SCIATICA (Slip disc, Lumbar radiculopathy, Gridhrasi)

Sciatica

Is your lifestyle taking a toll on your spine!

“Sciatica makes life miserable”

The most ignored part of your body is your back and spine. Our  sedentary lifestyle and incorrect sitting posture affects the spine and this ignorance can make it susceptible to discomfort and injury. our spine supports our body helping it to perform movements like bending, twisting and standing upright. Apart from desk bound routine and bad postures, unhealthy food habits and deficiencies also results in spinal disorders.

Sciatica is neuralgia of the sciatic nerve characterized by pain radiating down through the buttocks and the back of thigh. There is a inflammation of the Sciatic nerve, which arises from the lower lumbar and sacral region of spines and passes down across the buttock down the back of leg and divides into two main branches just behind and above the knee. Sciatica pain can be felt along or pair of the pathway of the nerve and feeling of numbness is also felt. 

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) disc in your spinal column that is pressing on the root of the sciatic nerve. This condition is known as Sciatica or lumbar radiculopathy. Being overweight and leading an inactive lifestyle puts you at high risk for Sciatica. Sciatic nerve is more exposed to injury and inflammation than most other nerves. If you ever get it, do not panic! Help is there in the form of alternative remedies which in many cases, have less side effects and less toxicity to the body as well are much less invasive.

Whether your Sciatica is acute, chronic or episodic, finding relief is your number one priority ! Activities like walking, standing, bending over, driving a car, working at a computer, catching up on household chores, sneezing or coughing, and many other activities of daily living can cause sudden and intense pain.

Ayurveda described sciatica as  Gridhrasi (Gridhrasi means vulture), as the gait of the affected person resembles that of a vulture’s walk and the inflamed nerve appears like its beak. As many as 4 out of every 10 people will get sciatica, or irritation of the sciatic nerve, at some point in their life. Generally 30 is the age where the sciatica pain might begin in a person and they go on aggravating as the age advances.

“Say no to your pains, because an hour of pain is as long as a day of pleasure”

Introduction

Sciatica  / Lumber Radiculopathy

Sciatica is defined as the pain in the distribution of sciatic nerve or its component nerve roots. The syndrome is now accepted as being caused by lumbar disc prolapse. However, sciatic nerve lesions can occur due to pressure in the buttock or upper part of thigh.

When radiculopathy occurs in the lower back, it is known as lumbar radiculopathy, also referred to as sciatica because nerve roots that make up the sciatic nerve are often involved. The lower back is the area most frequently affected by radiculopathy.

Lumber Plexux

Sciatica is a serious disease of nervous system leg pain on one side is a classic hallmark of sciatica. The patient of sciatica feels severe pain in the buttock which may radiate down the posterior aspect of the thigh and calf to the outer border of the foot. In severe cases, patient may feel weakness of the calf muscles or foot drop. Sometimes the pain is so severe that the patient cannot stand and is crippled. Often the pain disappears with rest., only to return days or weeks later after some slight injury or extra excretion.

The Sciatica nerve is the longest nerve in the body. There are two nerve roots that exit the lumbar spine (L4 and L5) and three that exit the sacral segment (S1, S2, and S3). All five nerves bundle together to form the sciatic nerve, and then branch out again within the leg to deliver motor and sensory functions to specific destinations in the thigh, calf, foot and toes. Near the knee, the sciatic nerve divides into two nerves: the tibial and peroneal nerves

Sciatica affects: 

1. Muscles- It starts stiffening  due to the dryness; improper diet  and imbalanced lifestyle which deteriorates the curvature of the spine which leads to the deterioration of the intervertebral disc.

2. Bone- The bony tissue is affected  due to the muscles and osteoporosis

3. Bone marrow- The disc and the neural tissue spine is compressed due to the pressure from all sides.

Ayurveda says, that it is an aggravation of Vata dosha that is responsible for the disc problems. At the same time, accumulation of Ama (toxins) in the body is also one of the reasons behind the same. To deal with these two causes, healthy digestion is required. Indigestion is actually related to ama accumulation. Healthier the digestion process lesser the ama accumulation in the body. Ama is actually a undigested food material.

Structure of a Nerve cell

"The longest axon in the body is the sciatic nerve which runs from the lower end of the spinal cord to the tip of the big toe."

Risk Factors

●     Age Most people who get sciatica are between 30 and 50 years old.

●  Overweight Extra pounds can puts pressure on your spine, which means people who are overweight and pregnant women have a greater chance of getting a herniated disk.

●     Diabetes can cause nerve damage.

●     Job. Lots of heavy lifting or prolonged sitting can damage discs.

●    Smoking contributes to the problem

Causes

●     Slipped disc: A slipped disc occurs when the soft inner portion of the disc juts out through the outer ring. It can happen due to lifting heavy weights, or being overweight, or due to weak muscles.

●  Degenerative disc disease (DDD): Sciatica is a common result of the ageing process. This happens when the cushion between the bones dries out and flattens. Overweight, high impact sports, poor posture can cause this.

●     Piriformis syndrome: The piriformis muscle, located in the lower part of the spine, one to the thigh bone, and helps one rotate the hip. The sciatic nerve runs under the piriformis muscles, so muscle spasm can compress the sciatic nerve.

