Sciatic Nerve Pain

Archive for the ‘nerve pain’ Category

What could possibly be worse than struggling with a painful condition and feeling ashamed to discuss the problem because of its intimate nature? Such is the case for many suffering with pudendal neuralgia, a little known disease that affects one of the most sensitive areas of the body. This area is innervated by the pudendal nerve, named after the Latin word for shame. Due to the location of the discomfort combined with inadequate knowledge, some physicians make reference to the pain as psychological. But nothing could be further from the truth. Unfortunately, discussing the condition with gynecologists, urologists and neurologists often proves fruitless since most know nothing about the condition and therefore cannot diagnose it.

Pudendal neuralgia is a chronic and painful condition that occurs in both men and women, although studies reveal that about two-thirds of those with the disease are women. The primary symptom is pain in the genitals or the anal-rectal area and the immense discomfort is usually worse when sitting. The pain tends to move around in the pelvic area and can occur on one or both sides of the body. Sufferers describe the pain as burning, knife-like or aching, stabbing, pinching, twisting and even numbness. These symptoms are usually accompanied by urinary problems, bowel problems and sexual dysfunction. Because the pudendal nerve is responsible for sexual pleasure and is one of the primary nerves related to orgasm, sexual activity is extremely painful, if not impossible for many pudendalites. When this nerve becomes damaged, irritated, or entrapped, and pudendal neuralgia sets in, life loses most of its pleasure.

So, where exactly is the pudendal nerve? It lies deep in the pelvis and follows a path that comes from the sacral area and later separates into three branches, one going to the anal-rectal area, one to the perineum, and one to the penis or clitoris. Since there are slight anatomic variations with each person, a patient’s symptoms can depend on which of the branches are affected, although often all three branches are involved. The fact that the pudendal nerve carries sensory, motor, and autonomic signals adds to the variety of symptoms that can be exhibited.

Because pudendal neuralgia is uncommon and can be similar to other diseases, it is often misdiagnosed, leading some to have inappropriate and unnecessary surgery. Early in the diagnosis process, it is crucially important to undergo an MRI of the lumbar-sacral and pelvic regions to determine that no tumors or cysts are pressing on the nerve. In addition, the patient should be screened for possible infections or immune diseases, as well as having an evaluation by a pelvic floor physical therapist to determine the health of the pelvic floor muscles and to uncover whether skeletal alignment abnormalities exist. An accurate patient history is needed to assess whether there has been a trauma or an injury to the nerve from surgery, childbirth, or exercise. Tests that offer additional diagnostic clues include sensory testing, the pudendal nerve motor latency test, and electromyography. A nerve block that provides several hours of relief is another tool that helps to determine if the pudendal nerve is the source of pain.

One of the most common symptoms that accompanies pudendal neuralgia is severe depression. Some people with the disease have committed suicide due to the intractable pain. For that reason, it is important to consider antidepressants, as they can help lessen the hypersensitivity of the genital area in addition to relieving bladder problems. Certain anti-seizure drugs reportedly help to alleviate neuropathic pain while anti-anxiety drugs provide substantial relief of muscle spasms and assist with sleeping. Uninformed physicians are reluctant to prescribe opiates for an illness that shows no visible abnormality, yet the desperate nature of genital nerve pain requires that opiates be prescribed for these patients. While medications are not always satisfactory, they do help take the edge off of the pain for many people. Until the correct treatment is determined, it is imperative that patients with pudendal neuralgia receive adequate pain management since the pain associated with this illness can be intense.

Treatment depends on the cause of distress to the nerve. When the cause is not obvious patients are advised to try the least invasive and least risky therapies initially.

· Physical therapy that includes myofascial release and trigger point therapy internally through the vagina or rectum assists with relaxing of the pelvic floor, especially if pelvic floor dysfunction is the cause of nerve irritation. If no improvement is found after six to twelve sessions, nerve damage or nerve entrapment might be considered.

· Botox is now used in medical settings to relax muscles and shows promise when injected into pelvic floor muscles; though finding a physician adept at this treatment is difficult.

