sciatica

WHY SCIATICA PAIN IS WORSE AT NIGHT & HOW TO SLEEP BETTER AT NIGHT WHEN YOU HAVE SCIATICA?

Below are some of the possible causes of sciatica pain at night:

Attention and Distraction

You may simply be more aware of your pain at night when there is less to distract you from it. This doesn’t mean the pain isn’t real — it is — only that you may be noticing it more at night than you do when you have other things to occupy your mind.

Body Position

When you lay down, the weight of your body may put pressure on your nerves in ways that it doesn’t when you’re upright. This is particularly common with sciatica and other chronic pain caused by pinched or compressed nerves.

Temperature

Cooler temperatures help many people sleep better. However, cold can also make sciatica pain worse.

Medication Timing and Dosage

The medications that control your pain well during the day may be wearing off too soon at night. You may then need a different dose at night.

HOW TO SLEEP BETTER WITH SCIATICA PAIN?

Try Sleeping in Different Positions

If your sciatica pain is caused by pinched or compressed nerves, adjusting your sleep position may relieve some of the pressure. For example, people with sciatica who prefer to sleep on their side often find it helpful to sleep with their affected leg on top. People with hip or knee pain may find relief by sleeping with a pillow between their legs.

Adjust the Temperature

Experiment with different room temperatures when you sleep. It may take some time to find the best temperature for you: cool enough to help you sleep, not cold enough to make your pain worse.

Get Appropriate Exercise During the Day

Exercise during the day can help reduce some kinds of chronic pain, and it may help you rest better too.

Practice Good Sleep Habits

While the day’s stimulations may distract you from your pain, they won’t help you sleep. Develop a sleep routine that helps prepare your body for rest. This might include turning off the TV and other screens 1-2 hours before bedtime, reading a book, or taking a warm bath.

Prepare Your Mind for Rest

The stress of chronic pain can make it even harder to rest. Try meditation or deep breathing exercises to lower your stress and help reduce your perception of pain. https://www.nhs.uk/conditions/sciatica/

How Doctors diagnose sciatica?, sciatica

FIRST VISIT TO A DOCTOR WHEN YOU SUFFER WITH SCIATICA, WHAT QUESTIONS ARE LIKELY TO BE ASKED BY YOUR DOCTOR IN THIS FIRST VISIT? HOW DOCTORS DIAGNOSE SCIATICA?

The first thing your doctor probably will do during the first visit is asking questions about your back pain. Your doctor will ask questions like:

  • Do you have numbness or weakness in your legs?
  • Do certain positions help your discomfort? 
  • Has the pain kept you from doing any activities?
  • Have any home remedies eased your pain at all?

Your doctor may also want to know about your lifestyle and may ask these questions:

  • Do you do a lot of physical work, like heavy lifting?
  • Do you sit on a chair or hard surface for long periods?
  • How often do you exercise?

Your doctor may want to give you a physical exam to try to figure out which nerve is causing your problem. They may have you do some exercises to see if the exercise make your pain worse, such as rising from a squat, walking on your toes and heels, and raising one leg while lying on your back.

If your pain is ongoing (chronic) or severe, your doctor might also get some imaging tests done. X-rays, CT scans, and MRIs can look for herniated disks or bone spurs that clearly would be causes of sciatica.

If your doctor diagnoses you with sciatica, it is important to remember that in most cases sciatica clears up in a few weeks without surgery. If over-the-counter drugs haven’t made a dent in your pain, your doctor probably will prescribe anti-inflammatories or muscle relaxants. You might also need to do physical therapy or get steroid injections to help relieve your discomfort. Acupuncture and treatment by a chiropractor are alternative treatments that also may be helpful. The conversation about surgery will start only after you’ve first tried non-surgical treatments. https://www.nhs.uk/conditions/sciatica/

First visit to a doctor for sciatica pain, sciatica

FIRST VISIT TO A DOCTOR FOR YOUR SCIATICA PAIN, WHAT TO ASK A DOCTOR IN THIS FIRST VISIT?

The first visit to your doctor when you have sciatica pain may be very stressful because you don’t know if indeed what you are experiencing is sciatica pain or you have a sprain or you accidentally pulled a muscle. Below are some of the questions to ask your doctor in this first visit:

  • Is my activity level or lack of it attributed to this pain?
  • Is this pain permanent? 
  • What is sciatica and how to differentiate it from a sprain or pulled muscle?
  • How to diagnose sciatica and how to diagnose a sprain on the back?
  • Will I need surgery?
  • If I have sciatica, will it clear up after a few weeks with medication?
  • Will physical therapy or acupuncture help my pain? When do I start physical therapy or acupuncture?
  • Will I be able to do things I could do before the pain started?
  • Is this condition hereditary? https://www.nhs.uk/conditions/sciatica/
sciatica

WHY SCIATICA PAIN IS WORSE IN THE MORNING & WHAT TO DO TO LESSEN THIS MORNING PAIN?

