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?

People have a common perception that most injuries, medical conditions only affect those who spend several hours working outdoors. But what if we tell you that people who stay indoors- such as homemakers - are also susceptible to numerous health problems?

There s a saying:  Home is where the heart is.  But for countless homemakers, home is the place where  hurt  is! Scores of Indian homemakers encounter various injuries every year while engaging in household chores like cleaning and washing. The most common ones are-

Sprain- if you re a neat freak, you wouldn t mind spending half of your day cleaning the entire house. Here s a small tip- go slow if your cleaning duties include shifting heavy appliances and furniture from one place to another. There s a high chance that you may end up with a sprain injury. Sprains occur when you accidentally twist your ligaments. Another major cause of sprain injuries is a sudden fall. If you re mopping the floor or cleaning the bathroom, there s a fair chance that you may slip or lose balance. One must be cautious when working with water.
Back injuries- These are the most common types of injuries at home. Bending, lifting a heavy bucket or an abrupt movement, can strain your back muscles or ligaments leading to back injury. Many times the injury can result in a persistent, sharp stabbing pain, and hinder your usual routine.
Joint compression- Homemakers spend a considerable amount of time standing in the kitchen. As tiring as it is, standing for prolonged periods puts pressure on your joints- knee joint, hip joint as well as those in the feet and the ankle. This leads to wear and tear of the synovial joints, eventually causing them to tear. In due course of time, you will find it difficult to move around and walk even a meagre distance.
Prevention-
Starting to get worked up? Don t be. These problems can easily be prevented if you follow these steps-

Avoid overstretching, bending and twisting
Avoid lifting heavy weights. If possible, use a waist belt to keep away from traumatic injuries.
Keep your body weight in check. Mild exercises can help you with that.
Maintain a healthy diet- calcium intake can help your bones get stronger.
Use muscle braces to keep your joints protected.
Treatment-
The most preferred and effective choice of treatment for curing muscle injuries and joint inflammation is physiotherapy. Physiotherapy uses manual therapy, mechanical force and exercise therapy to promote mobility.

The most common method of treating such injuries is the RICE technique.  RICE  stands for Rest, Ice, Compression and Elevation. Keep the injured part at rest. Put an ice bag on the injured portion. Compress the injured area. Elevate the wound/injury for faster relief.
Anti-inflammatory drugs like Ibuprofen and Aspirin are prescribed to reduce inflammation and swelling. Painkillers can offer you instant relief from pain.
Physiotherapy treatment can effectively cure you of such injuries, that too in a short span of time. If you follow the treatment guidelines, recovery will take about 2-4 weeks. 

Common Problems Faced By Homemakers Who Stay Indoors - How Physiotherapy Can Be Of Help?

Cervical spondylosis is fast becoming the bane of modern life. An age-related wear and tear problem affecting the spinal discs in your neck, cervical spondylosis is increasingly affecting the young because of the use of cell phones, laptops and the like.

Cervical spondylosis is a general term used to define shrinkage of discs in between vertebrae in the neck region. Along with disc degeneration, bony projections also form in the area and are called bone spurs.
Other causes of cervical spondylosis are dehydrated discs. Discs are thick, pad-like cushions in between vertebrae that act as shock absorbers. They are made of a gel- like material that can dry over time. This causes the spinal vertebrae to rub together causing pain. The discs also crack which allows the internal gel-like material to spill out and impinge on spinal nerves causing symptoms.

There is a narrowing of the space required by the spinal cord and nerves that emanate in the upper spine to go to various parts of the body. Pinching of these nerves can cause alarming symptoms like

Numbness and weakness in your arms, hands, legs and feet
Lack of coordination and difficulty in walking
Loss of bladder or bowel movement
Stiffness and pain in neck
Treatment and management
Usually, cervical spondylosis doesn t cause any symptoms. But when you start experiencing pain, stiffness and weakness of muscles, it s best to go to a doctor who will diagnose the problem and then treat it.
Treatment for cervical spondylosis depends on the severity of your symptoms. Its goal is to get rid of pain, allow you to carry on your daily activities and prevent any permanent damage to your spinal cord and nerves.

Medicines

Anti-inflammatory drugs are prescribed to reduce pain and inflammation. Example Ibuprofen.
Corticosteroids are oral medications to get rid of the severe pain. If these don t work, your doctor can suggest steroid injections.
Muscle relaxants medicines relax the muscles in the upper part of the spine and help in curing neck pain and stiffness
Anti-seizure medications are also prescribed to dull the pain of damaged nerves in the spine. These include epilepsy medications, such as gabapentin and pregabalin.
Physiotherapy

Non surgical treatments are usually very effective in treating cervical spondylosis and surgery is usually not required. Physiotherapy is a bulwark for patients as it helps manage the condition very well.
Neck exercises that help stretch and strengthen muscles in your neck and shoulders can help manage debilitating symptoms of cervical spondylosis.
Few patients also benefit from traction, which can help provide more space for nerve roots within the spine.
Surgery

Surgery is the last resort for treating cervical spondylosis.
It is suggested when non-surgical treatments fail and the pain and neurological signs such as weakness in your arms or legs get worse.
It is done to create more room for your spinal cord and nerve roots.
Cervical spondylosis surgery typically involves removing:

Herniated disk
Bone spurs
Part of a vertebra

Cervical Spondylosis - How to Treat It?