· Pudendal nerve blocks using a long-acting analgesic and a steroid can reduce the nerve inflammation and are usually given in a series of three injections four to six weeks apart.

· If physical therapy, Botox, and nerve injections fail to provide adequate relief, some patients opt for pudendal nerve decompression surgery.

There are three published approaches to pudendal nerve decompression surgery but there is debate among members of the pudendal nerve entrapment community as to which approach is the best. Since there are advantages and disadvantages to each approach, patients face considerable confusion when deciding which type of surgery to choose. Because there are only a handful of surgeons in the world who perform these surgeries, most patients have to travel long distances for help. Moreover, the recovery period is often painful and takes anywhere from six months to several years since nerves heal very slowly. Unfortunately, early statistics indicate that only 60 to 80 percent of surgeries are successful in offering at least a 50 percent improvement.

Patients whose surgeries are not successful or who do not wish to pursue surgery have the option of trying an intrathecal pain pump which delivers pain medication locally and helps to avoid some of the side effects of oral medications. Others pursue the option of a neurostimulator either to the sacral area or directly to the pudendal nerves. These are relatively new therapies for pudendal neuralgia so it is difficult to predict success rates.

Some pudendalites have devised ingenious contraptions for pain relief ranging from u-shaped cushions cut from garden pads all the way to balloons filled with water, frozen, and inserted into the vagina. Most have a favorite cushion for sitting and many have special computer set-ups for home and office use in order to avoid sitting. Generally speaking, jeans are a no-no, so patients revise their wardrobes to include baggy pants and baggy underwear if they are able to tolerate wearing underwear.

Clearly more research is required to find effective methods to better manage the pain and debilitation of pudendal neuralgia. But in the meantime, friends and family close to those who have this devastating illness play a huge role in helping patients cope, thereby maintaining the best quality of life possible. Support, love and understanding are of primary importance for those suffering with this affliction.

Violet Matthews
http://www.articlesbase.com/diseases-and-conditions-articles/taking-the-shame-out-of-pudendal-neuralgia-65174.html

Micro Lumbar Discectomy (MLD) Spine Surgery

Since the initial description of a herniated intervertebral disc as the cause of sciatica (pain radiating down the back of the leg) in 1934, the operation to relieve this pain has undergone considerable refinement. Compression of a nerve root in the low back causes pain in the leg, back pain and sometimes dysfunction of the nerve. Usually pain begins in the low back, then radiates into the leg with tingling numbness and weakness in the leg. The cause is herniation or bulging of softened intervertebral disk material into the spinal canal compressing the overlying nerve root. In older individuals, an over-growth of bone (osteophytes) may compress the nerve. Diagnosis is dependent upon the history of pain, physical examination of the patient, and

Anatomical changes seen with CT/MR imaging of the spine :

• Pain the the back and extremity, usually the back of the leg
• Pain and limitation of raising the leg with the patient lying on his back
• Loss of sensation in the leg
• Weakness in specific muscle groups in the leg
• Loss of reflexes at the knee and ankle
• CT/MR images showing compression of a nerve root by disc material or osteophyte

Case History : Herniated lumbar disc with sciatica, pain and numbness

PS is a 30 year old housewife and mother who had experienced recurring episodes of low back pain for the past 10 years. This pain was progressively more severe for the past two years. A month before admission to the hospital she awoke with excruciating low back pain, and pain with numbness down the back of her right leg. She complained of weakness in the leg and the weakness progressed although the pain had improved.

Examination demonstrated pain when the right leg was passively elevated. There was weakness in the muscles which flexed up the foot at the ankle, numbness to pin prick over the top of the foot. The reflexes at the knee and ankle were normal.

A MRI image demonstrated a very large herniated disc fragment compressing the right L5 nerve root. A microlumbar discectomy was performed because of the failure of conservative treatment and the presence of severe pain and weakness. She left the hospital the same day and enjoyed immediate, near complete relief of sciatic pain.

The weakness is greatly improved, but the numbness persists. Comment: The L5 nerve root is usually the root compressed by a fragment of disc material which prolapses from the disc space between the 4th and 5th lumbar vertebrae. The nerve root controls the muscles of elevation of the foot at the ankle, elevation of the big toe, sensation on the top of the foot…

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Taking over the counter drugs (OTC) is usually the first step in trying to get rid of those little nagging aches and pains we all suffer from during the normal course of our daily life.

