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Back pain of Sciatica could be managed by self-care

TAREQ Salahuddin
The longest nerve in your body, the sciatic nerve runs from pelvis through hip area and buttocks and down each leg. It controls many of the muscles in lower legs and provides feeling to thighs, legs and feet.
The term sciatica refers to pain that radiates along the path of this nerve from back into buttock and leg. The discomfort can range from mild to incapacitating, and may be accompanied by tingling, numbness or muscle weakness. Rather than a disorder in and of itself sciatica is a symptom of another problem, such as a herniated (condition where an organ bulges through a hole or weakness in the wall which surrounds it) disk, that puts pressure on the nerve.
Sciatic pain usually goes away on its own in six weeks or so. In the meantime, hot and cold packs, over-the-counter pain relievers, and exercise or physical therapy can help ease discomfort and speed recovery. Surgery to relieve pressure on the nerve may be an option when symptoms don't respond to conservative treatment and pain is chronic or disabling.
Sign and symptoms
Pain that radiates from lower (lumbar) spine to buttock and down the back of leg is the hallmark of sciatica. You may feel the discomfort almost anywhere along the nerve pathway, but it is especially likely to follow one of these routes from lower back to knee, from the mid-buttock to the outside of calf, the top of foot and into the space between last two toes, from the inside of calf to inner ankle and sole.
The pain can vary widely, from
a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock. Sciatic pain often starts gradually and intensifies over time. It is likely to be worse when you sit, cough or sneeze. Usually only one lower extremity is affected.
In addition to pain, one may also experience numbness or muscle weakness along the nerve pathway in your leg or foot. In some cases, one may have pain in one part of leg and numbness in another; tingling or a pinsand-needles feeling. This occurs most commonly in toes or part of foot; a loss of bladder or bowel control. This is a sign of ‘cauda equina syndrome’, a rare but serious condition that requires emergency care. If you experience either of these symptoms, seek medical help immediately.
Causes
Sciatica usually results from
compression of a nerve root in lower (lumbar) spine. By far the most common cause of this compression is a herniated disk in lower back.
Other conditions that may put pressure on the sciatic nerve include lumbar spinal stenosis, Spondylolisthesis, Piriformis syndrome, spinal tumors, trauma, sciatic nerve tumor or injury,
Risk factors
Risk factors are health problems, lifestyle choices and inherent qualities, such as age or race, that make it more likely you will develop a particular condition. Major risk factors for sciatica include age, occupation, physical activity, genetic factors, diabetes etc.
When to seek medical advice
Mild sciatica usually goes away given a little time and patience. Consult a physician if self-care
measures fail to ease symptoms or if pain lasts longer than six weeks, is severe or becomes progressively worse. Get immediate medical care if you experience sudden, severe pain, numbness or muscle weakness in your back or leg; the pain follows a violent injury, such as a traffic accident or you have trouble controlling your bowels or bladder.
Treatment
For most people, sciatica responds well to self-care measures. You will heal more quickly if you continue with your usual activities but avoid what may have triggered the pain in the first place. Although resting for a day or so may provide some relief, prolonged bed rest is not a good idea. In the long run, inactivity may make symptoms worse.
Here are conservative measures that one can take:
Cold packs: Initially, wrap an ice pack or a package of frozen peas in a clean towel and apply to the painful areas for 15 to 20 minutes at least four times a day to reduce inflammation and relieve discomfort.
Hot packs: After 48 hours, apply heat to the areas that hurt. Use warm packs, a heat lamp or a heating pad on the lowest setting.
Stretching: Initially, passive
stretching exercises can help you feel better and may relieve compression, but avoid jerking, bouncing or twisting.
Over-the-counter medications: Nonsteroidal anti-
inflammatory drugs (NSAIDs) such as aspirin and ibuprofen which help alleviate both discomfort and inflammation, are the most helpful for sciatica.
Prescription drugs: Drugs prescribed by physician are most reliable.
Physical therapy: If you have
a herniated disk, physical therapy can play a vital role in recovery. Rehabilitation typically includes exercises to help correct posture, strengthen the muscles supporting back and improve flexibility. It is the cornerstone of your treatment programme and should become part of your permanent routine at home.
Regular exercise: It may seem counterintuitive to exercise when you are in pain, but the fact is that regular exercise is one of the best ways to combat chronic discomfort. Exercise prompts body to release endorphins -- chemicals that prevent pain signals from reaching your brain. Endorphins also help alleviate anxiety and depression, conditions that can make pain more difficult to control.
When conservative measures don't alleviate pain within a few months, then other measures or surgical approach may be applied.
Prevention
It is not always possible to prevent sciatica, but the following suggestions can play a key role in protecting your back:
Regularly exercise, maintaining proper posture when sitting, using good body mechanics are helpful.
Being conscious of how one stand, lift heavy objects and even how one sleeps can go a long way toward keeping back healthy. That is because poor posture stresses the back, leading to fatigue and stress on joints and nerves. For the best sleep posture, choose a firm mattress. Use pillows for support, but don't use one that forces your neck up at a severe angle.