●   Pregnancy: The extra weight and the pressure on the spine caused by pregnancy can cause compression of the sciatic nerve. The symptom will usually go after child birth.

●   Spinal Stenosis: Your nerves travel through passageways in your spine, and when this space narrows (stenosis), it can put pressure on the nerves in your low back.

●    Tumors of the pelvis and spinal infections Although very rare tumors and infections like post herpetic neuralgia can compress the sciatic nerve.

● Spondylolisthesis: If a vertebra slips forward over the vertebra below it, it is called spondylolisthesis. This slip can pinch the nerve root and cause sciatica.

●     Osteoarthritis of the lower spine: This is a slow deterioration of cartilage  around joints in the lower back. Lifting heavy weights in wrong postures can become the cause of this.

●    Ankylosing spondylitis:  This type of arthritis stiffens the lower portion of the back. Ligaments and tendons attached to the spinal cord may be affected. Unhealthy food habits increase the risk of this problem.

●   Injury: Sciatica may be  caused by any type of injury to the spine. One Can develop sciatica  because of direct nerve compression from an outside force. For example, if one is injured in a car accident, resulting in a pinched nerve in the back or due to injections. The sciatica nerve may even be injured by walking, running or riding a bicycle. Prolonged standing or sitting on one side of the edge of a chair may also lead to this disease.

●     Deformities of the lower spine and exposure to cold and damp.

●  Acidosis: Excess acidity of the blood and tissues and a rundown condition of the system generally.

●    Herpes infection.

Ayurveda-

●  Intake of Vata aggravating foods like pigeon pea, Bengal gram (chana dal), peanut, red lentil (masoor  dal) flat bean.

●     Excess intake of dry, light and cold food

●     Excess intake of pungent, bitter and astringent food

●     Heavy weight lifting, improper lie or sitting positions

●     Suppression of urine, feces

●  Others: The situation commonly arises from long hours in uncomfortable car seats and an uneasy office chairs without proper back support, wrong postures, use of 6 - 8 inches high density  mattress, an inactive lifestyle, stress and lack of appropriate nutrition are some of the factors.

“Obesity and prolonged sitting increases the risk of sciatica”

Signs & Symptoms

●   Throbbing, aching, acute, dull, scorching, pressure, numbness, tingling, or shooting pain are common symptoms. Back discomfort is common, but leg issues (particularly the buttocks) are the most common complaint. 

●     Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of Sciatica.

●   Pain can be mild ache to a sharp burning sensation or excruciating discomfort. Sometimes it may feel like jolt of electric shock. It may be worse when you cough or sneeze.

●     Prolonged sitting also can aggravate symptoms

●     Usually only one lower extremity is affected

●     Tingling or a pins and needles feeling, often in your toes or part of your foot.

●     A loss of bladder or bowel control

●   Pain that feels better when patients lie down or are walking, but worsens when standing or sitting

●     Sciatica symptoms vary based on where the compressed nerve root is located. For example:
-L4 nerve root sciatica symptoms usually affect the thigh. Patients may feel weakness in straightening the leg, and may have a diminished knee-jerk reflex.
-L5 nerve root sciatica symptoms may extend to the big toe and ankle (called foot drop). Patients may feel pain or numbness on top of the foot, particularly on the "web" of skin between the big toe and second toe.
-S1 nerve root sciatica affects the outer part of the foot, which may radiate to the little toe or toes. Patients may experience weakness when raising the heel off the ground or trying to stand on their tiptoes. The ankle-jerk reflex may also be reduced.

●   Numbness in one limb, difficulty in balancing

 “Always keep the spine erect and maintain a healthy posture”

Risk Factors

• Repeated lifting
• Participating in weight-bearing sports
• Poor posture
• Obesity
• Smoking
• Sedentary lifestyle

Diagnosis

Usually self-diagnosed

History of trauma, exposure to damp or cold, splinter control, and history of previous attacks.

Ask about your medical history. They will likely ask about the type, location and duration of symptoms, presence of weakness, any current therapy, questions regarding your family medical history, and if your symptoms have caused you to miss any work.

Perform a physical examination. Your caregiver may test you for weakness, numbness, or tingling in your back, buttocks, and legs through a series of exercises and reflex exams.

Blood Tests. You may need blood taken to give your doctor information on how your body is working.

Give you an X-ray. X-rays are far less expensive than any additional testing you may receive. However, they can not produce an image for much other than broken bones, or very severe spinal deficiencies.

Give you a Magnetic Resonance Imaging (MRI) test. An MRI machine is also used to take a picture of your lower back. This picture will be used to check for problems and changes in your backbones, nerves, and discs.

Electromyography (EMG). An EMG tests the function of your muscles and the nerves that control them. The testing is done while your muscles are resting, and during activity.

Computed Tomography (CT) scan. A special x-ray machine uses a computer to take pictures of your lower back. It may be used to look at your bones, discs, and nerves. You may be administered a radioactive dye in your IV to help improve the pictures.

Special signs-

●     SLR test- Restriction of straight leg raising is usually much more marked in lesions affecting the nerve roots. SLR test gives a useful indication of the severity of the sciatica, and increased capacity for painless SLR is objective measure of improvement.

●     Tenderness of nerves.

● Intensification of pain in back and leg during rotator Extension of lumbar spine very suggestive of ruptured disc.

