Gridhrasi is what Sciatica is known as in Ayurveda. It is the disorder that causes mild to agonizing pain in the sciatic nerve or neuralgia. These nerves, emerging from the pelvis, run along the hamstring and may cause intense pain in one or both the legs when a person suffers from Sciatica. Sciatic pains fill your life with misery as the simplest of daily activities cause sudden and excruciating pain. There are two types of sciatica i.e. true sciatica and pseudo sciatica. Sciatica may be caused due to bulging disc or herniated disc, degenerative disc disease, piriformis syndrome, pregnancy or trauma etc. 

According to Ayurveda, Sciatica is caused due to impairment in Vata i.e. the dosha responsible for the functional ability and movement of the body and also in some cases due to impairment in the Kapha i.e. the dosha that is responsible for body fluids and lubrication. Ayurvedic herbs that improve the symptoms of Sciatica are:

1. Babunah is also known as Bitter Chamomile. Not only is it used to relieve and reduce the pain faced by a sciatica patient, but it is also used for treating problems such as rheumatism due to the advancement of age. Compressed bitter chamomile flowers are prescribed for sciatica.
2. Guggul is also known as Indian Bdellium. Since guggulu is well known for its anti-inflammatory properties, it relaxes the sciatic nerves.
3. Rasna is also known as Vanda Orchid. Intense or agonizing pain due to the sciatic nerve issues can be reduced by this ayurvedic herb due to its anti-inflammatory properties. 
4. Juniper oil is extremely helpful when massaged onto the thigh muscles with firm strokes or pressure. It is used extensively in massage therapy for treating sciatica since the extent of reduction in sciatic nerve pain is tremendous. 
5. Jaiphal is also known as Nutmeg. After being mixed with sesame seeds oil, nutmeg is coarsely powdered and then fried till it turns brown. This is then applied to those areas where the sciatic pain is intense for instant relief.
6. Kumari is also known as Indian Aloe. Properties of Indian Aloe are extremely helpful in treating lower back ailments such as sciatica and lumbago.
7. Shallaki is also known as Boswellia or Frankincense. Containing anti-inflammatory properties, shallaki is applied externally to get relief from sciatic nerve pain. 

Ayurvedic preparations such as yogaraja guggulu, Vataganjakusha, Saindhavadi taila are also very useful in treating Sciatica.

Ayurvedic Treatment of Sciatica

Pain causes a lot of discomfort in the body no matter whether the pain is in the back, legs or in the head. Almost all people experience lower-back pain at some point in their lives, which can be extremely painful and can cause considerable annoyance. The first medical specialty that comes to mind for relief of lower-back pain is Orthopedics. The other two specialists that play a vital role in treating lower-back pain are the neurosurgeons and the physiatrists.

Pain in the Back
It is very difficult for the body to source the pain when it is deep and this pain could be due to infection, disease or injuries in the back, stomach and heart. It is even possible that the pain radiates to different places in the body. Often back pain is accompanied by body changes like redness, fever, neurological problems, heat, and changes in body functions and for that diagnosis of the back pain may be very severe. Patients suffering from lower-back pain and with symptoms that comprise of weakness in the foot or other symptoms of a neurologic insufficiency must definitely see a neurosurgeon.

Back pain that occurs due to reversible problems is known to vanish in a few hours or in a day. However, if it continues longer and is accompanied by body changes, then there are chances that the condition can become worse. Visiting a doctor becomes a must for back pain if any of such characteristics are witnessed. It is always better to get evaluated by a physician.

When to Consult a Doctor Immediately

    Back pain that is followed by a shock like a car accident.
    The pain in the back worsens and is constant
    Back pain continues for more than 4-6 weeks
    The pain does not improve even after taking typical remedies such as taking pain relievers or after resting.
    Severe pain in the back in the night and that is alleviated by rest
    The back pain is accompanied by abdominal pain
    Numbness in the upper thighs, buttocks, groin or in the genital area
    Weakness or tingling sensation in the arm or legs

Role of a Neurosurgeon
The neurosurgeon provides non-surgical as well surgical care depending upon the nature of the illness or the injury, and he does not just operate. The neurosurgeons are experts and offer treatment to patients suffering from any injury or disease in the spine, brain or peripheral nerves that deal with arms, hands, feet and legs. But there are many other neurosurgeons that confine their practice to treating back pain.

Lower Back Pain - 8 Signs When You Must Visit Your Doctor

The causes and symptoms of chronic lower back pain

Lower back pain is characterized by a feeling of pain around the lumbar region (curve of the back connecting the upper back and glutes- muscles in the buttock that are responsible for thigh movement) caused by muscle or ligament injury. The spinal area is most likely to be affected by lower pain as it may impair routine activities like walking and standing. Any lower back pain that lasts for more than ninety days can be considered as chronic.

