Friday, July 12, 2019

What is Sciatica?

What is Sciatica?
“My sciatica is acting up” is a common phrase.  People generally use the word to describe butt pain, back pain or leg pain.  To a doctor, sciatica refers to pain travelling down one side of the lower back and or butt down the back of the leg.  Sciatica may stop mid hamstring or continue to the calf and foot.  The term refers to the path of the sciatic nerve, a large nerve bundle that carries sensory (what you feel) and motor (how you move) nerves down the leg from the lower spine.  It is the thickest nerve in the body. 

Sciatica is a broad term which does not specify the cause of the pain; rather, it is a description of symptoms.  Sciatica can result from any of the following:

A pinched nerve in the spine due to a disc, arthritis, or spine slippage
A gluteus or pyriformis (buttock) muscle injury or spasm
A hamstring injury
A soft tissue injury to the hip such as a labral tear
Pressure on the sciatic nerve along its path through the pelvis from any cause

The medical term for sciatica originating from a pinched spinal nerve is radiculopathy.  Radiculopathy is radiating pain from an irritated nerve along the path of that nerve.  (You can also have a radiculopathy down the arm from a pinched nerve in the neck.)  Radiculopathy is often accompanied by burning and shooting pain and can also be associated with weakness and numbness. 

If you are suffering from the symptoms of sciatica for longer than 3 days, see a doctor.  If you have accompanying leg weakness, such as trouble lifting your foot as you walk (a foot drop) see a doctor immediately; you may have a herniated disc.  While this is not life threatening, it can become permanent if not treated early.  Taking steroids by mouth or injection are part of the treatment. 

If ignored, sciatica pain often causes other joint trouble.  Limping to avoid pain can lead to a rotated pelvis, excess stress on the opposite hip and knee, and twisted dysfunctional posture.  This can begin a never-ending cycle of pain that may take twice as long to recover from as the sciatica cause itself.  

With the right diagnosis and treatment, sciatica will resolve.  Strengthening and stretching is always essential to recovery.  Consider a maintenance exercise and stretching routine to prevent sciatica from returning.  Modifying irritating activities are also important to full recovery.  Spine straining exercises such as rowing, medicine ball twists and throws, and heavy lifting may need to be eliminated from your work-out routine for life.  Be wary of moving furniture or lifting heavy items.  Especially avoid combining Bending, Lifting and Twisting motions (BLT).  As with all injury prevention, listen to your body and stop if you feel pain.  

Wednesday, May 15, 2019

How do Wellness, Mindfulness and Health Relate?

Wellness and Mindfulness are buzzwords implied to be associated with Health. The terms seem to be everywhere:  in print and social media, as labels of health and wellness centers, and as titles of corporate lectures geared to improving productivity.  Associated visuals include yoga, herbs, stacked stones, greenery, and water.  The words are often used together but what do they really mean, how do they relate, and, most importantly: what do they do for our health?

Wellness implies a lifestyle of overall happiness, good health and psychological fulfillment.  Wellness has been identified as components numbering between 5 and 8 depending on the source.  The most common five are listed here first:
Physical:  fitness, nutrition, sleep, activity levels and overall health
Intellectual:  creative and mental activities, learning, curiosity
Emotional:  the ability to deal with stress, be flexible, have relationships and a positive outlook
Social: having supportive friends and or family, giving back to the community
Spiritual:  prayer, meditation, religion including love and hopefulness
Occupational:  personal and career satisfaction from work, family, or volunteer responsibilities
Environmental: having pleasant, healthy, stimulating surroundings
Financial:  being satisfied with current and future financial status

Disease risks are suggested to go down as a benefit of wellness.   Longevity is implied, along with a generalized improved feeling of energy, less illness, better mental health, and overall fitness ability.  Wellness encompasses the non-objective measures of health that make you feel better internally.  Wellness measures are individual to each person and are only valid if acceptable to the person they are for. 

Mindfulness is the act of letting go of stressful, negative thought processes and slowing down to be more aware. It includes various techniques and practices such as:
Meditation: a technique used to calm the mind
Relaxation: being free from tension and anxiety
Self-reflection:  thinking about ones’ thoughts and processing
Awareness: consciousness and realization
Gratitude:  thankfulness and appreciation for the good around us

Mindfulness has been practiced for thousands of years as part of Buddhism, Hinduism, and yoga.  It has been brought into non-religious meditation practice and recognized by health providers as a key to stress reduction, stable mental health and overall positive outlook and attitude.  Memory, attentiveness, productivity, creativity, and empathy all benefit from mindfulness.

