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Sciatica(Nerve Compression, lumbar radiculopathy) Homeopathic treatment



The term sciatica describes a symptom rather than a specific disease.If you are feeling pain in your lower back or hip that radiates down from your buttock to the back of one thigh and into your leg, then you might be suffering from Sciatica. Sciatica is the term given to low back pain which travels in the distribution of the sciatic nerve and is caused due to compression of the sciatic nerve. Others use the term more specifically to mean a nerve dysfunction caused by compression of one or more lumbar or sacral nerve roots from a spinal disc herniation. The sciatic nerve is the largest and longest nerve in the human body which runs from each side of the lower spine through deep in the rear and back of the thigh, and all the way down to the foot, connecting the spinal cord with the leg and foot muscles.

Sciatica refers to pain that begins in the hip and buttocks and continues all the way down the leg. This condition is often accompanied by low back pain, which can be more or less severe than the leg pain. The term "sciatica" indicates that the sciatic nerve, which travels from the lower back through the buttocks and into the leg, is thought to be the cause of the pain in this condition. True sciatica is a condition that occurs when a herniated lumbar disc compresses one of the contributing roots of the sciatic nerve. This type of low back pain is less common than other causes and conditions that produce back pain.

The most common symptom of true sciatica is posterior thigh, lower leg or foot pain that can be much worse than the accompanying lower back pain. Usually a patient will experience moderate to severe pain, which begins in the buttocks and runs down through the leg or foot.Pain caused by general compression or irritation of one of five spinal nerve roots of each sciatic nerve or by compression or irritation of the left or right or both sciatic nerves. Symptoms include lower back pain , buttock pain, and numbness, pain or weakness in various parts of the leg and foot. Other symptoms include a "pin and needles" sensation, or tingling and difficulty moving or controlling the leg. Typically, symptoms only manifest on one side of the body. The pain may radiate above the knee, but does not always.

Sciatica is a relatively common form of lower back and leg pain, but the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve to cause the pain. Treatment for sciatica or sciatic symptoms often differs, depending on underlying causes and pain levels. Causes include compression of the sciatic nerve roots by a herniated (torn) or protruding disc in the lower back. It is important to know that true sciatica will produce pain that radiates beyond the knee. Often a patient will have a previous history of lower back pain beginning a few days or weeks before the leg pain occurs, then the leg pain becomes worse than the back pain, and in some cases the back pain will completely disappear.

Pathophysiology of Sciatica


Sciatica is generally caused by the compression of lumbar nerves L3, L4, or L5 or sacral nerves S1, S2, or S3, or by compression of the sciatic nerve itself. When sciatica is caused by compression of a dorsal nerve root (radix). it is considered a lumbar radiculopathy (or radiculitis when accompanied with an inflammatory response). This can occur as a result of a spinal disk bulge or spinal disc herniation (a herniated intervertebral disc) , or from roughening, enlarging, or misalignment (spondylosthesis) of the vertebrae, or as a result of degenerated discs that can reduce the diameter of the lateral foramen (natural hole) through which nerve roots exit the spine. The intervertebral discs consist of an anulus fibrosus, which forms a ring surrounding the inner nucleus pulposus. When there is a tear in the annulus fibrosus, the nucleus pulposus (pulp) may extrude through the tear and press against spinal nerves within the spinal cord, cauda equina, or exiting nerve roots, causing inflammation, numbness, or excruciating pain. Inflammation in the spinal canal can also spread to adjacent facet joints and cause lower back pain and/or referred pain in the posterior thigh(s). Pseudosciatic pain can also be caused by compression of peripheral sections of the nerve, usually from soft tissue tension in the piliformis or related muscles.

Slipped disc or sciatica or  nerve compression if left untreated
The spinal discs are composed of a tough spongiform ring of cartilage (annulus fibrosus) with a more malleable center (nucleus pulposus). The discs separate the vertebrae, thereby allowing room for the nerve roots to properly exit through the spaces between the vertebrae. The discs cushion the spine from compressive forces, but are weak to pressure applied during rotational movements. That is why a person who bends to one side, at a bad angle to pick something up, may more likely herniate a spinal disc than a person jumping from a ladder and landing on their feet.
Herniation of a disc occurs when the liquid center of the disc bulges outwards, tearing the external ring of fibers, extrudes into the spinal canal, and compresses a nerve root against the lamina or pedicle of a vertebra, thus causing sciatica. This extruded liquid from the nucleus pulposus "may cause inflammation and swelling of surrounding tissue, which may cause further compression of the nerve root in the confined space in the spinal canal.

Diagnosisof sciatica:

Diagnosis begins with a complete patient history. Your doctor will ask you to explain how your pain started, where it travels, and exactly what it feels like.