Sciatica is often worse for people in the morning because of the way they sleep. Lying down in an incorrect position can further irritate nerve roots. This is because of the way the spine rests when you are lying on your back. In this position, the sciatic nerve exit spaces in the spinal column, called the foramina, become more compressed. This limits the space nerve roots have to travel through and can worsen the underlying cause of the sciatic pain.

WHAT TO DO TO LESSEN SCIATICA PAIN IN THE MORNING?

If you’re experiencing sciatic nerve pain in the morning, try and do the following:

  • Fix your posture: Try to elevate your legs while lying down. This position helps alleviate the pressure of your spine’s natural curve, which may be able to reduce your pain. Place a pillow beneath your knees, or between the knees if you’re sleeping on your side. Additionally, if you sleep on your side, avoid laying on the side affected by sciatica.
  • Stretch: When you wake up, incorporate some simple stretches to your morning routine. Yoga poses like child’s pose, as well as soft stretches of the lower back like pulling one knee to your chest while laying on your back, may help elongate the spine and alleviate some pressure placed on the sciatic nerve overnight. https://www.nhs.uk/conditions/sciatica/
sciatica

2 MAIN SCIATICA SYMPTOMS THAT REQUIRES IMMEDIATE TREATMENT

(1) Worsening neurological symptoms

Severe damage to your sciatic nerve roots can cause progressive neurological symptoms and requires immediate treatment.

The symptoms may affect one or both legs and typically include the following:

  • Numbness
  • Weakness
  • Tingling
  • Abnormal sensations, such as crawling
  • An abnormally increased sensitivity to pain (hyperalgesia)

It is also possible for the symptoms to occur only below the knee without involving the entire limb. While these symptoms may not warrant surgery, some form of immediate medical treatment is usually needed.

(2) Changes in bowel and/or bladder control

Consult your doctor immediately if you have any sudden, unexplained changes in your bowel and/or bladder control. These changes may include:

  • An inability to control your bowel and/or bladder movements.
  • Difficulty in passing urine, a reduced urinary sensation, a loss of desire to pass urine, or a poor stream.

These 2 symptoms above indicate a rare, but serious medical condition called cauda equina syndrome. Cauda equina syndrome can occur suddenly or gradually and typically requires immediate surgery to control the symptoms. If patients with cauda equina syndrome do not receive prompt treatment, it can result in difficulty in walking and/or other neurological problems, including lower-body paralysis. Doctors advise treating this condition within 24 to 48 hours of symptom occurrence to preserve lower limb function. https://www.nhs.uk/conditions/sciatica/

back pain, sciatica, Stretch exercises

4 Lower Back Stretches for Sciatica Relief

  • 1. Camel Pose (Ustrasana)

(a) Kneel with your body upright and hips stacked over the knees. Take padding (a blanket or fold your mat so it is double thickness) under your knees if they are sensitive.

(d) Draw your hands up the side of your body until your thumbs reach your armpits. Hook your thumbs into your pits for support as you start to open your chest toward the ceiling.

(c) Maintain the position of your chest as you reach your hands back one at a time to grasp your heels. If you need a little more height, tuck your toes under. Otherwise, the tops of the feet can be flat on the floor.

(d) Bring your hips forward so that they stay over your knees.

(e) If it feels good, let your head come back, opening your throat. If that doesn’t work for your neck, you can keep the chin tucked instead.

(f) Release by bringing your chin toward your chest and hands to your hips. Firm your abs and support your lower back with your hands as you slowly bring your body to an upright kneeling position.

  • 2.Wide-legged Seated Forward Fold Pose

(a) Begin seated in Dandasana (Staff Pose), with the spine tall and the legs extended straight out in front of you.

(b) Take your legs as wide apart as you comfortably can, keeping the feet flexed and active so that the inner legs don’t collapse inwards. Your kneecaps should point straight up toward the ceiling and your heels should be rooting firmly into the ground. If your inner legs begin to collapse, it’s a sign that you’ve taken the legs too far apart.

(c) Place your fingertips on the ground in front of you, just between your legs. Maintain the length along the spine, keep your shoulders relaxed and your chest lifted. Inhale here.