●    Popliteal compression Radiating pain can often be aggrieved by pressure over the course of the tibial nerve through the popliteal fossa. It is an additional finding in Favour of root compression.

●     Muscle power in lower limb tested against resistance.

●     Knee and ankle jerks when L4 root is involved knee jerk is depressed. L5 root lesion both knee and ankle jerks usually brisk but there may be weakness of dorsiflexion of the toes.

●    Tone and size of gluteal muscles judged by asking patient to contract  both buttocks, marked wasting may be clearly visible.

●     Sensations Impairment of perception of pin-prick commonly found in dorsum of foot

●     Rectal examination in older patients.

 "Sciatic endometriosis also called catamenial or cyclical sciatica is a sciatica whose cause is endometriosis and whose incidence is unknown. Diagnosis is usually made by an MRI or CT-myelography."

Neurological testing

●     L4,5, S1,2 hamstrings— flex knee against resistance

●     L4,5 tibialis posterior— Invert plantar- flexed foot

●     L4,5 tibialis anterior— Dorsiflex ankle

●     L5,S1 extensor digitorum longus— Dorsiflex toes against resistance

●     L5, S1 extensor hallucinate longum— Dorsiflex hallucinate against resistance

●     L5,S1 peroneus longus & brevis— Evert foot against resistance

●     S1 extensor digitorum brevis— Dorsiflex hallucinate (muscles of foot)

●     S1,2 gastrocnemiu— Plantar flex ankle joint

●     S1,2 flexor digitorum longus— Flex terminal joints of the toes

●     S1,2 small muscles of foot— Make sole of foot into a cup.

●     Imaging of spine

●   Straight X-rays for detecting disc narrowing in lumbar spine, or lesion of sacroiliac or hip joint.

●     Myelography to localize level of disc protrusion and to differentiate from tumours

●     Magnetic  Resonance Imaging (MRI) useful in assessment of root lesion

●     Computerized tomography (CT scan)- may help diagnose piriformis syndrome.

“Sciatica may be the first symptom of spinal caries”

Lifestyle

Tips for software professionals to avoid back pain and Sciatica:

●     Select a correct chair with a relatively straight back and good lower back support. Or can keep cushion or rolled up towel to support the back.

●     Correctly positioned the chair, keyboard and monitor. Feet should be on the floor, with knees at hip level, forearm should form a right angle with upper arm and the computer should be at the eye level.

●     Adapt a relaxed, upright working posture and allow a chair to support.

●     Avoid slouching forward or leaning back too far.

●     When you are at work stand up, walk around, stretch forward, backward and side to side once in 30 minutes.

●     Increased stress and strain enhances the chances of back pain. Hence remember to relax!

●     Take a break from constant sedentary work and stretch your back. Walk 20 paces after every 20  minutes of sitting in one particular posture.

●     Avoid long distance travel on jarring vehicles, do not wear tight outfits.

●     Wear good comfortable footwear. Do not wear high heel. Use Cushioned soles while walking.

●     Avoid too much bed rest can lead to stiff joints and weak muscles which can complicate your recovery.

●     Use a stool under your feet while sitting so that your knees are higher than your hips.

●     Place a small pillow or rolled towel behind your lower back while sitting or driving for long periods of time.

●     If you drive a long distance, stop and walk around every hour. Bring your seat as far forward as possible to avoid bending.

●     Do not lift heavy objects just after a ride

●     Drink sufficient water to cleanse the system

●     Avoid using low density mattress. Sleep on a firm mattress

●     Dry friction bath every morning and sun baths taken every alternate day.

“Stress and back pain are interconnected”

Exercise

●     Go near the wall, move your right leg at the back 5 times, repeat the same on the other side.

●     Butterfly exercise, sit on the ground hold the feet with the hands and move both the legs from the hip joint.

●     Moving both the ankles in both the directions and in full circle ten times

●     Contract and relax knee Joint ten times

“Daily practice of Yoga helps to keeps the spine flexible”

Yoga

Regular practice of Hatha yoga can help to correct poor patterns of posture that created the tiny injuries which lead to back pain.

Makarasana (Crocodile pose)

●     Lie flat on the stomach and raise the head and shoulders .

●     Relax the whole body and close your eyes.

●     Maintain the natural and rhythmic breathing.

●   Awareness on the breathing process with concentration on the lower back and relaxing the whole body.

Bhujangasana  (Cobra pose)

● Lie flat on the abdomen with the legs straight, feet together and the soles of the feet uppermost.

●   Place the palms of the hands flat on the floor below and slightly to the side of the shoulders. Fingers together and pointing forwards.

●     Rest the forehead on the floor.

●     Slowly raise the head, neck and shoulders, raise the trunk as high as possible.

●     Use the back muscles more than the arm muscles.

●     Arch the back, tilt the head back. Pubic bone remains on the floor. Naval raised to a maximum of 3 cm

●     To return, slowly bring down head. Relax the lower back muscles. Inhale while raising the torso, breath normally in final position, exhale while lowering the torso.

●     Awareness Breath with the movement and the smooth, systematic arching of the back.

Tadasana (Palm tree pose)

●     Stand with the feet together 10 cm apart with arms by the sides

●     Raise the arms over the head, interlock the fingers and turn the palm upward

●   Place the palm on the top of the head. Fix the eyes at a point. Inhale and stretch the arms shoulders and chest upwards. Raise the heel coming up onto the toes. Stretch the whole body from bottom to top, without losing balance. Hold the breath and the position for a few seconds.

