Pain Management and Pain Relief Information

Archive for January, 2011

Like some of my patients over 40, you may begin to experience pain on one side of your hips/buttocks, some numbness or tingling running down your leg, or even weakness in your legs. You may find it harder and harder to sit comfortably or even have sharp pain when trying to stand or walk. If this sounds like you, you may have an increasingly common condition called sciatica – a cluster of symptoms that points to herniated or degenerating, spinal disks.

Sciatica affects people over age 30 and is almost always the result of a problem with the lower spinal disks causing radiculopathy, or compression/irritation, of the sciatic nerve that sends pain and/or tingling, numbness down into the legs. Let’s talk about what causes lower spinal disk problems.

Causes of Sciatica

As I tell my patients, sciatica is not really a diagnosis in itself, rather a condition that includes several symptoms that can have different causes.

Here are the most common of those causes:

1. Herniated lumbar disc – sudden twisting motions, or impact injuries, of lumbar, spinal disks causes the inner disc to bulge out between disks. This bulging puts pressure on surrounding nerves, the sciatic being the most prominent.

2. Lumbar spinal stenosis – a hardening, or “stenosing” of the spinal disks causes it to become inflexible and rub against the sciatic nerve. Most common in people over 60, but can occur earlier in athletes and people in occupations with a lot of impact shock to the spine.

3. Degenerative disk disease – degeneration of the disk can occur normally with the aging process. The edges can be rough and irritate the surrounding nerves.

4. Isthmic spondylolisthesis – a big medical name for when a disk is injured and falls out of place, sliding over another. The loss of space between the two disks can compress the nerve exiting the disks at this level and cause pain and irritation.

5. Piriformis syndrome – the piriformis muscle extends across the buttock. The nerve root, that includes the sciatic nerve, can get pinched or irritated as it runs beneath the piriformis down to the thighs.

6. Sacroiliac Joint Dysfunction – irritation of the sacroiliac joint can irritate the lumbar nerves and cause sciatic-like symptoms.

Other less common causes of sciatica can be pregnancy, muscle strain, spinal tumors, scar tissue from previous injuries, or infection.

Treatments for Sciatica

For my patients who have sciatica, almost always, treatment will include some sessions with a physical therapist who will design specific exercises to address the condition causing it. That is why correct diagnosis of what is causing the sciatica is crucial.

The good news about sciatica is that it almost always gets better in a few days to weeks after starting exercise treatment. Depending on the cause of your sciatica, it could take up to 12 weeks to fully resolve. You may still continue to experience flare-ups of it as well. Some particular causes, like nerve entrapment that doesn’t respond to exercise, or even chiropractic, may require surgery to return the nerve to its proper position.

Some Things You Can Do To Help Yourself

•Heat or Ice – Apply either heat or ice packs, or alternate between the two, depending on which feels best to you. Do this for about 20 minutes then repeat every 2 hours when sciatica flare first begins.

•Over the counter pain remedies – Such as ibuprofen, can be helpful.

•Homeopathic pain remedies – Arnica or Traumeel, sold at better health food stores, can help relieve symptoms without the side effects of nonsteroidal anti-inflammatory drugs.

•Magnesium – 500 mg of magnesium can help relieve pain causing inflammation.

•Quercetin – Another herbal anti-inflammatory helps relieve inflammation.

•Vitamin B1 and B6 – Helps relieve nerve irritation and numbness.

•Vitamin C – 1000 mg a day also helps to relieve inflammation.

•Calcium – Optimal calcium helps prevent deterioration of bone and spinal disks.

•Vitamin D – Insufficient Vitamin D can contribute to spinal disk, as well as overall bone and joint degeneration as your body will not be able to use calcium very well.

•Water – Optimal water intake is crucial to keeping discs buoyant, lubricated and moving correctly. Dried out disks can open the door for degenerative problems setting in.

•Acupuncture – Promising in relieving nerve pain of sciatica by restoring the normal flow of energy in the nerve and muscles involved.

•Massage therapy – Massage helps stimulate the muscles where the numbness, tingling is occurring to increase blood flow to them, decrease pain and numbness.

•Chiropractic manipulation – Chiropractic manipulations work on coaxing the spinal disks back into their correct place and releasing the pressure on the surrounding nerves.

