The pain in the lower extremity of the body caused by the irritation of the sciatic nerve (the large nerve running down from the lower back of the body to each one of the legs) is referred to as Sciatica. Sciatica is caused by injury, inflammation or compression of the sciatic nerve and causes pain or numbness spreading to leg, buttocks, and hips. In Ayurveda, Sciatica is known by the name of Gradhrasi. It is believed to be aggravated by the imbalance of Vata Dosha.


Causes -

Sciatica can be caused by strenuous physical activity such as heavy weight lifting, or to exposure to extreme cold. Pressure on buttocks due to sitting or lying continuously for long hours, injury due to a fractured pelvis or trauma to thighs also damages the sciatic nerve.


Symptoms -

Pain in the back and the lower extremity of the body is the primary symptom of Sciatica. Also, there is a burning or tingling sensation in the affected area. It can also become numb. One may even find it difficult to walk. In severe cases, it becomes impossible to bend the knee or move the foot.


Treatment Through Ayurveda -

Through Ayurveda, Sciatica can be treated internally and externally by balancing the energies involved in the doshas:

Internal methods of treatment: Yogaraja Guggulu is the herbal pill consisting of Guggulu resin, twenty-five types of herbs and ghee effectively treats all types of pain associated with the nervous system. Dashamula Arishta, an elixir having sixty-three herbs, jaggery, plums, honey, and water has anti-inflammatory properties which help in toning up the affected nerve.

External methods of treatment: Application of Sarshapadi medicinal oil (made up of camphor, mustard oil, and vegetable turpentine as a base) on the affected area helps in relieving pain.

Panchakarma therapies are very effective in the treatment of this condition. They aim to relieve inflammation and release nerve compressions and spasms for strengthening the entire spine and the surrounding tissue. Generally, treatment through the Panchkarma therapies takes four to five weeks depending upon the severity of the condition. Following are some of the processes involved in treatment through Panchakarma:

Kativasti and Elakizi, Naranga Kizhi, Navarakizhi are very important in the treatment of sciatica.

Sarwang Abhyang is the full body massage with medicated warm oils for lubricating and nurturing the body for the pacification of Vayu.

Swedana refers to steaming the body for detoxification.

Vasti refers to the administration of medicated oils and decoction through anal route for treating the vatic disorder that is Sciatica as per Ayurveda. It pacifies dryness and strengthens intestines and is one of the permanent cures for most of the vatic disorders.

Siravedha is the venous puncture or venesection.

Agnikarma is the Cauterisation or burning the affected part.

Raktamokshan is the process for Blood purification.

Take Away-

Sciatica refers to the pain in the lower body due to an irritated sciatic nerve, caused due to nerve compression or trauma or injury. Through Ayurveda, Sciatica can be treated through internal or external methods as well as through Panchakarma therapies.

Sciatica - Panchakarma Therapy To Heal It!

Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

Cubital Tunnel Syndrome is also known as Ulnar Neuropathy, a nerve compression syndrome where the Ulnar nerve, also known as the funny bone nerve, gets compressed due to heightened pressure or stretching. It can lead to numbness or a tingling sensation in little and ring fingers, sometimes pain in forearm and an overall weakness in the hand. Ulnar nerve is one of the three main nerves in the arm. It runs in a groove on the inner side of the elbow. Since it travels through a narrow space and has very little protective tissue, the nerve is quite vulnerable to compression.

Symptoms
The symptoms of this condition may range from mild to severe. Some of the mild symptoms include:

Numbness in little and ring finger as the fingers fall asleep
A tingling sensation, usually like the pinch of pins and needles in ring and little finger
Pain in forearm
Weakness in the hand
Some of the severe symptoms include:
Reduction in overall hand grip
A claw like deformity in hand
Wasting of muscles of the hand
Bending elbow over a long period of time like while using cell phone or during sleep can cause ulnar nerve compression. Resting the elbow for a long period over a hard surface can also cause an irritation of the nerve, leading to such symptoms. In some cases, the nerve snaps back and forth over a bony bump, resulting in an irritated nerve. People who undertake intense physical activity, especially using their arms, are more likely to develop this problem. Eg. baseball pitchers. Apart from this, people who have suffered from a dislocated elbow or have arthritis are also at risk.

Generally, doctors diagnose this condition through the symptoms. However, nerve tests are also conducted to check the level of nerve compression. Electromyography is a procedure in which electrodes are placed on the skin and muscles to measure muscle health. Determining muscle health and level of compression helps decide the mode of treatment. Generally, the symptoms of cubital tunnel syndrome are managed through a conservative treatment. However, in cases of severe compression, surgery can be considered as an option to relieve pressure, moving nerve to the front of the elbow or removing a part of the bone.

