one leg s ankle should rest on the other s knee. Like the standing hamstring stretch, the upper torso is to be bent towards the extended leg. With all these exercises, relief is not far away!


Top Ways To Get Pain Relief From Sciatica

4 exercises to strengthen your knees

Knee pains and pains in the joints are not restricted to a certain age group anymore. Younger people of today face this problem too. To stay active all your life and escape the severe aches associated with weakening of muscles, joint pains or arthritis, you must start now. The only way to keep your knees fine and working is to exercise. 
4 moves that help you strengthen your knees.
1. Leg lifts (inner thigh) - lie on any one side, lay your head on the arm of the side below you. Make sure this hand is straight above your head, touching the ground. Keep your legs straight, one above the other. Lift the leg on top a few inches above, hold for few seconds and bring it back. Do this for 10 times and then with the other leg, on the other side. This exercise strengthens your inner thighs, eventually strengthening the knees.
2. Hip raises: lie flat on your back, your shoulders touching the ground. Bend your legs comfortable, your feet resting firmly on the ground. Raise your hips and thighs so that from your head to feet, you form an angle. Wait in this position for about 10 seconds, lower your hip until it touches the ground. Repeat for ten counts.
3. Lunges: stand straight. Take a step ahead with your right leg. Left leg remains in its place. With your back straight, bend your knees so that both are at 90 degrees. Go back to standing position; take your right leg back to where it was. Do the same step with your left leg. Repeat both sides ten times.
4. Bent leg extensions: this is pretty easy and all that you need to do it sit on a chair comfortably, with your back straight first. Your feet firmly flat on the ground in front of you, lift the right leg straight extending to the front. Make sure your thighs stay on the chair. Bring your leg back to the original position, firmly planted on the ground. Do the same with your left leg. Repeat 10 times on both sides.
If you would like to consult with me privately, please click on'consult.

From lybrate: if you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over whatsapp, facebook and other media.


The Only 4 Moves That Strengthen Your KNEES

Inguino-scrotal and Inguino-labial swellings are common in children during infancy. A common cause of an Inguino-scrotal swelling in children is the presence of a patent processus vaginalis. It presents in the form of an inguinal hernia or hydrocele. Male infants are often affected 3 to 6 times more than the female ones. Processus vaginalis is the outpouching of peritoneum that extends through the inguinal canal. It is first seen during the 3rd month of intrauterine life. It follows the gubernaculum and testes through the inguinal canal and reaches the scrotum by the 7th month of gestation. 

Differential diagnosis of inguino-scrotal swelling in children: 

Inguinal hernia and hydrocele 
Torsion testes, epididymorchitis 
Undescended testes 
Varicocele 
Enlarged inguinal lymph node 
Abscess or lipoma 
Normally after the testicular descent, the portion of processus vaginalis surrounding the testis becomes tunica vaginalis. The processus vaginalis gets obliterated, eliminating the communication between peritoneal cavity and scrotum. A patent processus vaginalis is seen up to 20% in adulthood. 

Hernia and Hydrocele: The testicles or ovaries form in the abdomen near the kidneys, between 3 to 4 months of fetal development. Further, they gradually move down into the lower part of the abdomen as the fetus continues to develop. On descending downwards, small part of the peritoneum (a layer of tissue lining the abdomen from inside) that attaches to the testicle is drawn with it into the scrotum. This forms a pouch or sac. A similar process occurs in females as the round ligament of the uterus descends into the groin at the labia. The sac formed is processus vaginalis. Any connection between the abdominal cavity and the scrotum or groin is eliminated. When closure of the processus vaginalis is delayed or incomplete, it may stretch and eventually become a hernia. Stretching of processus vaginalis creates the inguinal sac that allows organs an extension from abdomen and entry into the sac. If fluid, rather than organs, builds up and remains in the sac, the child has a hydrocele. Approximately 80 percent to 90 percent of inguinal hernias appear in boys. They are more common on the right side, but in about 10 percent of cases, they occur on both sides (bilaterally). 

Epididymorchitis: Epididymitis is the pain and swelling of the tube that attaches to each testicle called as the epididymis. Orchitis is pain and swelling of the testicle. Since epididymis and testis lie next to each other, differentiation of the inflamed part is difficult. Hence, the term epididymo-orchitis is often used. Infection with bacteria often causes these problems. Other causes are infections from surgery or from a catheter that drains urine. The mumps virus also can cause orchitis. Analgesics or anti-inflammatory medicines can reduce the pain. Antibiotics are used if the problem is caused by bacteria. 