Most of the time these non-prescribed drugs work just fine. However, it’s when the little aches and pains become a persistent chronic pain that we run into problems.

That nagging, chronic backache can become a debilitating problem. Those Irritating little headaches that keep you in a constant bad mood can take on monumental proportion and make your life an absolute hell.

The search for headache pain relief can be all consuming. This is when the cheap OTC drugs you buy at the discount stores become ineffective.

Hopefully, you are smart enough to realize that doubling up the dosage is not a good idea. Your first step should be is to consult your doctor if the OTC drugs are not doing the job. A chronic headache or chronic back pain is something you can’t ignore.

You should not delay about seeing your doctor if your problem is persistent headaches. Ask about getting an MRI (Magnetic Resonance Imaging) procedure done on your head.

It’s painless and a very good way to spot a growing cerebral aneurysm forming in your head. This is a fairly new technique for spotting this sort of problem and is gaining popularity with the doctors.

The MRI is also a great tool being used to spot a ruptured disc in the spine. The MRI is a non-invasive way to look inside of you to see what is going on. If you have any luck at all your test will come back negative.

Usually, the first thing a doctor will try, after passing the MRI test, is physical therapy, and/or some mild prescription drugs. The cause of your chronic pain can be anything from a pinched nerve to a strained muscle. The physical therapy, while expensive, may just be the cure you’re looking for to get rid of your problems.

However, you may have to start taking a regime of prescribed drugs if the workouts do not take care of your never-ending pain. This is where the dangers start to pile up.

Every prescribed drug has an adverse drug reaction. These reactions can affect your liver, stomach, kidneys, and even your heart. You must discuss the possibilities of this problem with your doctor.

An alternative to the prescribed drugs is herbal, or natural pain relief medications. These are pills, ointments, and spray-ons that are manufactured from plants and other natural elements of the earth.

Although new, they don’t have the adverse side effects as conventional medicine and appear to be moving up into first place as the preferred way to get pain relief.

Richard Tolar
http://www.articlesbase.com/alternative-medicine-articles/how-to-get-relief-from-chronic-pain-without-prescribed-drugs-92543.html

Posture – Slouching is when you drop your shoulder forward and your head downward. The tendency is for your back to work extra just to maintain your balance. As a result, it puts pressure on your vertebrae, which will likely cause your back to ache. Stop slouching and start to stand and seat straight. This will not only make your look good, it will also make you feel good.

Massage Therapy – Massage helps relieve back pain, shin splints, frozen shoulder, carpal tunnel type symptoms, neck stiffness, sciatica, bursitis, headaches, tennis elbow, and low back stiffness by treating trigger points. Trigger points are accretions of waste products in the region of a nerve receptor which manifest themselves in the forms of dull ache, hot or cold, harp pain, pins and needles, and tingling among others.

Exercise – Your bones should carry your weight. But if your weight exceeds the carrying capacity, then you should be feeling pain right now. There are certain exercises that strengthen the bones. Meanwhile, loosing weight is another way to relieve the stress on your bone. People who are either obese or overweight and experiencing pain might not realize that the main contributor to the pain they feel is their weight.

Balneotherapy – “balneo” (from balneum) is a Latin word meaning bath. Balneotherapy is a kind of hydrotherapy that involves bathing in warm water or mineral water. Researches found that balneotherapy possesses significant beneficial effects for people experiencing body pain. Balneotherapy meanwhile should not be applied to people with heart condition unless supervised with primary care provider.

Sleeping position – the best way to sleep is on your side with your knees bend with a pillow between your legs. For pregnant women who experience back pain, sleeping on the side would be the best remedy for it. Place a pillow under your abdomen to support its weight.

Vitamin D – pain can be a manifestation of Vitamin D deficiency. Vitamin D can be found in fortified milk and cereals, soya milk, margarine, fish, and sunlight.