For mild cases, a towel or a protective cover for elbow is recommended. The towel should be wrapped around the elbow loosely. An elbow splint can be worn at night to protect the elbow from being bent for long time.

How can a physical therapist help?
A physiotherapist has an essential role to play in treatment of this syndrome. A therapist can help the patient to learn ways of avoiding pressure to the nerve. After surgery, with restrictions of movement, a therapist can help achieve smooth recovery and movement of the elbow. Your physical therapist will determine the activities that bring on your symptoms. The recommendations at this point will be to avoid those activities for a time. Remember, the nerve is irritated and at times swollen. If the irritation and swelling are reduced, the symptoms should resolve.

Cubital Tunnel Syndrome  - How Physiotherapy Can Help You?

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?

Rotator cuff is the name given to four muscles and their tendons, which keep your arms in your shoulder sockets, allowing you to lift your arms and do day-to-day stuff like combing your hair, cutting vegetables etc.

The shoulder joint is a very important joint of the body and this is why any tear that happens in the rotator cuff can be devastating.

Causes

Tears can happen in rotator cuff due to a number of factors like injury and degeneration due to age. Tears that happen due to an injury to the shoulder are called acute. Degenerative tears are tears that happen due to degeneration of the tendon over time.

Common causes of degeneration are lack of proper blood circulation, which impedes the rotator cuff s ability to repair itself. Repetitive stress is another cause where we stress the tendon by repeating the same shoulder motions again and again while playing games like tennis, cricket etc. and doing jobs that require us to extend our arms upwards a lot. Lifting heavy objects can also lead to tears.

Symptoms

Chronic shoulder and arm pain are good reasons for you to see your doctor. If you suffer from pain in your shoulder at rest, while sleeping on the affected shoulder or pain while lifting and lowering your arm, then there is no time to wait.

The doctor will do a physical examination by moving your arm in different directions. He may follow it up with X-rays and MRI to check how big the tear is in your rotator cuff.

Treatment

Once confirmed that you indeed have a rotator cuff tear, your doctor will start the treatment. The goal of any treatment is to reduce pain and make your shoulder joint work properly again.

Nonsurgical Treatments: 

Nonsurgical treatments include rest, using of a sling to protect the shoulder and modifying your daily activities. This means you may not be able to do activities that cause shoulder pain. Your doctor can also prescribe pain and anti-inflammatory medicines. Strengthening and physical therapy bring up the rear of this type of treatment.

What you must remember is that nonsurgical treatment relieves pain and improves function in the shoulder, but does not improve shoulder strength. The size of your tear may also increase over time.

Surgery: 

Surgery, which attaches the rotator cuff to your bone, is done if you suffer from continuous pain and symptoms over a year or so. If you have a large tear, conservative treatments will not work and surgery will have to be resorted to. 

If you have been suffering from chronic shoulder or arm pain, waiting and watching is definitely not an option. You must visit an orthopedic surgeon at the earliest. Remember, if treatment is not started soon enough, your rotator cuff tear will get larger and will require only surgery.

Rotator Cuff Tears: What Are My Options?

Why Does Your Back Hurt?

Most of us, experience back pain due to incorrect posture or longer duration of sitting.

Sometimes you may experience back pain because of exertion - you spent the entire day doing the same kind of job or maybe you bent in a wrong manner while picking up your child. However, the actual cause of your spinal agony may not be very clear, but it pays to be aware of the possible reasons that can cause backache. It is good to consult a doctor if your back pain is consistent and recurrent.

Here are few of the causes:

1. The position of your pelvis

The pelvis consists of three bones that can shift depending on which muscles become weak or stiff. This brings about a pull in the muscle of the lower back, resulting in severe strain to this area. You should consult a physiotherapist for suggestions regarding the best exercises for strengthening your pelvic area.

2. Weak abdominal muscles

A cause of your back pain can be weak stomach muscles. Abdominal muscles play an important role in balancing out the constant bending that your back muscles perform. When you've weak abdominal muscles, your spine is not able to maintain proper balance, resulting in severe stress on the spinal column.

3. Disc injuries

Located between the bones of your spine, discs perform the function of a shock absorber. Physical injury to these padded cushions can cause them to break open, leading to a condition known as herniated disc. This can then bring about pain in the back area.

Few precautions that can be taken for a hurting back. Despite the causes, there are certain precautions that you can take, which are:

- Avoid sitting in a bad posture, that is, keep your back straight as much as you can. Pull and stretch your body in continual intervals to keep it relaxed.

- Consult the right physician instead of doing exercise that can aggravate your pain.

- Take a break from work and go for short walks, every couple of hours.

If you would like to consult with me privately, please click on 'consult'.

Why Does Your Back Hurt? + What To Do About It

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