Sciatica can truly be a genuine pain in the butt – but it’s not something you have to live with. Regular exercise, stretching, is the best preventative measure against sciatica. Try to avoid long periods of sitting. With proper nutrition, and treatment of underlying contributing conditions, sciatica doesn’t have to put you on the sidelines. You can be up and running and back in the game in no time.

Have you ever wonder why your back hurts when driving for long distances or a long period of time? I have recently retired and I have noticed that when I drive for more than an hour or two my lower back really starts to hurt. I do get extra relief by removing my wallet from my back pocket because it feels like I am sitting on a rock which has been driven into my butt cheek! If you have ever experienced this then you need to see what is actually happening when you sit in your car seat.

Today’s modern cars have got lower to the ground causing the seats inside the cars to also be lowered. What this does is take away the natural curvature of your spine away thus making you feel quite uncomfortable. Unfortunately even the so-called lumbar seats may help for short periods of time, but under long trips that take hours your rear feels like it has been clamped down to the seat, and let the back pain begin! No wonder it feels so good when you stop and get out of your car!

With our cars becoming lower and with our seats being tipped back it also causes pressure on the spine because we find ourselves looking at a 15 to 20 degree angle to see straight ahead, designers! Do you realize that sitting in this position actually causes our pelvis to roll back even causing more discomfort? Maybe they are just trying to keep us awake while driving; because I know back pain will keep you awake.

We can help to eliminate this type of back pain by sitting as close to the pedals as possible sitting with our arms bent slightly in a normal driving position, remember how we were taught, keep your hands at the 10 and 2 position on the steering wheel?

One way that I have found to help fight the back pain is to have a good lumbar support, you can even purchase one if your vehicle does not have one. Placing slight pressure on your lower back with the lumbar can help lessen your lower back pain. Another suggestion I have is especially if you take long journeys, is to stop occasionally or extend your trip to allow for traveling shorter distances. A word of caution when exiting your vehicle after driving for a long period of time, try not to bend or stretch because your back is more inclined to be injured because of extended sitting period.

I hope that I have given you some insight into why driving may cause back pain, and that you will use my advice to make your driving experience more enjoyable.

Orthopedic surgeons who have patients with scoliosis must carefully evaluate their patient’s condition and plan the scoliosis surgeries they perform. Since scoliosis causes abnormalities of the spine, it is important for the surgeon to be able to fully examine the condition of a specific patient. Although two-dimensional images have been helpful to surgeons, a new technology is giving surgeons an actual model of the patient’s spine that they can hold in their hands and view from any angle. They can also easily consult with other surgeons and the patient using the model.

This ground-breaking technology is being embraced by orthopedic surgeons as it helps them to diagnose the damage the scoliosis has done and to plan detailed procedures that can improve the patient’s condition. Unfortunately this innovation has not come to the attention of every surgery performing these procedures. If you are a patient with scoliosis, ask your doctor if he has heard of this technology and whether he will be using it in your treatment, especially if you are facing a scoliosis operation.

A patient with scoliosis of the spine has a CAT scan or MRI and the images are used to form an exact replica of the patient’s spine. A bone like powder is used in a patented production method to form the model. The doctor can use this model to show the patient their specific spinal condition and to explain the procedures he is recommending.

These three-dimensional models are accurate to within 1/35th of a millimeter and give your doctor the best way to get the information he needs to make an informed and accurate decision about the condition of your spine and your scoliosis treatment. Being able to prepare for problems that can occur during surgery, that are not revealed with traditional imagery, can mean a shorter and more successful result.

Having a three-dimensional, Anatomically Correct Reference Model (ACRM) of your spine can result in a more accurate diagnosis, a more specific treatment plan, and less time in scoliosis surgery. A highly skilled surgeon, equipped with this latest technology, can aid in your treatment for scoliosis and recovery from this debilitating condition.

As exciting as this technology is, unfortunately it isn’t well known in the surgical community. Be sure let your physician or surgeon know about these amazing 3D models so that you can be sure that they have the very best tools available when planning on how they are going to operate on you.

Like some of my patients over 40, you may begin to experience pain on one side of your hips/buttocks, some numbness or tingling running down your leg, or even weakness in your legs. You may find it harder and harder to sit comfortably or even have sharp pain when trying to stand or walk. If this sounds like you, you may have an increasingly common condition called sciatica – a cluster of symptoms that points to herniated or degenerating, spinal disks.