(d) As you exhale, slowly begin to walk your fingertips forward until you find an edge that feels appropriate for your body. Avoid moving so deeply that your spine begins to round and your shoulders collapse; keep the emphasis on lengthening evenly through the front and back body.

(e) If it feels comfortable, you can come down onto your palms, forearms, or take your torso down onto the ground between your legs. Otherwise, simply remain on your fingertips. Take 10 to 15 breaths here.

(f) To come out of the pose, use an inhale to come upright, with your core engaged to protect your spine. If you like, you can bend your knees and bring the soles of your feet together as a counterpose for your legs, or bend both knees into your chest and hug yourself.

  • 3.Frog Pose (Mandukasana)

Before you get into position, consider placing a yoga mat or blanket underneath you to help soften the pressure of your knees on the floor.

(a) Begin in a tabletop position on your hands and knees. Make sure your hands are underneath your shoulders and knees are below the hips. Stay here and breathe for three to five breaths.  

(b) Inhale and slowly move your right and left knee out towards the side as you exhale, stopping to hold and continue breathing whenever you feel the stretch. Depending on your flexibility, this step might bring a powerful stretching sensation to your inner thighs and groin area. Avoid pain and do not force your body into a deeper stretch than it’s ready for. 

(c) Continue opening your hips as you turn your feet out towards the side and flex your ankles so that your inner feet, inner ankles, and inner knees are touching the floor. 

(d) Slowly lower down to your forearms with the palms either flat on the floor or pressed together. 

(e) Stay here and breathe deeply for a count of 5 to 10 breaths or 30 to 60 seconds. Your breath, as in all yoga poses, is an excellent guide. If you’re pushing yourself too far in the stretch, your breathing will become shorter and more forced. If you can take long, slow, deep breaths, it’s an indication that the stretch is appropriate for your body.

(f) To release frog pose, slowly slide your knees closer together and return to the tabletop position. Alternatively, some people prefer exiting the pose by sliding their feet together on the mat and pressing their hips back into a wide-kneed variation of child’s pose.

  • 4.Side Lunge (Skandasana)

(a) Begin in Wide-Legged Forward Bend (Prasarita Padottanasana).

(b) Bend your left knee into a half-squat. Keep your right leg straight and flex your foot so that your toes leave the floor so you are resting on the right heel.

(c) There are a lot of options for arm variations. Keep your hands on the floor if you need them for balance. Otherwise, try bending your elbows and bring your hands into anjali mudra ​(palms together) with the left elbow inside the left knee in a kind of half Garland Pose (Malasana).

(d) Drop your hands to the floor for support and shift to the other side. https://www.nhs.uk/live-well/exercise/exercises-for-sciatica/

back pain, L5-S1 herniation, sciatica, slipped disc

CAUSES OF TINGLING FEELING IN UPPER BACK, CAUSES OF TINGLING FEELING IN MIDDLE BACK AND CAUSES OF TINGLING FEELING IN LOWER BACK

A tingling feeling in the back is commonly describes as a pins-and-needles, stinging or “crawling” sensation. Depending on its cause and location, the feeling can be chronic (long term) or short live (acute). Seek immediate medical attention if the tingling is accompanied by (a) sudden weakness in the legs (b) problems in walking and (c) loss of control of bladder or bowel.

TINGLING FEELING IN UPPER BACK

Tingling feeling in upper back is commonly caused by nerve compression, nerve damage or nerve irritation. Some causes include:

  • Cervical radiculopathy. This is a pinched nerve that occurs in the spine within the neck. This occurs when one of the shock-absorbing discs that lies between each vertebra (the bones of the spine) collapses, bulges or herniates, pressing against sensitive nerve. This often happens due to aging or improper body mechanics. Most cases heal with rest, over-the-counter pain relievers and physical therapy. https://cks.nice.org.uk/neck-pain-cervical-radiculopathy
  • Fibromyalgia. This is a disorder of central nervous system that produces widespread muscle pain and fatigue. Pain, ranging from dull and achy to tingling and is often worse in area where there is a lot of movements such as the shoulders and neck. This condition if often treated with pain relievers, anti-inflammatories, muscle relaxers, antidepressants which can help relieve pain and symptoms of depression that occur when living with fibromyalgia. https://www.nhs.uk/conditions/fibromyalgia/
  •  Brachial plexopathy. The brachial plexus is a group of nerves in the spinal column that send signals to the shoulders, arms and hands. If these nerves are stretched or compressed, a stinging, tingling pain can develop. In most cases the pain is felt in the arm briefly. The stinging can radiate around the neck and shoulders. Treatment involves pain medications, steroids to reduce inflammation and physical therapy. https://www.evidence.nhs.uk/search?q=brachial+plexus
  • Lhermitte’s sign. This is a shock-like sensation linked to multiple sclerosis (MS). The pain usually lasts only seconds but can reoccur. There is no specific treatment for Lhermitte’s sign although steroids and pain relievers are common treatments. https://www.mstrust.org.uk/a-z/lhermittes-sign

