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Sciatica

Sciatica is described as pain, numbness or tingling in the leg due to compression of the sciatic nerve. The sciatic nerve runs down the back of each leg from the lower spine. The pain associated with sciatica can range from dull ache to excruciating pain that makes movement difficult. The pain may be felt in the buttock, down the back of the leg, below the knee and in the foot.


Causes of sciatica


  • Disc herniation
  • Pelvic fracture
  • Spinal tumors
  • Pelvic injury
  • Pain along one side of the body
  • Worsening in cold weather
  • Osteoarthritis causing pressure on the sciatic nerve

A physical examination along with checking of reflexes on bending, lifting the leg etc are done. X-ray and MRI might be done. Typically sciatica is indicative of another medical problem; which must be attended to. NSAIDs and ice packs provide relief from the pain. Lifting of heavy objects and strenuous back bending are to be avoided. Physical therapy, massage therapy and stretching exercises might help in tackling chronic sciatica.

Physiotherapy

Physical therapy also known as physiotherapy, includes evaluating, diagnosing and treating numerous disorders and disabilities through the physical way. This branch of medicine helps people restore, retain and maximize their strength, function, movement and overall well-being.

People who practice this branch of therapy are called physiotherapists. Diagnosis, treatment and rehabilitation of patients are their main areas of work. They primarily work with physical disorders and disabilities. Physiotherapy helps a person


  • Become flexible
  • Improve mobility
  • Reduce pain
  • Stay active
  • Prevent injury
  • Recover from injury

Physiotherapy helps the human body to remain functional. Physiotherapy is recommended when the human body suffers some physiological trauma. During physiotherapy the patient is examined physically and if required imaging studies are carried out so as to decide the right type of therapy. It is recommended in the following conditions:



Heat therapy: Heat therapy improves the blood flow to the injured area thus speeding up healing. Heat therapy also loosens the tight tissues thereby relieving pain. Various heat treatments include ultrasound, hot pack, infrared heat, Paraffin wax bath, Diathermy

Cryotherapy: Cold therapy helps in minimizing the swelling and pain. It is very useful in acute injuries. Various treatments include ice massage and ice pack application

Strengthening exercises with Physical Therapy: Certain conditions may have caused the muscles to weaken, there are certain types of exercises aimed at strengthening the muscles thereby helping rehabilitation and improving performance.

Range Of Motion exercises: ROM exercises help in improving and maintaining the flexibility of joints. They also help in reducing the stiffness of the joints. Various exercises include:

Passive Range of Motion exercises: (PROM)

Active Range of Motion exercises: (AROM)

Active Assistive Range of Motion exercises: (AAROM)

Soft tissue mobilization/Therapeutic massage:This relaxes the tight muscles thus relieving pain and reducing swelling

Electrical stimulation: This method is used to prevent muscle atrophy in people with paralysis. Electrodes are placed on the surface of the skin thus causing the muscle to shorten.

TENS: Transcutaneous Electrical Nerve Stimulation is a type of never stimulation wherein a low degree electrical current is passed through the surface of the skin to the affected part. This process helps in relieving pain momentarily.


Other types of physical therapy treatment include taping, bandaging, joint mobilization, ergonomic training, postural training, balance exercise, traction, fitting of orthosis, etc. Physiotherapy has various specializations like geriatric, pediatric, orthopedic, neurological, sports, cardiovascular and pulmonary.



Pain Patch

The applications of pain patches are increasingly becoming popular in contemporary medical care as it provides quick relief to reduce pain. The pain patches are attached on top of the skin through which epidermal absorption of the drug takes place. In most cases, pain patches are administered near the joints.


Composition of drugs in pain patches

The type of drug applied through a specific pain patch is very important as it indicates the clinical value of the drug, the applied patch, the duration of action and side effects associated with it. Pain patches are specific to each condition.


Cancer: Transdermal method of pain patch is used to control pain and discomfort caused due to an existing carcinoma. Fentanyl transdermal system is one of the most prominent drugs used in case of cancers. It contains anopioid drug with analgesic functionality. The pharmacokinetics of this pain patch system is that the drug binds to the opioid receptors of the brain and spinal cord in reducing the sensation and perception of pain. The drug fentanyl, which is coated on the pain patch, is kept for at least three days to attain maximum pain relief. The advantage experienced by the patient through this drug is that it also reduces the emotional perception of pain.

Fentanyl is administered to most of the oncogenic cases, however precautions and thorough examination of the patient history is essential in order to administer the drug through the pain patch. Certain underlying medical conditions such as head injuries traumas, low blood pressure and even the presence of gallstones can hinder the fentanyl incorporation as it can lead to adverse reactions. Lactating mothers are not advised to take this pain patch, as it would affect the baby's central nervous system. Certain antibiotics such as erythromycin, ketoconazole and chemicals such as barbiturates and anti-seizure medications can be a hindrance as they unite with the fentanyl causing adverse reactions to the patient, which may be fatal.


Arthritis: Pain patches used in case of arthritis mostly belong to the non-steroidal anti-inflammatory drugs. The drugs incorporated though the patches have a warming effect in the intended zone of pain or discomfort following a neuro signal is sent to the brain in blocking the pain perception at that respective zone. Salicylates, lidocaine patches and capsaicin are generally used. Most of these patches offer pain relief only for a period of 12 hours. Skin allergy and irritation are most common side effects.


Sciatica: This condition is also known as spinal disc herniation and most patients suffering with this condition experience a sharp and radiating pain. This kind of pain happens because of the nerve compression caused by a dis-positioned or herniated disc. In most scenarios magnetic and anesthetic pain patches are used in order to reduce the intensity of pain. The patches block the pain receptivity for shorter period of time.


Shingles: Zoster viruses cause shingles and they are very painful. In most cases Lidoderm a famous anesthetic drug is used to relieve pain. The drug is administered through the skin as a patch on a clearer part of the skin as broken skin can cause aberration when a pain patch is applied. Most of these Lidoderm pain patches are disposable and they are advised to be placed for at least 12 hours for effective pain relief.

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Bibliography / Reference

Collection of Pages - Last revised Date: October 20, 2019