Sciatica affects people over age 30 and is almost always the result of a problem with the lower spinal disks causing radiculopathy, or compression/irritation, of the sciatic nerve that sends pain and/or tingling, numbness down into the legs. Let’s talk about what causes lower spinal disk problems.

Causes of Sciatica

As I tell my patients, sciatica is not really a diagnosis in itself, rather a condition that includes several symptoms that can have different causes. Here are the most common of those causes:

1. Herniated lumbar disc – sudden twisting motions, or impact injuries, of lumbar, spinal disks causes the inner disc to bulge out between disks. This bulging puts pressure on surrounding nerves, the sciatic being the most prominent.

2. Lumbar spinal stenosis – a hardening, or “stenosing” of the spinal disks causes it to become inflexible and rub against the sciatic nerve. Most common in people over 60, but can occur earlier in athletes and people in occupations with a lot of impact shock to the spine.

3. Degenerative disk disease – degeneration of the disk can occur normally with the aging process. The edges can be rough and irritate the surrounding nerves.

4. Isthmic spondylolisthesis – a big medical name for when a disk is injured and falls out of place, sliding over another. The loss of space between the two disks can compress the nerve exiting the disks at this level and cause pain and irritation.

5. Piriformis syndrome – the piriformis muscle extends across the buttock. The nerve root, that includes the sciatic nerve, can get pinched or irritated as it runs beneath the piriformis down to the thighs.

6. Sacroiliac Joint Dysfunction – irritation of the sacroiliac joint can irritate the lumbar nerves and cause sciatic-like symptoms.

Other less common causes of sciatica can be pregnancy, muscle strain, spinal tumors, scar tissue from previous injuries, or infection.

Treatments for Sciatica

For my patients who have sciatica, almost always, treatment will include some sessions with a physical therapist who will design specific exercises to address the condition causing it. That is why correct diagnosis of what is causing the sciatica is crucial.

The good news about sciatica is that it almost always gets better in a few days to weeks after starting exercise treatment. Depending on the cause of your sciatica, it could take up to 12 weeks to fully resolve. You may still continue to experience flare-ups of it as well. Some particular causes, like nerve entrapment that doesn’t respond to exercise, or even chiropractic, may require surgery to return the nerve to its proper position.

Some Things You Can Do To Help Yourself

•Heat or Ice – Apply either heat or ice packs, or alternate between the two, depending on which feels best to you. Do this for about 20 minutes then repeat every 2 hours when sciatica flare first begins.

•Over the counter pain remedies – Such as ibuprofen, can be helpful.

•Homeopathic pain remedies – Arnica or Traumeel, sold at better health food stores, can help relieve symptoms without the side effects of nonsteroidal anti-inflammatory drugs.

•Magnesium – 500 mg of magnesium can help relieve pain causing inflammation.

•Quercetin – Another herbal anti-inflammatory helps relieve inflammation.

•Vitamin B1 and B6 – Helps relieve nerve irritation and numbness.

•Vitamin C – 1000 mg a day also helps to relieve inflammation.

•Calcium – Optimal calcium helps prevent deterioration of bone and spinal disks.

•Vitamin D – Insufficient Vitamin D can contribute to spinal disk, as well as overall bone and joint degeneration as your body will not be able to use calcium very well.

•Water – Optimal water intake is crucial to keeping discs buoyant, lubricated and moving correctly. Dried out disks can open the door for degenerative problems setting in.

•Acupuncture – Promising in relieving nerve pain of sciatica by restoring the normal flow of energy in the nerve and muscles involved.

•Massage therapy – Massage helps stimulate the muscles where the numbness, tingling is occurring to increase blood flow to them, decrease pain and numbness.

•Chiropractic manipulation – Chiropractic manipulations work on coaxing the spinal disks back into their correct place and releasing the pressure on the surrounding nerves.

Sciatica can truly be a genuine pain in the butt – but it’s not something you have to live with. Regular exercise, stretching, is the best preventative measure against sciatica. Try to avoid long periods of sitting. With proper nutrition, and treatment of underlying contributing conditions, sciatica doesn’t have to put you on the sidelines. You can be up and running and back in the game in no time.