Torsion testis: It is a painful condition that occurs in the boys. It is a twisting of the testicles and the spermatic cord (the structure extending from the groin to the testes that contains nerves, ducts, and blood vessels). A decreased blood flow to the testes is caused by torsion of the testes. This torsion essentially strangles them of oxygen and nutrients. While it generally occurs in adolescent boys, it may also occur during fetal development or shortly after a baby is born. Urgent surgical procedure is undertaken if testicular torsion is confirmed in a child. The chance of survival for the testicle is best if surgery is completed within six hours of symptom onset.

Know The Types Of Inguinoscrotal Swelling In Children!

With changing lifestyles, the small household chores have become the workouts for most of us. When not done properly, however, these cause more harm than good. The spine often bears the brunt of this damage. Read on to know if you are damaging your spine on a daily basis. If yes, time to change the way you do these activities.

Carrying shopping bags: While two bags might look more expensive, carrying one bag tilts the weight to one side and causes the spine to bend. Instead, opt for two small bags, and this weight distribution is friendly on the spine.
Cleaning the floor: Either sit down completely or stand and use a mop. Never bend down and try to clean the floor with a cloth. The spine posture created during this is very unhealthy and puts pressure on the spine.
Tying up shoe laces: While it is difficult to sit down and tie the shoe laces, it is definitely worth the effort. Bending down and tying is harmful to the spine posture, and when repeatedly done, can be damaging in the long run.
Washing vessels: Bending and washing vessels is a strict no-no. It puts too much pressure on the back and the disk wears out faster. Try standing and keep a stool at knee level, on which you can rest the knee. Take turns to do this on the right and left knee.
At the washbasin: Bending down to brush the teeth or wash face is bad on the spine. Over a long period, this can put lot of strain on the spine. Try to rest your hand on the wall or the sink and see the pressure on the spine reduce.
Office/school bags: It is very easy to sling a bag onto the shoulder and go on. The bag could contain books of a school kid or laptop of an office goer, whatever may be the situation, this puts uneven pressure on the back and can cause shoulder and spine issues. Always try to put the bag on both your shoulders. This distributes the weight and makes it easy on your shoulders and spine. Especially for people who are going to do some walking with the bag, it is definitely not advisable to carry it on one side.
Sitting: For those who end up sitting for long hours, there is too much stress on the back and so support is advisable. Take short breaks and avoid sitting for more than an hour at a stretch.
Bad mattress: While a soft mattress is very inviting, it does not support the spine and does not leave you fresh in the morning. Choose a mattress that supports the spine and see the difference.

Spine Health - 8 Everyday Activities That Are Actually Harming It!

A decrease in bone density leads to osteoporosis. In this condition, the bones become weak and brittle. Fractures are a common result of osteoporosis. Symptoms or signs do not show up until it is too advanced.
To maintain bone mass and slow the deterioration of the bone, a number of homeopathic medicines are available. Mild osteoporosis is easier to treat with homeopathy. In advanced cases, homeopathy can be taken along with conventional medicine for best results.

What are the best remedies for osteoporosis?

1. For treating fractures in osteoporosis, the best natural homeopathic remedy is Symphytum officinale which helps in knitting/uniting the fractured bone by increasing the production of callous.When a bone is fractured and the surrounding tendons and ligaments of the bone also get severely damaged, the natural homeopathic medicine Ruta Graveolens is given. It also helps in mending the damaged bones, decreasing the pain, soreness and stiffness. If nerves get crushed between damaged vertebral bones, the pain can be managed by Hypericum perforatum. Silicea is prescribed when pus or fistula has formed at area of the fracture. If a patient is having troubles in assimilating calcium, Silicea can help to enhance digestive powers.

2. Calcarea phosphorica, Phosphorus and Sulphur are used for treating the curvature of bones in patients with osteoporosis.

3. For pain, patients of osteoporosis are given Calcarea fluorica. If there is pain in long bones and it gets worse during night time, patients are prescribed Syphilinum and Fluoric acid. Besides these natural homeopathic remedies, a diet filled with adequate vitamin D and calcium should be followed along with regular exercise.

Homeopathic Remedies for Osteoporosis

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

Don't wait any longer, manage your Osteoarthritis Specialist online with a Lybrate doctor today

Consult for Osteoarthritis Specialist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES