What is sciatica?

Sciatica is pain which is referred to the back and outside of a leg due to a compression of the Sciatic nerve. The nerve is located in the lower back known as the lumbar and sacral region of the spine. It is made of L4, L5, S1, S2 and S3 nerve roots. The term sciatica can also be used interchangeably with other terms such as lumbosacral radicular syndrome, ischia, nerve root pain and nerve root entrapment.

What are the symptoms of sciatica?

Main symptoms of sciatica is pain which can feel sharp or achy radiating down a leg. Symptoms usually affect one leg, but in severe occasions can be present in both. However, it may also be accompanied with other symptoms such as:

• Tingling
• Pins and needles
• Lower back ache
• Loss of muscle strength (usually not very prominent)
• Loss of sensation in the area of pain (usually not very prominent)

What causes sciatica?

There are several conditions that can cause sciatica:

• Disc bulge – bulging disc can compress the nerve root causing sciatic symptoms. Most of the time disc bulge affects one side, however, if the bulge is central, it might compress the spinal cord and cause symptoms to radiate in both legs.
• Foraminal stenosis – is narrowing of the foramen due to arthritic changes. Foramen is the space on each side of the vertebra where nerve roots are coming out. Symptoms usually affect one leg.
• Piriformis syndrome – is the tightening or a spasm of piriformis muscle which is located under the glutei which are located at your buttocks. Piriformis spans the sciatic nerve, hence, when in spasm, can produce sciatic symptoms. It usually affects one side.
• Lumbar stenosis – is narrowing of the spinal canal where the spinal cord is located. Narrowing of the spinal canal will compress on the spinal cord and most likely result in symptoms in both legs.
• Spondylolisthesis – is a condition where one of the lumbar vertebra slips forward compromising the space of the spinal canal. This may result in sciatic symptoms being felt in both legs.
• Tumours/malignancies – sciatica can also be caused by an abnormal tissue growth in the spine area. It might affect one or both legs.

How can I treat sciatica pain?

First, treatment depends on the cause of your sciatic pain. For the majority of cases where only one side is affected conservative, a non-operative approach is recommended such as physiotherapy, osteopathy, massage, acupuncture and more. Most of the time it produces very good outcomes, however, in cases where symptoms radiate in both legs or when conservative treatment is unsuccessful, minimally invasive operation is needed.

In other words, according to the cause and the severity of your pain your therapist will tailor the best treatment for you.

What operation is available for sciatica?

There are two most common operations performed to treat sciatica:

• Diskectomy – is the procedure where a surgeon removes a portion of the intervertebral disk which is pressing onto the sciatic nerve causing symptoms. Operation is usually performed under a general anaesthetic. Recovery time after the surgery usually varies between 1 – 4n weeks.
• Laminectomy –is the procedure where a surgeon removes/shaves off the back of the vertebrae to increase space of the spinal canal and remove the nerve compression. Operation is usually performed under a general anaesthetic and recovery time varies from few days to several weeks.

How long does it take for sciatica to go away?

Symptoms usually affect one leg, but in severe occasions can be present in both.

Healing time very much depends on the cause of the sciatica. If you have symptoms radiating in one leg and they are not caused due to a serious condition, it is likely that your symptoms will improve significantly within 4 – 6 weeks. If your sciatica is caused due to a more serious condition, it might take several months for full recovery.

What to avoid if I have sciatica?

Try to avoid anything that exacerbates the symptoms. You might still be able to do some form of exercises, but the exercises must be prescribed by a qualified healthcare professional such as an osteopath, sports therapist or physiotherapist. The list of activities to avoid can include:

• Heavy lifting.
• Excessive bending of the lower back.
• Bed rest.
• Certain exercises.
• Being sat for long periods of time.
• Sudden twisting and turning.

Keep in mind…

Click here to stretch your sciatic nerve. It will help you to keep pain away!

We hope this information is useful. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always glad to help. If you like this blog, please share!

We are always happy to help!

 References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895638/pdf/bmj-334-7607-cr-01313.pdf 

https://my.clevelandclinic.org/health/diseases/12792-sciatica

https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435#:~:text=Sciatica%20pain%20can%20be%20almost,a%20jolt%20or%20electric%20shock

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What is a pudendal nerve?

It’s a nerve that runs from your pelvis to the genitalia where it forms branches of other nerves. It sends sensory information to the brain from the lower buttocks and the area between the buttocks and genitalia, area around the anus and rectum, vulva, labia majora and clitoris in women, and scrotum and penis in men. This nerve is also responsible for the control of anal sphincter and urethral sphincter muscles, which opens and closes during the bowel movement and urination respectively.

What is pudendal neuralgia?

Pudendal neuralgia is a painful and long lasting condition.  The compression or damage of the pudendal nerve causes it.