A physical examination may help pinpoint the irritated nerve root. Your doctor may ask you to squat and rise, walk on your heels and toes, or perform a straight-leg raising test or other tests.

Most patients with sciatica have compression of the L5 or S1 nerve roots. X-rays and other specialized imaging tools such as magnetic resonance imaging (MRI) may confirm your doctor's diagnosis of which nerve roots are affected.

Causes of Sciatica:

 Any condition that compresses the sciatic nerve causing Sciatica pain is listed below:

  • Herniated lumbar discs: Is the most common cause of sciatica in the lumbar spine.
  • Degenerative Disc Disease: Aging is known to cause disc weakness further causing disc herniation.
  • Some genetic predisposition may also make you prone to disk problems.
  • Diabetes: affects the way your body uses blood sugar, making you more likely to develop nerve damage.
  • Lumbar Spinal Stenosis: is narrowing of one or more neural passageways in the lower spine due to disc degeneration and/or facet arthritis.
  • Isthmic Spondylolisthesis: results from a stress fracture at the 5th lumbar vertebra. The fracture combined with disc space collapse may allow the vertebra to slip forward on the first sacral segment causing the L5 nerve root (look in the picture above) to become pinched as it leaves the spine.

Piriformis syndrome relationship to sciatica

  • Piriformis syndrome: is a controversial condition that, depending on the analysis, varies from a "very rare" cause to contributing to up to 8% of low back or buttock pain. In 15% of the population, the sciatic nerve runs through, or under the piriformis muscle rather than beneath it.Running directly above the sciatic nerve, the Piriformis muscle starts at your lower spine and connects to each thighbone. Piriformis syndrome occurs when the muscle becomes tight or goes into spasms, putting pressure on the sciatic nerve. Active runners and walkers, prolonged sitting, car accidents and falls may contribute to this condition. When the muscle shortens or spasms due to trauma or overuse, it's posited that this causes compression of the sciatic nerve. It has colloquially been referred to as "wallet sciatica" since a wallet carried in a rear hip pocket compresses the buttock muscles and sciatic nerve when the bearer sits down. Piriformis syndrome cause sciatica when the nerve root is normal.

     
  • Trauma: A car accident, fall or blow to the spine can injure the lumbar or sacral nerve roots. Also your occupation that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods makes you more prone to develop sciatica.
  • Spinal Tumors and Infections are rare disorders that may compress the sciatic nerve.
  • Sciatic nerve tumor or injury. Although uncommon, the sciatic nerve itself may be affected by a tumor or injury, leading to sciatic pain..
  • Spinal disc herniation
    Spinal disc herniation pressing on one of the lumber or sacral nerve roots is the primary cause of sciatica, being present in about 90% of cases.
    Sciatica caused by pressure from a disc herniation and swelling of surrounding tissue can spontaneously subside if the tear in the disc heals and the pulposus extrusion and inflammation cease.
  • Spinal stenosis
    Other compressive spinal causes include lumbar spinal stenosis, a condition in which the spinal canal (the spaces the spinal cord runs through) narrows and compresses the spinal cord, cauda equina, or sciatic nerve roots. This narrowing can be caused by bone spurs,spondylosthesis inflammation, or herniated disc, which decreases available space for the spinal cord, thus pinching and irritating nerves from the spinal cord that travel to the sciatic nerves.
  • Pregnancy
    Sciatica may also occur during pregnancy as a result of the weight of the fetus pressing on the sciatic nerve during sitting or during leg spasms. While most cases do not directly harm the fetus or the mother, indirect harm may come from the numbing effect on the legs, which can cause loss of balance and falling. There is no standard treatment for pregnancy induced sciatica.
  • Other
    Sciatica can also be caused by tumours impinging on the spinal cord or the nerve roots. Severe back pain extending to the hips and feet, loss of bladder or bowel control, or muscle weakness may result from spinal tumours or cauda equine syndrome .In some cases, no cause may be found. A number of problems can affect the bones, joints and muscles, all of which could possibly result in sciatic pain.

Slipped Disk or Disk Prolapse :-

 

Pain in the back due a ‘slipped disc?’ (also referred as herniated disc) can be very agonizing and can effects ones life in many ways. It can effect even the normal essential movements like sitting standing and walking; causing sharp shooting pains in the area of the affected disk. In severe cases relentless pain can occur even with simple movements causing one to lie down in one position for hours and days at a time. Homoeopathic treatment can be very effective in both the acute and chronic cases of slipped disk problem. It can even be a big boon for the patients as it can save advanced cases from the surgeon?s knife.