●     Lower the heels while breathing out and bring the hands to the top of the head.

●     Relax for a while and repeat the practice 5-10 rounds.

●    Awareness on synchronisation of breath with body movement, maintaining balance and stretch of the whole body.

Shalabhasana (locust pose)

●    Adopt the position of the advasana.(lying down stomach touching the floor)  Raise both the hands and feet upwards.

●     Hold the breath and leg in the final position.

●    Awareness Synchronisation of breath with the leg movements as well as on  the lower back muscles.

Sarpasana (Snake pose)

●     Adopt the position of the Advasana. Place the chin on the floor.

●     Interlock the fingers and place the arms and hands on the back at the level of spine. Chin on the floor, using the back muscles raise the chest from the floor and push the hands further back and raise the hands as high as possible without straining hold for comfortable time  and slowly return to the advasana and relax the body.

●     Inhale prior to raising the chest; retain the breath while raising and in held position and exhale while lowering down. Practice for two three times.

●     Awareness On the breath and contractions of spinal and arm muscles.

Marjariasana (Cat stretch pose)

●   Sit in vajrasana, raise the buttocks and stand on the knees. Lean forwards and place the hands flat on the floor beneath the shoulders and fingers facing forward.

●     Thigh perpendicular to the floor is the starting position.

●     Inhale, raise the head and depressing the spine, back becomes concave.

●     Exhale ; lower the head and stretching the spine upward. Practice for 5-0 rounds.

● Awareness On the breath, mental counting and the stretching sensation around the shoulders.

●     Relaxation in

Shavasana (Corpse pose)

●     Lie down on the spine with the arms and legs slightly apart, palm facing upwards.

●     Eyes and lips gently closed. Head, neck and spine straight in a line.

●     Relax the whole body and stop all the physical movements.

●     Awareness in the natural breath as well as on the relaxation  in the whole body.

Advasana (reversed corpse pose)

●     Lie on the stomach. Stretch both arms above the head with the palms facing downwards.

●     The forehead should be resting on the floor.

●     Relax the whole body, become aware of natural breath and allow it to become rhythmic and relaxed.

●     This Asana acts as a base position in the most of the recommended practices of backache.

●     Awareness On the breath and relaxation in the whole body. 

●     Visualisation of tight, congested back muscles relaxing, letting go of tension and flushing the area with fresh blood.

●     Pranic energy is visualised flowing into the back muscles in conjunction with the breath.

“Correcting your posture can get rid of this problem”

Knee to Chest Stretch Pose

Oiling feet  every day is very beneficial. It relieves sciatica and other Vayu elements

Pranayama

Nadi Shodhana Pranayama

●     Sit comfortably with your spine erect and shoulders relaxed. Keep a gentle smile on your face.

●     Place your left hand on the left knee.

●     Place the tip of the index finger and middle finger of the right hand in between the eyebrows, the ring finger and little finger on the left nostril, and the thumb on the right nostril.

●     We will use the ring finger and little finger to open or close the left nostril and thumb for the right nostril.

●     Press your thumb down on the right nostril and breathe out gently through the left nostril.

●     Now breathe in from the left nostril and then press the left nostril gently with the ring finger and little finger.

●     Removing the right thumb from the right nostril, breathe out from the right.

●     Breathe in from the right nostril and exhale from the left. You have now completed one round of Nadi Shodhan pranayama.

●     Continue inhaling and exhaling from alternate nostrils.

Bhramari: Breath in till the lungs are full of air.

●     Close the ears with thumb and eyes with the middle fingers.

●     Press forehead with both the index fingers lightly close the eyes

●     Then press the eyes  and nose bridge with remaining fingers. Concentrate on Ajna Chakra.

Acupressure

Stimulation- With the help of thumb or fingers Press the point for 2 minutes.

Leg- Press the midpoint of calf muscle at the back of the leg for 2 minutes.

Marma

Kshipra Marma

●     These are four in number 2 in hands and 2 in legs.

●     Location : Kshipra  marma is located at the web space of thumb and index finger of both the hands and legs. By applying pressure  about 15-18 times this Marma can be stimulated. It is a ligament type of marma.

●     Stimulation : On dorsal side of hand, thumb should be at right angle to the index finger. Pressure is applied in between the web space with the help of thumb and fingers supporting from down.

●     In leg bend the toe, separate the first finger and pressure is applied in between the space with help of thumb.

Kukundara marma

●     These are 2 in number. Stimulation of this marma provides energy to lower extremity.

●     Location: Present at the sacroiliac joint, that is the meeting point of vertebral column and pelvic girdle. It is located at the region of belt,

●     Stimulation: Sit in sukhasana, press with thumb at the back. Pressure is given 15-18 times.

Katika Tarun marma

●     Stimulation: By sitting in vajrasana over heel. Or it can also be stimulated with thumb.

Gulpha marma

●  It is a non- medicinal approach that stimulates the nerve of whole lumbo sacral plexus and provide relief from backache in the fastest manner.

●     Location: It is present at the lateral aspect of lateral Malleolus 2 in number. It is located at the ankle joint.

Mudra

Vayu Mudra

●   Formation- Index finger tip is to be placed at the base of the thumb and the thumb is to be placed on the back of the index finger gently. Other fingers are to kept be straight.

