Say you saw it in the Beacon | Fitness & Health
BALTIMORE BEACON — APRIL 2017
9
Sciatica can resolve with time, treatments Dear Mayo Clinic: Three weeks ago I was diagnosed with sciatica. I didn’t have much pain initially, but it has been extremely painful the past few days — usually when I’m sitting. Would physical therapy be an option for treatment? I don’t like to take medications for pain. Are there other treatments I should try? Could surgery help? Answer: Sciatica can cause significant discomfort. The good news is that time and treatment often successfully resolve this condition. In most cases, surgery is not necessary to treat sciatica. Sciatica typically refers to pain from irritation of one of the spinal nerves in your low back. Although the source of the irritation is in your back, you feel the pain of sciatica along the affected nerve where it is located in your leg after it exits the spine, typically in the buttock and leg. Sciatica usually affects only one side of the body. Sciatica pain is often a dull pain, but it also
Well-being From page 6
is a marker of future health problems. That’s surprising, and needs further study, said NIA’s Haaga, adding that meanwhile it’s something doctors might consider. A broken hip during the senior years has long been known to send patients on a downward spiral. But this study implicated long-healed fractures of any type as early as middle age to poor health later on. Those breaks might be an early signal of bone-thinning osteoporosis, or the beginning of balance and muscle problems that increase the risk of later frailty, Haaga speculated. • Good mobility — no trouble walking
can be sharp and, at times, you may feel the pain travel or shoot down your leg. Symptoms of sciatica may include numbness, tingling or weakness along with the pain.
What causes sciatica?
Sciatica develops due to a change in one of the cartilage pads in your spine, called discs. A small component of the disc pokes into the spinal canal, creating inflammation or swelling. That, in turn, leads to inflammation of the nerve, and triggers the symptoms of sciatica. Pressure on the nerve from the disc may contribute to sciatica, as well. Other, less likely, causes of nerve irritation include bone spurs, cysts or other lesions in the spine that grow near a nerve. Physical therapy can be an excellent treatment option for sciatica. It often involves learning stretches to improve your flexibility, techniques for pain control, and exercises to strengthen and condition the
quickly or getting up from chairs — is one of the best indicators of well-being. Indeed, prior fractures were a risk for poor later mobility. • Obesity seems to pose little risk to seniors as long as they’re otherwise in good physical and mental health — without the diabetes or heart disease that so often accompanies extra pounds. Haaga noted there’s controversy about whether being overweight in the senior years might even be helpful. • Sensory function — problems with hearing, vision and smell — also plays a role in seniors’ vulnerability. McClintock said it contributes to social isolation, and mobility and nutrition problems. — AP
muscles that support your back. This type of physical therapy helps reduce sciatica pain and lowers your risk for future injuries. In addition to physical therapy, staying active in whatever type of physical activity you can best tolerate can help ease pain and other symptoms, too.
Newer drugs that help
Though you mention that you prefer to avoid medications, newer drugs are available that can work quite well for pain caused by sciatica. They are not potentially habit-forming like narcotic drugs, or opioids, can be. Drugs like gabapentin, duloxetine, nortriptyline and pregabalin can be useful for managing severe pain or pain that makes it hard to sleep.
Corticosteroids are another treatment option. These potent anti-inflammatory drugs are delivered via an injection that places the medication just where it is needed. You have an imaging exam, such as a CT scan or an MRI, before a corticosteroid injection, so your healthcare provider can see where the medication should go. Imaging also is used to guide the injection as it’s being delivered to ensure safety and accuracy. In about 90 to 95 percent of sciatica cases, the problem is successfully resolved with time and conservative, nonsurgical treatments. If sciatica persists despite these treatments, though, surgery may be considered. See SCIATICA, page 10
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