What exactly is slipped disc and how can it cause such pain? Our spine comprises of mainly the bones (vertebrae), the disks and the spinal cord .Bones (vertebrae) are stacked one on top of each other to form the backbone. Through these vertebrae passes the spinal cord .Discs are a kind of cushions that are positioned between two vertebrae. They act as shock absorber in the spine. These disks are round and flat in shape and are made up of tough outer covering which surrounds a jelly like material called nucleus.

Although the slipping of the disc can be triggered due to a trauma like over stretching or lifting weight etc. It is difficult to pinpoint one single cause for this kind of disc problem. This problem often occurs out of gradual degeneration of the disk and is related to the aging process. Gradually over a period of time, as we age, the discs loose their water content and both the outer shell as well as the inner nucleus becomes stiffer and brittle. As the discs wear out, their outer covering becomes more prone to getting torn. It is when the outer covering of the discs that get torn and the nucleus moves out to irritate the nerve passing by, that the pain occurs. The pain can occur in back, hips or even legs. This is called as slipped disk.

herniated disc

Although the slipped disk can occur anywhere in the backbone, the lumbar are (lower back area) is more prone for this kind of disk problem.

The gel-like center (nucleus) of a disk may protrude into or through the disk's outer lining. This herniated disk may press directly on the nerve roots that become the sciatic nerve. Nerve roots may also get inflamed and irritated by chemicals from the disk's nucleus.

Approximately 1 in every 50 people will experience a herniated disk at some point in their life. Of these, 10% to 25% have symptoms that last more than 6 weeks.

In rare cases, a herniated disk may press on nerves that cause you to lose control of your bladder or bowel. If this happens, you may also have numbness or tingling in your groin or genital area. This is an emergency situation that requires surgery.

Characteristic of sciatica

 

• One-sided pain

• Lightning or shooting in character

• Symptoms are aggravated with change of posture (regarding hip and leg) especially leaning forward, raising leg in lying posture. They often add fuel to the fire of suffering.

However, in the case of longstanding history of sciatica, the pain may gradually become localized to the buttocks and back of the leg. In this situation, the patient may have a vague aching pain that does not reach all the way to the lower leg or foot, though it may have done so earlier in the course of the disease 

If you suddenly start feeling pain in your lower back or hip that radiates to the back of your thigh and into your leg, you may have a protruding (herniated) disk in your spinal column that is pressing on the roots of the sciatic nerve. This condition is known as sciatica.

  • Sciatic nerve happens to be the longest nerve in our body. It starts from our spinal cord in the lower back and passes down through the hip into the back area of the lower leg When we say ‘Sciatica’ we refer to the pain in this sciatic nerve. As this nerve passes down through the pelvis, hip and to the backside of the lower leg, the sciatica pain whenever it occurs, is felt in the areas through which it passes. This nerve controls many muscles of the lower leg and also controls the sensation of thigh, leg and feet.

          Pain that travels from the lower back or from the hip through the back part of the thigh to the lower part of the leg or to the foot is usually very indicative of sciatica.

         Sciatica pain can range from a simple dull ache to severe electric like shocks. The pain can at times be so severe that the patient may hardly be able to move out of bed. Usually patients complain of pain while walking or standing but at times reverse of this happens, the pain is worse while lying down in a normal sleeping or lying posture and patient has no other option other than to stand or walk or lie in certain uncomfortable posture

    Patients with sciatica may suffer from additional symptoms such as numbness and weakness along the course of nerve, tingling and pins and needles feeling (mostly in the foot or toes) and loss of bladder and bowel control ( this an emergency medical condition).

Sciatica refers to pain that begins in the hip and buttocks and continues all the way down the leg. This condition is often accompanied by low back pain, which can be more or less severe than the leg pain.

Symptoms of Sciatica:

 

  • Usually sciatica affects one side of the body.
  • Radiating pain from lower back through the back of the thigh and down through the leg to the foot or toes.
  • Pain may be constant or intermittent, dull, sharp, shooting, burning or tingling sensation.
  • Weakness, numbness or difficulty moving the leg or foot.
  • Everyday activity like walking, sitting and standing may be painful and difficult.
  • Coughing and sneezing can increase the pain.
  • Losing control of bowel or bladder – this is a sign of Cauda Equina Syndrome which is an emergency situation and requires immediate medical attention.