Apana Mudra

●     Formation - Tip of the thumb is to be joined to the tip of the middle and ring finger. Apana Vayu is concern with the expulsion of body wastes, and keeps the body clean.

Chakras

 Solar plexus Chakra or the Manipura Its a third chakra.

Location - Solar plexus below the diaphragm. It affects the lower back, the sympathetic nervous system.

Meditation

Concentration on Manipura chakra while meditating

Color Therapy

Blue light for instances, have been known to  provide permanant relief in cases of sciatica and inflammation.

Diet

●     Food that are easily digestible and do not make gas are good

●     Wholesome diet In Sciatica

●     Kulthi (horse gram), wheat, red rice

●     Amla, Pomegranate, Raisins

●     Drum stick, Patola or Parwal (snake gourd)

●     Milk, Ghee, sesame oil

●     Meat soup

● Pain relieving spices: Ginger, clove, methi seeds, cinnamon, turmeric, garlic, black pepper, kalonji.

●   Eat healthy food which is rich in fibre. Avoid sweets, soft drinks and overeating to reduce the chances of weight gain

●     Eat easily digestible warm food and drink warm water

●     Take nourishing foods that balances Vata.

●     Eat all items lubricated with oil or ghee

●     Drink hot water with your meals in a proper amount.

●     Drink milk with dates.

●     Hot milk with turmeric and cardamom at night.

Avoid

●  Avoid gas forming foods such as urad dal, chana rajma, lobia, peas, potato, Arvi, lady’ finger, cabbage, cauliflower.

●     Avoid rice

●     Avoid frozen and preserved foods, Vata body type needs freshness.

●     Do not skip the meals

●     Avoid cold drinks, raw vegetables Uncooked food is not good for Sciatica.

●     Suppression of urges

●     Avoid heavy exercises

●     Avoid Day sleep and Sleepless night

●     Riding vehicles

●     Fast food, little food, starvation

●     Avoid prolonged sitting, standing and improper lifting.

●     Strenuous  stretching exercises

●     Curd, tomatoes, tamarind, shrikhand, amrakhand etc.

●     Avoid dry, cold foods

●     Avoid walking in cold air

●     Avoid drinking cold water

●     Avoid tea, coffee, sugar, white flour, pickles

Herbs

●  Guggulu: Commiphora wightii It has an anti-inflammatory property. Sciatica nerves become relaxed when there is an external application of the oil of the guggulu.

●   Jaiphal: Myristica fragrans or Nutmeg Coarsely powdered nutmeg is mixed with the oil of sesame seeds and fried until brown. This oil applied externally to obtain relief from the sharp pains of sciatica.

●   Kumari: Aloe vera It can be taken internally as well as used externally. The pulp of the leaf should be taken daily for obtaining relief.

●     Shallaki : Boswellia serrata The gum of shallaki is known to have anti- inflammatory property.

●     Rasna Alpinia galangal: Due to its anti- inflammatory property it is used.

●  Juniper: Juniper oil is used in the massage therapy of sciatica.The oil is massaged with firm pressures on the leg and thigh muscles to reduce pain.

●     Babunah : Bitter chamomile  A compress of its flower is prescribed for the treatment.

● Willow bark It contains salicylic acid  and  was widely used for pain relief. Aspirin was originally synthesized from willow park.

●     Ginger and Turmeric have anti- inflammatory properties.

●   Chebulic myrobalan (Harad): Take a small piece of fruit after every meal as it is quick back pain relief provider.

●     Night jasmine: 

    The fresh juice of the leaf of Nyctanthes arbor- tristis is given in a dose of 5 – 10 ml to treat sciatica. Or eat Parijat leaves 10 leaves for 10 days or decoction of the paste of 10 leaves boil in a glass of water till it is half. Drink it in empty stomach for few days. An effective remedy for Sciatica.

Home Remedies

●   Garlic 2-3 garlic cloves should be eaten in the morning. Or take garlic milk at night. Milk is prepared by adding the pulp of the crushed garlic in buffalo milk. 4 cloves to 110 ml of milk and boil.

●  Ginger Honey tea: It has mild aspirin like effect. Place ginger in boiling water for 30 minutes, after cooling add honey to it and drink.

●    Khas khas grass: Prepare a mixture with sugar candy, to be taken twice a day with a glass of milk.

●   Lemon is a natural remedy for back pain. It is sour in taste but it’s reaction in the body is alkaline

●     Raw potato in poultice form is effective in backache cure

●     Mint oil Take mint oil and massage the back with it

                                                                  "Consult a Spine specialist."

Prevention

Knee Elevated Bed Wedge Pillow for sciatica

●  The incidence of spinal problems will be greatly reduced when those following sedentary lifestyle, unused to back exercise or strain, learn to practice a few yogic asana daily to preserve strength and flexibility of the spinal muscles, discs and ligaments.

●   Avoiding  excessive use of chairs and backrests which weakened the back muscles and leaning to lift a heavy weight from the floor correctly - that is, from the squatting position with knees bent, so as to protect the vulnerable lower back from excessive strain and injury will also preserve a healthy back.

Treatment

Treatment of lumbar radiculopathy may reduce pain and swelling, improve your ability to walk, and allow you to do your normal activities.

