Leg pain sciatica

The onset of leg pain sciatica is a very disturbing-event for any person. It hurts; a lot. Whilst cases have much in common in a sense each is as individual as we all are.

The treatment and management of each and every case needs to be personalised to the individual; what one patient needs may be contraindicated in another. Such is the care of the lower-back; it is an art as well as a science.

In my fifth decade now of treating back pain I have been privileged to manage the condition in many thousands of people, mostly with spinal-manipulation, manual traction and deep tissue massage. Not all were successful initially as I slowly learned the hard way the art of health care. It's not called "the practice" for nought.

The cost of care

In disturbing research[1] scientists declared that the cost of care of back and neck pain in the US was the third-largest after diabetes and ischemic heart disease.

Self-limiting

What is controversial in the above investigation, reported in JAMA in the May 10, 2019 edition, is that they describe leg pain sciatica as "typically self-limiting," and this despite the enormous burden placed on society; over 100 billion dollars in 2009, and certainly more than double that now. 

Will your leg pain sciatica get better of its own accord with no intervention or treatment?

I personally try to answer this question, wearing two-hats. I am both a doctor and a patient; I too suffer from chronic lower back pain with episodes of sciatica.

Three golden-rules

  1. If the pain goes down the leg, get professional advice.
  2. If you go into an antalgia, a crooked stance not unlike the Tower of Pisa, go to bed; you should not sit and will be unable to stand for any length of time.
  3. After just one episode of leg pain sciatica, accept that you shall without fail do lower-back exercises before arising every single morning for the rest of your life.
Antalgia of a woman suffering from leg pain sciatica.Antalgic list to the right; a very serious sign.

If folk followed these three rules, admittedly requiring considerable discipline, I believe half the spinal surgeons and many DCs too would be put out of business; that is my honest, humble opinion.

Pain down the leg

Pain down the leg is an ominous sign for those suffering from lower back pain; it means that either the sciatic or femoral nerve has been affected. Dismiss this warning-sign and the chances of you ending up under the knife increase exponentially.

Antalgia

The term "antalgia" means leaning away from the pain but in fact there are two kinds.

In one you lean away from the painful side to get relief, and the other towards; they are quite different. Both take at least six weeks for the so-called annulus fibrosis to heal.

The postero-medial type[2] is the great deceiver; the bulge is far easier to reduce with spinal manipulation, you return quickly to a normal posture, but it still takes six-weeks for the fibres to heal. Relapse is common amongst those who stop the exercises, cease following their doctors' instructions and return to a normal life too quickly.

Lower back exercises

We get taller at night and fluids infuse the joints of the spine making it stiff and more vulnerable to injury. What does a cat do on awakening? This greatly exacerbates an already swollen disc potentially causing leg pain sciatica. 

Increased pain in the early hours is the norm for many enduring lower back pain; it is my firm belief, having worn both hats, as a doctor and fellow-sufferer, that those who exercise every single morning before arising would be far better off. I do them myself; they take only a couple of minutes.

Self-care

It is my fervent belief that the most important person to care for the human-frame is the owner him or herself. I say this both as DC and a patient; there are some things that no other person can do for us, than we ourselves.

We expect too much from our doctors; there is only so much they can do. Your dentist cannot brush and floss your teeth for you; neither can your DC do your lower-back exercises. There are some things we have to do for ourselves and, if we refuse, then pain, a large expense and disability are to be expected.

Just talk to any person who has false-teeth or has had spinal surgery; worse than pain it is extremely disabling. You simply are not able to do all things you want. 


"Those who will not hear, must feel."

- Dutch saying


So just for a moment let us talk about taking responsibility, call it self-care if it helps, for the wellness of our own bodies against the three greatest users of medical funds, namely diabetes, cardiovascular disease and spinal pain.

Covid may well have changed all that but that thorny subject we'll leave for another day.

Diabetes

The prevalence of type-2 diabetes is reaching epic levels in many societies; sometimes over a third of adults. Even children are now affected. Here are two vitally important things you can do, neither of which will be easy, but the alternative is too ghastly to contemplate.

  1. Take a short walk, perhaps just ten-minutes, after every starchy meal.
  2. Strictly limit all refined carbs.

"Do not eat any refined-carbs, period."

Dr Atkins


Cardiovascular disease

Clogging of the walls of blood-vessels with what is known as arteriosclerosis is the chief cause of the emboli that get stuck and block off the supply of oxygen to the heart and brain.

The other is the development of fragility of these self-same walls of arteries, often associated with high blood pressure, allowing them to bulge and ultimately burst; it's known as an aneurysm. The result is catastrophic.

Is there anything we can do?

  1. The chief cause of cardiovascular disease is diabetes. So, take walks and limit refined-carbs.
  2. Keep blood-pressure under control.
  3. Stop smoking.

Leg pain sciatica

Leg pain sciatica contributes greatly to spinal-conditions which rank third in the use of medical funds.

What can you do to help yourself?

  1. Do these lower back exercises very faithfully. Personally I never miss.
  2. Choose your chairs carefully, and generally sit less.
  3. When you instinctively know something is too heavy for you, get help.

A bridge too far?

Is all of this a bridge too far? I'm sorry, but pain, disability and frequent consultations with doctors of every ilk will eventually consume your future; and probably cut short your life. There is no other way.

Brother Ass

The renowned monk, St Francis of Assisi once described his body as Brother Ass. Yours might be Sister Jenny; a lovable, useful but very stubborn companion. If one of the greatest of the saints found self-care so difficult, can it be less so for us?

In fact treating Brother Ass kindly I believe is a spiritual discipline for every Christian; scripture teaches us that our bodies are the temple of Almighty God. We are not protected by the blood of Jesus when we wantonly break the rules of the universe. Our Lord knew that and he would not submit to the temptation to jump from the pinnacle of the temple.

Gravity, that great rule of the universe that holds the stars in their place, held for the Master too when he had his man-hat on; at other times he could still the waters and walk on the sea.

  1. Expenditures and Health Care Utilization Among Adults With Newly Diagnosed Low Back and Lower Extremity Pain
  2. Postero-medial disc herniation. Web: https://tinyurl.com/564vxfy
  3. Specific details about leg pain sciatica. Web: https://tinyurl.com/cpa6dxvp

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