Home Remedies for sciatica Self care measures:

 

  • Cold and hot packs. Use alternate cold and hot packs to reduce swelling and relieve discomfort.
  • Practice good posture. Stand up straight with your ears aligned with your shoulders, your shoulders aligned with your hips and your buttocks tucked in. Your knees should be bent slightly.
  • Regular exercise: improves flexibility and helps prevent age-related degenerative changes in your back.
  • Lift objects safely. Always lift from a squatting position, using your hips and legs to do the heavy work. Never bend over and lift with a straight back.
  • Avoid sitting or standing for extended periods. If you sit at work, take regular breaks to stand and walk around. If you must be on your feet, prop one foot on a small block or footrest, and then switch feet throughout the day.
  • Use proper sleeping posture. Take pressure off your back by sleeping on your side or on your back with a pillow under your knees.
  • Avoid wearing high heels. Shoes with heels that are more than 1½ inches high shift your weight forward, throwing the body out of alignment.
  • Do abdominal crunches. These exercises strengthen the abdominal muscles that help to support your lower back. Lie with your back on the floor, hands behind your head and knees bent. Press your lower back to the floor, lift your shoulders up about 10 inches off the floor, and then lower them. Repeat 10 to 20 times daily.
  • Lay in the face down position and clasp your hands behind the lower back, then raise the head and chest slightly against gravity while looking at the floor.
  • In the above position with the head and chest lowered to the floor, lightly raise an arm and opposite leg slowly, with the knee locked, 2-3 inches from the floor.
  • Stretch. Sit in a chair and bend down toward the floor. Stop when you feel just slight discomfort, hold for 30 seconds, then release. Repeat six to eight times.
  • Lay on the back and gently pull the knees to the chest until a comfortable stretch is felt.
  • Walk/swim. Walking and swimming can help to strengthen your lower back.

 

 

Conventional treatmentst of sciatica

Medication
Although medicines are commonly prescribed for the treatment of sciatica, evidence for analgesics is poor. Specifically, NSAIDS, do not appear to improve immediate pain and all NSAIDs appear about equivalent. Evidence is also lacking in use of opioids and muscle relaxants. In those with sciatica due to piriformis syndrome, botulism toxin injections may improve pain and or function.There is little evidence for steroids, either epidural or by pill.
Surgery
Surgery for unilateral sciatica involves the removal of part of the disc, known as a discetomy. While it results in short term benefits, long term benefits appear to be equivalent to conservative Treatment of the underlying cause of the compression is needed in cases of epidural abscess epidural tumors, and cauda equine syndrome

Homeopathic approach or treatment to Sciatica:

 Homeopathy as a natural system of medicine offers distinct advantages to the people who suffer from sciatica. The biggest advantage that homoeopathy offers is that it is able to treat the pain very effectively and is able to rectify the compression or irritation on the sciatic nerve. Another great benefit of using homoeopathy is that along with the treatment of sciatica homoeopathy also aims at strengthening the patient’s constitution in order to prevent further recurrences.

Wear and tear phenomena are common for everyone. If you happen to use the bones in one position only all the time or most of the time, then, naturally, that point will suffer more friction loss than other places. If friction loss occurs evenly, people will lose some height only with age. But, if it has not occurred evenly then, more friction loss occurring in one place can damage disc to cause disc degeneration or disc bulge or disc prolapse which can induce sciatica. So, caring position is equally important against medicines to rule out exciting cause or maintaining cause.

The goal of treatment should not be aimed only at relief but also to prevent recurrence. Rebounding, recurring attack can be given knock outs, when the reviver counsels the sufferer about correct posture in addition to drugs. In addition, “No more attacks” can be brought easily, when a Homeopath selects and prescribes a right drug constitutionally with detailed analyses of cause, nature of pain, aggravating factors, characteristic symptoms of disease and characteristic symptoms of the sufferer. Homeopathy can provide miraculous relief from this nervous pain without any side-effects by controlling the inflammation and infection of the nerves. Also, Homeopathy can treat paralysis or weakness of the leg by rejuvenating the sciatic nerve. It favours enhancement of neuron regeneration / reduction of disc bulge / ruling out other causes to revive impinged nerve. In case of fractured bones which compress the sciatic nerve, surgery may be absolutely needed to relieve the suffering by releasing the compression mechanically (surgically).

Slipped disc or sciatica or  nerve compression if left untreated

Homeopathy is the only form of treatment that has shown an overwhelming positive response in treating Sciatica. Constitutionally prescribed Homeopathic remedies can effectively and permanently reduce pain and other symptoms of Sciatica.

Homeopathic medicines treat by strengthening our vital force which is an intelligent energy principle in our body that balances many functions and provides protection from illness. Homeopathic treatment being based on the hypothesis of "like cures like" and a deep emphasis on the principles of holistic medicine (treat the whole person), its remedies work by stimulating the body's own healing power by introducing tiny doses of natural substances that stimulates a person's immune system and defense system to correct itself naturally. Due to the individualized constitutional approach of Homeopathy a remedy which matches all of your symptoms will stimulate your vital force to restore balance and health. Homeopathic remedies are gentle and easy to take and are regulated by the FDA and formulated according to the Homeopathic Pharmacopia of the United States.