Use of back supports, medication, physical therapy, steroid injection in the spine, and even surgery.

Allopathy

Advise:

●     Weight reduction

●     Strengthen lumbar area muscles and tendons, you can bring back its weekend elasticity

●     Avoid salt in your dinner, or particularly painful days.

●     To avoid bending and twisting from the back, and lifting of heavy weights.

●     Avoid sitting for long periods of time (sitting puts more strain on back than standing)

●     Lumbar corset to be used all day long.

Acute stage-

●     During acute pain any movements are avoided

●  Complete bed rest on firm bed with cotton mattress for 2-3 weeks. Back supported by a hardboard.

●     Rest must be absolute and in no case, the patient should assume sitting position.

Medicines

• Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor’s order, but should only be purchased as the result of a doctor’s recommendation.
• Muscle relaxers may be used to decrease pain and muscle spasms.
• Opioids are a strong medicine given to reduce severe pain, but will only be prescribed for extreme cases.
• Oral steroids can be used to reduce swelling and pain.
• Steroid injections may be given through a needle into your lumbar spine. This may help decrease your nerve pain and swelling, however, you may need more than one to show signs of improvement.

• Physical therapy: Your physical therapist may teach you certain exercises to improve posture, flexibility, and strength in your lower back. They may also teach you how to remain safely active and avoid further injury. 
• Swimming & Water workout for pregnant women : What's more, many pregnant women report that water workouts help ease swelling in their swellings in their legs and feet and relieve sciatica pain
• Transcutaneous electrical nerve stimulation: This treatment, called TENS, stimulates your nerves and may decrease your pain. Wires are attached to pads and then attached to your skin, then the wires send a mild current through your nerves.
• Surgery: You may need surgery to relieve a pinched nerve if your condition has not improved within 4 to 6 weeks.

●     Analgesic + Muscle relaxant  If muscle spasm and pain very severe

●     Inj. Diclofenac 75 mg IM

●     Pain relievers orally ibuprofen, Aspirin, ketoprofen, Acetaminophen.

●     Injection of 2% lignocaine into the sciatic nerve

●     Steroid injections

● Muscle relaxant Tab Mobizox or Spontrel,  three times a day after meals. Methocarbamol (Robaxin), Cyclobenzaprine (Flexeril), Metaxalone (Skelaxin), Tizanidine (Zanaflex), Baclofen, Oxazepam

●     Antacid gel, Gelusil MPS one tablespoon along with each meal.

●     Rubefacient cream voveran gel or move

●     Hot fomentation

Sciatica due to herniated intervertebral disc-

●  Conservative treatment Complete rest in bed in supine position with only one pillow for 3-6 weeks. When pain is relieved, plaster jacket to immobilize the lumbar spine completely for 3-6 months. After this the jacket is removed and a lumbar corset worn at all times during the day.

●     Local heat application- Hot water bottle on your lower back for a couple of days.

●     Infrared rays or hot fermentation to the back twice a day

●   Epsom salt helps to reduce swelling thereby relieving back pain. Two cups of salt should be mixed in water in bathtub and the patient should soak in it  for 30 minutes.

●     Chiropractic care includes massage of the foot.

Physiotherapy: and back exercises

●     Most people with sciatica get better in a few weeks  without surgery

●    A complete bed rest for 24-48 hours relieves back pain in most of instances. Walk a little, every few hours to keep the blood flowing and the muscle toned.

●   Electrotherapy electric heating pads are used, ultrasound therapy and interferential therapy is prescribed.  Most heat therapies are also advised.

●   If sciatica symptoms are severe or become progressively worse, then immediate referral to a specialist is necessary.

●   Surgery- If your pain lasts for more than 3 months, See your doctor immediately. Or  if your sciatica causes severe pain and weakness, numbness, loss of bladder or bowel function and significant neurological deficit.

●   Operation consist of hemilaminectomy, removal of the protrusion, and curettage out nucleus material from the central part of the disc. It is the most effective cure.

Naturopathy

●     Juice fast therapy- detoxification of body for curing purpose.

●     If the disease is acute, the patient should adopt a raw juice diet for at least five days.

●  In this regime, he should take juices of fresh fruits and vegetables such as orange, apple, pineapple, pear, peach, carrot and beet every two hours from 8am to 8pm.

●     Warm water enema should be used daily during this period to cleanse the bowels.

●  Followed by restricted diet for about seven days. Breakfast- orange, mosambi, pineapple, or grapefruit. Lunch- fresh raw vegetables salad such as carrot, cabbage, cucumber, tomato and radish with lime juice and olive oil dressing and soaked raisins, prunes, figs or Dates. Dinner- fresh raw vegetables salads, or one or two vegetables steamed in their own juices such as spinach, cabbage, carrots, turnip and cauliflower. This may followed by few nuts or some fruits like apple, pear, plum or cherries.

●    After the restricted diet, the patient may adopt a well-balanced optimum diet like whole grain, brown rice, raw and sprouted seeds, buttermilk and cottage cheese.

●  Acupuncture The needles are inserted in a specific points and the blocked energy flow are restored. It is good for Sciatica..

●  Hydrotherapy- This therapy includes treating through various forms and temperatures of water. During acute pain hot pads or fomentation bags are advised. Hot (slightly more than 38-40 degree Celsius) water spinal bath treatment given. It  help in relaxing and reducing the stiffness of the muscles. The spinal bath treatment includes the whole back completely in water. It helps in relieving the pain to a great extent.