What causes pudendal neuralgia?

Some causes of Pudendal neuralgia are:

• Giving birth.
• Pudendal nerve compression which can be caused by muscle or cancerous or non-cancerous tissue growth next to the nerve.
• Prolonged sitting including cycling and horse-riding.
• Broken bone of the pelvis.
• Surgery to the pelvis area.

There are some cases where the cause of pudendal neuralgia can not be determined.

What are the symptoms of pudendal neuralgia?

There are several symptoms that you may experience if you have pudendal neuralgia. However, symptoms and the intensity may vary depending on the cause of the condition. Most common symptoms are:

• Pain which might feel like burning, prickling, shooting or crushing situated around the lower buttocks, anus and genitalia.
•  Pain can be intermittent or constant, however, the intensity may vary throughout the day with pain being at its worst while sitting and ease off while lying down or standing up.
• Symptoms can build up gradually or suddenly.

There are a number of other symptoms that can be associated with pudendal neuralgia.

• A sensation of a foreign object around the area between the anus and genitalia. Usually, people describe it as having a tennis sized ball.
• Pins and needles or numbness in the pelvic area.
• Sudden or frequent urges to go to the loo.
• Heightened sensitivity to touch to the point where wearing clothes can irritate the area and exacerbate the pain.
• Painful sexual intercourse, erectile dysfunction in men and difficulty achieving orgasm.
  

What is the treatment for pudendal neuralgia?

Conservative treatment is usually the primary approach to treat the pudendal neuralgia if the nerve compression or damage is not severe. In addition, you should seek medical help as soon as possible if you have constant pelvic pain. As a result of an early stage treatment you may have more effective results.

Treatment can include avoiding anything that makes it worse, for example: wearing loose clothing, managing your time sitting down, avoiding cycling or other activities which places stress on the pelvic area. 

Besides, physiotherapy, behavioral therapy,  osteopathy and sports therapy are an option, too because a specialist can teach you on how to loosen the pelvic floor muscles and apply some articulation techniques which can ease off the symptoms. 

These approaches can be combined with pain medication or you should see a pain management specialist if you have been suffering from pudendal neuralgia for a long time and if pain has a negative impact on your mental health and the quality of life.

Is treatment of pudendal neuralgia invasive?

As mentioned in the previous section, most of the time treatment of pudendal neuralgia is conservative. However, when conservative treatment fails then health practitioners consider invasive procedures. 

They will offer you a nerve stimulation where a small device is surgically placed under your skin. The device sends electrical impulses to the nerve which help to block the pain signals from reaching the brain.

They may suggest steroid injections and local anesthetic. They can help alleviate the pain for a few months at a time. 

Pudendal nerve decompression operation can also be performed if there is some form of tissue that is compressing the nerve.

How long can this condition last?

This is a very personal experience for everyone suffering from pudendal neuralgia. If it has been caught and addressed early, it might take several weeks for the symptoms to improve significantly. If conservative treatment did not work and you had to have an operation, it might take anywhere between 6 months to a few years for full recovery.

Can I exercise with pudendal neuralgia?

In short, yes you can. However, ensure to consult a healthcare professional regarding the type of exercises and the exercise intensity. Generally, avoid cycling, horse-riding and other sports that involve sitting or placing excessive strain on the pelvic area. Some specific pelvic floor, Pilates or yoga exercises may also help to alleviate the symptoms.

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

References:

http://pudendalhope.info/sites/default/files/NantesDiagnosticCriteria.pdf 

https://www.pudendalhope.info/sites/default/files/Hibner.pdf 

The post Numbness, pins and needless, pelvic pain: Pudendal neuralgia appeared first on Perea Clinic.

There are quite a few reasons for tingling sensation in your hands or fingers. Most of the time it is trivial caused by nerve compression because of too much time spent in one position. However, there are more serious conditions which may cause the same or similar symptoms and they cannot be ignored. The list below will briefly explain the most common reasons:

Raynaud’s syndrome:

It is the phenomenon where the small blood vessels known as capillaries are being constricted, restricting the blood flow into the toes and fingers. This might occur due to cold weather or stressful situations. Symptoms may also include pain, pale skin and numbness.

Thoracic outlet syndrome:

Condition where blood vessels and nerves are compressed between your collar bone and the first rib. The compression usually affects both sides, but it is not unusual to experience the symptoms on one side. 

Cervical radiculopathy:

It is the compression of nerve roots coming out from the cervical spine, the neck. The compression could occur due to a few reasons such as disc prolapse, spinal stenosis which is the narrowing of the spinal canal or spondylosis, which is the arthritis of the spine. Alongside tinging you might also feel shooting pains down the arms, weakness, numbness and loss of sensation. It usually affects one side.