Hence every individual suffering from Sciatica must consider Homeopathy to provide relief and lifetime cure. Homeopathic treatment can change a person’s life from one of distress to one of health.

 

 

Homeopathic Remedies for sciatica Medicines names

Besides some of the following ingredients, the product contains Dr Gurpreet Singh Makkar(punjab,India), Research based, highly effective medicines

Aconite
Sciatica from exposure to colds, dampness and from suppressed perspiration indicates Aconite. there is much numbness, perverted sensation, pricking and a sense of coldness in the parts, especially toes. The pains are very severe and worse at night; the patient is restless, there is tingling along the affected nerve.
Ammonium mur
Sciatica, with aggravation of pain while sitting, somewhat relieved by walking and entirely relieved by lying down. Pains in the left hip as if the tendons were too short. Legs feel contracted. Painful jerks, feet feel as if asleep.
Arsenic album
Sciatica with pain is marked by complete intermissions; it exacerbates every night at a particular hour, and becomes unbearable; it is increased by vigorous and relieved by gentle motion. It is aggravated by cold, but relieved momentarily by warmth.
Belladonna
Sciatica pains come on suddenly. There is a neuritis, and the course of the nerve is sensitive; the pain is especially severe at night, the parts are sensitive to the touch, the least concussion or a draft of air aggravates. Severe lancinating pains coming on in the afternoon or evening; has to change position often; worse from motion, noise, shock or contact; cannot bear the clothing to touch him. Relieved by letting the limb hang down, warmth and the erect posture.
Colocynth
Chief remedy of sciatica in worst cases. There are pains in the sciatic nerve extending the knee or to the heel, worse from any motion, and especially aggravated by cold. The pain is paroxysmal, followed by numbness and partial paralysis. There is a sensation which has been described as if the thigh were bound with iron bands, or as though screwed in a vise; the muscles are fearfully tense and fixed. Particularly is the right side involved and there are stitches during walking. There is a sense of constriction around the hip. The pains, too may come suddenly and leave suddenly, they may be sticking and burning, and all are worse from cold or damp and at night,when the patient can find no easy position for the limb. Colocynth typifies the sciatica due to nerve changes with no special inflammatory conditions attending it.
Gnaphalium
This remedy is quite similar to Colocynthis. O’Connor thinks it is the best remedy in the absence of the other symptoms and many others consider it specific.It has intense neuralgic pains along the nerve,and numbness. The whole trunk and the main branches seem affected, worse when lying down, worse from motion, stepping and better whiles sitting in a chair. The pains extend to the toes.
Magnesium phos
Right sided sciatica, worse cold application, touch and at night, relieved by warmth, bending double and by pressure.
Nux Vomica
Sciatica in persons who does a good deal of mental work, has mental strains and leads a sedentary life, found in prolonged office work, overstudy, and close application to business, with its care and anxieties. Person who are nervous, irritable, hypersensitive and overimpressionable with digestive disturbances, portal congestion, and hypochondrical states. Convulsions with consciousness.
Ailments from high living, so called modern living, coffee, tobacco, alcohol, quinine, taking highly spiced seasoned food, irregular diet, overeating, sexual excess, long continued mental exertion, sedentary habits, want of exercise, loss of sleep, using aromatic patent medicines, pills or exposure to cold.
Modalities;- Aggarvation morning, walking at 4 a.m., by mental exertion, after eating or overeating, touch, noise, anger, spices, narcotics, during dry weather, in cold air. Amelioration in the evening, while at rest, lying down, and in damp wet weather.
Rhus tox
Sciatica with muscular and ligamentous involvement. It is seldom adapted to recent cases, but comes in later. The pains are tearing and burning, worse during rest, relieved by motion. There is lameness and a disposition to muscular twitchings, bowels are constipated. It is a rheumatic sciatica, the fibrous sheath of the nerve being involved It is the best remedy for a combination of lumbago and sciatica. Sciatica arising from over-exposure to wet or from lifting, wrenching and over-exertion. Great relief from warmth.
 
 

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About Dr. GS Makkar


Dr. GURPREET SINGH MAKKAR is a dynamic homeopath from India(pb). He is an ardent student of classical Homeopathy. He is a registered doctor degree holder (B.H.M.S.) from Sri Guru Nanak Dev Homoeopathic medical college(S.G.N.D Barewal Ludhiana,PUNJAB, India.
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