●     In neutral immersion bath, complete body parts are immersed in the tub with the head above the water level. This is a sedative and relaxing treatment. The water temperature is slightly around body temperature (35-36 degree Celsius)

Ayurveda

●     Bringing back the aggravated Vata or Vata kapha to the state of equilibrium and thereby to the state of health.

●     Panchakarma therapies

●     Dhanyamla Dhara Warm herbal liquid is poured from a hung vessel over the affected parts of the body.

●     Pichu Application of warm oil dipped cloth over the lower back on the area of L4 and L5 and S1.

●     Abhyanga swedam (massage followed by sedation) A whole body massage with specific herbal oils, followed by medicated steam bath. It achieves deepest healing effects by naturally harmonising body, mind, soul and the senses.

●     Pathrapotali swedam (Elakizhi) where Ela means leaf and Kizhi means bundle, is a type of sudation therapy using leaves. The most commonly used leaves are of tamarind, drumstick, Calotropis gigantica etc. which are chopped and mixed with lemon, grated coconut. This mixture is then fried in sesame oil and tired in a linen  cloth as boluses. It is then poured in a vessel  containing oil to heat the ingredients. Then, a gentle massage with warm boluses is given for about 10-15 minutes. On completion, the body is covered with a thick blanket and the patient is asked to take bath with hot water. This relieves body aches and stiffness.

●     Sarvangadhara (Pizhichil) or medicated oil bath

●     Kati Basti and Greeva basti (a treatment done onto the back to decrease spinal compression)

●     Navarakizhi Basti- the most important procedure in Ayurveda for curing Sciatica permanently. It is a rejuvenation therapy that is useful during convalescence period. This fomentation technique makes use of an indigenous variety of rice that has medicinal properties known Navara or Njavara. Pouches or kizhis are made of Navara rice that is cooked in cow’s milk along with certain herbs. Medicated oil is first smeared on the head and body of the patient, and the body is then massaged with these rice bags. The temperature of the kizhi is regulated depending on the tolerance capacity of the person. After the treatment the rice paste sticking into the body is removed and warm medicated oil is once again applied on the body. Finally patient is given a bath in moderately warm water.

●  Cleansing practices (Shankhaprakshalana) Constipation and impaction of feces are common with chronic back pain. The removal of all feces matter often brings pain relief. In this process 10-15 glasses of water is given to the patient to drink in the morning. In the evening light diet like khichdi is eaten.

●     Panchakarma treatment  

● Massage therapy The lighter massage movement relax the stiffened muscles. Massage with Dhanwantharam Thailam or Mahanarayana taila. Regular massage over the body by til or mustard oil is a good practice to keep the body fit. Do warm oil massage of the body at least once every week.

●     Applying Vata balancing oil like ksheerabala oil on affected region

●     Sitz bath or kati basti with warm water to improve the strength of surrounding soft tissue and bones.

●     Mild stream bath in the affected area

●     Enema with appropriate oil for 7 days

●     Lepa with Marma Gulika

●  Yograj guggul Two tabs, twice daily after meals, with plain water. Lakshadi guggulu, Triphala guggulu.

●     It is good to take Balarishta. Along with that Sindhuvara taila 20 ml, with warm sweeten milk on alternate days. Apply Prabhanjana taila on the body.

●     Pouring 2 drops of sesame oil in umbilicus.

                                            "Sciatica is a neuralgia of the Sciatic nerve. "

Varmam Points  

Uppukkutri, Viruthi, Komberi, Veer adangal, Poovadangal, Naga kaalam, Porchai, and Ulsoothiram Varma points are manipulated to relieve Sciatica problems.                         

Varmam Therapy for Musculo skeletal disorders

Low Back Pain : Radiating pain, numbness, muscle weakness etc depending on the severity of the disease. In varma texts Lumbar spine is referred as “Pooraga El” and any abnormality in Pooraga El is referred as “Pooraga El Isangal”.  The following 10 Varmam points are stimulated to achieve a therapeutic effect in the treatment of patients.

Varma points for the treatment of Lumbar Spondylosis & Lumbar Disc Bulge

Varmam Points                                  Location                                     Function 

 Varmam Points

1 . Idakalai & Pinkalai Energy Tracts

That Travel From Foot To The Low Back Region Through Viruthi, Komberi, To Reach Nangana Pootu Stimulation Of This Points Regulates The Energy In The Low Back Region And Reduces Pain 

2 . Porchai Varmam

Porchai Varmam                    In The Sub Occiput Medial To Mastoid Bone           Regulates The Pranic Energy After Varma Treatment 

Location : In the prominent region on the hind side of the skull.  2 fingers below the charidhi varmam

Helpful in : Improving the health, eye and ear disorders, weakness, strengthens memory.

Carrying an infant till he/ she grows, has its own technique which we follow even till date, this is by holding the neck and the shoulder in one hand. The infant's head is held in such a way that the neck is made  to rest in a place between the thumb and the index finger. The thumb and the index finger will be touching  the Penkuzhi Varmam or the Porchai  Varmam.