TINGLING FEELING IN MIDDLE BACK

Tingling feeling in middle back may be caused by shingles. Shingles is an infection caused by the same virus that produces chicken pox (varicella zoster virus). It affects the nerve endings. Once you’ve had chicken pox, the virus can lie dormant in your system for years. If it becomes reactivated, it appears as a blister rash that often wraps around the torso producing a tingling or burning pain. Treatment includes pain relievers, antiviral medications, anticonvulsants, steroids, antidepressants and numbing topical sprays, creams and gels. https://www.nhs.uk/conditions/shingles/

TINGLING FEELING IN LOWER BACK

Tingling feeling in lower back can be due to one of the following:

  • Spinal stenosis. This is a narrowing of the spinal column. This narrowing can trap or pinch nerve roots. Spinal stenosis becomes more common as people age. This condition can be treated with pain relievers, anti-inflammatories, muscle relaxers, steroids. https://www.evidence.nhs.uk/search?q=spinal+stenosis
  • Herniated disc. This can occur anywhere along the spine. However, the lower back is a common place. Treatment consist of rest, ice, pain relievers, physical therapy. https://www.evidence.nhs.uk/search?ps=20&q=slipped+disc
  • Sciatica. The sciatic nerve runs from the lower back into the buttocks and legs. When the nerve is compressed, which can be causes by spinal stenosis or herniated disc or injury on spine, a tingling pain can be felt in your legs. To relieve pain a doctor may prescribe anti-inflammatories, pain killers, muscle relaxers, antidepressants. https://www.nhs.uk/conditions/sciatica/
sciatica

WHY SCIATICA IS PAINFUL?

One reason the sciatic nerve cause so much pain is because it is the longest nerve in the body. The nerve starts at the back of the pelvis and runs downward through the hip area and buttocks into each leg. Near the knee, the sciatic nerve divides into two nerves – the tibial nerve and peroneal nerve. The tibial nerve runs behind the knee and the peroneal nerve runs along the side of the calf and ankle. Through the tibial and peroneal nerves , the sciatic nerve stimulates the action of many muscles in the lower legs and enables feeling in the thigh, legs and feet.

In addition to pain, the following symptoms can also be felt, these include pins & needles, burning, numbness or muscle weakness. Such symptoms can be felt in the buttock, thighs, behind the knees, calves, ankle and sometimes the feet.

In rare cases, the cause of the sciatica may result in loss or control of bowel and/or bladder (e.g in cauda equina syndrome). This is one situation that requires urgent medical attention and potentially surgical intervention.

CAN SCIATICA BE ON BOTH SIDES?

Sciatica on both sides of the leg is rare and may occur due to degenerative changes in the vertebrae and/or the disc at several spinal levels or from serious condition as cauda equina syndrome.

back pain, Coccyx, coccyx or tailbone pain, sciatica, sciatica during pregnancy, seat cushion

5 BEST TIPS WHEN TRAVELLING BY AIRPLANE, COACH OR BY CAR WHEN YOU SUFFER FROM SCIATICA

  • Get an aisle seat. If you travel by coach or taking a flight, make sure you get an aisle seat. With an aisle seat you don’t have to worry about disturbing anyone.
  • Have plenty of stops if travelling by car. Make sure you stop regularly to walk around and stretch.
  • Stretch regularly. This relives pressure in your sciatic nerve and promote blood flow and reduce the pain.
  • If its a long journey try and shorten it by going to sleep in a hotel and continue the journey the following day.
  • Sciatic pain relief cushion. Invest in a memory foam seat cushion. Simple to use and easy to carry, U-Shaped seat cushion designed to reduce pressure on the sciatic nerve while sitting. https://www.amazon.co.uk/Products-Innova-Orthopedic-Cushion-Removable/dp/B07Q6RVPXB/ref=sr_1_30?keywords=coccyx+seat+cushion&qid=1581838770&sr=8-30
Picture of a U-Shaped memory foam seat cushion. Picture is placed on top of a car seat with a U-shape of the cushion against the back of the car chair