Muscle tension:

It is one of the causes of tingling in your hands and fingers. It usually occurs due to overuse of the neck and upper back muscles or spending too much time in poor posture.

Stroke:

Stroke may cause sudden tingling in one or both arms. It is usually associated with other symptoms such as slurred speech, fallen one side of the face, inability to move your arms, severe one sided headache and sensation of strong heat. This is a medical emergency that needs immediate attention and medical advice of a professional.

Diabetes mellitus:

It can result in feeling tingling sensation in hands and feet because of nerve damage which occurs due to high blood sugar levels.

What to do when I have tingling in fingers and hands?

Occasionally all of us can experience tingling and numbness in our hands, arms and fingers. Most of the time is due to spending too much time in one position. If that is the case, symptoms usually subside within a few minutes.

However, if the onset was spontaneous and your symptoms are not getting better or are worsening, you should see a qualified healthcare practitioner. Check This Out to know the best childcare specialist who is near your neighborhood.

What treatment is available for tingling in hands and fingers?

This very much depends on the reason behind your symptoms. For example, if you have diabetes or Raynaud’s disease, you will have to be medicated. The type of medication will depend on the severity of the disease.

If you have thoracic outlet syndrome, muscle tension or cervical neuropathy, the symptoms can be managed conservatively with exercises and manual therapy. However, if conservative treatment is not effective, there are some invasive procedures which can be considered.

If you think you are suffering a stroke, you must call 999 immediately!

Can I exercise if I have numbness in fingers?

The ability to exercise with tingling in your hands and fingers is determined by the diagnosis. Most of the time medical careers will advise you to be as active as you can, however, in some cases, the activity levels may be limited. 

Will tingling in my hands and fingers go away?

Most of the time with appropriate Neurological Physiotherapy treatment tingling can be stopped or reduced to the minimum where it does not have a significant impact on your life.

Will I need an operation if I have tingling in my hands and fingers?

Operation can be considered when there is spinal stenosis or cervical radiculopathy caused by spondylosis or other abnormalities which do not respond to conservative treatment approaches. Most common procedures are trimming or removing the disc bulge, shaving some parts of vertebrae or increasing the spinal canal space with an aim to stop the nerve compression.

We hope this information is useful. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always glad to help.

The post Tingling in hands and fingers appeared first on Perea Clinic.

Unsurprisingly, many employees suffer chronic pain to the wrist related to time spent on the computer.

In fact, if you stop to think just how much time you spend in front of a screen, it may shock you. According to an article in the Independent, it can be as much as 1,700 hours a year!

Then, when you think about how many times you click your mouse, it gets serious. On average, about 5,000 times per day. It may require only a little effort per click, but it can be the hidden source of many problems.

Computer-related wrist pain

Wrist pain related to working at your computer

One of the most common conditions found in an office environment is Repetitive Strain Injury (RSI). The consequences of all this repeated activity can be surprisingly debilitating.

Repetitive Strain can have an impact on different parts of the body. As well as the wrists, it can cause problems in the fingers, elbows or even spread into the back.

It’s a result of these repeated movements causing inflammation and damage to soft tissue. This soft tissue includes muscles, nerves and tendons.

How to spot RSI

When you start to recognise symptoms of RSI you should take them seriously. Sticking your head in the sand is a bad strategy. If things feel ‘not quite right’ look into getting it sorted out early.

That being said, what symptoms should you look out for?

• Shooting pains in the wrist
• Numbness or weakness especially when using the mouse
• Sensing that the hands feel cooler or colder than normal
• Increased difficulty using the wrists for everyday activities like cutting vegetables

If you have noticed any of the above, or anything similar, get some expert advice.

Treating chronic wrist problems

As so often, the goal is to try to mitigate potential problems before they get serious. If you are office-bound, and your wrist pain is computer related, you need to become aware of your rights. Companies are legally obliged to give you breaks away from your computer.

Also, you are legally entitled to a Display Screen Equipment (DSE) assessment. Make sure you take full advantage of both.

Time away from your computer should be just that. Preferably you won’t be scrolling through your smartphone either. Your wrist needs a complete break.

But if you do suffer from worsening wrist pain, there are various things you can do depending on the severity. You may need to consider surgery or steroid injections if the symptoms are severe. However, there are many steps you can take before that.

One of the best things to minimise mild wrist pain is to up your daily levels of exercise. Simple things like walking can help alleviate symptoms. And swimming can be hugely beneficial.

Treatments with cold-packs or anti-inflammatory medication such as Paracetamol can be very useful.

But for a thorough investigation of the problem, and a complete course of rehabilitation, consider the following; –

• Physiotherapy
• Osteopathy
• Massage

If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help.

We hope this information is useful. If you like it, please share! 

The post Computer Related Wrist Pain – possible causes and treatments appeared first on Perea Clinic.