3 . Veera Adangal                       In The Semi Tendinous Tendon                                Relieves Knee Pain 

4 . Anna Kalam                         One Finger Above The Umblicus               Gives Energy To Lower Limb 

 5 . Poovadangal At The Junction Of The Thigh And Gluteus Relives Disc Compression, Sciatica 

POOVADANGAL Location: Near the ischial tuberosity Technique: Press with the center portion of the thumb over the point on both sides. Sustain the pressure on the point for 10 seconds. Afterwards press thundu varmam, mel mannai, keel mannai and uppu kutri.

6 . Komberi Kalam Middle Of The Leg Along The Medial Border Of Tibia       Enhances Energy To Walk 

KOMBERI KALAM Location: Eight fingers above the medial malleolus Technique: Place the tips of the middle three fingers over the point. Press three times (in a pumping motion) towards medial border of Tibia.

7 . Viruthi Kalam           At The Level Of Distal End Of First Meta Tarsal Bone       Strengthens Leg And Foot 

Stimulation  : Press with thumb 3 times than gap . Repeat for three times.(9 times)

8 . Mannai Adangal            At The Commencement Of Triceps Surae Muscle. Regulates Pranic Energy Flow In The Legs 

9 . Ullthodai Varmam        Middle Of Medial Aspect Of Thigh Strengthens The Leg 

10 . Mel Mannai  Between The 2 Heads Of Gastronemius Enhances Energy To Walk

MELMANNAI VARMAM Location: Upper end of the calf muscle (posterior aspect) Technique: Fix the middle finger at the point and press (Simultaneously the patient is asked to flex and extend the neck)

 

11 . Ullangal Vellai             Meeting Point Of Two Balls Of Sole Strengthens Leg And Foot 

Location : Centre of the sole of the foot.

Helpful in :Activating the energy in the body to make all parts of the body function effectively.

Stimulation : Place the thumb on the Varmam location and use upward pressure to stimulate the Varmam location. Do not press release action for five times. Repeat this thrice.

ULLANKAAL VELLAI VARMAM Location: At the junction of big and second toe in plantar region Technique: Place the tip of the thumb; press and release.

 

Ullengkal Vellai  Varmam 

Manipooraga Adangal Location: Five fingerbreadths below the umbilicus Technique: Fix the tip of the middle three fingers transversely on the point; gently press and lift upwards

                                         

KEELH MANNAI VARMAM Location: Lower end of the calf muscle (posterior aspect) Technique: Fix the middle finger and press

Kuthikal  Varmam Location: Seven fingerbreadths above the heel (posterior aspect) Technique: Place the tips of the middle three fingers over the point, press three times.

Kanpugaichal Varmam Location: One fingerbreadth below the lateral malleolus Technique: Place the tips of the three fingers of hand above the malleolus and glide downwards around the malleolus pressing the exact point.

Kalkulasu Varmam Location: Anterior part of junction of foot and leg. Technique: Place the central part of the thumb at the point described; press and release three times

Nanganapootu Location: Sacral Groove, Three Fingerbreadths From The Lumbosacral Joint (Lateral Aspect) Technique: Place The Middle Part Of The Thumb At The Point Described; i. Provide 3 Rounds Of External Rotation At The Sacral Groove ii. Glide Laterally To Reach Anterior Superior Iliac Spine iii. Finally Give Clockwise Rotation Using 3 Fingers On Anterior Superior Iliac Spine

Pulimuthadangal Location: Just above the nail of the big toe Technique: Fix the central portion of the thumb and apply deep pressure

Mudichu

No 30 Mudichu Varmam

Sara Mudichu Varmam

Back of head

Located between C7 &T1

Location: Prominence corresponding to C7 vertebra Technique: i. Place the middle three fingers over the prominence. Give pressure in a clockwise rotation for three times then stretch the fingers up to the right shoulder ii. Follow the same technique in the opposite side iii. Manipulate in a clockwise and anticlockwise rotation 3 times each and then stretch downwards along the spine up to the T6

Sciatica & foot drop Initially for first two days Kondai kolli, Porchai kalam Then 

 Kal Kulachu Kal kulachu 

 Ullangal vellai 

 Ukutri 

 Kuthikal 

 Padankal 

 Viruthi kaalam 

 Komberi kaalam

 Jadapiral 

 Poovadanga, should be activated daily

In  olden days that whenever hot water bath is taken , water should be poured from toe to head  and in case of cold water bath , the water should be poured from head to toe.

If yoga asanas (yoga postures) are properly practiced, it will result in good health. The basic reason for that is yoga asanas properly tunes the nerves system (along with varmam points present in the nerves system), resulting in regulated blood flow throughout the body.

Every yoga asanas has its effect on certain group of varma points enabling proper health, flexibility, mobility and physique. For example, if you consider Padmasana (one yoga posture), it produces mild pressure on these varmam points: Viruthi varmam, Kanpugaichal varmam, Ullthodai varmam, and Mulaathara varmam. Because of that, Iddakala (Left) and Pingala (Right) nerves gets tuned and strengthens the vertebral column. It increases concentration, memory, serenity on one's face, and etc.

Accupressure Points for Sciatica

Besides lower part of thumb.

points

“Say, goodbye to pains”

Link: https://madhuchhandacdmo.blogspot.com/2018/01/sciatica-slip-disc-lumbar-radiculopathy.htmlS

* Medicine as suggested above should only be taken under the consultation and supervision of registered medical practitioner.