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12 SEPTEMBER 2022 FAMILY VALUES — AN ADVERTISEMENT FEATURE IN


Sciatica and low back pain – tips on how to avoid surgery


Low back pain and sciatica are common and affect many adults of all ages at some point in their lives


Tere are unusual or rare cases of low back pain that are due to specific medical conditions. Your health professional should be able to identify these with some careful and detailed questioning. Te majority of low back pain


is what’s termed as ‘mechanical’. Tis indicates that there’s no defin- itive pathology identified. Pain is often aching, widespread and located anywhere from the mid-spine to the upper thighs, as there’s a wide area of innervation from the small nerves in the lower back. It’s thought para-lumbar muscle spasm may cause persistent low back pain as the muscles stop working together in tandem. Sciatica is a term used when there


is a nerve-related or neuropathic pain. It’s usually a constant searing or burning pain radiating to the leg below the knee. Tis occurs when a major spinal nerve is damaged


by a prolapsed intervertebral disc or a bony outgrowth, known as an osteophyte, causing narrowing of a nerve exit space as it leaves the spinal canal. Tese


complaints may settle


given a short period. Initially they may be helped by over-the-counter painkillers and anti-inflammato- ries. A TENS machine, along with graded non-impact exercise such as walking, swimming, a cross trainer or Pilates and stretching, can be gently undertaken. When low back pain and sciatica


are severe and persistent it may be necessary to see a pain medi- cine specialist. Tey advise on prescription medication as appro- priate to the complaint and the individual’s health status. Tey may also discuss the option of having spinal injections. In the case of low back pain it may be necessary to undergo a set of X-ray


After being zapped by mild heat, Te nerves regrow slowly so it should bring about longer-term relief and ‘reset’ the function of the lumbar spine


guided diagnostic injections to iden- tify a possible bony structure that may be generating the pain. Tese can involve blocking the nerves to the facet joints in the lumbar spine, which cause an exacerbation of pain on rotation or extending the lumbar spine. A secondary target for diagnostic injections may be the large sacroiliac joints,


which may be similarly blocked by injection. Should these injections abolish the pain it may be neces- sary to proceed to a radiofrequency lesion denervation procedure to enable longer-term recovery from the pain and associated muscle spasm. Tis involves zapping the nerves to these structures with a lesioning machine and insulated needle to damage them with mild heat treatment. Te nerves regrow slowly


so it should bring longer-term relief and ‘reset’


about the


function of the lumbar spine. Sciatica can be treated by


injecting a spinal nerve with steroid under ultrasound or X-ray guidance. Tis should be done by a specialist under live imaging to ensure accu- rate needle placement. Te steroid can


reprogramme the


delivered around the injured nerve. It may cure the sciatica pain. A further targeted injection of the affected nerve at the point that it exits the spine may help and is also diagnostic. Tis is usually done after imaging such as an MRI scan to identify, in combination with the symptoms, which level nerve is affected. After injections it’s advisable to


undertake spinal reconditioning via physiotherapy and non-im- pact stretching exercises to help prevent recurrence. Dr Blackburn recommends exercise such as swimming, using a cross-trainer, yoga or Pilates. Tese combined with walking gradually increasing distances should help to get you back on the road to recovery.


injured


nerve to reset to its resting state rather than being hyper-excitable and is a potent anti-inflammatory


Neck Pain Persistent neck pain affects many adults of all ages. Te pain may


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