Causes of lower back pain

There are plenty of causes for lower back pain. Anything that exposes the lumbar area of the spine to a level of stress beyond its capacity can cause lower back pain. These causes are-

1. Disorders of the discs

The spinal area in the lower back comprises of small bones called the vertebra, which are connected to each other by pieces of cartilage known as discs. These discs act as shock absorbers, and when exposed to excessive shock can cause the disc to bulge, resulting in herniated discs. Wear and tear of the discs can also occur.

2. Spinal stenosis

Spinal stenosis occurs when the area around the spine becomes narrow. It may affect the nerves surrounding the lower back, resulting in pain.

3. Wear and tear of the joints and ligaments

Normal wear and tear of the joints and ligaments cause difficulties in holding the spine in its proper position and this progresses with age. This may cause a vertebra to slide over another and affect the nerve endings, giving rise to pain.

Symptoms of lower back pain

The symptoms of lower back pain are usually a dull or excruciating pain in the lower back. It can also affect other parts of the body such as the hips and the legs. In case of severe pain, simple activities like walking, bending and sitting will be impaired.



The Causes and Symptoms of Chronic Lower Back Pain

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

An orthopaedic fracture is a serious issue that will require lots of care for the bones to heal and re-join. A broken bone is usually plastered so that the tissue may grow back together by fusing eventually, over a period of weeks. When these bones begin to rebuild in an effort to come together, the new bones are called soft callus. This will require lots of energy, which primarily comes from calories. This ensures that essential proteins like amino acids can be taken from the right type of food which would stimulate good blood flow. 

So, let us take a look at the best diet that one can follow in order to recover from a fracture.

Kale: Leafy green vegetables and herbs like kale can help in supplying good amount of protein and iron as well as calcium, which is highly important for good and strong bones. One can also find plenty of calcium in salmon and other kinds of sea food like sardines; consuming these can speed up the process. Sea vegetables like seaweed can also help in the process.
Yogurt: Calcium can be supplied by various other kinds of food including yogurt, which has two kinds of amino acids. These amino acids are lysine and glutamine, which can assist the bones in swift calcium absorption for better recovery of the broken bones.
Spinach: This is a very important ingredient in the bone healing process thanks to its dual elements of calcium and zinc, which come together to cause the appropriate chemical reaction for bone rebuilding. Other zinc heavy food items include pumpkin seeds and wheat germ as well as red meat.
Broccoli: Ingredients like broccoli are rich in Vitamin K1, which is known to very good for the bone recovery process. This vitamin helps in mineralisation of the bone so that they may fuse with each other and form a new mass. One can have up to one cup of this green vegetable per day for a quick and effective fracture recovery process. Other ingredients like cheese and raw dairy products are known to have plenty of this vitamin as well.
Green Bell Peppers: High on vitamin C which helps in producing the skin and tissue structuring element called collagen, green bell peppers are an excellent ingredient that can help you in your fracture healing process. Vitamin C can also be found in citrus fruits like oranges, strawberries as well as tomatoes.
Milk: While milk has plenty of calcium, it also has another important ingredient called vitamin D. When calcium and vitamin D come together, the bones tend to heal much faster as vitamin D helps the bones in absorbing the calcium at a much high rate.

Recovering from Fracture - 6 Foods You Must Consume

The shoulders are the most mobile joints in your body. Shoulder joints undergo wear and a tear over time and hence become unstable. Shoulder arthritis is one of the painful conditions affecting the shoulder joints. Arthritis not only takes a toll on the tendons and muscles, but also affects the ligaments and joints too. They usually cause symptoms such as joint pain, resulting in limited mobility.

Treatment:

Nonsurgical or Lifestyle treatments:

Take rest or avoid the activities that provoke pain or change the way of your arm movements.
Physical therapy boosts shoulder mobility.
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin alleviate pain and inflammation.
Corticosteroid injections in the shoulders can also help to ease the pain and inflammation, although temporarily.
Applying moist heat or ice packs over the shoulders for about half an hour at least thrice a day brings relief.
Drugs such as methotrexate can be administered in case one is suffering from rheumatoid arthritis (a chronic disease attacking multiple joints of the body).
Dietary supplements such as chondroitin and glucosamine may help reduce pain.
Surgical treatments (if your pain results in disability and does not lessen with nonsurgical options)

Join replacement surgery or arthroplasty involves replacing the damaged parts of the shoulder with a prosthetic (artificial) joint.
Few mild forms of arthritis may be treated using the Arthroscopic procedure (minimally invasive surgery). It requires a surgeon to ease the joint pain by making small incisions to  clean out  the joint. A tiny camera fitted into the joint guides the surgeon through the surgery.
Resection arthroplasty is a method that involves the surgical removal of the bone from the collar bone and substituting it with a scar tissue to treat arthritis of particular joints.

Everything You Need To Know About Shoulder Arthritis Treatment

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