There are differences between wellness, mindfulness and health.  Objective state of health, as determined by a doctor, nurse or other medical professional can be measured:  blood pressure, blood sugar, blood chemistries, weight, and negative tests for diseases.  In contrast, wellness is a subjective state, thought of by some medical health professionals as counterproductive to overall health.  Wellness is even associated with holistic and alternative health as a contrast to standard medical care.  Mindfulness is often considered an aspect of wellness representing psychological health.

Unfortunately, statistics reveal that despite our new attention to wellness and mindfulness, the US population’s health has declined.  Rates of depression, diabetes and cancer have increased in the past 20 years by 10-30%.  If wellness is tied to alternative medicine, proceed with caution:  alternative medicine ignores all standard medical practice including prescribed medications or regular MD visits and exams. To be clear, wellness and mindfulness are not substitutes for health. 

Still, the ideas behind the words are valuable to living a fulfilling, peaceful and happy life.  Addressing the components of wellness may not actually improve health measures, but will likely keep you feeling grounded and less stressed.  Staying calm and focused through mindfulness techniques will reduce injuries and accidents.  Wellness and mindfulness lifestyles reinforce healthy habits including sleep, nutrition, relaxation, avoiding toxins, spending quality time with friends or family, getting exercise and feeling grateful.  These are unarguably a recipe for overall happiness, less stress and feelings of better health. 

Sunday, April 7, 2019

Taking Over the Counter Pain Relievers for Arthritis

Osteoarthritis is the most common cause of joint pain in the US, affecting over 30 Million adults. The first line of medication treatment recommended by physicians for osteoarthritis is either acetaminophen (Tylenol) or a Non-Steroidal Anti-Inflammatory (NSAID).  70% of people 65 and older take Over-the-Counter (OTC) pain relievers at least once a week.  Studies show that after 2 weeks of regular use, they effectively reduce pain by 50% and increase mobility by 60%.  They are inexpensive, relatively safe, and widely available. 

You can purchase 3 types of NSAIDS at the drug store:  ibuprofen (Motrin), naproxen (Aleve)  and aspirin (Bayer/Bufferin).   They are very effective to reduce pain, inflammation, and even fever.  They do not cause the side effects of prescription pain relievers such as addiction, dizziness, sleepiness, or constipation.  Because the over the counter doses are lower than prescription, they have less risk of stomach bleeds or cardiovascular events such as heart attacks or strokes.  Tylenol is another product sold for pain relief at the drug store, but it is not an NSAID and while it reduces pain and fever, it does not reduce inflammation.  All the medications work within 30-60 minutes. 

These medications are recommended for short term (10 days to 2 weeks) use.  They have been researched to provide their strongest pain relief in the first 2 weeks of regular use, becoming less effective after 20 weeks.  For some, Advil is more effective than Aleve and vice versa.  The only way to know what will work best for you is to try, so buy the smallest amount possible to start.  Generic is fine as long as the product is made in the US. 

Always start with the lowest dose, as you can add a second pill within an hour if no effect.  Make sure you follow the dosage recommendations.  Aspirin and Tylenol have the maximum dose listed in directions on the bottle;  ibuprofen and naproxen labels recommend over-the-counter doses that are half of the prescription version of these drugs.  It is never a bad idea to take the medications with food or milk; an empty stomach can get irritated as NSAIDS reduce the protective lining.  Taking the medication with an OTC acid reducer like Zantac, Pepcid or Prilosec will reduce the irritation to the stomach. If your symptoms persist, speak with your doctor who will likely prescribe another type of pain reliever. 
If you also are suffering from headaches, cold or flu symptoms, read the labels of combination products as they often contain pain relievers.  Most contain acetaminophen (Tylenol) which can be taken with NSAIDS.  Your daily acetaminophen dose should not exceed  2000 miligrams. Taking aspirin or salicylate products with ibuprofen or naproxen is not advised. 

Finally, if you are having trouble swallowing pills, you can try children’s liquid doses or a topical product such as aspercreme which has a form of aspirin in it.  There are NSAID containing prescription gels and patches which provide the least overall side effect risks.  If you notice leg are swelling, headaches, stop the NSAID, check your blood pressure if you can, and call your doctor. Some people develop life threatening allergic reactions to NSAIDS, so look out for swelling of the mouth or face, itching, rashes, or trouble breathing in which case you must call ambulance immediately and ask if anyone around you has an Epipen for immediate use. 

For most, OTC NSAIDS are wonderful, allowing the maintenance of an active fitness life which prevents other health problems such as heart disease or diabetes.  Taking 1 OTC dose once a day on active days is common and acceptable.  Just make sure you let your doctor know about these and any OTC products you are taking.