SCIATICA AND HOMEOPATHIC MANAGEMENT

                                                                            SCIATICA

DEFINITION:-

          Sciatica or sciatic syndrome is characterized by pain along the course and distribution of the sciatic nerve due to compression, i.e. buttock, back of the thigh, and outer side of the back of leg and foot.

AETIOLOGY (OR) CAUSES:-

-          Compression or mechanical irritation of the corresponding roots.

-          Compression is herniation of the intervertebral disc either between L4-L5, L5-S1.

-          Lifting of heavy object.

-          Extra strain.

-          Compression of spinal cord by tumours or by hemorrhages’.

-          T.B of spine, ankylosing spondylitis, arthritis etc.

-          Neuritic disorders like leprosy, S.L.E. polyarteritis nodosa.

-          Recurrent attack of low back pain.

The intervertebral disc consists of two parts – the outer covering annulus fibrosus. Due to degenerative changes in annulus fibrosus (the protective covering over the nucleus pulposus), it is likely to rupture and the soft pulpy material be pushed out suddenly in the posterolateral direction and compress upon the concerning nerve root. Such a situation may develop while lifting a heavy object or after extra strain over the back.

SYMPTOMS:-

-          Onset is usually related to past dated trauma, exposure to cold or damp weather or even previous attacks.

-          There is severe pain in the direction of one or both the sciatic nerves which is made worse by coughing, sneezing or even by pressure.

-          Onset is sudden or gradual.

-          Pain is of a gnawing or burning character.

-          The nerve is sensitive to touch, pain get worse at night, on motion.

-          The pain is associated with numbness in the distribution of nerve.

-          Associated symptoms: painful tender heels, cramps in calves.

SIGNS:_

-          LASEGUE’S SIGN OR STRAIGHT LEG RAISING TEST:

Keeping the leg straight at the knee, any attempt to flex the limb at the hip is resisted and is painful. The pain is due to stretching of the sciatic nerve.

INVESTIGATIONS:-

-          X-ray of the lumbar spine.

-          Myelography.

-          MRI scan.

TREATMENT:-

-          Complete rest in bed for a period of 4 weeks.

-          Use of analgesics like pain killers.

-          Use of injections via the epidural route.

-          Use of physiotherapy and traction.

HOMEOPATHIC DRUGS:-

1.       AMMONIUM MURIATICUM:-

      Neuralgic pain in amputated limbs. Sciatica, worse sitting, better lying. Shooting and tearing in tips of finger and toes. Pain as from ulceration in finger tips. Contraction of hamstring tendons. Ulcerative pain in heels. Bruised pain in coccyx when sitting. Backache, as if in a vise when sitting. Heat in palms and soles. Better; open air. 

2.       ARSENICUM ALBUM:-

      Especially useful for chronic sciatica case, the patient is restless and anxious, moves about, tearing pains, pain from hip down posterior part of leg to knee. Trembling, twitching, spasms, weakness, heaviness, uneasiness. Cramps in calves. Burning pains. Peripheral neuritis. Diabetic gangrene. Pain and burning in back. [Oxal. ac.].Pain relives by external warmth.

3.       CAUSTICUM:-

     Left-sided sciatica, with numbness. Paralysis of single parts. Heaviness and weakness. Tearing joints. Unsteadiness of muscles of forearm and hand. Numbness; loss of sensation in hands. Contracted tendons. Cannot walk without suffering. Rheumatic tearing in limbs; better by warmth, especially heat of bed. Slow in learning to walk. Unsteady walking and easily falling. Restless legs at night. Itching on dorsum of feet.

4.       CHAMOMILLA:-

    When the pains make the patient irritable, they are snappish, can’t give a civil answer. In nervous persons. There are drawing tearing pains worse at night, and from external warmth. Pain from the left ischium to the os calcis and sole of the foot, with cramp like tension of the muscles.

5.       COLOCYNTHIS:-

   Sciatic pain, left side, drawing, tearing; better, pressure and heat; worse, gentle touch. The pain comes suddenly, is constant in character, and becomes intolerable in paroxysms. Sharp shooting, tearing pain. Extending down the course of the sciatic nerve, followed by numbness. Crampy pain in the affected hip, as though the parts were screwed in a vise, lies upon the affected side, with knee bent up.

6.       DIOSCOREA:-

     Sciatica; pains shoot down thigh; worse, right side; better, when perfectly still. Lameness in back; worse, stooping. Aching and stiffness in joints. Felons in beginning, when pricking is first felt. Cramps in flexors of fingers and toes. Worse; evening and night, lying down, and doubling up. Better; standing erect, motion in open air; pressure.

7.       GNAPHALIUM:-

     Cramps in calves of legs and feet when in bed. Rheumatic pain in ankle joints and legs. Intense pain along the sciatic nerve; numbness alternates with pain. Frequent pains in calves and feet. Gouty pains in big toes. Better; drawing limbs up, flexing thigh on abdomen. Chronic muscular rheumatism of back and neck. It is very good remedy for right side sciatica.

8.       LYCOPODIUM:-

     Numbness, also drawing and tearing in limbs, especially while at rest or at night. One foot hot, the other cold. Painful callosities on soles; toes and fingers contracted. Sciatica, worse right side. Cannot lie on painful side. Cramps in claves and toes at night in bed. Limbs go to sleep. Twitching and jerking. Stiffness and weakness of the affected limb, obstinate constipation.

9.       MAG PHOS:-

     Cramps in calves. It’s wonderful remedy for any type of pain. Good remedy for right sided sciatica, pain is like tearing and electric shock type, Twitchings. Sciatica; feet very tender. Writers’ and players’ cramp. Tetanic spasms. General muscular weakness. Weakness in arms and hands, finger-tips stiff and numb.

10.   RHUS TOXICUM:-

    Hot, painful swelling of joints. Pains tearing in tendons, ligaments, and fasciae. Limbs stiff paralyzed. The cold fresh air is not tolerated; it makes the skin painful. Tearing down thighs. Sciatica; worse, cold, damp weather, at night. Numbness and formication, after overwork and exposure. Tenderness about knee-joint. Tingling in feet.

11.   STAPHYSAGRIA:-

Important remedy when sciatica occurs in elderly peoples. Muscles, especially of calves, feel bruised. Backache; worse in morning before rising. Extremities feel beaten and painful. Joints stiff. Crural neuralgia. Dull aching of nates extending to hip-joint and small of back.

Some of other homeopathic drugs for sciatica are arg.nit, arnica, belladonna,calc carb, calc phos, causticum, coffee, gelsemium, kali iod, lachesis,lac can, ledum pal, nat mur, nat sulph, phos, pulsatilla, plumbum met, sepia, sulphur, zinc met.