May 2, 2011
Sciatica
Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or compression of the sciatic nerve. Sciatica is a symptom of another medical problem, not a medical condition on its own.
Causes, incidence, and risk factors
Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the spine and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.Common causes of sciatica include:
· Piriformis syndrome (a pain disorder involving the narrow piriformis muscle in the buttocks)
· Slipped disk
· Degenerative disk disease
· Spinal stenosis
· Pelvic injury or fracture
· Tumors
Symptoms
Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or a burning sensation. In some cases, the pain is severe enough to make a person unable to move.The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts. The sensations may also be felt on the back of the calf or on the sole of the foot. The affected leg may feel weak.
The pain often starts slowly. Sciatica pain may get worse:
· After standing or sitting
· At night
· When sneezing, coughing, or laughing
· When bending backwards or walking more than a few yards, especially if caused by spinal stenosis
Treatment
Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.In some cases, no treatment is required and recovery occurs on its own.
Conservative treatment is best in many cases. Your doctor may recommend the following steps to calm your symptoms and reduce inflammation.
· Apply heat or ice to the painful area. Try ice for the first 48 - 72 hours, then use heat after that.
· Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
· While sleeping, try lying in a curled-up, fetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.
If at-home measures do not help, your doctor may recommend injections to reduce inflammation around the nerve. Other medicines may be prescribed to help reduce the stabbing pains associated with sciatica.Physical therapy exercises may also be recommended. Additional treatments depend on the condition that is causing the sciatica.
Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.
Prevention
Prevention varies depending on the cause of the nerve damage. Avoid prolonged sitting or lying with pressure on the buttocks.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Friday April 8, 2011
Plantar Fasciitis
Plantar fasciitis is irritation and swelling of the thick tissue on the bottom of the foot.
Causes, incidence, and risk factors
The plantar fascia is a very thick band of tissue that connects the heel bone to the toes. This band of tissue is what creates the arch of the foot. When the fascia is overstretched or overused, it can become inflamed. When the fascia is inflamed, it can be painful and make walking more difficult.Risk factors for plantar fasciitis include:
· Foot arch problems (both flat feet and high arches)
· Obesity
· Repetitive loading on the feet from long-distance running, especially running downhill or on uneven surfaces
· Sudden weight gain
· Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
· Shoes with poor arch support or soft soles
This condition is one of the most common orthopedic complaints relating to the foot.Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.
Symptoms
The most common complaint is pain in the bottom of the heel, which is usually worse in the morning and may improve throughout the day. By the end of the day the pain may be replaced by a dull ache that improves with rest.Signs and tests
Typical physical exam findings include:· Mild swelling
· Redness
· Tenderness on the bottom of the heel
X-rays may be taken to rule out other problems, but having a heel spur is not significant.Treatment
Conservative treatment is almost always successful, given enough time. Treatment can last from several months to 2 years before symptoms get better. Most patients will be better in 9 months.Initial treatment usually consists of:
· Anti-inflammatory medications
· Heel stretching exercises
To relieve plantar fasciitis:· Apply ice to the painful area. Do this at least twice a day for 10 - 15 minutes, more often in the first couple of days. Roll your foot over a frozen water bottle.
· Rest as much as possible for at least a week.
· Take acetamin for pain or ibuprofen for pain and inflammation.
· Try wearing a heel cup, felt pads in the heel area, or an orthotic device.
· Use night splints to stretch the injured fascia and allow it to heal.
· Wear properly fitting shoes.
If these fail, putting the affected foot in a short leg cast (a cast up to but not above the knee) for 3 - 6 weeks is often successful in reducing pain and inflammation. Alternatively, a cast boot (which looks like a ski boot) may be used. It is still worn full time, but can be removed for bathing.Some physicians will offer steroid injections, which can provide lasting relief in many people. However, this injection is very painful and not for everyone.
In a few patients, nonsurgical treatment fails and surgery to release the tight, inflamed fascia becomes necessary.
-This article was published by Pub Med Health.