If you have a desk job that involves sitting right in front of your computer throughout the day or for a major part of the day, you could be unknowingly putting yourself at augmented risk of reduced hip mobility. The hips are one of the major muscles in your body that are used in a number of activities you do everyday.

Causes of Hip Immobility-

1. Sitting for long hours at the same place and working. This is common to people who work in front of the computer screens for extended hours continuously.

2. Toxic Synovitis, which is an inflammation of the hip joint. It causes pain and stiffness.

3. Juvenile Arthritis

4. Rheumatoid arthritis

5. Tendinitis or inflammation of the tendons that causes severe discomfort in movement

6. Ankylosing spondylitis that mainly affects the spine. It can cause extreme pain and discomfort in the movement of the hips. This makes it difficult to sit, stand or lie down.

7. Injuries

8. Fractures and breakage

9. Muscle and tissue ruptures near the hip region

10. Sprains and strains

11. Lack of proper blood circulation

12. Pain and injuries in the lower back region which can spread to the hip, causing stiffness and swelling

Physiotherapy for Hip Mobility-

Physiotherapy alias physical therapy is considered as one of the fastest growing allied areas of present generation medicine. Being an important rehabilitative service needed in a community and a vital therapeutic supplement of the medical profession, it's the treatment of diseases and disabilities using physical exercises, heat radiations, cold therapy, hydrotherapy, acupuncture and therapeutic massage. 

As doctors, physiotherapists or physical therapists are essential in helping the patient to recover and rehabilitate from a state of incapacity, due to genetic defect or the result of an accident or an illness. Physiotherapy for Hip Mobility involves certain exercises. Below give are some of the most common exercises for hip mobility-.

Lying Hip Rotations. One has to lie on the back on a padded mat, then put one leg over the other, exactly over the knee on one s lower thigh. Now, use either a towel or the hands to get to the leg that is placed below and without hyperextending, slowly pull this leg s knee closer to the chest.

Butterfly Movements and The Frog Posture.

The Kneeling Lunge. Here, one has to lunge forward with one knee on a padded mat. Then position the foot carefully beyond the knee that is put forward. Place your hands over the knees; straighten hip of the rear leg while leaning with the hips forward. Hold this particular stretch and repeat with the opposite side.

The Squatting Position.

The Pigeon Posture. In this, your knees need to be right below the hip on the padded mat. Then lower the outer side of the right buttock to the mat. You have to position your right heel in such a manner that it is exactly in front of the left hip. Hold this stretch for about 5-6 breaths and exhale deeply through the nose.

Bending forwards or backwards, guided and assisted by a physiotherapist.

Stretching Exercises.

Hot compresses on the area of inflammation.

Ice packs can also be applied alternately on the spot of injury.

Massage helps to regulate blood circulation and is an important part of physiotherapy.

Physiotherapy for Hip Mobility

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

Sciatica is a very common neuropathic pain that is caused by damage to the sciatic nerve, a large nerve that runs from the lower back region down the end of each leg. It is the largest single nerve in the body.
This condition affects around 4 out of 10 people at some point of their lives. The nature of the pain varies from a mild ache to a sharp stinging sensation and may cause feelings of numbness and extreme weakness.

Causes of sciatica
The causes for the onset of sciatica are numerous. Some of them are as follows:
-slipped lumbar disc
-muscle inflammation
-internal bleeding
-pregnancy
-obesity
-awkward sleeping position
-uncomfortable footwear
-spinal injury

How can physical therapy help?
There are many ways of treating sciatica, such as medication, acupuncture and surgery, which can provide relief. The most common and easy treatment method however is physical therapy. A progressive and controlled exercise routine that is specifically tailored to the nature of the condition in consultation with a physical therapist acts as an effective remedy in treating the problem. It alleviates pain and also eliminates the chances of relapse.

Physical therapy exercises used to treat sciatica are of many types. They are a combination of core strengthening, muscular stretching and aerobic conditioning routines, which aim at correcting the root of the problem.

The different types of exercises employed to treat sciatica include the following:
Strengthening exercises
These aim at strengthening the spinal column and the pelvic region, which includes the hips and buttocks. They help in making the muscles and ligaments in this region more robust and allow for improved flexibility and support. Lunges and squats are some of the examples.

Stretching exercises
These provide pain relief through improved agility and flexibility. The most important aspect of these routines is stretching and exercising the hamstring. Hamstring, stretches, calf stretches and tricep stretches are a part of stretching exercises.

Aerobic conditioning
These are cardiovascular exercises of low intensity, which provide pain relief through the release of endorphins and the facilitation of fluid and nutrient exchange. Examples of these are swimming and brisk walking.

Reduce Sciatica Pain With Physical Therapy

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