Hot and cold – back pain can be alleviated by applying cold pack at their back. Other people find heat to be a source of relief. A combination of either hot or cold and massage would also work for other people. Trying out any of these would not do you harm so feel free to explore the possibilities of finding relief to either of them.

Rest – at the office, an all day’s work would mean seating for long hours. This is okay if you are maintaining a good posture all throughout the day. However, the temptation to slouch is great that you completely forget you are slouching. After that, you complain about the pain at your back. Surprisingly, a few minutes of rest is all you need help remove the pain.

John Furnem
http://www.articlesbase.com/medicine-articles/natural-solutions-and-remedies-for-pain-relief-85337.html

In the entire body are around 206 skeletal bones, which include the long bones, short, fat, and uneven bones. Inside the bones are red blood cells, (RBC), bone marrow, phosphorus, calcium, and magnesium. Magnesium is silvery white elements of metallic that start from organic compounds and works with calcium to afford support and strength to the muscles, which the bones connect with to defend the internal organs and movement. Calcium is similar to magnesium, yet it is produced from alkaline metals from the earth.

The body’s skeletal muscles give us the support we need to move, stand, walk, sit, and so while supporting the posture. Muscles contract, shorten, and expand. The muscles attach to bones, as well as tendons. Once the muscles begin to contract, it stimulates the muscle fiber, which feeds off the motor neurons.

The nerves are made up of extensions of nerve cells, which are thread-like and transmit impulses outwardly from the body of cells. (Axon) The cell bodies are branched extensions of nerve cells (Neurons), which receive electrical signals from other nerves that conduct signals back to the body of cells. This action emerges from dendrites. Dendrites transmit nerve impulses to the main area of the body that when interrupted can cause major problems.

We call this large, major system the Central Nerve System. (CNS) Dendrites are also called the tree sometimes, since it stores minerals that crystallizes the system and forms the shape of a tree. The CNS is a network of neurons, or nerve cells that include the muscle fibers. The fibers and nerve cells chain together and consist of cell bodies, dendrites, axon, etc. Messages are conveyed through these neurons, which sensations are transmitted to the brain, thus carrying motor impulses that reach the vital organs and muscles.

We use our muscles and the components combined to move. The skeletal muscles are transmitters also, since these muscles send energy that creates muscle contractions and forms as ATP. The muscles also form as adenosine Triphosphate, ADP (Adenosine Diphosphate Phosphate), and hydrolysis. Hydrolysis is reactions that occur with fluids. Thus, chemical reactions emerge with compound reactions and causes decomposition. In addition, it reacts by producing two or more additional compounds, which may include a combo of glucose and/or minerals, etc.

Adenosine Triphosphate is components of our RNA. The compounds of adenine and organic ribose sugar, which makes up the components of nucleic acid and energy, which is carried via molecules. Ribose has five-carbon sugars, which is discovered in living cells.

Its constituents, RNA, plays a vital part in the metabolically structure, since compounds include nucleic acids, riboflavin, and ribonucleotides exist. Riboflavin is necessary for growth and energy. The pigments are made up of orange-yellow crystals, which derive from Vitamin B complex. Riboflavin is vital to particular enzymes also. Riboflavin is sometimes known as Vitamin G and lactoflavin as well.

We achieve tone from our muscles, since they act as retainers. The action causes the muscles to hold back a degree of contractions, which breaks down the transmission of nerve impulses or white crystalline compounds that release from the ends of neuron fiber (Acetylcholine) by use of enzymes known as cholinesterase.

The enzymes of the brain, blood, and heart decomposes acetylcholine, breaking it down into acetic (Vinegary) acids and choline, which suppresses its’ stimuli and affects the nerves. The action is sometimes known as acetyl-cholinesterase. Enzymes are proteins, which are complex. The elements produce from the living cells and promote specific biochemical reactions. Enzymes act as catalysts.

Each element outlined makes up the parts of the body that when affected can lead to back pain. For instance, if the muscle tone fails to hold back contractions, and breaking down of nerve impulse transmission at a given time, the muscles are overexerted, which causes back pain.

John Pawlett
http://www.articlesbase.com/health-articles/bones-and-back-pain-problems-98620.html